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.

Exactly Boom25, there are lots of people who can’t answer phones. In nurseries even having your phone out of the staff room would be a disciplinary.

Soonto be60 - our surgery was trialling this for ALL appointments. And there are occasions when I’ve needed and emergency appointment and still be well enough to go to work (e.g. the time I found a breast lump).

If I’m in a class with no TA then I can’t just step out to answer a call and in my school, GP or not, I wouldn’t be allowed to answer in class not would I want my Year 6’s listening in!!

No, we don't all pay for it. Only people in employment pay. More of the population don't pay than do. And we certainly don't pay the true cost of the service. My father worked at a low paid job all his life until retirement at 65. He paid his way in tax and NI. But he had an AAA and ended up having major surgery, a week in intensive care, six weeks in HDU and a further 12 weeks in hospital. He then had another stint for a month for elective surgery linked to the AAA. He finally spent his last week in hospital having got a blocked bowel. His GP was fantastic from start to finish. The cost of this care probably exceeded his contributions ten fold plus.

Well, someone paid for it.

We have only recently started asking for the reason for the appointment at the surgery where I work. The feedback we have had from the GPs is that it helps them deal with a same day problem more efficiently, they can immediately say, so you have a chest infection? Or something of that nature. I also feel that patients think they need to tell us absolutely everything. They don't. If you said to me "I'm really struggling with my mental health " I would make a same day appointment. Nothing else needs to be said. It is helpful if more information can be given about children, such as if the temperature still remains high despite Calpol. But if someone rings to say they need a same day appointment for a sick note or a repeat prescription then we can't accommodate that and we can often deal with this without the need for an appointment. Most surgeries have a policy for these requests. If you need a further sick note from one that has already been issued by hospital for example, we can deal with this over the phone and via a request to the GP as we will have a discharge summary from the hospital. The GP won't necessarily need to see you. They will know already you have say broken your leg. The balance here is dealing with patients need and patients expectations. It's tricky and a lot depends on the practice manager and the support given to staff by the GPs.

More of the population don't pay than do.

That really isn't true I am afraid. Latest figures released by the government show that 76% of people of working age (16-64) are in employment in 2018/19. Bear in mind this will include people such as stay at home parents who choose not to work but are supported by partners who do earn and contribute, often at a high rate.

People older than that may well be retired but will have contributed significantly over their lifetimes and many people now work past 64.

The feckless terminally unemployed are actually a small proportion of the general population (and can presumably be given working hours appts anyway).

I'm surprised that so many people on MN haven't dropped down dead seeing as they are not able to get GP appointments at all because of the awful receptionists that sit behind the glass waiting to listen to everyone's most personal stories!

People still get medical help, they just use a&e hence the 11% increase in attendances. Those who are really poorly and do use a&e appropriately often wouldn't have ended up in such a bad way had they received help sooner at gp level.

The 24% includes people
in households supported by working partners I mean, reducing the non-contributors even further

Our surgery has an online booking system. To use it, one has to get online and keep refreshing until a handful of appointments are released at exactly 7:30 am. Then, as fast as you click on a time, it tells you someone's beaten you to it. Click on another and its gone too. 90 seconds later, there's nothing.

I'm very comfortable online, but even I'm stressed out and anxious doing it. And only successful 50% of the time.

I don't know what the answer is. But yes, OP. There's clearly a huge variation in what different practices do, so the advice on your OP is basically only useful to the posters on here who are with your practice.

@soontobe60
Surely if you are unwell enough to need an urgent appointment you're unwell enough to be in work? I'm a teacher too. When I've waited for a call back, I've explained to my Head that I need my phone on silent and to be able to answer a call from the GP. They've been happy for this as at least I'm inschool and not phoning in sick. Any employer should understand this.

I was a teacher too, and it's not as clear cut as that. You say if you need an urgent appointment then you're too unwell to be in work, then contradicted yourself saying your head would understand if you had to take a phone call.

My GP operated this system, with the added bonus of not being able to pre-book appts, so ringing at registration/1st period is your only option.

On one occasion, I had to ring on the day, and was not too unwell to be in work, but would have been within a few days of I didn't get medication. So I drove 50 minutes to work, made the phone call, got an appt, organised cover for 2nd and 3rd lesson, drove an hour each way to the appointment then taught again, so that I could get meds to ensure I could continue to work. It was either that, or take a sick day and hope that I could get an appt that day. Not exactly an efficient setup.

