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.

In my opinion any triage should be carried out by someone with some training ideally a nurse but a health care assistant at a push.

And as for A and E - when I went in a couple of years ago - I nearly collapsed at the reception desk whilst waiting to tell them my symptoms, and was only taken seriously when they finally clipped on the heart monitor onto my finger and all the alarms started to sound.

Yes the NHS is under pressure, and does do a wonderful job - but there are also a lot of people for whom actually getting them into the Doctors/Hospital is a huge hurdle in the first place.

My GP surgery had the same triage system and I absolutely hate it. Having said that, I understand the reason for it and have never refused to tell the receptionist why I need an appointment. I'm lucky enough to be able to have privacy when making the phone call though. And I'm not prepared to take out my frustration on the poor receptionist who obviously couldn't care less what my problem is. She's only asking because she's been told to.

OP YABVVVU. You are basing all GP surgeries and all receptionists and all patients as if they are dealing with the same scenario, that being, a surgery with next to zero immigrants with limited language, with profesional and competent staff with bizzare lack of memory that completely forget the conversations they had with patients and have a set up where no one else can hear them, in an area where no one working in the surgery lives anywhere near or lives anywhere near anyone that attends the surgery so they have no potential for knowing the patient. It is a ridiculous and unrealistic scenario and enough people are telling you this that you should be rethinking your systems rather than berating people with reasonable nad justifyable concerns about your demands. Start with not wasting GP time making phone calls prior to EVERY appointment. Sheesh, that is just stupid.

How can someone not medically trained or part of the medical profession be able to adequately carry out triage.

A health care professional usually has to study for years with a degree and medical training so how on earth can the onus to triage be put on someone who's job is to man a reception desk.

I have always refused to tell the receptionist why I need an appointment I'm entitled to my privacy .

I do not want someone who isn't a medical professional carrying out 'triage' it's a complete joke and only a matter of time before someone seriously ill dies

In the past we have phoned the doctors because our non verbal son is distressed and we think it may be a medical reason but no specific symptoms. In our son's case this would be treated as an urgent appointment because when in distress, he becomes unmanageable and unsafe to be around. In the OP's system I wonder how well this need for urgency would be managed?

@purplelila2- maybe slightly unkindly deduced- but OP and colleagues appear to go through the list, pick the ones they like most, or by how descriptive you've been to the receptionist. So be as semantic as popular, and you'll catch their eye for a call back and then an appointment.....

Right, about your online system. It is quite likely it is either clunky to use or doesn't work properly, if you're getting few people using it. My Dr has an online system. I tried it a few times and each time there was a different problem. Think 404 page not found, auto message saying you need to confirm your email in person with the practice etc. I didn't bother after those few times as I can recognise a system that hasn't been tested properly! They now have a better system that does work, but for at least 2 years it didn't and they either weren't aware it weren't in a position to fix it.

You need to recruit 5 or 6 patients of different ages and levels of computer experience and pay them to test it weekly.

Once it's working not only will patients recommend it to their friends but it will massively help those who are in open plan offices, with embarrassing complaints etc. I am a teacher and there is literally nowhere to take a private call in my building. I don't want to take one on the train, either! But I can use a computer service easily.

Some people have health problems that are embarrassing and find talking to the doctor difficult. For example, I can’t imagine speaking to a receptionist about my symptoms with an anal fissure.

I have no issues with telling the receptionists my issues, however we have a busy body one at our doctors who tried to tell you her thoughts instead of passing them along to the doctor. They are not thier to diagnose for you just to simply pass the information along. One time I called up and mentioned I think I had tonsillitis and I’d had the symptoms 5 days, she said she had no appointments, I mentioned that my temp was over 41 and I had white spots on my throat she magically had an appointment. I know some people ring non stop for non emergency things but if she had looked at my history she would have realised the last time I’d been to the doctors for something other than my lifelong condition (which is mostly dealt with over telephone) was 4 years previous. I’m not a frequent flyer. Some receptionists think they are qualified as doctors and that’s not on.

People of all ages will use online systems that are properly designed and maintained. Check out your local council website and you'll probably find you can book and pay for all sorts of things there without speaking to a human being.

*In our system, the receptionist would simply add you to the triage list with a one line summary, you would get a call the same day (unless you walk in/ring up after 5pm in which case it has to be the next day), and the doctor would then book you an emergency appointment.

Our receptionists do not book GP appointments. Ever.*

Then can you finally see what people are saying? Stop acting like you’re some higher being telling everyone that they’re doing themselves no favours no telling the receptionist their medical problems when we (thankfully) don’t go to your practice.

Bully your own patients not the entirety of MN when not all surgeries work in the same way!

Or you could LISTEN to what people are saying, but medical school seems to have left you tone deaf.

People of all ages will use online systems that are properly designed and maintained.

Some people will - neither my mother (in her 70s) nor my MIL (in her 90s) can use computers, never mind online systems!

I can’t imagine DH speaking in his open plan office to a receptionist about his anal fissure either!

People of all ages will use online systems that are properly designed and maintained. Check out your local council website and you'll probably find you can book and pay for all sorts of things there without speaking to a human being

If only!!

