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.

You are a GP... a mechanic for bodies... you are not some special entity that needs barriers before people are allowed to see you. All people are asking is that they get an appointment when they need one. Doesn't seem much to ask really does it?

Take up your issues with the government for not providing the NHS with enough money for GP's not the poor buggers that need to see a Dr!

My dd was having mental health issues at the age of 15. Was seeing a psych etc... I git sick of explaining her problems to the school mums that worked on reception. You are misguided if you think this info does not go any further! Even when complaints are made to 'practice managers'.

This system has come about simply because the NHS is in crisis. It is not normal or desirable and does not happen in other countries. I am shocked and sad that doctors aren't open about this and choose to blame the victims instead for being so vain and silly as to not want to tell a stranger in an open public room what their symptoms are so that a doctor can decide whether they will see you in another month or not.

A receptionist is not qualified to triage patients.

The op's receptionist isn't triaging patients, they are writing the reason for the urgent appointment request next to the patient's name, so that the GP can triage.

I phoned my GP surgery earlier this year for an emergency appointment - I'd had a GI bleed, fainted twice and had a high temperature. I have Crohn's disease so assumed it was due to this. Told the receptionist my symptoms and was given an appointment that day.

When I saw the GP he asked what was wrong and said the noted showed that I had a temperature. That was the only symptom the receptionist had passed on so what if they operated a triage system op? Presumably just a high temperature wouldn't have flagged as high on your list op?

The op's receptionist isn't triaging patients, they are writing the reason for the urgent appointment request next to the patient's name, so that the GP can triage.

Oh yes...

See the post bellow yours?

Well this has gone well.

A quick question for you all - what would you like us to do when there are NO appointments? When every GP and ANP and PN are fully booked and have extras squeezed in? When the coming weeks are fully booked and the clinics are solidly booked almost before the appointments are released?

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. If you don't like it (and trust me we absolutely hate it) then do something about it. Vote cleverly (locally and nationally), use your appointments carefully if you manage to get one.
I can assure you that no HCP or admin I've ever worked with is happy to say NO to patients, I hate saying we're full, have no availability etc etc. That's not what we're here for.
But it is a finite resource and that sucks for everyone.

why is first come first served so bad

Because there aren't enough same-day appointments for everyone who wants one, if you phone in order you may find that the people most in need of a same day appointment are at the end of the list when there are no appointments left. Whereas some people earlier in the list maybe needed to be seen within a few days, so if you'd known about the later patients, you could have booked someone else for tomorrow instead.

Last time I called my GP’s surgery it was for my DD. I was a bit taken aback to be asked why my small child needed an appointment, but the answer “unexplained bruising” got her right to the top of the list. 😂

@SoxonFeet mine doesn't work this way either and I live in a very overpopulated area so I completely agree with you. If I want a non urgent app I can usually get one within the week assuming I'm not particularly with who I see and I have never not been able to see someone same day if it is urgent or related to my child. They will ask if you need seeing the same day and you don't get to pick a time, you have to accept whatever they have but you will be seen. I think I have been asked twice if I minded giving them a brief idea of what it is because they were particularly busy that day and personally I don't mind but had I have said I didn't want to explain over the phone I am pretty certain they wouldn't have enforced it. So glad I have the surgery I have as to be honest OP you sound very obnoxious and not particularly someone I'd want to tell my problems to

So in your system someone tells the receptionist what is wrong, they write it down and three drs put the information in order and decide who to ring first. They then phone everyone and make appointments for those who need them. Unless you are diagnosing a lot of patients over the phone, which sounds pretty dodgy as you can’t examine them, how does this multilayer system save time? In our surgery you ring up and ask for an appointment, the receptionist asks if it is urgent and then books it, or you can do it online. Presumably the phone calls and triaging must take a fair bit of time and then you have to see a fair proportion of the patients anyway.

WHY??? Why should I have to tell a non medical staff member my medical problems often within earshot of others? If your surgery does do this then I feel the only way to make sure personal information is not disclosed to others (bad enough the receptionist has to know) is to have a phone in only triage system with a separate dedicated number that is answered in an office away from the ears of others.

What a crazy system. So if I had herpes or severe mental health problems (I don't), I would have to broadcast it to the waiting room to get help?

maltesersgalore

I get it. What the OP should be saying, though, is really that she knows that they are breaching ethical guidelines by coercing patients to tell people other than their doctor about their medical problem, but they have no choice. Not this cold, supercilious defence of a necessary evil.

We’ve had this system for over a decade, and it is explained clearly to every new person who registers.

No one in my family has been to my doctors surgery in the past 10 years.

