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.

My surgery has this system. I went to my surgery to make an appointment in April and reluctantly explained to the receptionist what was the matter. She told me that it was minor and I had to go to a hospital 20 miles away to a minor injury clinic.
I refused and insisted on seeing a GP. I said I had the right to see my GP.
She said I didn't.
We argued and she eventually agreed that a doctor would ring me.
As I got home 10 minutes later the phone rang and the GP said I must be seen straight away and to go straight back.
He apologised for the receptionist.
She is still there and just as bad.
I think they are trained to be dragons and dislike people.

@privateeyefan

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.

One up on ours then :/ we can see a GP only on the day, we have to ring 'on a suitable day when we wish to see the GP. ' An annual leave day usually, for the sake of a 5 minute appointment for a prescription for a month's worth of high dose steroids, which, despite using fairly regularly and being consultant driven they won't prescribe without seeing me.

Humph.

Glad yours will book on a different day though. I've used up 3 days of annual leave this year for GP appointments, all of which I could have waited a few days for.

The receptionist at my GPs is awful for judging me on the phone and in person. I VIVIDLY remember the day I was abroad for work and needed to reschedule the midwife appointment they had moved back a week because I never had a named midwife and she literally said that "I need to rearrange my life if I love my child and not put work first" erm okay let me jump on the next flight home to see her only 6 hour one way travel, appointment was for 8am, I got the text at 3pm, not sure I could have gotten a new flight
Or the time she told me my problem was for a health visitor, however the health visitors had told me to call them, that was a funny time of having to explain it to 6 people, before my partner took me to A&E to be put on antibiotics because the receptionist told me "it's normal to be in pain when breastfeeding and stop calling her", only this was 2 months in and feeding had gone fine before and after and I'd been in agony for 3 days and on no sleep.
Sorry for the rant but maybe just employ nice people who don't mind talking nicely to others?

@privateeyefan
Still wondering what happens in the case of patients NOT wanting a same-day appointment - can they just book one without needing doctor review?

This system does seem very inefficient OP. My doctors has a routine appointment system ... you don’t provide the receptionist with detail on what the appointment is for and are simply booked in (usually two weeks wait). If the matter is more urgent you go on the duty doctors list and are called that morning if calling in the morning or that afternoon if you call in the afternoon. For the duty doctor same day call back you are asked to give a brief outline. As you are requesting an urgent appointment this is not a problem at all. I would be annoyed if asked what a routine appointment is for - these should just be booked in by receptionists. I get your point about allocating patients based on special interests but the point of a GP is that you have general medical knowledge and are not specialists, if specialist care is needed this should be a referral surely.

I also wonder how many times the OP has tried to use the online system.

Our practise has one. Works great 9am-7.59, but you can only book yourself into an appointment after 8. So at 8am it’s just as problematic as the phone. By 9 it’s fine as all it has to say is “no appointments, try again tomorrow”

RTFT. The receptionists don’t triage. They simply put people on the list for the doctors to triage.

RTFT. You’ve had at least 50 replies from posters where the receptionists at their surgery do, in fact, triage. I know this doesn’t support your narrative though.

A plea from a vet...please do the same for your vet receptionists! You can almost always get an appointment that day where I work and the receptionists book them in... but it is so much easier to have even one word in the "reason for visit" column rather than a blank. We have 15mins/appointment- a luxury compared to poor GPs and many vet practices only have 10min/appt. I like to skim read the history for each patient before I call them in but, as I only want to use up 20 or 30 seconds of the appointment doing this, it helps if I have some notion of why the pet is there as it allows me to whizz past the irrelevant stuff.

As far as humans are concerned- our GP runs the same system as OP- ie ring first thing, very brief outline of problem to receptionist, doctor calls back. For walkins- if you don't want to or can't say out loud a note is fine- I once drove down at opening time with a note written out ready- couldn't phone as hideously painful tonsillitis so bad I couldn't speak at all. Receptionist read the note, saw my pleading look and got me sorted with an appointment.

