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.

But ops post said everyone gets a call back on the day??

It appears each surgery has its own rules. I didn't make the triage list so no call back. It's laughable... until someone dies.

Quite @bathsoup

I can only imagine my polite, affable Dad, didn’t make ‘pneumonia ‘ sound urgent enough for his GP receptionist.

My gp’s surgery is a real mixed bag. The reception staff are part time and have a habit of not informing the next receptionist coming on duty what tasks they have left half done. So repeat persciptions don’t get to the doctors for signing. Messages don’t get passed on and call backs can be two days later.

When my husband was under hospice care. His drugs would be decided by the hospice doctors. They have the best understanding of pain management so they would be the one who decided on what drugs and the doses but they couldn’t pescribe and give out the persciption. So the system worked by them facing though to our gp the relevant information for him to write out the perscription. More than once I would physically watch the fax go though the fax machine at the hospice only to get to the gps surgery an hour later for them to deny they had received it. Theses were items like oral morph, gaberpentin and fentanyl patches so major pain relief which was only given out in a few days supply at a time so I didn’t have backup or spares and my husbands dosage was going up practically daily.
What was happening was a part timer was half dealing with it then going home and no one was any the wiser. These things just made a difficult time even more difficult.

I had this many years ago, aged 14. No mum. On my own in surgery. Wanted an appointment to discuss horrid acne.Receptionist grilled me, did I want to go on pill, was it my periods? In front of packed waiting room. It was mortifying. Sounds like nothing has changed.

No @Mammajay the OP (who I notice isn't appearing to stand up for their 'principles') actually said

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

Deconstructed male boss was out this morning so I was able to call the doctors (9.30am, got through almost straightaway, yay). Reception desk is right next to waiting area.

Receptionist: How can I help you?
Me: Hello my name's Freda Bloggs...
Receptionist: Fre-da B-loggs...
Me: I've received an invitation for a cervical screening...
Receptionist: You want to book a smear test?
Me:

What can you do eh?

What a messed up system.

I live here in the U.S. and here's how we go about it. You phone when you want an appointment and the lady at the doctors office asks if they've seen you before - if the answer is yes she looks you up on the computer. When she has you on her screen it typically goes like this;

Her - "Would you like a morning or afternoon appointment"?

Me - Morning. Late morning if possible.

Her - We can get you in Tuesday at 11am. Will that work for you?"

Me - Yes, that'll be great.

Her - Do you have any changes to your insurance? Are you still at ..." your address here.

Simple.

I couldn't imagine telling someone my medical problems in front of other people. How awful!

My GP's office never asks what I want to see the doctor for and neither did the GP's I saw for many years before this one. If I'm feeling really unwell I'll ask (when I phone) if it's possible to see the doctor that day and if it's in the early morning they'll squeeze you in that afternoon.

I saw my GP just today and in the waiting room/reception there were just two people waiting (including me) and this elderly man telling the two receptionists all about his recent trip to southern Idaho to look for property/house to buy. He droned on and on very loudly. He wasn't at all keen on Meridian, Idaho. He reckoned it was as big as Seattle and suspected it had a lot of crime. lol I would not have liked to have heard him shouting about his erectile disfunction problems or his backed-up bowels.

Telling the receptionist my probl has twice got them to transfer me to a nurse who has been able to find an appointment. Perhaps more surgeries should make a nurse available to triaj some of the calkls.

@Panicmode1 - mine has this recording too!

Been lurking on this thread a while. Haven't rtft but have read all OP's posts - though unless they've had a name change fail they haven't posted for some time as far as I can see.

"Seriously, what do you expect us to do? It is not the fault of the NHS or each individual Practice that we are under funded, under staffed and under resourced" none of which is patients fault either!

"If you don't like it (and trust me we absolutely hate it) then do something about it. Vote cleverly (locally and nationally)" the same - and more - could be said to hcps. They have the additional ability to feed back to professional organisations and govt agencies of the difficulties they and their patients are facing RATHER than aiming their frustrations at the patients who are largely powerless and often vulnerable.

Some hcps even feed into the narrative of patients should be unendingly grateful and unfailingly appreciative - even when they've had poor service because "it's free" - because it's NOT free we all pay for it and we all deserve professional and caring treatment whatever our health issues, yes even supposedly "self inflicted" issues - because it's NEVER that simple, and actually the vast majority of ill health IS self inflicted because none of us live perfect lives!

"The NHS is not free. It is free at the point of delivery and I for one am sick of being expected to gratefully jump through hoops because those who work for it seem to think they are dping me the most enormous favour." Hear hear! Hcps are not gods! They are employees doing a job.

"but let's not forget the NHS is free." NO ITS NOT!

