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.

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'.

Interesting that you responded to this and not to the rest of my post (which made it obvious I know this, and had missed out ‘until the end’, for which I apologise.)

You have had it pointed out that unless you’ve compared the results of this system with a system where you deal with ‘no-info’ calls in the order they came in relative to the other calls, you are not likely to be running triage based on medical need, you are running a twin track process where those with more urgent problems who haven’t disclosed to a receptionist are given lower priority than those with less urgent problems who have told the receptionist about them. Which isn’t triage based on medical need. It’s partly triage based on medical need, and partly triage based on ‘these people are annoying and make my job harder.’

Unless you’ve run a trial, and have good evidence that the non-disclosure patients are reliably less urgent than the disclosures, of course.

I always find it a bit awkward when I’m sat there waiting for an appointment and you can hear every word even on the phone call the receptionist will repeat back for example so I’ve booked you in to see Dr Z for your erectile problem, or they constantly repeat back so it hurts when you wee? Ok can you confirm your name, address and dob. Was that X street? Ok Mr Jones I’ve booked you in for X time and day.

It’s in no way private or confidential via phone or walk in. I just always ask for the nurse they don’t quibble that one and if I then need a doctor they quickly grab one while I’m in there to sign off on it.

IncrediblySadToo

As for elderly users of the internet:

www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/active-communities/rb_july16_older_people_and_internet_use_stats.pdf

It looks like Age Concern thinks over 4 million elderly people can’t use the internet; not just the few I know!

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

Ambulance dispatchers do it all day, every day.

Indeed, JassyRadlett, but OP is not responding to posts pointing out that what s/he is describing is not a triage system.

And, crucially, Ambulance services don't leave someone waiting hours for a callback without having any idea what might be wrong with them.

The GP's decide if an uti is more important than "it's personal"

So how long before one of the "its personal" crowd who was actually dangerously ill/suicidal dies as a result of being ignored or put to the bottom of the pile for an appointment? Im sorry but I dont actually believe GP Managers would take that litigation risk. When I book an appointment online I don't put anything in the reason box. It's clearly stated that its optional. I still make the appointment as I've already selected an available slot. How can you ethically discriminate against someone that has chosen not to fill in a stated optional box on a from? or who is too embarrassed to tell a receptionist that they have a bad smell emanating from their genitals, keep pooing themselves, have STI symptoms, feel like hurting themselves, think they have been raped etc etc.

I get that GP surgeries are overloaded and there are LOTS of health anxiety and pisstakers clogging up the appointments, and that needs dealt with, but unofficial triage by non-medically qualified people, with no safe guarding training etc, is surely not the way.

My GPs surgery no longer allows appointments for UTI's. I can understand thrush perhaps because there are over the counter products available, but painful, bleeding UTIs with awful lower backache seems inhumane. I have had a receptionist tell me I couldn't have an appointment twice. She is very unpleasant to deal with. I know they are only carrying out the GP's instructions, but it is how it is delivered.

I have diverticular disease and was suffering and in pain with this and I then also had a matching UTI. When I eventually got an appointment the Dr had no problem and was sympathetic because I was in such a state. It took a full week to get an appointment. This is where it goes badly wrong.

I have also been turned away with whooping cough because it was "just a virus". I then infected my pregnant daughter.

I do appreciate that GPs have a difficult job but the tone of op is one I had hoped we had left behind in the seventies where GP's were demi-gods and my late dm would speak to hers in hushed tones. I always remember the Practice Manager in our last surgery referred to the patients waiting area as the "pig pen". Where is the dignity in this.

There are faults on both sides but maintaining the dignity of patients is important and most of us are just people who are sick, in pain and wanting to see their gp within a reasonable timeframe and then swiftly forgotten.

If this is what the surgery want to do, then they must organise for the receptionist requesting this information to be in a private room and not at an open-plan desk situation.

I refuse to tell a receptionist. They’re not a medical professional, they’re a receptionist. I might as well tell the person working in morrisons for all it’s worth, they can’t help advise me on my symptoms at all. It’s a private issue generally between my GP and I, nothing to do with anyone else.

Also, like Hell am I going to waltz up to a desk and tell a receptionist what is wrong with me in front of strangers sitting in the waiting room. It’s called dignity.

or worse, your mum's nosey neighbour, you kids schoolteacher, the guy across the road that leers at you etc etc

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.

