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‘Calling a specialist? Only in sudden situations!’
Tanja Manschot is an experienced GP who, after years of working in the centre of The Hague, at GP organisation Arts en Zorg, started a practice in the Statenkwartier together with her husband. She has now been a practising GP for 10 years and has been an enthusiastic user of the consultation network since the beginning of Prisma.
‘When I started as a GP, we could only call specialists if we had an issue,’ says Tanja. ‘There was nothing else. Later, digital options were added and nowadays I prefer to use a digital consultation rather than call. It’s quick, easy and it can be done in your own time.’
‘For example, I use Prisma when my consultation hours are over. After which I open the Siilo app at home on the couch in the evening to read the first answers I get back. Calling to get a specialist on the line is something I really only do now in acute situations.’
No stupid questions
‘When I just started using Prisma, I found posting a case a bit scary. After all, everyone can see your name. Even fellow GPs. What would they think of my question? Isn’t it a stupid question? But after first reading along for a while, I noticed that everyone is helpful and eager to share knowledge. No one is judged for a ‘stupid’ question. That feels safe. I also noticed that many GPs are walking around with the same type of questions. There is a lot of mutual recognition. That too helped me get over the line to post my first case.’
A lonely profession
‘If you are dealing with a complicated case and you are in doubt whether to refer or not, the GP profession can sometimes be quite lonely,’ says Tanja. ‘I was already using Siilo to approach specialists one-to-one. But now, through Prisma, you can talk to several specialists, from different disciplines, all together in one conversation. That’s really valuable, because it means you have a group of people around you with whom you can spar.’
‘A while back, for example, I had a question about a patient who was withdrawing from treatment. I wondered whether this man was unwise, or incapacitated,’ says Tanja. ‘After I posted the case in Prisma, I received answers from a psychiatrist, an addiction doctor, a doctor for the mentally disabled and an internist with knowledge of disciplinary law. This led to an instructive discussion. By consulting in this way, I feel supported in my approach’.
The regular teleconsult
I don’t use the regular teleconsult much any more. Sometimes still for a dermatology question. If I have a picture of a skin rash and I want to know exactly what it is and which ointment I can best prescribe. In other words, a question that does not require too much discussion between doctors and for which I am sure which specialism I should write to for it.’
Concise and focused answers
‘Before I post my case study, I always check that the question has not been asked 100 times before. I would find that annoying,’ says Tanja. ‘All previously posted cases are in the knowledge base and very often I already find an answer to my question there.’
‘The answers are concise and focused on the GP profession. I find that remarkable and pleasant, because specialists sometimes go very deep into the subject matter in their teaching. But I don’t usually need that as a GP in practice.’
Screenshots and security
‘Another advantage of Prisma is that I can add a photo or video to every case, whichever specialism I am addressing. Because that is not only interesting for dermatology cases, but also, for example, to be able to share a screenshot of lab results or a video of a child walking strangely,’ Tanja explains. ‘I tell my patients when I put an issue down in Prisma. I then explain that the platform is secure and that many specialists are watching. I then come back with a solid answer and a good policy. That gives confidence.’
Prisma is currently only available for GPs, specialists and RGPOs that are based in the Netherlands.