I do agree if you need a same day appointment, then you are unlikely to be in work at all.

I think that what people don’t understand is that some surgeries have a triage system for ALL appointments.

And I am sure many people think they need a same day urgent appointment when they don't. The complaint I hear most is - that by the time you get to see the GP you are better anyway. Well that means you had a mild self limiting illness that could be managed by yourself or with a visit to the chemists. You did not need to see the GP at all.

How do you sign up for online OP? I was at my GPs for an appt and the receptionist asked if I'd like to sign up for online booking. When I said yes I was told I'd have to come back to the surgery on another day with proof of id. Despite the fact that they were clearly accepting who I said I was when I turned up for my appt. Doing that would have meant taking annual leave to visit the surgery during working hours so I haven't done it

That is the same at absolutely every GP surgery that is introducing online access.

Think about it - they cannot risk giving someone access to another person’s medical records. Just think of the legal consequences that would have.

Your system needs amending. The only person who should be hearing symptoms is a doctor. Not even a nurse, as nurses are for carrying out doctors' instructions, not for diagnosing. Otherwise we might as well dispense with medical degrees.

As for telling receptionists about symptoms. Wtf? They're not qualified to hear them.

Here, we have more and more signs at doctors' receptions and waiting rooms, saying 'please shut the door for data protection ' and you're going to tell me that in the UK I'd have to tell a random person whatever embarrassing problem I have, even in front of other patients?

Soontobe60 people like dh and me contributed to your father's care. We are happy to do so. But what really irks me is that despite paying huge amounts of tax, when dd was ill with her mh the system provided nothing. Nada. Zilch. She was diagnosed and had therapy and turned around because I had £6000 to pay for private psychiatric care. What of those young people whose parents don't? My GP told me to find her help on the internet. And yet despite psychiatric consultant led care and just before diagnosis she had a mini crisis and took 11 anti-histamine just before exams and 48 hours later worried she had harmed herself and went to a&e to check herself out, there was money for an o'night admission, a 1 to 1 mh nurse (who woukd havr passed an audition for Prisoner Cell Block H with no acting skills) and a referral to SS. All to faciliatate a CAMHS assessment the following morning; the same CAMHS who refused care six months previously. Had I been called at 2pm instead of 5.45pm her psychiatrist coukd have been contacted who wd have arranged for her to be assessed at a private hospital. That however would have been too sensible. We did go home that night, she was assessed by CAMHS on the following Tuesday. They promised counselling within 3/4 weeks locally over the holidays. When this didn't materialise they denied they had promised it. The CAMHS practitioner when I confirmed the psychiatrist's diagnosis of ADHD told me dd was too old at 17 to have that diagnosis.

The problem is about the mismanagement of resources and competencies of front line staff who are not working within a joined up system and do not have the intellect to look beyond computer says and one size fits all/all parents are crap mentality the system has become inculcated with.

Do forgive me if I think the behemoth requires total reform probably commencing with its extinction.

Actually nurses aren’t there to carry out doctors’ instructions, they a valuable resource in their own right. I’d far rather see the nurse who’s been at my practice for over 20 years than the endless stream of locums.

If your receptionists are getting a lot of abuse from people unhappy about telling them their symptoms, then clearly your triage system isn't working, much as you'd like to think it is.

Maybe rather than post a rather PA post on MN you could have an all staff meeting and try and come up with a better system.

Lots of posters here have given you very understandable reasons why explaining symptoms to a receptionist will not work - maybe you could acknowledge that.

As an aside in A and E you're triaged by a nurse, not a receptionist.
Maybe you could have a system where people can phone a nurse initially?

Experience in our GP practice is very different.

The receptionists are known for repeating your name and symptoms back to you - so anyone in the village who happens to be in the waiting room can hear.

If you do give your symptoms, they tend to suggest a nurse appointment first. You then go to the nurse and get told you need a GP. And by then you've lost the chance of a GP appointment that day.

So best thing to do here is to refuse to give details and just insist on an appointment with a GP.

If you have a great system then I'm sure a triage works, but it doesn't here. And being told what great looks like won't stop anyone here changing approach.