Ours is on its 4th overhaul and each time you have to go into the surgery snd fill out another form and take ID to get a password. Their system is screwed but they get shouty because you should check results etc online I bloody well would happily do it if it sodding well worked! FFS

Our surgery was great until they merged with two others, now it’s a bloody nightmare

The GP doesn't need all patients to go online though - sounds like 10% or so could make a positive difference to everyone.

I was able to get a repeat prescription and a referral letter by using my practice's online system recently. That's two appointments that were saved and half a day of my time! It was amazing!

Doctors need a different strategy for the working age population and the retired. It should be possible to have a practice focused on children, teenagers, working age, retired...being all things to all people is inefficient.

montStM. My mum in her 70’s books her golf/Pilates etc online so I’m sure she could handle booking her GP appointments

My Aunt (90 this year) just bought herself a new iPad because her phone was a bit fiddly to FaceTime my mum

(She’s gold though her GP wasn’t going to refer her to the hospital for something due to her age and she told him very clearly she’s was in her ‘80’s not her coffin! So he had better! He did the hospital were disgusted he was so ageist and the problem was sorted)

You cant judge all older people by the few you know

I see exactly what you're saying. IMHE I've found that elderly people in particular don't like to tell the GP too much as they're scared that if they know everything that's going on, what they have difficulty with they'll lose their independence, ie put in a home. They understandably don't want this to happen (who does?) and keep things to themselves. It doesn't do any good in the long run but their pride is very important to them.

Coincidentally we have new young GPs at our surgery.
My neighbour was told by the GP that he isn't here to care for her?!
Another was told that time off due to stress was what annual holidays is for.
And I was given options and expected to decide which medication I would like to try. I don't mind this but haven't had it before, previously taken the docs advice and gone with that.

It seems there might have been a diktat from on high that GPs need to tell their patients to get a grip and that they aren't counsellors. Though I am in Scotland where there is a serious shortage in country areas so perhaps we are being dealt with less sympathetically due to that.

Thankfully my gp has online booking for appointments (and many of the new patients that have flooded the practice recently since two sole operator gp's shut down can't work computers!) 20+ appointments are released at 6am fir same day, brilliant system. We have 8 full gps and 4gp registrars, big practice

I do hear you - but that doesn't stop me hating the system with a passion. It's 2019, ffs, can't we have a webform or something? in our surgery some of the receptionists are not very nice and you can sense them judging you as you speak. It does really put people off.

If you’re a child or over 60 getting an appointment at our GP practice is guaranteed.

If you’re an adult? Pot luck. Current wait time approximately 7 weeks for routine appointments.

We did have online booking, but it was decided it was discriminatory and removed.

I'm a GP Receptionist and make the on the day appointments over the phone. I don't ask what's wrong, sometimes I'm told, sometimes too much information is offered. It appears I do book in the same people time and time again. So much so I can see their faces as the speak to me over the phone, I even know their voices without asking their name.

However when all the morning appointments have gone there is an emergency clinic late afternoon. when people ring in the GP's want a brief idea of the emergency. It's usually chest, urine, throat, ear, eye infections. Now these people who need to see a GP have to wait to be seen until later because the regulars have an appointment to see the GP in the morning.

Some people want an emergency appointment when the pharmacy next door can help them. Then we have people who don't phone first and just walk in and are seen because at the front reception desk we don't ask the problem just ask "is it urgent" which of course it is (a letter for PIP or a renewal sick paper isn't).

I can certainly see the practical benefits (for the GP) of using receptionists as triage nurses. In some respects it's a rational use of resources.

However from the ethical point of view, isn't it problematic to discriminate against patients who refuse to give medical information to someone who is not a medical professional and isn't bound by medical ethics?

That seems like a pretty dodgy position for a doctor to take.

I can see the benefits of a triage system, but it's not always practical. Our surgery phones open for next day appointment booking at 3pm. I share an office with my trainee. Most people these days who work in an office environment work in an open plan environment. It often takes several attempts to get through to my surgery and you can often be kept on hold for some time, so it's not just a case of stepping out of my office for a minute. I don't mind telling the receptionist my medical info, but I don't want to share it with my trainee.

If this is how you want the system to work then you need to put medical students or similar on reception. There is absolutely no way in hell that I am discussing my or my familly's medical issues, in public, with someone with no medical training, in a large queue, in a small room, with people from my community that I potentially know listening.

It would be ok if the people on reception did just type a one word summary verbatim, but they dont, they try and gibe medical advice and make medical decisions they are nit qualified to make. I was recently refused an appt for my son as the receptionist incorrectly "thought" he didn't need a particular vaccination. i had to go back on a different day to get an appointment with one of the receptionist who doesn't do that to get it done. I also do not accept being told by someone who might not even have done Biology GCSE that I am not ill enough to see a doctor.

What if the appointment is for something like depression, suicidal thoughts, addiction, self-harm? Do you really expect people to blurt that out in public and how is that triaged?

What we do is not triage but take a message over the phone to pass on. The GP's decide if an uti is more important than "it's personal".