Conducting a Successful Video Consultation

By Holly Carver / 14 May 2020

Aesthetics provides advice for holding patient consultations online

With COVID-19 causing aesthetic clinics to close across the country, many practitioners are now turning to video consultations to stay in touch with their patients and keep their business going. 

However, for some, it can be quite daunting to set up and organise. For those new to virtual consultations, Aesthetics outlines key considerations to ensure that your patients get the most out of their time with you, and help your consultation go as smoothly as possible.

Organisation

Remote consultations can be used for a variety of patients and appointment topics. According to research and guidance from the University of Oxford, it is possible to conduct limited physical examination via a virtual consult, however you must carry out a physical examination of patients before prescribing the patient any injectable cosmetic medicines.1,2

When setting up an online consultation with a patient for the first time, it’s important to ensure that both patient and practitioner are prepared. You can do this by:

  • Sending an email or text confirmation of the appointment, with a time and date as you would when setting up a normal consultation. 
  • Letting the patient know how the consultation will take place and if there are any particular programs or apps they need to download, with the link required to access the session, for example via Skype, Microsoft Teams, Zoom, Doxy.me, as well as others.

Setting up

According to new guidance for video consultations for GPs published by the University of Oxford, dependable and a good technical connection (to avoid reduced speed) are important.2 If technical connection is high-quality, it enables practitioners and patients to communicate in a similar way to face-to-face consultations. 

It is suggested that using ethernet cables can increase internet speeds, so these can be considered to maximise video quality.3 It is also recommended for all parties to restart their computer or device before a call, so that no other software can interfere with the video or microphone.

In response to COVID-19, the NHS released a set of guidelines for conducting video consultations, updating information previously given on general online appointments.4,5 Although working outside your usual clinical environment, the NHS states that practitioners should make sure that the background of their video consultation remains professional and that there is privacy. This will avoid distractions for both practitioner and patient, helping patients to feel at ease to discuss any issues with you and ensure patient confidentiality.4

In theory, the consultation itself should be no different to a face-to-face meeting, although the video quality may cause the picture to be blurry. To avoid this, the NHS recommend that, if the patient wishes you to observe something, for example a skin rash or acne, it would be beneficial to encourage them to send you clear photos prior to or during the consultation; of course in a suitable manner that abides by data protection regulations.4

Conducting the consultation

Throughout the consultation practitioners should take written records, the same as you would in a standard consultation, to ensure that you stay aligned with medical best practice, and ensure that these are kept securely in line with data protection requirements, as with any images shared.6,2

Dr Toby Makmel, aesthetic practitioner and co-founder of aesthetic software company Clinicminds, which features a virtual consultation function, shared some words of advice with Aesthetics. He says, “It’s very important to bear in mind that the majority of patients are not used to doing these kind of appointments, so practitioners will need to make sure they guide their patient through the process. Instruct them well and take things more slowly – leave longer pauses to account for potential delays and don’t speak too quickly in case the patient can’t catch what you’re saying. You need to give the patient the chance to really take in what you outline, and then give them the opportunity to respond.” 

If experiencing any technical difficulties during your consultation, telemedicine site doxy.me recommends lowering the resolution of your video. By doing this it requires less bandwidth and computer power, resulting in less disruption during your call. It is also suggested that practitioners could try using headphones to eliminate echo or audio feedback.3 When doing these consultations it’s important to abide by guidance from individual regulatory bodies on remote consultation and prescribing.7,8,9

Closing the consultation

To ensure that both parties have all the correct information, the NHS recommends that practitioners should summarise the outcome of the consultation at the end of the call, and ask the patient if they want to ask any final questions before signing off.4

Following the end of the consultation, practitioners should send a written summary of advice given in the video, and provide the opportunity for patients to book a follow-up appointment. Feedback questionnaires for staff and patients, sent digitally, are helpful so that improvements can be made where necessary. While practitioners may have these already, these can be adapted specifically for video consultations. For example, whether they felt the consultation was kept at a professional level.4

Top tips for video consultations

American plastic surgeon Dr Samir Pancholi, has been conducting video consultations since long before COVID-19. He comments, “Virtual consults are fun and provide a great initial interaction and bond. Maybe it’s because patients are more relaxed in their home vs. the clinic or maybe it’s because it feels more focused for a one-on-one interaction.” 

When asked what his top tip is for making the consultation run smoothly, he replies, “It can be difficult for patients to focus with this medium. Ask them to try their best to create a calm atmosphere for their consultation. In the office, we can control quite a bit. At home, anything from the dog and kids to ambient traffic noises can interrupt the flow of the consultation. It’s a good idea to have them prepare for a solid 30-45 minute window of uninterrupted time to have the consultation and patient care coordinator meetings.” 

He continues, “Also, get the lighting right! Avoid sitting with your back to a bright window, though do make use of soft, natural lighting when available. You can set up simple two-point lighting by sitting near a window and putting a lamp 180 degrees apart from it. Take a look at yourself on camera and make sure you have even lighting from the front without being too washed out. Too much from the back and you will get the ‘angel’ halo effect, while too much from the top can make you look ominous like the villain in a movie.”

The future of video consultations

While video consultations are being used during the COVID-19 lockdown, their use may become common practice in the future. Dr Makmel notes that video consultations can be a good way to encourage new patients to get in touch. 

He highlights, “For some people, the anxiety of going into a clinic and having a face-to-face appointment stops them from attending. Patients may feel more comfortable to have the first point of contact via virtual means and they can really get more confidence from that. I believe that this makes it more likely for them to come to your clinic and visit for a second or follow-up consultation, when they can.” 

Dr Pacholi agrees, commenting, “I think they are here to stay. They are personable and there is a great translation of information.” 

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