FINDING DOCTOR MORTON
by Val Weedon MBE
The introduction of online services for most medical practices has helped local GP surgeries to prioritise cases. Other clinical staff such as nurses, pharmacists and even physiotherapists have been recruited to help reduce the burden on our doctors.
We are all being encouraged to take more interest and control of our own health. Making sure we lead healthy lifestyles to reduce the risk of developing serious health conditions such as cancer or heart disease. For women, we have our own health challenges and as a woman in her 70’s I’ve found it a struggle to get the understanding and treatment that allows me to lead the best, healthy life I can.
As a post-menopausal woman, I’ve worked hard to get my health back on track after the disruption of some of my treatment during the pandemic. Moving house from Kent to Norfolk in 2021 didn’t help and led to further disruption in treatments for other conditions you tend to accumulate as you get older. Every condition I had meant a new referral to a new consultant. And each one had a very long waiting list.
One of my issues was with my menopausal medication. My new GP didn’t feel confident prescribing parts of it, without me seeing a clinical expert. In this case, a gynaecologist.
There were no appointments, and my condition was not seen as a priority. I had to suffer in silence or find other ways of coping. To get some support during this testing time I joined a women’s health chat forum on Facebook to seek solace with other women going through a similar thing. To my surprise they were more than just a comfort, they gave some very helpful suggestions.
One suggestion was contacting a private online medical helpline that catered specifically for women with a variety of health issues, including menopause. This is when I was alerted to the services of Dr Morton’s Medical Helpline. Cue the angels singing!
The website was easy to navigate, it was simple to register, and the fees charged were reasonable. Once my account was set up there were several options to consult a doctor. I could either pay a one-off fee or pay a regular monthly subscription. I opted for the one-off consultation, as I wasn’t sure if my enquiry was something they were able to deal with.
To my delight I received a quick reply on the same day. The advice given was exactly what I was looking for. I was so impressed I decided to switch over to the monthly subscription as I knew I would be using this service on a regular basis. I have used it several times since for different medical issues and all of them dealt with promptly, in a friendly and professional manner. Prescribed medication usually arrived the next day and on one occasion an urgent prescription was emailed over to my local pharmacy the same day so I could start treatment straight away.
All the doctor’s working for Dr Morton are fully qualified doctors and are all registered with the GMC (General Medical Council) most of them also work in the NHS. We forget sometimes that our GP services are technically private as they are contracted to work for the NHS and not directly employed by them. We also forget that the NHS isn’t really free. We all pay towards it through our tax system.
Finding a unique service like Dr Morton’s has been a blessing. And I was curious to find out more about the woman who founded it and her reasons for doing so.
Karen Morton is an exceptional doctor. And she’s also an exceptional person. Let me explain.
There are only two other doctors that I’ve come across in my life of equal status. The first was Dr Jean Watkins, my family GP at Thamesmead, south London. She cared for me during my time having two children right up until they were adults. But she was also involved in the community she served, especially focussing on women’s health and wellbeing. I kept in touch with Dr Watkins after she retired some years ago, and every year we sent each other Christmas cards. I’d always keep her updated on our growing family particularly when the grandchildren came along. Sadly, Dr Watkins died in November 2023.
The second doctor was Shashi Singh, our family GP who cared for me when I moved from London to Medway in early 2000, after the children had left home.
She was a menopause expert and helped me through some challenging times dealing with my menopause symptoms following a full hysterectomy I’d had back in 1997. Mrs Singh ran a Well Woman clinic for several years helping lots of other women. Until the dreaded CCG’s (Clinical Commissioning Groups) were introduced and they cut her budget, leaving about 300 women stranded and having to find alternative arrangements for their menopausal needs. I started a campaign to try to get our clinic re-instated, but the CCG were having none of it. A few other fortunate ladies and I, including my own daughter who’d suffered early menopause, managed to get referrals to Chelsea & Westminster where they have a special Menopause Clinic.
Dr Jean Watkins and Dr Shashi Singh are not just doctors, they both wanted the best health outcomes for the women they cared for. I now add Dr Karen Morton to my list. I’m not saying there aren’t other brilliant doctors, but these are three doctors that have all impacted on my life and made a difference to the improvement of my health.
When I spoke to Dr Morton, she outlined the background to setting up her unique online helpline service.
“The NHS has changed in the sense that it’s much bigger. And the things that people and doctors have to deal with. There are so many fields of medicine now it’s almost impossible and too big for General Practice. The wonderful construct of cradle to grave, the Dr Finlay’s Casebook example, was wonderful in its time, but now people don’t stay in the same place, so there just isn’t cradle to grave and medicine is just simply too big. One doctor couldn’t possibly keep up with all the aspects of medicine. So that makes the service very slow for people. Now if you look at other models in other countries, for example, every woman in the States or mainland Europe, would have their own gynaecologist. They just wouldn’t go through their GP. General Practice is a fantastic thing, but I think of GPs as being there to sign post, to travel with patients through difficult medical journeys or difficult life circumstances. Still dealing with very simple medical needs, monitoring blood pressure, being a detective to spot the stories that are worrying patients and then referring on if necessary. This means it’s become paralysing for people with the steps involved. Particularly for women’s health. If they could go straight to a women’s health specialist, then we would have a different mindset.”
