I think that having your doctor treat you over the phone for a new medical problem is very problematic. It is even more worrisome if the doctor you are dealing with is a physician who is covering for your regular doctor.
There are many reasons that patients try to get diagnosed and treated over the phone. There are also many reasons that your physician may choose to treat you over the phone. Seldom are these good reasons.
A patient might not want to take the time to come in for an office visit or the doctor might not have an appointment available when the patient needs to be seen. To me, a primary care doctor has a duty to see a patient who needs evaluated regardless of how full the schedule might be.
Problems might arise outside of the doctor's office hours. To me, a patient who is evaluated over the phone for a new problem should either be triaged to see a doctor soon (through the E.R., an urgent care or at their own doctor's office) or be advised to try an over the counter product and seek face to face medical attention if the symptoms worsen or do not resolve. Unfortunately, some patients have been known to intentionally wait to call until after hours in an attempt to get treated over the phone and avoid an office visit.
A patient and/or doctor might be trying to avoid the expense of an office visit. With some health insurance plans (i.e. HMOs), the doctor gets a set amount of money every month for each patient whether or not they are seen in the office. This creates an inherent conflict of interest in that the doctor makes more money by treating a sick HMO patient over the phone and reserving appointment slots for those who pay for each visit.
I don't blame the patient for trying to get medical advice over the phone. Locally it seems to be a readily accepted practice of both doctors and patients. The patient feels they are getting all the benefits of an office visit, evaluation and treatment, with none of the downside, time and expense. The doctor should be the one that knows better.
It is well documented in the medical literature that patients' ability to accurately self-diagnose their ailment is very poor. So, for example when a woman calls and states that she has a yeast infection or a urinary tract infection, she is more often than not, incorrect. While gas pain is could be just indigestion, sometimes it is a heart attack and while a fever and stiff neck could be strep throat, it is also sometimes meningitis.
A proper diagnosis is often difficult even during an office visit. It is often impossible to do over the phone. These misdiagnoses may just be a nuisance and involve inappropriate and ineffective treatment, or it could result in a catastrophic delay in a proper hands-on evaluation by a physician with potentially life saving timely treatment.
An incorrect phone diagnosis of an acute illness is an avoidable and indefensible liability. A patient and physician might benefit when things go right, but when things go wrong, only the lawyers benefit.