Yes why bother with 7 years medical training to become a GP, just tell everyone they dont need appointments, of any kind. Just Google it! or ask an untrained receptionist who thinks their mum's cousin's brother was fine when they had a temperature and purple spots so you will be too!

Our GP has a new phone system where a recorded message by one of the doctors specifically asks you to tell the receptionist why you need to see the doctor and explains it makes it easier for them to prioritise appointments. They also have a nurse practitioner who can deal with a lot of stuff so it helps them take the pressure off GPs. It never occurred to me not to tell them what I need but clearly is problem enough for them to put this message on the phones.

So you walk in and have to discuss your problem in front of other patients?

I’ve never yet had a receptionist decline a request to talk in private. And don’t most people phone in first anyway?

What about confidentiality? I get that you’re all under pressure, but don’t we all have a right not to discuss our medical concerns with anybody other than a qualified professional?

You can claim that “right” if you wish. You just might miss the opportunity to have an appointment sooner. An experienced GP’s receptionist is able enough to know what’s urgent and what isn’t, and really has no interest in your haemorrhoids. Do you also refuse to have a student in the room with you? They’re not qualified either.

I am so glad I have American healthcare (an unpopular opinion on MN I know)

If I need to see the doctor, I can call at 8am and get an appointment that day whether I describe the symptoms or not. The surgery answer phone picks up initially and says press 1 for appointments, 2 for prescription refills and referrals, 3 for medical records, 4 if you would like to leave a message for the doctor etc etc

Appointments gets you the receptionist who will book an appointment and never says no, 2,3 and 4 get you a staff member whose sole job is to take care of those roles and if the are on the line to someone else it automatically puts you through to their voicemail to leave a message with precise instructions on what information they need. 4 gets you a list of doctors so you can pick your one and is answered by a returned call from a nurse or the doctor that same day (if you call before 4pm)

If you need a doctors appointment at a weekend, you call the same number and an on call nurse for the practice is paged. They can access your medical records and will advise you if you should come in for an emergency appointment with the doctor covering that weekend, or wait with suggested treatment at home or go to A and E etc.

We also have an online portal where we can book non emergency appointments, send the doctors email and view all our blood test/medical history.

This is available to everyone who is enrolled at the practise whether their care is paid for via private insurance or government scheme or subsidised private insurance (Obama care style)

Very early in the thread after the op made it clear she (assuming the op is a she) felt her time was impirtant and must not be wasted. I gave several examples of how my practice has wasted my time for no good reason over the years. I also asked the op to reflect upon the fact that I am a professional in a high stress role. Don't think Ibadded I leave my home by 7.15am (1 hr 15 mins before surgery opens) and return to it at about 8 to 8.30 pm. Whilst surgery operates until 8pm, switchboard closes at 5pm and reception is only open for patients with pre-booked apts. The OP has not responded despite being tagged. I can only assume because the views of the scummy old patients are irrelevant.

There is a hub where we live now offering apts until 9pm Mon to Fri and all day Saturday and half day Sunday. I have been once and ds has been once. It is a helpful initiative work working people. It serves about 8/9 practicea.

Do you also refuse to have a student in the room with you? They’re not qualified either

What a non-point. A medical.or nursing student a) has more medical training already at that point than the receptionist by reaching the stage of placements in a clinical setting b) is being fully supervised by someone in the room who is qualified (unlike the receptionist) and c) isnt making clinical judgements, is simply observing or learning under supervision (unlike the receptionist)

@seatoski You know when you read about all the awful things about american healthcare and take it with a pinch of salt because that is not your experience? Trust me if there was a similar thread about healthcare in the US the examples would be much worse than here.
Because in reality people who need to get seen do usually get seen. People ringing in with a cold wanting an urgent appointment, don't get seen that day.
Although of course like anywhere there are good and bad Drs.

OP it’s been asked a few times now, how can you possibly justify a system where you will call back somebody who has told the receptionist they have a non urgent problem BEFORE you call back someone who could have anything from life threatening that day to a non urgent problem? How is this triage? It’s dangerous.

I had to speak to the dr about a sexual assault so I could get some help.
It nearly killed me explaining it to the dr so how do you suggest I tell the receptionist in a room full of people?

I think there ought to be a more confidentiality around the receptionist I don't want to ask to go speak somewhere more private and draw more attention to myself.