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.

This thread is so depressing

Being a GP is an almost impossible task and this shows why

Everyone wants it to work perfectly for them without understand at all that GP is in crisis with extreme demand and GPS leaving in droves

Patients are increasingly complex and GPS manage all levels of illness that would previously be hospital only. Some people access GP when they are seriously sick.

Add in then that a number are asking for nonsense letters (for schools for parachute jumps etc) or prescriptions same day because they forgot and ran out and there is the issue

You will never ever have enough appointments anyway but with the job being so hard now there aren’t enough GPs to even manage previous demand

So what’s the answer everyone?

We allow GPs to find systems that let them prioritise and best manage the demand?
Or we moan and say it doesn’t suit us thanks?

NHS is broken.

"but I doubt they leave because of abusive patients" - I refused to work on reception any more after a man threw a pen at me and harassed me over the phone.

I've witnessed other receptionists quit after being shouted at or racially harassed by patients. I came close to quitting one day when a patient told me that if he died it would be my fault, and he wasn't the first or the last.

"I pay your wages" is another favourite.

@Ghanagirl I think you're probably right.

but I doubt they leave because of abusive patients

Several people on this thread have stated that their GP surgery has installed glass walls between their receptionists and the public, making it harder for them to be heard. Why do you think those walls are needed?

Decomposing - disagreeing with you isn't "a lack of empathy". Even public sector workers are allowed a difference of opinion.

Of course disagreeing isn't lacking empathy.

Saying that patients are daft for being embarrassed to discuss medical issues with a receptionist is though.

Yes I find the OPs attitude incredibly arrogant. Apart from anything else, is it OK to keep patients who you deem to be lower down your list hanging around all day in the hope that at some point they might get a call back?

Most of us need to work and will need to make a decision whether to go in or not that day. That is why we request an appointment before working hours.

If we have not heard back before needing to go to work then, absent a leg having dropped off or something, most of us will make the decision to go into work even if we are pretty ill because if we can't guarantee an appointment then we can't take the day off work.

Some of us, like me, work in an area where we are not allowed personal phones during work time. What happens then - you call back, we are not waiting with bated breath for your call so no appointment gets made?

The current systems being used in GPs surgeries really do not serve their patients well. Patients appear to be an inconvenience.

We have a brilliant system where I am (not U.K. but British isles) you phone up and the receptionist books you in for your appointment, without asking what is it for, generally for later that day. Or the next if you can't make it the same day. Then the doctor's surgery charge you about £60 for your 10 min appointment.

If you happen to need A & E, again there is almost immediate care and attention, but it costs £180 to go in.
If you need an ambulance it will cost you approx £360

We tend to have medical insurance here understandably.

People in financial problems are taken care of through our benefits system so everyone gets seen and there's no barriers to medical care.

However, everyone does really consider whether they actually need to see a doctor

Oh and just to add, my adult DS with ASD cannot conduct a conversation over the telephone. He gets very muddled and his words become very indistinct. He can't use telephone banking for example.

Under your system he would never get an appointment ever.

What do you actually do to support people who cannot fit in with your system?

@Doriana classic example of ‘but it isn’t perfect for meeeee and my life so it therefore isn’t any good’

What’s your solution then?
You basically want to be able to call before work and get an appointment that suits your working day presumeably same day?

Right, so that’s 100s of people calling before 9am
And there aren’t enough actual appointments for everyone that calls and decides they want same day access

So how do you square that circle?

More appointments? That needs more GPs and there aren’t enough as it is (secret being that it isn’t such an amazing and hugely well paid job despite the millions of DM readers wanting to tell you it is)

How else would you solve it?

Are you all actually happy with patient led access that the person wanting same day access for the ingrown toenail they have had for ten years that is actually much better directed to a chiropodist, vlogs the phone lines and gets in to be seen before you with your severe back pain?

However, everyone does really consider whether they actually need to see a doctor

Of course they do. What I find frustrating though is the amount of things that I am forced to see a Dr for, that I can't then get an appointment for. So, I need blood tests every month to monitor the effects of drugs that I take - they make me see a Dr to get these forms. Why? Repeat medications - some of them I have to see a Dr for. Why?

My blood test results are never normal and yet often I'll get called back to see the Dr to discuss them but seemingly without rhyme or reason - sometimes they are improved and I'll get called in where other times worse results will be ignored. It seems to depend on the tolerance of the GP reviewing them. They never change anything though because it's the hospital that prescribed the meds.

Don't get me wrong, it's good that they are taking an interest but it just seems like a waste of appointments. How many times is this repeated. These would be perfect times for a telephone call to just check in with me.

We don't have this system luckily. You ring up at 8am, and get a same day appointment

We simply don't have enough appointments available to do this - @privateeyefan

No, because you are too busy double handling patients.

@privateeyefan - Our problem isn't the rate at which new patients are registering; it's the rate at which we're losing GPs without being able to replace them I wonder how much of your "system" caused that?

Perhaps they were fed up of double handling patients, spending hrs on the phone and booking appointments, when you employ receptionist for that? For me (having been a receptionist in various roles for my entire working career) it is a huge anomaly having a dr booking appts.

I mean, it happened, but it certainly wasn't the norm. A receptionist is employed to do those kids of things in order to give the GP more time for patients and notes etc

Do you also make appts if your patients need to come back for a follow up, say in 2 weeks etc? The time you spend making appts could be spent on notes, and that would cut down on "catching up on notes time" during the day, surely?

@Soontobe60 not obvious enough to be given an appointment, obviously.

have stated that their GP surgery has installed glass walls between their receptionists and the public, making it harder for them to be heard. Why do you think those walls are needed? Good point, but again, I have been in public facing jobs all my career, some where I was behind a screen, and one where I had an emergency door that I could close if feeling threatened. I eventually left those jobs, but it wasn't because of the general public. That said, of course that doesn't apply to everyone.

