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.

Regarding those who are worried about the receptionist knowing your business, I used to work as one and we had full access to your entire medical record.

E.g. If you phone for an appointment, I might go to your notes to document that you phoned. When I click on them, I can immediately see every discussion you've ever had with your doctor.

There aren't degrees of access to the notes, literally everything is visible to employees. It really surprised me when I got the job.

It looks like, e.g.:

14th July 2019 - Always, Receptionist.
Patient called to book an appointment for gynae reasons, would not elaborate. Added to triage list.

13th July 2019 - Dr. Someone, GP
Patient came in to discuss their vaginal prolapse. On examination, second-degree vaginal prolapse.

10th July 2019 - Dr. Someone, GP
Mental health, supportive chat. Having relationship issues with partner.

Keeping stuff from the receptionist has absolutely zero positive influence on your privacy, it just makes everything take longer. And having so much access to medical notes actually makes it all incredibly uninteresting. You will not be the first person in the world to have x problem, the receptionists have probably seen and heard it hundreds of times.

Oh - a lot of us also scan all your letters! So we have seen all your outpatient letters. They come to the practice via fax or email, and are managed by the receptionist/administrator to make sure they're scanned and go to the right GP.

Nurses might be valuable, but they're not there to diagnose. Fact. Otherwise universities could shorten their medicine programmes because surely half of that time is unnecessary, as a nurse can do as good a job as a GP.
Nurses are great for repeat wound dressing, blood pressure measuring and other things that do not really require input from someone more qualified. But they should not be used to triage patients.
The point of locum GPs v long-standing nurses is neither here nor there, as a proper system works always with the same GP, or first-line HCP. Otherwise you stand the chance of missing important clues or dismissing patients, because you don't know them.

I for one would refuse a student if my issue was too embarrassing, yes. I am a human being and am allowed to have feelings and I should not be forced to discuss private matters in the presence of someone else if I do not want to.

Has it never occurred to surgeries that people might unnecessarily claim it's urgent, because their local practices are so dire they'll either be (almost) dead or in hospital before they can see their doctor? Or are at least worried about that. If you could call your GP and get a non-urgent appointment within the week like anywhere else, people might be less inclined to want one now now now rather than in three flippin' weeks.

I hear you, im not a receptionist, but I cant understand when people dont want to tell you why they need to see the doctor. You're a health professional and unless I know you personally I'll tell you my life story if you need it

Receptionists aren't health professionals.

kikibo - many Advanced nurses do actually diagnose, and do it very well. A lot of them run minor illness clinics, work in fracture clinic, etc.

Re: "But they should not be used to triage patients." - A&E is largely triaged by nurses!

I assume you've not got any experience working in healthcare...

My old doctors had a ‘sit and wait’ policy, they opened at 8 (people used to queue from 7) but you were guaranteed an appointment, might be a couple of hours wait but you’d be seen. Moved towns, couldn’t even get registered and had to go to local CCG for help. Got registered and surprisingly fairly easy to get an appointment. Moved in with DH (another town) and they operated a similar system to OP, I don’t really have a problem speaking to receptionist but I couldn’t stay home to phone to either be told no appointments left that day and to try the next day. Receptionist admitted that could go on like that all week, totally unrealistic for those who commute. I wouldn’t have minded but it was them who insisted on seeing me to issue my repeat prescription for the pill. I ended up buying on line eventually.

I’ve since moved again and can now book on line. Great. Except appointments for HCP are usually 3 weeks wait and GPS 5-6 weeks. My migraines recently started getting worse so as I had a week off I tried to get an appointment but there were none left. I was triaged and got an appointment within 10 minutes and just made it by the skin of my teeth! At least give me a reasonable time to get there, if I couldn’t drive or had kids I’d have had no chance.

Regarding those who are worried about the receptionist knowing your business, I used to work as one and we had full access to your entire medical record.

@Alwaysunderwhelming, when I saw the GP with DV injuries I was assured this would be recorded separately from the rest of my medical record and it wouldn't be seen by everyone (general admin staff, receptionists). Was she feeding me a white lie?

Nurses are brilliant diagnosticians, or at least the ones in my practice are. They have much more experience and I trust them far more than the 12 year old who come and go every few weeks.

Cheaper - there is a mechanism to hide "sensitive" information, but it would only happen in a case where the doctor has agreed it with the patient. In your case they would have used that.

But the kind of thing people on the thread are sensitive about (gynae etc.) are recorded on the normal record.

Sorry if I made that unclear when I said there aren't degrees of access. There are in theory, but they're very rarely used except in a case like you've mentioned, where the patient and doctor have agreed it.

@Alwaysunderwhelming

No, no experience in working in healthcare. And I have always lived in places where nurses are not used for this kind of thing, as they're not meant for it.

I'd be interested to know how many of these patients return later as their symptoms haven't cleared up or have got worse because they were misdiagnosed.

Of course this completely ignores my point about no longer needing medicine degrees. Hell, if a higher qualified nurse can do the same job, then why still offer medicine degrees for GPs? You might as well stop those, replace all GPs with advanced nurses and have the odd specialist in general medicine for them to consult. Will definitely be cheaper, whether it'll be better, is another thing, but who cares about patients, eh?

The assumption that healthcare is better abroad is total falicy. It isn't, however, when you have to pay to go and see a GP, even if the consultancy will then be reimbursed, you think twice before making an appointment.

