To turn up 30 mins late for a GP appointment

[Kasterborous]

I had a GP appointment today and turned up five mins before my appointment time, booked in it said only one person before me. So why did I have to wait 50mins with a bored 14 month old!! It pees me off every time I go its the same, so why can't I turn up 30 mins after my scheduled appointment time!?

disclaimer I know I am being a bit unreasonable but i didn't sleep well last night because this sodding eczema is itching like nobody's business

I would love to have longer appointments but I would still have to see the same number of people and would have less time for all the other things I have to do. It would take me 3 hours to see 12 people instead of the 2 hours I do it in now. We never see more than 8 people on the trot without a break for catchup or paperwork. I see 8 patients from 8.30 to 9.40 then if on time I do referrals, paperwork, audits for the health board, write up protocols, review other patients results, grab a quick coffee and start again on time at 10.30. If I am running late which occasionally happens I get someone to bring me a coffee and start on time again at 10.30 for another handful of patients.

If I'm on call I do the phone calls and arrange the extras and sort out the house calls. It is a huge time management skill and takes a lot of experience to get to grips with and I've been doing this for 22 years.

You never know what is going to come through the door next. I had a quick and easy tonsillitis this morning followed by a lady with awful problems with her mum and her care and this took a lot of time so with some patients you can have them in and out in 2 minutes others take longer even up to 20 minutes and if you get one or two of these per surgery you are stuck.

Consultations are much more complicated than 20 years ago. We are doing in GP what was done in the hospitals years ago and many conditions are now managed by us that would have been referred years ago.

I was chatting to a patient who wondered what we did when we weren't seeing patients and I showed her the pile of work I had to do every day behind the scenes and she couldn't believe it. I spent 3 hours this afternoon in my own time following up patients results and making sure they had come for investigations and the results were back because believe it or not if the hospital fail to send us a result and it gets missed it is our fault.

I think you make a valid point SuburbanRhoda I don't think I've ever been to a GP and waited less than thirty mins. You wouldn't think there would be an emergency everytime. Especially when you have an early ish appointment. But then as someone pointed out GP's may have being doing house calls before starting their surgery. My worst wait was an hour and twenty mins sat in the waiting room miscarrying my first baby an in tears the whole time.

Surely it's possible to be glad that doctors will take the time needed with a patient and / or allow emergencies to be seen as a priority and be annoyed when you are kept waiting for a very long time with a small person to keep out of mischief too? I don't think that you are selfish, OP, and I reckon people that are saying you are would be equally put out if they had been waiting so long for their appointment.

And I say that as someone who must have put the appointment system completely out of synch this morning at the hospital...

Er, if it's v. v. common for pretty much everyone's GP to be running 15 minutes behind (not that this is a representative sample but not one person here has said "my GP is always on time" unless I missed it) then seems fair to say that in general the GPs are overbooked and need to see fewer patients for longer blocks. Are your appt. blocks really only 10 minutes? Like, you are actually scheduled for 9:50 between the 9:40 patient and the 10:00 patient? Who could possibly think that would work?

The fact that they are not seeing fewer patients for longer appt. blocks indicates that they're prioritizing the cost of their time over the cost of yours, which does not seem right to me.

Oops, meant to say if it's common for everyone's GP to be running 30 mins. behind, not 15.

Keats, give us more GPs and more time and we would do that. That why we (in my practice)do short blocks of patients. As I said just up thread I am nearly always finished my first 8 patients booked from 8.30 to 9.40 by 10.00. And none of it is our time it is all the patients' (or the health boards ) we are just doing work associated with patient care. In our surgery 2 doctors do visits, 1 doctor deals with all the "urgent" queries from patients, nurses, pharmacists, health board. And the other 2 sign and process up to 200 repeat prescriptions and 180 pieces of mail a day.

We have to read each letter and about 50% need us to open the patient record, check them, issue new medication, phone a patient, refer on else where some times taking 3-4 minutes per patient. For 90 patients that's about 4 hours work. Just because we aren't seeing you doesn't mean we aren't doing patient care of some sort. You can't do it quickly or you make mistakes.

You're not selfish op, it is annoying, especially if you have got a young child to attempt to entertain. I always end up waiting at least an hour to see the gp. I can only think of one time, ever, where I got to see the gp within 20 minutes of getting there. Of course if theres an emergency then theres no problem waiting, obviously, but theres no way theres an emergency every time I have been there. Its more about packing too many patients in and not enough time in the day.

Our GP practice has just started a new system for appointments. Patient rings up on the day and speaks to the receptionist giving an idea of the problem. Patients own GP or another GP if own is not available then telephones the patient back on that day to discuss the matter. If it can be dealt with on the phone all well and good, if not an appointment is made for the patient to see a GP on that very same day.

I haven't had personal experience of this system yet so cannot comment how well it is working.

Its more about packing too many patients in and not enough time in the day

well they could see less patients so that nobody had to wait but then they will only see half the amount of patients so thats not going to help patients much

I think you've hit the nail on the head, Keatsie.

There would be less money into the NHS if GPs saw fewer patients in a day.