With this background in mind, was this what inspired her to set up an online service that particularly attracts women with health issues to contact her?
“It’s very straightforward really. I realised that I rarely go to a doctor myself, and my family ask me what they’re worried about. Then about 15 years ago, I started to get calls from mothers with daughters who were overseas, in their gap year (with health issues) So, I thought if only they had their own urine dip test and, if it was positive, and they had an antibiotic, they wouldn’t have all this anxiety. There was also one defining moment when one of my patients had travelled all the way to Bangkok and brought her daughter home because she had a dreadful pain in her abdomen. I put a telescope into her tummy, and she had a serious chlamydia infection. Now I thought this was tragic. This young woman’s life will never be the same. Whereas, if she had been equipped with the right antibiotics for chlamydia infection, she could’ve prevented this. It was a defining moment for me.”
Dr Morton set about and produced the first Gynae Travel Pack. They are not First Aid kits, but packs that contain prescribed medicines to named individuals, so you will have to phone or email for a consultation ahead of your travel plans.
“I recruited 50 brand Ambassadors. Everyone used something, whether it was something for thrush or cystitis, or an infected mosquito bite. I realised that quite a few of them still needed advice, so decided that I would have a helpline to go with it. That was the start of Dr Morton’s – the Medical Helpline.”
Having developed the concept of the helpline, Karen realised that it didn’t have to be confined to those people who travel abroad, but often just a word with a doctor for other simple health issues is often all that is needed.
The Dr Morton’s online platform was designed at the end of 2013 but went live at the end of 2014.
“I thought it would take off like a rocket, but things rarely do. It’s grown steadily. The travel pack still exists, and we have one for men and older people now. I had a co-founder and developer for the technical stuff, plus the doctors that would be working with me needed to be connected via their computers. It had to be ultra secure, and we had to be regulated of course. I started with this idea, but the reality was huge. I have a wonderful team of doctors. They all work remotely and are all qualified and registered doctors.”
The service has been a huge success with very few complaints. The main issue has been if there is a delay in medicines being delivered. On rare occasions, to the wrong address.
“The fulfilment component of any business is the most difficult. They call it the final mile. For us everything goes Special Delivery. We have a fantastic pharmacy. We don’t prescribe anything that could be considered to have a street value. We’re very principled and have the same principles when prescribing antibiotics.”
I ask Dr Morton about use of private care and where her service sits in the use of health care providers. There are other more expensive services for much bigger health issues such as knee replacement. These are often used by those who have private health insurance. Or others perhaps pay by credit card.
Dr Morton’s service is an online service only, at very reasonable cost. You can phone for an appointment with a GP or a gynaecologist. Or you can send a written message via your account. She expressed her concern for women’s health services being set up and the celebrity razzmatazz around menopause.
“Although it’s great that some celebrities help to raise awareness, but it has also raised expectations and allowed an explosion of very costly services playing on women’s vulnerability and desperation. I am a menopause specialist and trainer and feel that menopause should be part of life’s journey and women should receive the help they need. If you were to google menopause clinics and find the price of consultations, you’ll see across the country it will vary anywhere from £195 to £350 on average. There’s a lot of what I call over investigation. If a lady is 50 and her periods are coming every couple of months with symptoms, there’s no mystery to that. The diagnosis, measuring anything, doesn’t add to the discussion, but it is a money spinner. I’m not interested in that. Of course, I want the Company to be a great success financially, but it isn’t necessary to have the margins so high that its unaffordable to much of the population. Of course, I realise that even our prices would seem like a lot of money to some. But I don’t think there is any other comparable service in the UK”.
What sets Dr Morton’s Medical Helpline apart from other competitors?
“There are sites like ‘Peppy’ who have specialist nurses for menopause, but I don’t think that’s good enough. Some women come to us and there are nuances to their story, that makes us think there is something more going on. The current cystitis maybe a prolapse, or maybe the bleeding pattern needs to be investigated further. There’s more to it than just menopause.”
This is where having access to qualified gynaecologists at the press of a button is key with services like Dr Morton’s. Having those experts to hand to ask a simple question early on is vital. Again, to highlight Dr Morton’s Helpline is an online service only, but often it’s that early and immediate assistance that is so needed. Getting an appointment with any doctor through the NHS often involves a waiting time that causes a patient anxiety. Dr Morton’s service not only reduces pressure on our NHS doctors, it saves time and money in the long term.
There are many other women’s health issues other than menopause and Dr Morton is keen to empower young women to take control of their reproductive health from the word go.