If prs ticrs are left having to operate a triage system with non clinicians taking the medical detail of patients, it is because British people abuse the system. The number of appointments that are wasted because people who wanted an urgent appointment (and how dare anyone say that it's not urgent) to then get better and can't be bothered to cancel is appauling.

Im aslo fed up with people getting colds, caughs, sore throats, block sinus who are too impatient to ac ept that it does take a week at best often 3 weeks to recover and make appointment to see their gp e pe ting a miracle cure, and then get outrage whe. They are told to be patient, look after themselves and no, antibiotics won't make them better.

So many wasted appointments that leads to a system that has to prioritise on the basis of need. As for being too embarrassed to speak with a receptionist, this is ridiculous. Medical issues are just that to clinicians as much as receptionists, they have long stopped caring that someone wa ta to dicuss piles, erectile dysfunctioning or vuvlva soreness. These are just words to them, nothing to be embarrassed about.

@Alwaysunderwhelming receptionists May have full access but legally they cannot look at those records without reason. Eg) you cannot look up the mum from school run or even your own records without folk the process!

I think that's offensive to nurses, who are highly trained and experienced. Any doctor will remember times when a nurse has bailed them out of trouble, especially in the more junior days.

More complicated medical issues are sent to GPs. Society has moved on - nurses used to make the beds, but we have healthcare assistants now, and they actually do a lot more. Bloods, ECGs. ODPs are now their own specialty and scrub in theatre.

Demand on the service is huge, patients are living longer with complex multiple issues. Doctors are left to decide on the more complex things that a medical degree trains them to resolve.

@kikibo, I think you’ve genuinely come up with a really excellent suggestion. That would work for me. Trouble is we’re already 40,000 nurses short.

M0ther - you can't without reason and there is an audit trail. Whether there is anyone auditing this is another issue entirely (I've never known it to happen).

But generally reasons crop up all the time. Someone might ask when they last had a smear test, which warrants a look at the record. Someone might phone to ask a question, which needs documenting and warrants a look at the record. Prescriptions, all sorts.

Alwaysunderwhelming

Do you go and bellow that information across the supermarket or chat about it in the school playground?

What you can see in my notes or when you scan clinic letters isn't relevant to me because I'm not being confronted by it am I?

Me typing my reason for a visit into an online form won't be as embarrassing as discussing it face to face with someone for example.

So, I can choose to ignore the fact that a secretary has access to my medical history because I can. I can't ignore having to tell the same secretary over the phone or in a crowded reception area.

Alsohuman Yours might be but ours failed to diagnose my thrombophlebitis so that it's now worse than it needed to be. The gp I finally got to see 5 weeks later diagnosed it in about 15 seconds.
Another one didn't know that salmonella infection can lead to complications,thus failing to order blood tests but instead signed me off work for 2 weeks. I actually had serious liver problems and the gp I saw was frustrated that I hadn't been referred up straight away. I ended up off work a lot longer than 2 weeks!

So,no,they're not always brilliant. They have their limits and shouldn't be over confident.

I have sat in my GP reception area and am able to hear details like names, addresses, date of births and the reason why someone wants an appt. Its openly discussed on the phone when the receptionist takes the call and anyone sitting in the reception area can hear it all. I found out some interesting information about some people who live locally, not that I wanted to know or purposely was listening and certainly would never do anything with the information, but my guess is that some people woukd love that kind of gossip

I’ve had cancer. The GP receptionist told me that my recurrence test had come back as abnormal. When I asked to see the GP she told me there weren’t any appointments. I broke down, crying and clearly very upset. She just sat there and then asked me if I suffered from anxiety!

I begged her to get me an appointment and she did actually ask my GP to see me that morning. I was seen, and the GP told me that my results weren’t back! When my results came back a week later, they were normal.

This highlights the difficulties with untrained staff taking on too much responsibility. My problem wasn’t life threatening but I experienced stress levels and upset through the roof, all for nothing.

Decomposing, I can appreciate the bit about not wanting other patients to hear, but being embarrassed about giving a brief reason over the phone while being fine with the prospect of a receptionist reading your detailed record is a bit... daft.

Im trying to Vet a non urgent appointment.If I try to book on line there are no appointments available for the entire available dates.
I will at some point have to go in personally as my non urgent becomes more pressing.
There is radio on in the Surgery because some discussions could be overheard in the surgery so now you habe to raise your voice so that the receptionist et al can hear clearly.
For urgent I would just go and wait

@campion, I’ve known GPs make worse mistakes. I recently went to the funeral of a friend whose doctor failed to diagnose his cancer. Nothing’s perfect.

Doctors make mistakes as well, because it's impossible to get things right all the time and some presentations aren't typical.

But when a nurse makes a mistake it's always "because they're just a nurse", rather than because they're a trained HCP who got it wrong.

Our NHS GP system is failing us due to too few GPs. No wonder inappropriate A&E visits are so common. When you can't get a GP appointment what else is there to be done?

We have the ludicrous ring between 8am and 8.01am then hold for up to 30 mins for an appointment (if you are lucky) set up. Non urgent appointments are often not bookable at all, even 3 weeks in advance. It's highly dysfunctional and many vulnerable people slip through the net. It is unreasonable to assume that everyone can manage the ring at 8am requirement.