To let you know that you're not doing yourself any favours by refusing to tell the GP receptionist your symptoms?

[privateeyefan]

I'm a GP. My surgery operate a triage system - if you ring up or walk in asking for an appointment, then you get put on the triage list, and get a phone call from the doctor that same day, who can then make an appointment for you if you need one.

When patients ring up or walk in, the receptionists who speak to them will ask for a brief outline of the problem. This means that, as we usually have at least 3 doctors doing triage at any one time, we can prioritise the calls - if if see things that I know will need an appointment, then I will call those patients first so that I can get them into the surgery on the same day, often within the hour.

If you refuse to tell the receptionist what the problem is, and there is therefore nothing next to your name on the triage list, then I leave you until last. I'm not going to prioritise you over people I know will have to be seen, when I have no idea whether or not you will need an appointment. Therefore, if you don't tell the receptionist, your chances of a same-day appointment decrease substantially, and you will also have last choice of appointments over the next few days - the most convenient times after working hours will be long gone.

In addition, I, like most of my colleagues, have a special interest in a certain field. As I glance through the triage list, I generally pick out patients whose problem relates to my particular field of expertise, as do my colleagues. By refusing to give even the briefest of outlines, you rule out the chance that the GP with the most relevant experience will contact you directly.

Receptionists don't have medical training. Of course not. But that doesn't make them incapable of typing a one line summary of your problem dictated by you, in order to help the doctors do their job.

And please also remember - they speak to hundreds of patients daily. Your problem will occupy their mind for a few seconds, and then they will move on to the next patient and you will be swiftly forgotten.

I have to say, you don’t sound like you have much empathy with your patients, OP.

Or with people generally. I wonder why you started this thread?

Thank goodness my GP has an automated call system that simply books you in with the first available appointment. It’s none of a nosy unqualified receptionist’s business what I’m booking an appointment with my GP for. It’s certainly none of a nosy unqualified receptionist’s business to demote me on the list of appointments because they’ve diagnosed me on the phone and found me wanting. Any nosy self-appointed medical professional of a receptionist who put me down the queue would get sorted out.

You also haven’t addressed the point that people might be in a public place when they ring so can’t give details on the phone. I don’t really want the chap at the desk next to me knowing I have a raging UTI. If not saying the problem gets me bumped to the bottom of the list then I could end up waiting an extra 24 hours to start antibiotics.

Since most practices are run as businesses, maybe you could take a pay cut out of your six figure earnings to pay for a nurse?

1. GPs do not typically earn six figure salaries
2. There is a national GP shortage and many practices can't find GPs for love nor money, so reducing GP salaries is only going to make that worse

*I have to say, you don’t sound like you have much empathy with your patients, OP.

Or with people generally. I wonder why you started this thread?*

I don't see much point carrying this on further. I was simply trying to explain that if people are able to give the receptionist the briefest outline of the problem, then they can be prioritised, and the doctor with the most relevant experience and knowledge can call them back the same day.

I’m sorry OP, but that sounds like a ridiculous practice. Why wouldn’t your surgery consider doing a mix of timed appts and call backs/open appts?

So glad I’ve never encountered a GP system like this (and I’ve had several GP surgeries) - no wonder you have problems retaining receptionists.

but let's not forget the NHS is free.

Sorry, what? Maybe if you don't pay any tax or NI it is but for the rest of us it isn't free.

If I make an appointment at my doctors, which is rarely, I am not asked what my symptoms are. This is for the doctor not the receptionist.

So can you give some indicative numbers for how this works in practice.

If you have 3 GPS working full time, how many face to face appts, and how many calls do they do a day.

If you have a list of 80 people for example who have called for an apt, how many of those do you actually manage to get hold of by phone, how many then go on to have a face to face appt.

Also do you receive any data about how many of your registered patients are using walk in centres/ A&E instead of your practice and how that percentage compares to other practices that are not using your system.

