Remote consultations

  1. A remote visit/session (also known as e-visit, tele visit or online appointment) is in Poland an equivalent to in person visit in the clinic. It cannot fully replace a direct medical examination or psychological consultation and it should only apply in those situations if, for important reasons, a direct consultation cannot take place. We recommend the remote appointments should be only complementary and apply to follow up visits.
  2. In crisis situations (for instance during threat of epidemic) it is a recommended form of healthcare service provided by doctors, psychotherapists, psychologists and addiction therapists. In such circumstances, even the first visit can take place remotely and should be in the form of video call, where both the patient and the therapist/doctor can see each other, and the doctor/therapist can establish the identity based on the photo ID provided.
  3. Remote appointment/consultation takes place via a telephone or video conversation ensuring encrypted communication. To minimize the risk of third parties’ interference, you should ensure that you have the latest version of communication programme, updated operating system and anti-virus programme.
  4. Remote appointment/remote session is much more convenient than traditional in person appointment, because it can take place anywhere. In case of remote video consultations, access to internet is necessary.
  5. A remote appointment/session can take place outside the place of residence. Moreover, the patient does not have to wait in a queue. They also do not waste time and are not exposed to contact with sick people, who can spread microbes. A remote appointment/consultation is also a great solution to those patients who live far from the clinic or hospital. Thanks to online appointments people do not have to travel, especially in winter when road conditions are not conducive to travel.
  6. For appointments carried out remotely, we usually use HaloDoctor application/platform, Skype or WhatsApp applications. HaloDoctor app does not require installation of any software.
    After arranging an online session, the patient receives a link for a video consultation via an email. After clicking on the provided link, the patient joins doctor/therapist in a virtual consultation room. Video consultation allows for empathic relations between both parties and patient observation of their facial expressions, reactions, behaviour which like in person visit allows to evaluate a person’s state of mind.
  7. If the appointment/session is carried out by smartphone, it is necessary, that the telephone is stationary to allow stable camera image.
  8. Privacy and honesty. Mental health problems are very intimate spheres of every person. That is why it should not be discussed in the presence of third parties, (for example members of the family). Their presence can cause discomfort in disclosing important matters relating to relationships, important intimate details relating to various aspects of patient’s health, which might not give the full picture of the patient’s problems. This can lead to wrong diagnosis and wrong therapeutic treatment. We suggest using headphones with microphone, so only the specialist’s questions are heard by the patient. Presence of third parties, is possible, but only after agreement by the specialist and patient.
  9. Doctor, psychotherapist or psychologist should verify patient’s identity; therefore, photo ID should be prepared. During the appointment the specialist keeps documentation of treatment, therefore patient’s personal details are needed such as forename, surname, address, PESEL. In the case of people with intellectual limitations or legally incapacitated also details of their guardian are required. Since the direct verification of a physical ID is not possible, every effort should be made to reduce the risk of offering advice or issuing prescription to an unauthorised person. In the patient’s records you should find written an identification procedure.
  10. The doctor or psychologist do not accept responsibility for the information provided by the patient, which is incomplete, false or incorrect, especially in the case of providing third parties’ data without their knowledge or consent.
    The consequences of providing false, incomplete, incorrect, misleading data or other incorrect data fall on the sole responsibility of the patient.
  11. What to prepare before the appointment? Information sheets of hospital treatment, laboratory tests results, (such as CT or MRI scans), medical certificates, list of all medications taken currently and in the past regardless of the cause (psychiatric or otherwise). Records of past medical history, accidents, hospitalization and general documentation and information regarding the state of patient’s health. It is recommended to send to doctor’s email address before the visit, copies of scans (or legible photos from a mobile phone) of medical documents. We suggest turning off other applications before the online visit starts, so notifications and chats do not distract the session. If you have wi-fi connection we recommend switching to flight mode and later restarting wi-fi, so the session won’t be disrupted by telephone calls.
  12. During the visit the doctor can issue an electronic prescription in electronic form, which will be delivered by SMS/MMS or email. The Doctor can also provide an electronic sick note e-ZLA if there is such indication. The doctor can also refer a patient for additional tests or to refer to other specialists, (such as a psychologist or an endocrinologist) or recommend psychotherapy.
  13. Some of the medical certificates or referrals are only valid provided the physical copy with a signature and stamp is also kept (i.e., OL-9, health certificate for the purpose of proving disability or certificate of fitness for work. It could be sent to the patient by post or delivered by other means arranged with the specialist.
  14. If the mental state of a person receiving psychiatric treatment (currently or in the past) deteriorates, the symptoms of the current illness worsen leading to a direct threat to patient’s or other people health or lives, the doctor can decide to hospitalize the patient without their consent (information on this listed in Article 22-24 of the Mental Health Act). Acting in the case of urgent health risk is regulated by Article 4 of the act on state emergency medical services. Whoever notices a person or people who find themselves in the state of sudden health emergency are obliged to immediately act to effectively notify the relevant entities appointed by law to provide immediate help to the person who experiences sudden health risk.
  1. Doctor, psychotherapist or psychologist should identify the patient, which is why the patient should have a photo ID ready. During the appointment, the specialist keeps the documentation of treatment, therefore he needs the patient’s personal information such as forename, surname, address, PESEL – In the case of people with intellectual limitations or declared legally incapacitated, the details of the caregiver are also required. Since it is not possible to identify the patient by means of a physical ID, it is necessary to have all the procedures in place to reduce the risk of giving advice (prescribing medicine) to an authorised person. In the documentation you should find the description of procedure to identify the patient.
  2. To carry out remote visits we use such applications as: HaloDoctor, Skype or WhatsApp. HaloDoctor application does not require the installation of any software. Upon appropriate agreement, the patient receives a link to the video call to his email. By clicking on the provided link, the patient joins the professional in the virtual room where the video call is established. Video call allows for an empathetic relationship of interlocutors, and to observe the patient, their facial expressions, reactions and behaviour, which, as when visiting the clinic, allows for a more complete assessment of the patient’s mental state.
  3. If an online video consultation is carried out over the smartphone it is necessary at the start, that the telephone stands still, which allows for a stable image from the camera. Before the visit starts, we recommend pausing other communication applications to prevent distraction from calls and notifications. If you have access to wi-fi we recommend switching to flight mode and then starting wi-fi and then the sessions will not be interrupted by phone calls.
  4. What to prepare before a visit? Information sheets of hospital treatment, laboratory tests results (CT and MRI), certificates, list of all medicines taken currently and in the past regardless of the cause (not only psychiatric medicines). Information about previous illnesses, accidents, hospitalisations and generally all information and documentation relating to the patient’s state of health. Scans (or legible photos from mobile phone) of medical documents should be sent in advance to a specialist at the e- mail address provided (after agreement).