“My other speciality is in paediatrics and adolescent gynaecology. So, I see a lot of teenagers. I say to them it’s important never to take a day off school for a period. It should never be necessary. The moment they do, or the moment a young woman goes home from work, or doesn’t play in a team game, or go to a party, the first time that happens, the die is cast. That is the beginning of the gender pay gap, or not being able to achieve what they want to. And there is a need to educate mothers too.”
The success of Dr Morton’s Medical Helpline means they have grown and now need to increase their investment and capacity.
“We need to keep our tech stuff up to date. The area we have expanded most is with gynaecology. There’s an untapped workforce in the UK. We have GPs and within secondary care there are the trainees on a structured path to become consultants, but there are a huge number of non-training grade doctors. These would’ve previously been called Clinical Assistants, or Trust Doctors, or Associate Specialists. Most of them stay in one hospital for a long time. They are the real backbone of the service. But they’re not going to be consultants. A few of them take what’s called the CESR route, where they can break through and get recognition from the College to get a certificate of specialist training, a CCT (Completion of Training GMC Certificate). But that’s relatively few. Now these fantastic people are very experienced, but they have no way of expanding income other than doing locum work in hospitals. So, this is an experienced workforce that we are recruiting.”
Karen goes on to point out that these are fully fledged doctors, that means they’ve done their medical training. Many of them come from overseas, but the UK is their home and they’ve often been here a long time, very experienced. She says they are more experienced than trainees.
“We do recruit trainees to our service that have reached year 6 or 7 of their 7-year training post, most of them are looking for a consultant post. But this other workforce is under used and they love joining the service because it’s an opportunity for them to use their skills, to make a difference and to earn a bit of extra money.”
Karen was quick to point out that these doctors are not Physician Associates, which is a grade that has been popular for some time. PAs are a completely different grade of medical professional. They are trained to do clinical duties such as taking medical histories, carrying out physical examinations and developing and delivering treatment and management plans. They are not a nurse, they are not a doctor, they are Physician Associates. Popular in the USA for quite some time. They are people who do a three-year degree, having done a science degree previously. They are a pair of expert hands. But they can’t and don’t operate and they can’t prescribe medicines, which is presently being investigated.
“They are clever people and we’re finding how they are going to fit into the structure. Some GP practices will have a PA, but we don’t have them in our department at the hospital I work in as a consultant. But we do train them as part of their degree at the University of Surrey. I lecture on their course, and they do clinical attachments. We don’t use them for our service at Dr Morton’s medical helpline because they can’t prescribe.”
Karen then spoke to me about some of the work she deals with throughout her working week. Apart from her work as a Consultant Obstetrician and Gynaecologist, her service with Dr Morton’s also provides services within Primary Care for the NHS across West Sussex, Merseyside, and Cheshire.
"This involves logging into the Primary Care computer system and GP practices will have arranged 14 appointments for their patients. These are NHS patients. I will be doing that work in their system. If they need investigations, I will arrange that, through the NHS. It’s like I’m a specialist locum within their practice. This is one of the routes to market our service, but these contracts are difficult to negotiate because they don’t always know where their funding is coming from.”
The NHS is always being re-organised. Now it’s the Integrated Care Boards that are really the purchasers. First it was the CCG (Clinical Commissioning Groups) then PCNs (Primary Care Networks) and now ICBs. For Dr Morton being involved with GP surgeries in this way through her online service means there is an NHS component – free at the point of care.
“We then have a second group of women that come to us through their insurers. We provide women’s gynae services for a number of insurers, so it’s paid for by them. Then of course we have the direct customer (like yourself). There is no doubt the concept of self-pay for your own health services is burgeoning and most people are prepared to pay modest reasonable sum to get a good service. We are about to have a big campaign through a company who provide patient information to over 10 million people across the UK. So, in the women’s health section we are about to appear there as a service to raise awareness for people able to click from there to access our services. I think it will grow hugely popular.”
I ask Karen is she prepared to cope with the demand?
“Yes, we’re prepared for scalability. We’ve got enough doctors waiting to come on board and it will grow organically. The platform (the component, not the view you see) we’ve designed is infinitely scalable and secure. That’s how we designed it. That’s one of the reasons it took so long at the beginning to get it launched. There is such a mountain of code behind it.”
“We have medical specialist trainees who are working for the Advanced Menopause Specialist Certificate for the British Menopause Society. I have four trainees at a time and on alternate Sunday afternoons we hold a supervisory meeting so all clinicians doing work for Dr Morton’s service can discuss cases and get the benefit of the whole team. We’re a very meticulous, sound service with principled care.”
This has been endorsed by the Care Quality Commission who say in their report that 'Dr Morton’s – The Medical Helpline is Safe, Effective and Well Led.'
This is a huge compliment to Dr Karen Morton and her team. So, where does Karen see her service going from here.
“The health climate means we are focussing on the expansion of direct customer services.”
I applaud that. Dr Morton’s is a much-needed service. It has certainly given me peace of mind knowing there is someone there to answer medical concerns I have, that crop up from time to time.
That makes me feel better.
©Val Weedon MBE