I would be interested as you are adamant your system works, lots of people are pointing out why as a patient it would not work for them, so it would be useful to understand what metrics you are using to deem it a successful system.

Thank goodness my GP has an automated call system that simply books you in with the first available appointment.

Every system has its downsides. Under that system, someone with an urgent problem is not going to be prioritised over someone with a problem that could be dealt with in a few weeks' time.

It’s none of a nosy unqualified receptionist’s business what I’m booking an appointment with my GP for.

Our receptionists speak to hundreds of patients a day. They will not remember you.

It’s certainly none of a nosy unqualified receptionist’s business to demote me on the list of appointments because they’ve diagnosed me on the phone and found me wanting.

Our system ensures that this never happens. Our receptionists do no make that decision. It is done solely by the doctors.

If the NHS is free can I have a tax rebate please because I have been mistakenly paying towards it.

Free at the point of delivery is not the same as free.
(BTW I think free at the point of delivery is a good thing)

I understand that, but don't understand for the life of me how GPs expect people to be able to walk out of their job at a moment's notice to make the appointments they are offered. I'm assuming most GPs would not be able to leave their surgeries at a moment's notice to go to an appt.?

Especially infuriating when I know from the outset I will need an appt but can't prebook them. GP access clearly biased towards the unemployed/retired, which is more annoying because I'm trying to manage a chronic condition to stay in work :/

Rant over, but yes, I agree with the triage thing in principle, and don't have an issue telling the receptionist. It just irritates the hell out of me that I can't prebook appointments, as that's a waste of your time and priority appointments too.

I too agree that it must be a tough job, and disheartening to be working in a broken/near to breaking system. X

Oh FFS. Not this nonsense again.

It. Is. Not. Free. We all pay for it.

This. Again and again and again.

We are told the NHS is the envy of the world. We are told we should be infinitely grateful for its second rate service, the laziness of its staff, the shitty, disgraceful, receptionists like OP who put us at the bottom of the appointment list if we don't tell her, an medically unqualified person, all about our complaints.

The alternative, we're told, is the USA where poor people can't get medical treatment at all.

No-one ever looks to the European continent where (a) there is a national system of insurance, (b) there is no NHS, (c) there are multiple private healthcare providers falling over themselves to help you.

In European hospitals, if a receptionist acted like Carol Beer ("Computer says no") and put someone at the bottom of the appointments list because she felt like it, she'd be sacked. In European hospitals, the sick people come first, not the convenience of the staff.

My surgery doesn’t have this system. At my surgery the receptionists ask your symptoms and they decide if you need an urgent appointment or not.

I AM medically trained and if I ring for a same day appointment it means it’s needed and yet I’ve had a receptionist tell me it isn’t.

If you disagree with the receptionist only then do you go onto the GP triage list.

I have a fantastic GP, truly fantastic. Two receptionists are lovely and helpful and go above and beyond. I am MORE than happy to describe symptoms over the phone. What I am not happy with is having to impart sometimes very personal information in a queue of people with no privacy whatsoever. The vile receptionist at my practice, when I said I needed to speak about having termination shouted very loudly to the whole waiting room "ABORTION, we don't do that sort of thing here". Utter bollocks of course, but my God she thoroughly enjoyed embarrassing me. On another occasion when I had to drop in a stool sample, and explained what was in the package in a low voice because I was surrounded by people, kept pretending she couldn't hear me...until the whole fucking room knew that I had my own shit in my hands. THAT is not acceptable and I have complained repeatedly but she is still in the job. I have seen her do the same things to others. Google reviews of the surgery all focus on her. So, no, I will no longer describe my symptoms to her. I would far prefer to describe my symptoms to my GP thanks.

Every system has its downside

Yes of course. I think there are downsides to yours too and hopefully you acknowledge that?

Saying that the receptionist won’t remember the patient doesn’t really deal with the point that people may not be in a private place, or it may be a problem that people struggle to talk about. Surely you can empathise with that?