On the particular issue at the heart of the thread I think it's very telling of an arrogant and thoughtless and lacking in awareness attitude that means the op hadn't considered before posting - and even worse before supporting such a system at their surgery that:

1 Patients may have communication issues AS A RESULT of health issues - from being hard of hearing to speech impediments, to social anxiety to leading difficulties to lacking the MEDICAL knowledge to know to highlight certain symptoms to the ALSO not medically trained receptionist that an hcp would know to query/suggest.

As a former hcp myself I can see just with THAT issue that very ill patients could easily be overlooked leading to AT BEST more distress/discomfort for the patient and AT WORST potential for fatalities.

2 that patients that have experienced unprofessional, gossipy receptionists (and they definitely exist! I've had this issue myself as have several friends/family - I had to laugh at the suggestion to complain to the practice manager! Ime complaining about ANYTHING To most GP surgeries gets you marked as "that patient" and subsequently receiving an even poorer service! It can even result in being removed from that Gp's list - a major issue where I live currently is that gp's remove patients for the most ridiculous of reasons and it's impossible to get taken on by another until the relevant agency intervenes) either at that practice or another may well be understandably reluctant to disclose certain information, especially in small towns/villages where "everyone knows everyone" my current practice the layout within the practice is such that the ONLY private spaces are the Gp's/nurses office and the toilet! It's all open plan!

3 that patients making appointments by phone/accepting the call back from the GP could well be in a public place at the time! I can't think of anyone who'd be happy to discuss their vaginal thrush, potential unplanned pregnancy or erectile dysfunction while in the bloody queue at Tesco!

I also agree that rather than saving time it's WASTING time by adding an additional phone call to the one made by a patient to make an appointment!

"The triage system is the only way we can ensure that everyone who needs an appointment within 48 hours gets one." Bullshit! Many other GP surgeries work differently are you REALLY trying to say they don't treat their patients efficiently and effectively? Are you REALLY trying to say there are no flaws in your system that mean that patients who DO need to be seen urgently won't be? Despite a very long thread filled with reasons why this may indeed be the case?

"If you don't understand human vulnerability and emotional needs you are not cut out to be a GP."
Completely agree! Unfortunately there are a fair number of gp's like this.

I've also experienced receptionists - with NO medical training? NO knowledge of certain conditions and WITHOUT full knowledge of the patients history try and tell me myself or my dd DON'T need urgent appointments when I knew we DID and the gps have later agreed! Dd and I have certain conditions which mean that certain other conditions that can occur need more urgent treatment than they would for patients who don't have the long term conditions we do. Eg I have asthma, I also as a result of infections and certain surgeries have reduced lung function which mean that if I get a cold/flu type bug I am SUPPOSED to contact my GP ASAP to get prophylactic antibiotics - this is what I have been told to do - and they also want to see me in person to assess me fully. I've lost count of the number of times an UNQUALIFIED receptionist has given me the "you don't need to see a dr for a cold" spiel! Yes that may be true for most patients but it's NOT true for all patients. Dd has eds, as a result she has had many issues with one eye including a particularly bad infection a few years back that almost resulted in her losing that eye. Again we were TOLD that in the year - 18 months following if she had ANY symptoms with that eye again we needed to make an urgent appointment to see a GP - in our area there is a setup where MOST patients with eye issues are asked to visit an optician first as they can deal with MINOR infections and symptoms and can advise if a Drs appointment is necessary - dd had 3 further infections in that time period and EVERY time I had to explain/argue with the receptionist that I understood that USUALLY patients should visit optician first BUT that we had been TOLD to do it this way as a result of dds previous issues. That's just a couple of examples. There have been many discussions of this type even though I've raised the issue with several GP surgeries where this has been a problem, been promised it would be sorted...only to have the same nonsense the next time an urgent appointment was needed.

"Tbh this is the symptom not a cause. GPs are understaffed so they have to use this stupid system." It's off topic somewhat but there are several reasons imo why there are "too many" appointments needed by patients -

1 incompetent hcps misdx, often as a result of not really listening to patients.

2 Cuts to other areas of Nhs - eg in my area we've lost maternity services, paediatric services, a&e services have reduced hours, the sexual health clinic has had its services and hours severely reduced, mental health services are woefully inadequate, we've lost 3 dental practices and 2 opticians. All those patients still need to see SOMEONE!