Also, I don't know if it's possible in the UK, but my GP in the USA (medicaid doctor with many of the same understaffed/underpaid/over utilized issues that you have with the NHS) uses a very clever system of medical students on rotation and Physician Assistants. They all confer with him, but many of the routine things are first triaged by the students (if I'm feeling cheeky, I will make up a few extra symptoms to keep them on their toes) and then the PA and then if there are any questions at all, the GP. I have been using this practice for some years now and have never felt that my issues, big and small were inadequately addressed. They have a similar system to the OP's triage system although quite often I find that the PA can answer all my questions and I have no need to see the GP.

'You have no medical training and therefore your ‘special interest’ and ‘expertise’ is irrelevant. '

OP, who you are quoting, is a GP

There has to be some sort of triage system for when demand exceeds supply, though, doesn’t there?

I work in Australia, in a large private paeds clinic. It’s popular and all doctors are booked at least a few months in advance. However, when taking the booking details the receptionists prioritise any unwell sounding babies are in the “first cancellation” waiting list. Alternatively, if the GP referral sounds concerning to the doctor, or the GP phones and asks if someone can be seen urgently that can also be flagged by the doctor as “needs to be seen, next available with any doctor”. Gaps turn up all the time as people are sick, something important is happening at school etc and are filled promptly.

I know the NHS is adored in the U.K. and that any kind of hybrid private/public system like Australia’s is vilified but I’m horrified by the work load of NHS GPs on these threads. It seems exacerbated by woeful lack of access to psychologists. It sounds hideously stressful for all involved.

OP, come to Australia! Many of your colleagues are already here.

YABU by not appreciating the huge variation in competence and sensitivity of GP receptionists. I've been sat in the waiting room at our GPs listening to receptionists shouting very loudly about sensitive subjects to patients down the phone & then to their colleagues in the surgery about what they've just spoken to a patient about (including patient's full name and DOB). If I've got a cough fair enough, but at 6 weeks post partum when my arsehole was bleeding, I didn't really fancy telling my GP's receptionist over the phone.

Still wondering what happens in the case of patients NOT wanting a same-day appointment - can they just book one without needing doctor review?

If we want to see a patient again in a few weeks to follow up, we book the appointment there and then at the end of the first consultation.

For anything else, it goes through our triage list. Obviously, those calls would not be high priority, and would be pushed towards the end of the surgery.

I’m surprised that a qualified GP is writing this sort of thing on mumsnet .

If there is a concern about patients failing to report symptoms to a receptionist , for triage , in your practice, then you need to raise this as an issue in your practice , and actively work with the patient participation group and the reception team to gain the information you need for effective triage through patient engagement .

Writing this on mumsnet seems a bit inappropriate, particularly as there could be a whole host of reasons why a patient may not leave their symptoms with a receptionist in your practice , ranging from misunderstanding the process , to an inability to communicate effectively either through hearing or language barriers , or indeed because there may be an issue with the receptionist themselves and / or their interpretation of the patient complaint . For all you know they forgot to fill out the symptoms box .

Bearing in mind that a receptionist is not medically trained and is therefore (probably ) not able to take the same quality of history and symptoms as a trained clinician / medical practitioner, and can , themselves make mistakes in eliciting the picking out the pertinent issues in a conversation .. another consideration and issue .

Finally , it is worth considering why the patient didn’t leave a message with the receptionist , a young male may not wish and is well within their rights not to want to , or feel averse to have to divulge their incontinence issues with the receptionist .

Furthermore have you considered that someone may not wish to tell the receptionist that they feel in danger of harming themselves and other similar or extreme situations

Perhaps you need to consider , in your practice , as to why people are not leaving messages with the receptionist , rather than stating on a mumsnet forum , that your medical practice involves pushing people who haven’t left a message to the bottom of your list .

I would be annoyed if asked what a routine appointment is for - these should just be booked in by receptionists. I get your point about allocating patients based on special interests but the point of a GP is that you have general medical knowledge and are not specialists, if specialist care is needed this should be a referral surely.