So at an extremely late stage in the thread, you suddenly remember that you do , in fact, offer a discreet and efficient way of interacting with your triage system.

One that many people on the the thread have told you would be their preferred way of interacting with their GP's surgery and you never thought to mention it as an alternative.

I just can't get over the fact the OP thinks having to discuss your symptoms 3 times before treatment is considered is an 'efficient' way to do things. (1. Receptionist call 2. Dr call 3. Dr appointment, often with a different doctor).

The real issue is that you don't have enough capacity for the demand and so you are trying to find a way to avoid giving everyone who wants an appointment an appointment.

I get that there's a shortage of GPs, and because we let the NHS front line service of GP practices to be run as multiple independent businesses, they can't 'afford' a nurse to do the triage/take the pressure off Dr appointments, but essentially you've developed a system that delibrately wastes paitents time in order to reduce the workload of the GPs.

You have put barriers in place to make it harder for someone who wants to see their GP to actually see them in person. Great way to reduce your workload to one that is managable, really terrible as a service.

I don't know anyone amongst my local friends who are registered for an NHS dentist (except for their DCs, many do private for adults and NHS for kids), we are all 'entitled' to register with an NHS dentist as it's a national 'free at the point of use' service, but in practice, most people have to pay private prices for adult appointments, and we just didn't even notice that dentistry effectively has been removed from NHS provision for adults in many parts of the country.

There needs to be a complete rethink about how GP services are provided or GP appointments will go the same way, there is already a rise in private provision services (booking a skype/video call with a GP or nurse) being rolled out across many big firms in London to save the staff time lost to the patchy NHS GP provision.

There's no point walking about with 'save the NHS' badges on, while not addressing if it's actually providing healthcare to everyone who needs it.

Do you ever get people gaming the system? It doesn't take a genius to work out that telling the receptionist you've got heart attack / stroke symptoms will get you a quicker callback.

Well that doesn't work if you say you are having a heart attack they tell you to call an ambulance.

Our one loves to say ...R:
is it an emergency?
You :well no but urgent
R: ok well i have an appointment for 6 weeks time.
You: no i need to be seen before that
R: well i suggest if it's an emergency go to A and E or your nearest walk in centre...

EVERY TIME!

so you end up waiting the 6 weeks because you aren't feeling well enough to sit at the walk in or a and e for 6 hours!

OP’s surgery sounds great.

I’ve been a patient at three separate surgeries in the last ten years.

One insists you cue in the morning for an appt, I have never been able to get one over the phone. I’m a lawyer and work long hours, the expectation that I can cue for 40mins when I’d ordinarily be at work for contraception astounded me. Who’s paying all their NI to keep the NHS going-working folk that’s who. The receptionist were amongst the rudest people I’ve ever known and reduced me to tears on one occasion. They told me point blank I could not be seen and would need to cue again tomorrow.

Second surgery was amazing. Rarely needed an appt and Drs were fantastic and could get an appt by phone. I once lost critical medication and I had a dr phone and write a prescription by me by lunch time.

Third as useless as the first. I’ll have been waiting 3 months for a coil soon.

Or they say we don't do triage today so you will have to call back on these 2 days.

I don’t mind telling a receptionist my issues, it’s their rude attitudes that I don’t like. That said my current surgery the Receptionists are fantastic.

This is a classic case of a publicly funded service being run for the benefit of the provider, not the user. And people put up with it because they have no option. Small wonder people are opting for private health care where they call the shots.

If 4 million older people can't/won't use the internet, it doesn't automatically follow that the remaining 60 million or so shouldn't be able to book appointments that way (or have them booked on their behalf). For one thing, an efficient online system saves money that could be used to employ individuals to deal with the stuff where a humane human is needed.

I meant to add that at the last 3 schools I have worked at (two state, one independent) all 3 were providing some level of private cover for their staff. Workplaces just can't leave their staff to the mercies of these crappy systems. They need their workers in work!

Our online service doesn’t work. My mother’s had to request a new set up five times and most other locals the same. It seems to let you log in once then cancels your account. You then have to go in and get new details to book that one appointment.

Most of my friends on the pill now just pay for it via boots/Lloyd’s as getting a contraception appointment can leave you with no working contraception. Ring up too early your not due more for a month. Ring up too late and be told you should of rang when you was down to your last month. Can’t win. Then it’s random if you can get an appointment one nurse prescribes 3 months only at a time and says don’t bother with the break the other a years worth. Crazy.