Reading musicaltheatremum's post above, I wonder if there wouldn't be some scope for a radical idea like having 15 minute appointments, then if someone took less than their 15 minutes, the GP could do some of their admin or paperwork in the remaining time.

In my job I see parents by appointment and if I have a gap between appointments or someone takes less time than expected, I do my paperwork.

My record is a 2 hour wait (appointment at 11, seen at 1). They didn't apologise at all, but the poor doctor looked worse than I did by the time I got in there. I do wonder if they overbook surgeries a bit - at 11.00 I had ticket 26 which means they allowed about 6 mins per person.

I'm a GP, and I almost always run late, sometimes up to 45 minutes but usually about 20. I arrive at work on time and I don't do anything other than work, no personal phone calls or anything.

I'm very thorough and cautious, as I'm concerned that I may make mistakes and miss things if I don't cover all bases.

I've been there nearly 20 years so many patients know me well and want to confide a lot in me, which takes time.

I see depressed people quite a lot, and when someone tells you they're struggling to see the point in living you can't really hurry them out after 10 minutes.

Also, don't forget that after you leave the room the GP has to write a full and detailed account of your history and examination findings, they have to fill in forms for blood tests, X-rays etc, make to note to dictate a referral letter later if necessary. All these things take time. Accurate and detailed notes are essential in this climate of litigation.

And the bugbear for all GPs - the patient with multiple problems. No matter how many signs there are in the waiting room saying "one problem per appointment" people very very often try and sneak another couple in. They say "I know it's meant to be one problem only, but while I'm here can you just have a look at my dodgy knee?". This can add another 10 minutes to the 15 they may have already had. Of course they GP can refuse to deal with another problem, and we often do. But then we run the risk of being complained about. And often the "while I'm here Dr" problem can actually be the most serious one. People will spend 10 minutes talking about their sore toe, then mention as they leave that they've been coughing up blood for a few weeks and have lost 4 stone in weight, which obviously can't be ignored. Sometimes it's lack of medical knowledge that makes them unaware of which symptom is most serious. Other times it's fear that makes them hesitate to mention th symptoms they know is worrying.

I think all GPs running late should apologise, which I always do. But it really irritates me when patients reply "yes well I was beginning to wonder if you'd forgotten me" or some other smart-arse reply. As if I've been sitting painting my nails instead of seeing them.

The fact is that medical conditions are complicated, some are quick to sort, others aren't, and doctors never know what the next patient may have - a flea bite or a brain tumour.

mylittlefinger our surgery has something similar for the emergency appointments. It's a bit like triage.

Slightly off-topic, but it used to make me laugh when I phoned the surgery (we now have online appointments -yay!) and the receptionist would ask whether it was a medical emergency. I would say every time, "Well, I can't possibly say as I'm not medically qualified, but I would like to be seen today."

I bet they hated me.

Sue urban, I agree. What should be said is. Do you feel you need to be seen today. Most people know roughly what they want. A few want seeing yesterday some may just want to be seen in a couple of days. Best one today. Mum phoned just after 10. I phoned back at 10.25 saw child at 11.15. All very quick and happy.

I think if they apologise then that's fine but emergency or not, no-one have to wait 40 mins without an explanation. Just because its free doesn't mean you have to suck it up.

Of course you don't know what's coming through the door, ImagineJL.

It's just you would think that if some problems are more serious than expected and some less, we would have more posters reporting being seen on time because the person before them had a not-so-serious problem.

I think the reality is that 10 minutes isn't long enough for any problem, but as you say, you have to pack them in because your job demands it and that's why appointments always run late.

The other thing to bear in mind is that the receptionists can't provide interim explanations As they don't know what is happening. They can't say "sorry the GP is running late as they are seeing a poorly child who needs hospital admission" because they don't know. All they know is that a patient has gone into the room and not come out. They could come out at any moment.

Now thinking of changing my nn to Sue Urban ...

Our GP usually runs within 10mins of appointment time, the nurse clinics are usually bang on time and we have friendly receptionists! It can be done!

Suburban, people don't remember the occasions they are seen on time, only the occasions they weren't. So they're unlikely to mention them.

Well, it's good to hear that, families

I just try to keep healthy - seems to be working so far!

Fair point, ImagineJL.

A few months ago, took DD1 into the GPs and the duty GP saw her urgently in the treatment room. She had to be stabilised before being transferred by ambulance to hospital.

So, you may not have seen anyone come out, but there may have been people elsewhere in the surgery who needed urgent treatment.

Oh and we got glares when we were seen before everyone else...

If it's any consolation, those of us that work in primary care don't like keeping you waiting any more than you like being kept waiting. The knowledge that there are people piling up in your clinic is incredibly stressful. And running late usually means that I finish late!

Of course the GP or nurse should apologise for keeping you waiting, that's only polite. But the immense strain on primary care services means that there are more patients, needing more time, with more complex problems and apparently no more staff or money...

I'm sort of glad I started this thread. Even if I sound selfish and ranty. I've found it interesting hearing from the other side of the GP's and practice nurses. I do understand that things just come along that no one has any control over, and no one can predict who will need much longer than ten minutes. Apologies if I upset anyone.