3 Reluctance of GP surgeries to refer to specialists - there are many reasons for this but one is its financially disincentivised. There are in my opinion from my own experience and from discussions with friends, family and on here patients presenting with obvious symptoms of certain conditions which need specialist support and treatment who are fobbed off for DECADES by primary hcps who are trying to avoid referring to specialists. I've had this myself with endo (14 years until DX) and dd (12 years until DX),my mums had it (5 years of clear symptoms until gall bladder disease DX). I posted a there's discussing medical mysogyny as there are real recognised issues with women patients not being listened to, taken seriously and also because certain conditions present differently in women and are therefore "missed". The conditions that most frequently came up as patients reporting clear symptoms for very many years before finally getting DX were gynae (which I somewhat expected) but also thyroid conditions and gall bladder disease. It's unacceptable not only in terms of patients suffering BUT because while they're experiencing symptoms they are of course making multiple appointments with their Gp surgery to get the symptoms treated! It's a horrific waste long term of primary care resources and can result in more expensive treatments becoming necessary - surgeries, transplants, mental health services... And also costs the economy in other ways - lost work time etc

If I'd had my endo DX and treated in the early years of my reporting textbook symptoms of the condition, I would have had far fewer days off work, it is entirely possible I wouldn't have had 2 mc and a twisted ovary, the 2nd mc and twisted ovary required surgery which I can't imagine was cheap! And also meant I was off work again.

4 Some healthcare "remedies" and practices are CAUSING further problems for patients which aren't properly addressed - I'm thinking in particular of the utterly scandalous way mirena is being pushed on women and then when they experience distressing even harmful symptoms hcps are refusing to remove! And again costly to the economy in indirect ways too. Again there are some dodgy imo financing reasons why this is occurring

5 Hcps being allowed to not deal with certain aspects of healthcare for "conscience" reasons - particularly thinking of contraception and abortion - which can often result in wasted appointments. I'm fully expecting op to say "well if receptionist knows that's why they want to be seen they can be directed to Drs who are fine dealing with these".

But...
A - it is not an hcps business whether a patient wants to use contraception or access abortion services other than healthcare issues

B - not all hcps are open about this. Some are (nastily and sneakily imo) not open about such views in order to get hired, and I suspect possibly also in order that they may be able to prevent patients from accessing these services.

If those 5 issues were addressed I strongly suspect there'd be a LOT more appointments/resources available for us all!

"I hope their is some sort of automatic flagging up in the system for patients who have a learning disability or autism etc." Aye right! I have outright allergies to certain meds (not intolerance/side effects but serious allergies) which aren't even flagged! I've had gp's prescribe me meds I'm ALLERGIC to which I didn't recognise as I knew them under a different name and the PHARMACIST very LUCKILY picked it up!

"Utter rubbish. The symptoms of ecoli are very obvious" yea cos hcps NEVER make mistakes eh?

"What I am frustrated by is our inability to hold onto receptionists, because they can’t bear the abuse they get for asking what the problem is, as we direct them to do." Ah so it's BECAUSE of your ridiculous system which patients ARE voicing their objections to which has prompted this post! Now this thread has surely shown you WHY they hate it. So your claims that its better for patients, that it's worked at your surgery for X years etc are BULLSHIT!

No patients shouldn't be abusing receptionists (though I am somewhat sceptical as to if its actual abuse they're getting or simply frustrated, anxious patients expressing their feelings! Ime some surgeries class even questioning their practices of this type as "abuse") BUT you're COMPLETELY ignoring the FACT that your patients are very clearly NOT AT ALL happy with you running things this way.

You've repeatedly on this thread dismissed or ignored very valid points where posters have pointed out WHY your system is shite!

"B) there’s no need. Our receptionists don’t ask questions. They simply ask for an outline of the concern and type down what the patient says." Wow the sheer huge level of arrogance to post this after SO many posts outlining EXACTLY why there IS a need to change the system!

"Since most practices are run as businesses, maybe you could take a pay cut out of your six figure earnings to pay for a nurse?" Yep! Or from the surgeries profits!

SOLUTIONS?

1 DON'T treat your patients like idiots who are incapable of assessing their needs! The vast majority of patients know their own bodies and whether they need an appointment or not. TRUST patients and don't patronise them. Build good relationships with your patients - instead of treating them like an ungrateful inconvenience!

2 address the issue of patients who aren't as clued up or able to assess by educating them, where possible, my GP surgery has posters, info on their website and the receptionists and hcps also explain to patients that for certain ailments and conditions they could be perfectly well served by other community hcps like pharmacists and also that they can direct refer - ie make their own appointments with: Chiropody, primary care mental health, physio, the diabetes nurse, addiction service and dietitian.

3 offer ways for patients to give a brief description of their symptoms which won't involve them announcing them to all and sundry!

Years ago I had a great GP surgery who used a numbered ticket system which meant they didn't even call your name when calling through for appointments, and where (if patients wished to tell receptionists) they could write down symptoms on a notepad for receptionist, or if by phone appointment they plain trusted patients when the receptionist asked "emergency, urgent or standard appointment?"

With modern tech there's no reason why online or text services couldn't be used for those patients happy and able to do so.

4 free up appointments by addressing the issues I mentioned before that result in patients ending up having multiple appointments for the SAME condition unnecessarily.