Myths surrounding the psychiatrist and psychiatry

This destructive opinion is shared particularly by many men. It is associated with the often-found belief that a man who admits having problems, gives a signal that he is weak.

To maintain the imperative of being a strong man, men have denial strategies such as workaholism, alcoholism, sex addiction, gambling, drugs, etc. Showing weakness is associated with risk of being exposed to ridicule and rejection. Expressing and sharing one’s emotions can be considered a weakness. As a result of this, suppressing and denial of emotions in daily functioning often takes place and resorting to more and more desperate and less effective attempts to deal with problems rationally and intellectually.

Family factors can play important role here, in which seeking help and support was associated with experiencing constant disappointment and rejection and sometimes even shaming and humiliation.

Such a belief has many destructive meanings. It may result from the assumption that all problems should be dealt with completely independently. Reaching out for help can be viewed as a general failure. On the other hand, life can bring many things that often cause feelings of helplessness and being lost. Mental suffering can be kept inside, hidden and pretending to the outside world there is nothing wrong. However, the costs associated with this over time increasingly affects our functioning. Unresolved problems will remain, and they will be likely to torment us more and more.

Obviously, there is a difference between a trivial problem, which will disappear if you ignore it, and one that requires attention and resolution. Most people do not have difficulty telling the difference, but a lot of people make light of them and dismiss them, ignoring of them which can be detrimental. Seeking help for oneself may be delayed and put off, which in some situations cause the exacerbation of the condition or the other way round – more chronic nature, the risk of complications and even life-threatening conditions, (such as depression, psychosis and mental anorexia.)

Contacting a psychiatrist can be a simple way to look after one’s own health and better life quality, an attempt to improve your own functioning in the face of irritating and unpleasant mental ailments. It can be a kind of new opening in life and sign of modern thinking to take advantage of different resources which are available to us.

For many people, coming to terms with the fact that they cannot deal with something remains very difficult.

Difficulties in realising their plans and tasks cause feelings of threat, fear, hurt, feeling of guilt or anger. The feelings experienced are, on the one hand a source of suffering, they are a sign that life is not working out. On the other hand, these feelings are source of energy to remove obstacles we meet on our way. The feeling of discomfort associated with failures causes a sense of anguish, but simultaneously it is also a stimulus to remove this discomfort. It motivates to different than former activities, which may help more in overcoming the problem.

