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.

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.’

Indeed Jessy. I pointed this out upthread. What OP is describing is not triage.

I've had a GP receptionist insist I cannot have a doctor's appt for something & must see nurse instead.

Under our system that would not happen, as it isn't the receptionist's call. They book you onto the triage list, and a doctor makes the decision.

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.

It isn't. Because the patient will get a call that same day from a doctor.

Wow the OP is getting a hard time on here, unless you are a GP working under the pressure of hundreds wanting an appointment every day, surely you can't know what it's like, they've found what they believe is the best way to deal with the situation.

It's not hard to give a brief without stating something highly embarrassing and even if you can't, you could discreetly say "it's a bit embarrassing, could I write it down?" Or "I'm struggling to vocalise, but it's to do with my mental health" if you're getting a hard time for something like that then report to the practice manager.

There's got to be a way of meeting them in the middle here, they simply don't have enough appointments or staff, they can't see everyone. They KNOW quite a few appointments aren't going to be necessary (elderly people who are lonely who see the GP weekly for instance) so they need to be able to prioritise quickly. It might not be perfect but they have to do something.

Thank you OP for being a GP when it seems like such a tough and thankless job.

By which time he might be very unwell.

By which time he might be very unwell.

What do you think the alternative is? We don't have enough same day appointments for everyone who requests one. If we didn't triage, then your FIL might not get an appointment for several days.

If someone is deteriorating that quickly, then they need to call an ambulance.

So reasonable adjustments aren't being made.

So the receptionist who by the way in our surgery is rude and a complete gossip and nosey Parker, gets to know my private and intimate issues that could be mental or physical, and who has no obligation under the hippocratic oath not to repeat them to all and sundry! Sorry but I am so very glad you are not my GP. I understand you are under pressure, but at the same time patients should be treated with grace and respect individually , not some cattle market, and that doesn't include telling Sandra who lives down the road from me that I have a suspected anal fissure that's keeping me awake at night with the pain l, or that I am feeling so down that I can't see the point in living, both of these examples are real by the way, so she can tell her husband or children or Mary who lives next door who is gob smacked because you know, Silver looks so normal when she's doing the school run, or helping at the PTA bake sale.

Privateeyefan

It shouldn't happen at mine either. But you know what? Not all the receptionists are perfect. Some are fabulous. Some are diligent and patient. Many are overworked. Some are not great at their job. Some are not up to speed on technology etc and perform simple tasks much more slowly than is needed. I don't know why it happens but is does, and if people are burned once (or more) by poor advice from receptionists, they do not take risks with their health any longer.

I LOVE the NHS. But lately funding cuts mean attempts to use lower and lower levels of staff for problems which really need a doctor. A friend took her daughter to a MIU having badly fallen. The paramedic (or nurse) told them to take paracetamol and sent them away. They ended up in hospital later... it was a broken arm and had been missed.

I've been sent to the nurse instead of the doctor many times. I would say about 70% of times, that's been appropriate. The other 30% I've needed to see the doctor anyway. 30% is way too many times to get it wrong, and those extra appointments with the nurses are inefficient and costly.

While you're fiddling around triaging and phoning them, surely you could be seeing more patients every day?

I think the old system is the best. At my doctor's surgery in London, you could make an appointment in advance but if you needed to see the doctor more urgently, you could go to the surgery, have your name added to the list and wait your turn. Far better slumped in the waiting room knowing you would be seen on that day than having a receptionist giving you an appointment for Tuesday week, by which time you could be half dead.

As for discussing my private medical business with the receptionists - absolutely not. I knew one who shared all the patient's info with anyone who would care to listen. I'm sure not all are like that but it only takes one.

Indeed bobbypin

I said it on page 1 but I’ll say it again - that GPs work incredibly hard for very little thanks. I think it’s legitimate for people to query the system the OP mentions, that’s how starting a thread works, but I can’t believe people are going on about GP salaries and “why don’t you just come in earlier?” as though GPs don’t work incredibly hard already.

The sad truth is that whatever system is employed, given the shortage of appointments there are going to be drawbacks. I do feel strongly that people shouldn’t be disadvantaged for not stating the nature of the problem to the receptionist but that is no reason to start having a go at GPs generally who are not responsible for the recruitment/resource crisis, in fact they have been warning about this problem for quite some time but Mr Hunt didn’t want to hear it and just kept saying we would train/recruit more (funnily enough I heard him on the radio the other day acknowledging they were “struggling” to do this).

Wow the OP is getting a hard time on here, unless you are a GP working under the pressure of hundreds wanting an appointment every day, surely you can't know what it's like, they've found what they believe is the best way to deal with the situation.

The OP is a random anonymous name on the internet.

Nobody here knows whether they're actually who they say they are. For all we know, they could be a receptionist living in a fantasy land (yes, it happens!)

Perhaps that's partly why they're getting a hard time.

Random strangers telling other people what they think is good for them when they haven't been asked, rarely goes down well with anyone.

If you routinely don't have enough same day appointments for requests, it sounds like your practice is accepting too high a proportion of patients per GPs.

Every time either myself or DP has phoned with something that needed a GP input, even when there hasn't been a single appointment available on the online system, the receptionists have either made an appointment available or got the senior partner to call straight back within about ten minutes.

I used to be able to call in favours at the hospital where I worked for people who had phoned and explained concerning gynae symptoms to get them seen within a couple of days. Had they stuck to 'it's private', I couldn't do that - it was the information they gave me that made it possible; management wouldn't have lost any sleep over keeping them to their 29 week wait for an appointment.