5 invest in recruiting and training receptionists who are professional, discreet and compassionate. Train them to appropriately serve those patients with conditions/issues which can make communication difficult.

"Really hoping that privateeyefan is not really a GP." Agreed I suspect they're actually a receptionist - have you noticed there's been practically ZERO criticism or even acknowledgement of pps criticism of receptionists?

There are also certain other comments/the way they've worded comments and the way they've avoided certain questions which make me think this.

"Wouldn’t a better use of your time be to actually see patients rather than poring over a list of names and complaints , then phoning people up and booking them in for an appointment?
if that takes an hour , isn’t that time for 6 appointment?" Exactly!

"No, because so many of the people who ring up thinking they need an appointment do not need one, and their concern can be dealt with satisfactorily over the phone." What you're describing here is actually a telephone consultation. Which many surgeries now offer patients and don't mis-describe it. It's comments like this make me think you're a receptionist rather than a GP.

"What OP is describing is not triage." That's one of my reasons for thinking this too

"If someone is deteriorating that quickly, then they need to call an ambulance." And another one making me think that.

"So reasonable adjustments aren't being made." I genuinely don't think op understood what you meant, or what the regs are around this - because they're not an hcp.

Also I'm getting the feeling they don't fully understand how patients can complain about issues with their GP surgery. Repeated advice to "complain to practice manager" which is not always the most appropriate or efficient way to complain about certain issues.

"All complaints are handled confidentially. She would never be told who had made the complaint." Yep! I'm fairly sure now op is a receptionist and not even a very well trained/experienced one.

"No she's being selective about the questions she answers" VERY! Studiously avoiding addressing queries from those posters who clearly DO understand the rules and regs on very basic areas!

And some very odd answers to certain questions too.

"OP, who you are quoting, is a GP there's a good few respondents aren't convinced of this!

"I’m surprised that a qualified GP is writing this sort of thing on mumsnet" you're not the only one.

If we want an emergency appointment at our go surgery then the receptionists will ask what it's for but can only get an on the day appointment if we phone between 8 and 830

Anything non urgent they don't ask about, in general there is a 3 week wait if they are really busy

You say it reduces your chances of a same day appointment OP? At our GP surgery it reduces you chances of an appointment full stop. I have changed GPs because the receptionist told DS1 he had a viral infection and didn't need to see the doctor/nurse. He rang up every day for a week and was diagnosed but the receptionist. He ended up in A&E with pneumonia. Also DS4 has bouts of tonsitilitis. I phoned fo an appointment and said I think he has tonsillitis again. "Are you medically trained? Then I doubt it's tonsilitis" and she again refused an appointment. DS4 was 6yo

OP,

I hope you are listening to what people are saying.

You are a professional and are offered vulnerable people’s confidential information based on the fact that they know you have had many years of training and are in possession of a good brain.

Imagine walking into your divorce lawyer’s office and having to tell the receptionist private details about your marriage. Or walking into your tax accountant and having to detail your earnings to the village gossip. Make you feel uncomfortable?

I think that, due to the pressures of the useless NHS, and it being ‘free’ (haha), many GPS have lost sight of the privileged position they enjoy and how they are entrusted with many people’s greatest fears.

Every time I read this kind of thread I am so pleased I use a private GP and do not get treated like a body attached to a symptom.

@Graphista very good points there. The OP’s comments do seem off for someone in their position.

The problem I have is with receptionists who don't know, don't think to look, and don't give you a chance to explain about the relevant clinical context to your concern.

Went to see GP to ask for a walk in as soon was having breathing difficulties and we were just near GP surgery.

Receptionists: I'd go home and wait if I were you, the GP has a long list of people to see, it will be hours

GP clearly looked at DS clinical history and called him in next.

The worrying thing is, someone less confident that me might have taken the receptionists "advice"

All well and good but as others have said, not the same system in every surgery.
We have the "phone at 8.30 am" system too... it's like the old days trying to get concert tickets. No triage.

1 DON'T treat your patients like idiots who are incapable of assessing their needs! The vast majority of patients know their own bodies and whether they need an appointment or not. TRUST patients and don't patronise them. Build good relationships with your patients - instead of treating them like an ungrateful inconvenience!

100% THIS

The worrying thing is, someone less confident that me might have taken the receptionists "advice"

This is my biggest issue. When I was told by a receptionist that the whites of my eyes turning yellow wasn’t sufficiently concerning for a GP appointment, I googled and obviously found that it’s very concerning, and went to A&E. Someone in a more vulnerable situation may have believed the receptionist, or just not wanted to make a fuss by using urgent care (elderly people are especially prone to this, and are obviously less likely to look up own symptoms).

In the OP’s case at least a GP is the one considering the symptoms (I still think their stance is poor), but I don’t think that’s the norm in ‘triaged’ GP surgery’s.