Not always- plenty of GPs with a special interest are perfectly well placed to deal with chronic stuff. Also, if you do need a dermatology referral, for example, aren't you better off getting interim advice from a GP with an interest in the subject whilst waiting however many weeks or months till you can see a consultant dermatologist, rather than a GP who hates skin stuff?

Can I ask how much information you need to give for an emergency mental health appointment?

If you say it is mental health do they question you further? How do you decide what is a mental health emergency?

I can see GP services are stretched, only a year or so ago the lovely receptionist apologised that I had to wait 3 days for a routine appointment, a GP left and it is now 3 weeks. The surgery in the next village has been closed so patients will need to be registered at my practice. Not the fault of any staff but it is going to be awful for patients.

YABU. What short of triage system is that? U pick out the patients who's condition interests u the most or whos condition u have the most experience in and see them first. So if I have a boring rare condition I am less likely to be phoned back first. Thought triage ment u are prioritised in order of how urgent YOUR condition was not how well the gp understood it.
Also patients are entitled to privacy. You should respect that. As far as I know gp receptionists are not registered to a governing body to ensure they follow a code of professional conduct (eg condifidentality in small towns where everyone knows everyone u might not want the gp receptionist to know u had a std test/lump on a private part and so on....u shouldn't be less of a priority because u are a private person. My gp receptionist is an old school mates mum. I shouldn't have to tell her.....tbh I would make it up and tell the gp the real reason in person. Luckily she has never asked.

I can't get my head around that @privateeyefan 🤷🏻‍♀️

I understand the supply / demand issue for sane day appointments & hence, doctor triage system.

But when I know I need to see a GP for an ongoing condition, it's not urgent, but I need to come in, booking a week out is fine for me, why can't I do that in your practice?

Why do I have to talk to you about it? I know I need to be seen, I'm happy to wait, I don't want to talk on the phone?

Or is it that overall it's so busy you can't give an appointment, even with a couple of weeks' notice? (Aware it's different in Ireland)

This thread has made me realise how lucky I am with my gp surgery.

Mine has a recording on the phone explaining it's better if you give a brief outline so you can see the right person. In the surgery you also have the option to speak to the receptionists privately.Our receptionists are lovely and I can nearly always be seen the same day.

Last sept FIL was getting v forgetful and then started dropping things. We went down to the GP surgery and told the receptionist we were extremely concerned. Gp came to the house same day. He was admitted to hospital same day. It was a GBM brain tumour....he died just 8 weeks later. Reception triage at the GP practise is essential!!!!!!

Halo1234

U pick out the patients who's condition interests u the most or whos condition u have the most experience in and see them first.

The OP never said that. They priorities based on medical need, if the patient has disclosed. They allocate patients to the GP best places to deal with that area eg dermatology / gynae etc

I'm PA to a Consultant - For 15 years I've worked with this Consultant and recognise signs and symptoms to look out for - i.e overbooking my Consultant's clinic for something urgent or recognising that it's more routine.

My Consultant gives my name to patients and advises any problems to ring me.

No I'm not a medical professional. I am however experienced in our speciality and do know how to prioritise. I know which reports are urgent or not and need added to MDT.

I'm not some tyrant who thinks I'm above anyone else - thankfully I've not come across people who have demanded a doctor instead of me shrugs

*prioritise

Dobby irrelevant tbh as your job is very different to that of a GP receptionist

*But when I know I need to see a GP for an ongoing condition, it's not urgent, but I need to come in, booking a week out is fine for me, why can't I do that in your practice?

Why do I have to talk to you about it? I know I need to be seen, I'm happy to wait, I don't want to talk on the phone?

Or is it that overall it's so busy you can't give an appointment, even with a couple of weeks' notice?*

Because so much of the time people don’t need an appointment, and their concerns can be dealt with easily over the phone.

We unfortunately just don’t have enough appointments to give to everyone who asks for them, and that’s the same for routine appointments and same day appointments.