I was recently interviewed by Channel 4 News about my online gender clinic, GenderGP. You can watch the piece below:
The interview came on the back of a story which ran in The Guardian and The Times, among others, about my approach to treating gender variant patients and whether the needs of those patients can be effectively supported using an online model.
As you will see from the interview, and from the other articles I have published on this blog, my position on the matter is extremely clear: gender variant patients who are suffering as a result of a lack of access to timely support and care via their GP are an at-risk group. I set up GenderGP in order to provide professional support, care and access to medication, as appropriate, in order to alleviate their feelings of severe psychological distress.
So why did I choose to go down the online route and how can patients be sure that they are accessing the right kind of care for their individual needs?
It all began back in 2013, when NHS England invited GPs to apply for access to a fund of £50 million to explore a number of ways to extend access to GP services to better meet local patient needs. This included greater use of technology to provide alternatives to face-to-face consultations. Areas which were explored included consultations via phone, email, webcam and instant messaging. The idea was that greater use of telecare and healthy living apps would help people to manage their health without having to visit their GP surgery as often, saving them time and easing the burden on the over-stretched NHS.
I found the idea of using technology to facilitate access to healthcare fascinating and after successfully translating my skills online – I took on the role of prescribing GP for several online pharmacies and set up mywebdoctor.co.uk – I decided that it was the perfect platform from which to focus on my true passion: gender identity.
We have become accustomed to using online resources for every day tasks: homework, shopping, banking, entertainment. Some would say that healthcare has been slower off the mark, but given some of the illegal practices carried out on the web, that’s not so surprising.
As people become more and more comfortable accessing healthcare online, we begin to get an idea of its true potential. Those who find it difficult to access their local pharmacy due to health reasons, or their rural location, can have essential medications delivered to their door via an online pharmacy. Time-stretched mums can call and speak to their GP over the phone for reassurance of whether they should – or shouldn’t – make the trip to the surgery. If they choose to do so, people can bypass the NHS altogether and get almost instant access to a fully qualified GP via Skype to discuss anything that might be worrying them, rather than waiting in line for an appointment.
Transgender care is an excellent example of a need which is very comfortably met by this modern approach. My patients frequently tell me that their GP lacks the knowledge or skills to help them and that long waiting times for specialist services often increase their feelings of anxiety and depression. For these patients the internet and the access it provides is a real game changer.
GenderGP uses secure email as the first method of communication. This enables the patient to explain their situation and share their feelings, often for the very first time. Based on these initial emails I provide patients with tailored advice and access to robust information leaflets that patients can read through in their own time.
Because gender care relies less on physical examination and more on medical history and psychological support, face-to-face consultation through GenderGP often takes place using services such as Skype, maximising privacy and eliminating the need to travel long distances to specialist clinics (bearing in mind that, if you live in Wales, your nearest designated clinic is in London.)
We also use a variety of methods to provide access to psychological support, depending on the preference of the patient. Telephone, Skype and face-to-face consultations are available for all patients and tailored to their needs. All of our counsellors are specially trained in gender variance via http://www.pinktherapy.com/
Blood tests are organised via home testing kits or done by a willing practice nurse, and then prescription medication is arranged via an online pharmacy and delivered in discrete packaging to the home or office.
My appointment lists are not taken up with ten-minute appointments for patients with a quick query that I can deal with via email. They are hour-long appointments so that I can spend the necessary time with those who really need it. I don’t have a four-year waiting list (waiting time is closer to 4 weeks) and I am able to respond to most emails within 24 hours.
So maybe I am pushing the boundaries in this pioneering and controversial transgender medical clinic, but these patients need support and, through a combination of technology and my specialist knowledge, I have found a way to do this which is quick and highly effective – just ask my patients.