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.

What worries me is how do you know that Mrs A who didn’t tell the receptionist what her symptoms are isn’t in fact having a heart attack, or suicidal? You don’t, so how can you say “oh well Mr R told the receptionist his piles are playing up so I need to ring him back because I know what’s wrong, Mrs A can wait because it might not be urgent” BUT IT MIGHT BE URGENT but you’ve made her wait because the receptionist is her mums best friend/playground gossip and she didn’t want to say she was suicidal or had really bad chest pains.
Obviously I’ve used extreme cases, but less obviously urgent to a patient, but obvious to a dr, but not getting called back for hours, is bloody dangerous.

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?

That was in response to a poster calling receptionists "nosy".

Regarding people not being in a private place, when I call a patient I'm perfectly happy for them to say that they need 45 seconds to get to somewhere more private. I'd far rather they took that time, and we were then able to have a more productive conversation, than the alternative,.

We don't have this system luckily. You ring up at 8am, and get a same day appointment. Or on an app you can book an appointment a week in advance. Children get a same day appointment regardless of when you phone in.

The receptionists at my practice are, and I know this is harsh, but they're all cows. They are so rude and nasty and I haven't spoken to a nice one

I was sitting waiting for my appointment last week and I heard a telephone con3where the name of the indicmcidual was mentioned and their symptoms and their appointment time and date. So confidential.

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.?

Yep. I work so I can earn some money and I pay my taxes and NI contributions and I cannot just take the next available appointment.

also for anyone still reading - as PPs have said -

there is a national GP shortage by at least 5000 GPs which is going to get substantially worse in the next 5 years

surely even GP-haters can understand if it was such an easy/cushy job - or paid really well - then we wouldn't have such a national shortage?

there is a shortage because it can be a really shit job!! (as can all public facing roles!)

Average salary quoted on my GP's website is £89,000. Not one GP works full-time.

The NHS is not free. It is funded by the people. For the people. The people need to rise up and stop being grateful. It also needs to be taken out of the hands of politicians of all colours. I simply do not recall the NHS being better between 1997 and 2010 than it was between 1979 and 1997.

This is meant to be goady but maybe it’s going to be.

Do GP’s take into account that sick people are worried and don’t always behave logically. People with long term managed conditions are always on the look out for the next down turn so while it probably is a upset tummy they are thinking maybe this time they’ll never get better. So playing 50 questions with the receptionist is pretty hard.

We don't have this system luckily. You ring up at 8am, and get a same day appointment.

We simply don't have enough appointments available to do this. On a typical day, we will have at least twice as many people calling up thinking they need a same day appointment as we have appointments available.

We have to prioritise. People don't want receptionists making that decision, so in our system they don't - only GPs do.

My experience of a phone triage system is good, so I’m supportive of it.

However your logic on why you don’t call back those who don’t specify their reason for wanting an appointment is a bit ropey. Unless you have carried out comparisons of two systems - the one you run now with the no symptoms given calls left until the end, and the other where you triage as you do now but call back the ‘no symptoms given’ folk in the order they called amongst the other callers, you don’t know which is the most efficient system in terms of allocating appointments to those who need them most urgently. It may be that those who won’t give symptoms are almost always less urgent, but given the many reasons people have given for why someone may not want to or be able to share their symptoms with the receptionist, you don’t know that’s the case.

As it stands, you don’t know if your system is really triaging, or whether it’s running a twin track programme where part of triage is medical need, and part is ‘you didn’t give me your symptoms so you are now lower priority.’

@privateeyefan
Wouldn’t a better use of your time be to actually see patients rather than poring over a list of names and complaints , then phoning people up and booking them in for an appointment?
if that takes an hour , isn’t that time for 6 appointment?

I quit as a receptionist. The level of abuse was awful.

However your logic on why you don’t call back those who don’t specify their reason for wanting an appointment is a bit ropey.

They get a call the same day (or the next day if they rang up after 5pm). That's not the same as 'not calling them back'.

OP If your receptionists are literally just righting down what patients say then there is no need for the to do that at all. Why not use an automated answering machine? You could also allow submission through a webform for smart phone users and eliminate any need for people to have to tell the receptionist their intimate problems at all.

My mil is a gp receptionist, she's trying to quit but to be honest the ignorant judgy shit she tells me makes me cringe. "do you know a mum called today, wanting an appt just because her toddler had a temperature of 40 and was lethargic. I told her to try a cool bath and fan and calpol and the gp will call her back later" wow mil congrats on causing that febrile convulsion!

My GP’s receptionist is my MIL’s extremely gossipy next door neighbour. Not a fucking chance I’m talking to her about my mental health breakdown or the problems I’m having following my abortion.

@privateeyefan
Wouldn’t a better use of your time be to actually see patients rather than poring over a list of names and complaints , then phoning people up and booking them in for an appointment?
if that takes an hour , isn’t that time for 6 appointment?

No, because so many of the people who ring up thinking they need an appointment do not need one, and their concern can be dealt with satisfactorily over the phone. Or, their concern can be dealt with in an appointment with a nurse or HCA rather than a GP.

In addition, in 60 minutes, I see 5 patients (as we need a 10 minute breather to finish typing up notes in every 1 hour period). I can call up to 15 patients in that time, depending on how complex their concern or request is (sometimes more).

At my old GP practice the receptionist would ask for a brief description of why I was requesting an appointment and not question it. Fine. But my new GP practice, crikey, the hoops you have to jump with the receptionists there are insane. To me, this is not ok. They should not be deciding if I need an appointment, how urgently, or with who. That is for a doctor to decide. The receptionists have also made wrong assumptions based on this limited information. Think it is luck of the draw.

An example - I used to phone up and ask for a nurse appointment. Then one told me to say to the receptionist it was for diabetic bloods. That means anyone who can do bloods and has an appointment free can take me - phlebotomist, nurse, district nurse, health care assistant. The receptionist also knows enough to ask if it is fasting blood, they get first thing appointments.

The problem for me is discussing my business in front of an open plan area. I've seen my neighbours in the surgery waiting room therefore, I don't feel happy about disclosing information there. Sometimes I'm at work or sometimes I am in the car driving my children to school with the loud speaker on.
The last time I tried to make an appointment with a specific doctor (as advised by another doctor) the receptionist kept asking me why and what for. When I said I didn't want to discuss it in a waiting room full of people she then tried to guess...."is it for the coil" etc.

Our gp receptionist is a mum I don't like very much from the school. I really don't want her knowing my business. I know she could look up my file at any time but having to actually tell her would be a whole lot worse.

I've had a GP receptionist insist I cannot have a doctor's appt for something & must see nurse instead. Only to have the appt with nurse, be told I need to see the doctor (I knew this...) and be kept waiting an hour to be fitted in by the GP. I'm sure the extra unplanned patient squeezed into the poor GPs schedule was more of a hassle.

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

THIS. Give people the option to request an appointment online. Give them privacy if they are asking in person at the surgery reception.

"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?"

AND THIS. A system in which requests can only be made verbally (in person or over the phone) is hugely discriminatory.

OP If your receptionists are literally just righting down what patients say then there is no need for the to do that at all. Why not use an automated answering machine? You could also allow submission through a webform for smart phone users and eliminate any need for people to have to tell the receptionist their intimate problems at all.

We introduced online access two years ago, allowing people to book themselves directly onto our triage list. It has been a slow process though getting people to sign up.

The majority of our patients seem to prefer either ringing up or walking into the surgery.

Unless the receptionists are trained to extract the necessary information from patients who don't communicate well ( like my fil who thinks everyone knows all his health conditions) this system is going to miss things.