Giving the extra details helps staff to help you. I'd have loved to be able to get everybody seen more quickly, but there just wasn't the resources for that - but where they gave the answers that I could then use to persuade clinic staff or a doctor to say 'get them in asap', I'd take it.

I never asked if anybody could give me some details for shits, giggles and conversation starters in the school playground, you know.

If all I had to do was give a very brief outline and a doctor would call me back, then I'd be just about okay with that (I have real anxiety around HCP after a really severe breach of my confidentiality). If speaking to the doctor meant that I actually didn't need to go to the surgery at all, then that's a bonus!
If I had to persuade a receptionist that I needed an appointment then I just wouldn't be able to do that, even if it meant that I might die. I just couldn't do it. I would be able to type it if there was an online booking system for my area, but there isn't. As it is, I only darken the door of my GP when I called in for a review of my chronic health conditions.

I’ve no problem telling the receptionist over the phone what’s wrong, I always assumed that they needed the info to prioritise appointments. However our surgery has rather unfortunate acoustics and anything said at the reception desk gets magnified and boomed around the whole waiting room. I do feel a little sorry for walk in patients who are asked to explain the problem, I certainly wouldn’t be comfortable doing so at the desk.

What do you think the alternative is? We don't have enough same day appointments for everyone who requests one.
^ That's the issue, right there.
I'm not blaming you, OP, but it is.
My surgery and many others have a core of regular doctors, who aren't enough to go round - and then there are the locums, who sadly in some cases just want to get you in and out of the door as quickly as possible.
I could elaborate on my own personal experience of a dc with mental health issues who was repeatedly fobbed of, and suffered massively because of it.

To the GP saying emergency appointments are often not actually emergencies. I don’t know how it works at your practice but at mine it’s the ONLY way to get an appointment.

E.g I’m on long term medication, needs reviewing every month or the GP wont continue to prescribe. On the way out from my review I go to make my next appointment in a MONTHS time but they are already gone. So the only option is wait a month and phone up on the day, otherwise I don’t get my medication.

I tried to beat the system by making an appointment 2 months in advance to avoid this but NO you can only book 4 weeks in advance.

Patients are FORCED to make emergency appointments just to be seen.

Years ago, before cell phones, I was using the phone in the conference room at work to make an appointment with my gyn and a group of people walked in just as the receptionist asked, "What is the appointment for"? I hung up.

I made the mistake of telling the receptionist the other day what I needed an appointment for (DD had a UTI). She booked me in with the nurse. Who took, I kid you not, 30 mins to do an examination veeery slooowly, find the relevant medicine and dose and then, when she had written the prescription, still had to find a gp to sign it!! Which took another 20 minutes. When I got to the pharmacy it turns out the prescribed antibiotic cost so much that no pharmacy had it in stock. GPs have been told not to prescribe it, but memo hadn't reached the nurse. So we got a different one (via nurse, then gp signing it again, presumably). Two days later, it's clear antibiotic isn't working, we need ooh appointment with high fever at 9pm. Turns out second antibiotic the nurse has prescribed was the wrong one for pediatric utis.

Sometimes, attempts by surgeries to streamline services and save time/money don't work out as planned...

Triage system works very well at our surgery. I tend not to call unless I’m pretty sure we need the Dr and I’ve always been given an appointment for one of the the kids the same morning. I have no qualms talking to the receptionists. They are discreet and professional.

Our surgery is particularly good and thorough. When our DS was unwell and in hospital the GP called me several times to see how he was as he’d been on her mind (he was diagnosed with sepsis and she saw him first before referring us to A&E).

I’ve seen four excellent GPs at the surgery in recent months and would be completely lost without them and our nhs. No system is perfect but speaking to a GP within a hour of my initial call, and seen within a couple of hours is pretty impressive in my view.

If you routinely don't have enough same day appointments for requests, it sounds like your practice is accepting too high a proportion of patients per GPs

Our problem isn't the rate at which new patients are registering; it's the rate at which we're losing GPs without being able to replace them.

We’ve had this triage system for years and it works really well. I’ve never had a receptionist give me advise, they just take a note of what I’ve said and the dr will ring back that morning.

The one time I have told the receptionist I I was not going to tell her why, but I needed to speak to a Dr urgently about my adult DD, she asked if DD was safe, I said yes and the Dr phoned back within half an hour.

I feel very lucky, reading some of these replies, I don’t know what I’d do if a receptionist started giving me medical advice!

Sorry but this is nonsense.

The GP receptionists at our local surgery are the most rudest people you could come across, I have no intention of telling them anything and even when they have asked, the minute you tell them they interrupt with “I’m not medically trained”. They keep you waiting while they chat and then have “sit and wait” appointments where you are forced to wait with a sick and crying child. System is a joke.

When I book a GP appointment and the system asks me to give a summery of my issue (I can't book an online appt without writing something in that field, although I can be as vague as I want to, and am) it has in huge letters next to it "YOUR DOCTOR MAY NOT HAVE ACCESS TO READ THIS SUMMARY BEFORE YOUR APPOINTMENT", so I really really don't see the point.

Like many PP, our surgery doesn't have a phone triage system like OP describes, and we seem to get along just fine on the whole. I don't mind saying something vague on the phone to a random receptionists (we're lucky to have nice and professional ones), but I wouldn't, if I had to book in person - there's always at least one neighbour or client somewhere in the waiting room!