In other words, sense of helplessness could be such a stage in life, which may release new energy to deal with problems. In this context, contact with a specialist could be useful temporary support for his expertise and experience.

This belief may result from lack of knowledge or understanding or downplaying the problems. Colloquially, depression is often defined as brief, fleeting state of sadness or low spirits. In medical terms, depression includes a set of symptoms, including low mood, low activity, sleep disorder, anxiety, depressive assessment of the past and future; losing the will to live, decreased interests and withdrawing from life. These symptoms cannot be treated lightly, especially if they are accompanied by suicidal thoughts and attempts, which can be life-threatening.

It is worth knowing that approximately 10% of adults within a year experience longer lasting depressive mood disorder. Even though some of those people can deal with depression on their own, it does not change the fact that depressive disorders belong to the most common health problems. If we consider the consequences of depression, the rank of depression can be compared to other diseases which are dealt with by modern medicine (cardiovascular diseases, inflammatory and degenerative diseases of muscle- skeletal system, cancers.)

For several years, almost all developed European countries, have seen significant increase in the number of people treated for depression.

Anorexia nervosa is a serious disorder which requires intensive and long-term treatment with the help of various specialists. One of the symptoms of anorexia nervosa is a strong fear of gaining weight. This fear has sometimes paralysing force when trying to eat meals. Dealing with the problem of anorexia is complex and goes far beyond a simple advice concerning eating meals.

The destructive meaning of this myth, often present in the families of the people affected or those surrounding them it is that it influences the decision to stop treatment and subsequently end up suffering and dealing with the illness on their own. The family sometimes only after a few years admits they are not able to help a sick person. This sometimes happens when the symptoms are already advanced and well established.

Neuroses are mental disorders, in which a standard treatment is psychotherapy that provides a lasting and effective cure. The use of drugs is supplementary and supports the basic treatment. On the other hand, a neurologist is a specialist in the diagnosis and treatment of illnesses of the nervous system (for instance facial neuritis, sciatic nerve damage, vascular diseases of the brain, infectious diseases of nervous system, etc.) A neurologist, as specialist in his field, may not possess adequate knowledge concerning the diagnosis and treatment of neurotic disorders, the principles concerning using psychotropic drugs, the ability to use qualified psychotherapy. Many patients use the help of doctors of other specialities before they reach a psychiatrist. They get superficial, symptomatic help which can be often ineffective. Sometimes it can happen that a person with anxiety or depressive ailments is prescribed the wrong medication or incorrect dosage. The excessively frequent use of benzodiazepine drugs is a problem among neurologists and GPs and in the long run can cause addiction and difficulties in coming off them.

There are various groups of psychotropic drugs. Some of them belonging to the group of benzodiazepines or to the group of hypnotic drugs are indeed likely to cause addiction if taken for too long. Hypnotics belonging to the benzodiazepine group, can be used relatively safely for a period of 4 weeks. Practice shows that after approximately 2 weeks of taking, some of the sleeping pills become less effective. In anxiety ailments, treatment with benzodiazepine drugs lasts on average 4-6 weeks, only in completely exceptional cases more than over 8 weeks.

In relation to other drugs – such as antidepressants, neuroleptic drugs or normothymic drugs – there are no such restrictions. They can be taken for any length of time without the risk of addiction. That is, at any time, after agreeing with the doctor, the drug can be gradually withdrawn. Sudden, too fast withdrawal can sometimes cause unpleasant symptoms, but it doesn’t mean constant obligation to take such drugs.


Psychologist vs Psychiatrist

The psychologist is engaged in making a diagnosis and psychological treatment. The diagnosis is based on a very detailed interview with the patient and psychological tests carried out.

Psychologist is a profession requiring the completion of master’s degree in psychology. The psychologist’s task is to make an accurate diagnosis based on information gathered during an interview with the patient and psychological tests and providing professional psychological help.

A psychiatrist is a doctor. Thus, he is a specialist who completed medical studies, and then during further training obtained a specialisation in the field of psychiatry.

A psychiatrist deals with diagnosis and treatment of mental disorders. As a doctor, he can use treatment using a range of modern and selective psychotropic drugs, for which he prescribes appropriate prescriptions. Depending on the medical indications, the psychiatrist may issue various types of certificates, including sick leave.