I guess I could have worded it better.

@Soontobe60 and it wasn't a case of not being able to get an appointment. The receptionist SIMPLY WOULDN'T ALLOW ME TO BOOK ONE! Not on the day, not in a week, not ever. Because she had decided that there was no problem. This was 8 years ago and after the hospitalisation and diagnosis it was dealt with at the surgery (after 3 letters addressed to them were 'lost' and 'not received') The member of staff no longer works there.

*emergency shutter, not door.

yawn - I don’t think anyone on this thread doesn’t recognise the stress the system is under. But I ask you, as I asked the OP, do you think that the right to share confidential information about yourself has to be sacrificed for the system?

Because this thread is clearly stating that people do not feel comfortable with discussing the issues with the receptionist. For multiple reasons.

The problem is, in trying to weed out the ‘ingrown toenails’ to the man who has been having blood in his urine for two weeks but never goes to the GPs (sorry not a HCP so made up a scenario) the risk is people like the man fall through the system.

I think it's discriminatory to choose to leave patients until last because they've chosen not to conform to your rules.

Believing that not telling the receptionist their health problem is the patient being difficult.

It might be of course, or it might not be - and it isn't your place to judge either way

Treat each patient equally and fairly whether they have 'been cooperative' ( in your eyes) or not.

Withholding information from the receptionist might be so important to the patient

yawn as it is I totally agree with you about people moaning about work. The service can’t work around everyone’s working week.

Really surprised at the people who think that it's outrageous that GPs select cases in their area of interest once the really urgent sounding stuff has been addressed. I would expect this to happen whether it's a GP callback system or receptionists briefed to funnel patients towards the most suitable doctor, if available.

triaging GP appointments to ensure the best use of time means they can free up GPs to take the time to properly assess patients who present with MH issues.

This is true...I have a GP friend who has an interest in mental health. She'll pick these over the routine stuff; if there aren't any she'll mop up the other stuff while her colleagues deal with calls in their area of interest. Of course they all get a bit of everything as they don't all consult all day every day and if urgent it gets dealt with by whoever is free, but if someone has an interest and has done CPD in a certain field, what's wrong with them tilting their caseload that way? Everyone's a winner I'd say- patient, doctor, the other doctors who have to do a bit less of stuff that floats their boat. She tries to get the MH cases into a slot before a catchup slot so they can effectively have a double appointment as she says they usually need more time.

powershowerforanhour

What if the Dr with a special interest in a certain area isn't very nice or a patient doesn't like them for whatever reason or they just aren't particularly competent? Why should i, as a patient, have to see them just because they have an interest in dermatology for example?

@privateeyefan you still haven’t properly addressed your obligation to meet the needs of people with additional needs under the Equality Act. You must make reasonable adjustments for people with impairments i.e. those who are Deaf, have learning disabilities or mental health conditions etc. Many people have disabilities, yet live alone, with limited support. Saying they can book online is not a reasonable adjustment! For some people, contact with a GP is some of the only contact they have with other humans. GPs play a very important role in referring to social care.

I appreciate you are overworked, underfunded and under pressure but you are unwilling to consider other opinions. I have been undertaking some work with people with learning disabilities and the stats on these people dying early and unnecessarily is shocking. GPs play a role in identification and prevention but only if the at risk patients can meet the requirements of your flawed triage system.

On a personal level, I am beyond caring if a receptionist knows my personal business but I’m not so lacking in empathy that I don’t accept there are many people who do find it deeply painful and difficult.

@Alwaysunderwhelming the hospital I work in checks for patterns at random to cross check notes are accessed legitimately. We get a print out and suspicious activity would alert someone. Looking at notes for more people than the clinic had on their books, staff who'd rarely need access using it more regularly than expected and family members. It's all audited at my hospital!

I think from my experience a lot of problems arise when the patient says they need an urgent appointment but will often be unable or unwilling to come in at the time you give them. At our practice if a patient needs a same day appointment you have to book them in that morning. Afternoon same days are available to reception after the afternoon break in phone calls. Quite often I have offered a patient a same day appointment to be told they can't make the time because they have an appointment elsewhere. So then I will offer the next convenient time for them which may involve a wait. Or they might want to see a certain doctor and despite telling them they are on holiday for a fortnight they will complain about the wait.

I will always advocate for patients that are struggling to get in because of transport problems or caring responsibilities. But we are not there to try and fit around your online shop delivery or anticipated time that your boiler engineer might arrive. Which are genuine reasons I have had for people turning down the time I have given them for a same day appointment. We do not have a finite number of appointments and we have to manage the system in w certain way which means offering the first appointment available.

It doesn't look like the OP is coming back - too many questions she can't answer and a failure to accept that not every surgery works in the same way.

The receptionist triage and three week delay for an appointment could have had a very different outcome for my husband. Whilst I fully support patient triage this has to be done by a HCP and not by non-medical admin staff as seems to be the way it works in many places. I don't care how experienced a receptionist is they are not trained to spot red-flags.

What if the Dr with a special interest in a certain area isn't very nice or a patient doesn't like them for whatever reason or they just aren't particularly competent? Why should i, as a patient, have to see them just because they have an interest in dermatology for example?

Well presumably to hate them you have to have met them or talked on the phone at least once. So you can ring and say, " I need an appointment for my eczema...anyone except Doctor SkinPrat please". If it's a needs-seen-that-day and Dr SkinPrat is the only one with free slots you'll take them and be grateful (unless Dr GynaeNice sees the list and agrees to swap her tonsillitis case that's booked in at same time as your appointment with Dr SkinPrat). If not that urgent there might be a bit more leeway.