@privateeyefan just wanted to post in solidarity - another GP here. we don't have a triage system - and its a nightmare - I'm salaried so have no control over this - but we will see anyone who asks for a same day appt. patients abuse this to a horrendous extent. every day we have approx 50-60% of "emergency" appointments which patients have just lied to get to suit themselves - stupid excuses like "I'm going shopping tomorrow so wanted to be seen today", "I'm going on holiday at the weekend" etc

its soul destroying. some mornings i can have 35 patients booked in as well as all the associated tasks etc, its downright dangerous

trouble is they are so entitled that even when i challenge them ("so why did your longstanding hay fever need an emergency appointment?) as people expectations are out of line with what we can provide

so to all those here moaning about why can't we just see everyone - its because it means those that really need our extra time (for example very unwell or complicated issues, or mental health problem which take longer than 10 minutes) we cant give it to them as we are having too deal with everything else

ultimately it was brave starting a MN thread tho as GPs are universally hated on here - we are all cold hearted & arrogant don't you know - and some of the replies to this thread are pathetic!! we all know how hard each other work so don't let it get you down!

I understand that, but don't understand for the life of me how GPs expect people to be able to walk out of their job at a moment's notice to make the appointments they are offered. I'm assuming most GPs would not be able to leave their surgeries at a moment's notice to go to an appt.?

Of course not, but in your position, the GP would, during your phone call with them, book an appointment for you at a time that you would be able to make.

IME the issue isn’t being asked what the problem is, it’s how you’re asked and who can hear.

Once stood in a very long cue when the surgery doors opened first thing - the only way to get an appointment at my GP. A young boy maybe 13/14 was asked in earshot of everyone why he needed to be seen. He looked so embarrassed and said he didn’t want to say. The receptionist just pressed on and said he couldn’t have an appointment if he didn’t tell her what the issue was. Whilst that might be right in principle, this boy should have been taken to one side and asked discreetly.

Lots of posters are talking about problems with a different system, where the Receptionist is deciding who gets a same-day appointment, and not knowledgeable enough to make that assessment. That isn't what the op is describing.

In op's system, you ask for a same day appointment, the Receptionist asks what it is regarding and then types what you say on the list. That is the end of the Receptionist's involvement - typing the list. The GP looks through the list and decides what order to call people in to either offer them telephone advice, an urgent appointment, a non-urgent appointment.

Yes it would drive me bonkers as a patient. But so does phoning repeatedly at 8am only to find all the appointments gone (possibly to people who don't actually need an urgent appointment), which my current surgery does.

When there aren't enough appointments for demand, every system will have problems.

@ChardonnaysPrettySister
@DecomposingComposers
Sorry, poorly worded. Yes I pay taxes and NI. I meant if you're in hospital going in for an operation you haven't got someone waving a form in front of you asking you to sign before procedure etc.

At my surgery you only need to outline your problem to the receptionist if it's an emergency requiring an immediate response, ie the kind of call you might make to 999. Everything else is triaged via a quick call with a GP, usually within a couple of hours, and appointments are generally available within a day or so. You can also book appointments online. I haven't had to tell a receptionist my symptoms for years, and I don't think I'd want to start again now.

What reasonable adjustments are you making for those who have disabilities that involve communication? How are you ensuring that they are not being disadvantaged by this system?

I’m so glad our practice doesn’t operate this system. While three GPs sit working their way through a list of phone calls, they could be seeing patients. I wonder how much scarce appointment time is wasted with this crazy system?

"1. GPs do not typically earn six figure salaries

1. There is a national GP shortage and many practices can't find GPs for love nor money, so reducing GP salaries is only going to make that worse"

Yes, they do earn pro rata six figure salaries. My daughter is a junior doctor and is considering being a GP because of the part time possibilities and the comparatively easy money!

Added to that my sister is an accountant for our NHS trust and sees the invoices put through from GPs, so I know a bit about it.

OP get all your GPs to club together for a decent healthcare professional and stop blaming patients for your failing system.

Maybe come in early and take some calls yourself?