At the OP's practice the receptionist doesn't triage, clearly.

But many do and that isn't right.

@privateeyefan, Does your surgery apply this policy universally?

For instance, I used to work with deaf people. Can they email into the surgery to book a walk-in appointment? Is there a mobile number they can text? Are your receptionists trained in accepting video relay/typetalk calls?

Because if not, it's a case of the deaf person physically coming into the surgery to make the appointment face to face. And in the past (and still happening) many of them have been pushed to get surgeries to agree to a BSL interpreter for the actual appointment. The idea of them having to try and communicate why they want the want the appointment with a receptionist sans interpreter is .

@privateeyefan just loving the comment that you have to prioritise your time and have none to waste.

And you don't think that's the same for patients who have full time full on professional jobs then. Particularly irritating when:
It takes 40 minutes for your phones to be answered.
Blood results can't be given without a telecon with the dr who returns yr call which you miss because you are in a meeting - rinse and repeat with three 30 to 40 minute sessions of waiting for the phone to be picked up. Can ring for results between 11 and 1. If one rings at 12.40 and phone picked up at 1.05, response "you know yer supposed to ring before one" from a heavy handed ingrate.
Countless repeat prescriptions that either are not done or wrong which involves hours of my time.
The idiocy of 56 day prescribing for thyroxine which wastes your time and mine
The day I had a 7.10pm apt which I rushed home for to find a note on the door to say surgery cancelled.
The fact it can take a 10 week wait to get an 8am blood test and meanwhile the receptionist has a ruck about the dr not writing another one until you've had a blood test.

I have no issue sating what an apt is for. Indeed last time I made a non urgent review apt for dd it gave me great pleasure to say "It's for a mental health review and repeat for hef ads and ritalin - you know for the conditions diagnosed by a private consultant psychiatrist when the local nhs, camhs, refused their services and one of your drs told us to get help off the internet because they don't refer to private services. I did not appreciate the eyeroll - she asked and was told why "I am sorry you went through that" was the only appropriate response.

May I please ask privateeyefan that when you wish to ask patients not to waste your time, you and all GP's ensure their practices are organised in such a way that ensures also that the time of their patients is not wasted, that your phones are answered expediently and your staff are provided with some basic customer service training.

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. They are not and I am not prepared to be grateful for sub optimal service standards.

Finally if you wouldn't mind could you also train yiur reception staff not to call patients "luvvie", "darlin" and "dear". They don't address the GPs like that so they have no reason to address patients like that.

The surgery I go to does this, and I've found it works well; but then I'm not really arsed if the receptionist knows what I want an appointment for, it's highly doubtful they care anyway. However, I can see why people would feel uncomfortable doing so, and in a system where the receptionists are the gatekeepers (which used to be the case here) it didn't work as they had no idea who should be seen really.

I hate that it's a receptionist triaging the patient. I very nearly died when ours decided pneumonia and a perforated bowel weren't urgent.

Surely if it’s that over stretched then your not going to be giving those that need an appointment in a few days a same day appointment just to fill in the gaps anywaY. If you have 50 people to phone and 10 appointment slots it doesn’t take a doctor to work out that only the priority people on the phone get the appointment, also you may be phone them in order but you can still see down your list some people will deff need appointments. It seems like common sense.

We’ve had this system for over a decade, and it is explained clearly to every new person who registers.

So put up with it or shut up basically. How many of your patients actually think this is a good idea and how many just have to put up with it as the alternative is to not be able to see a GP at all. The shit that us mere plebs have to put up with really is beyond belief sometimes.

There's an expectant, belittling, patronising, superior way of asking that can be the thing that puts people off. No respect for the sometimes very valid reasons people don't want to give this info. "You haven't done yourself any favours" in the way you have phrased the OP but it's a good point.

I do agree with you to an extent op. Our GP is basically call at 8am and pray you get through. I've never had an issue with giving basic details to receptionists but luckily I rarely need to go. I do have a lot of respect and sympathy for the receptionists as they must get a lot of abuse . BUT there are a lot of jobsworths out there. And unfortunately we encountered once recently when DH was very poorly.

DH had pneumonia and was in hospital 5 days. Then he had 2 days at home with IV antibiotics being administered by district nurse team. The district nurse team then said he needed an urgent GP appointment so a GP could check his chest , his most recent blood test and prescribe oral antibiotics . When we called at bang on 8am we were in a queue and then finally got through at 8:02 to be told all appointments for day were gone. We explained the situation and the receptionist said 'there's no point in having an appointment because your blood tests won't be on the system yet'. When we insisted they would be she huffed and checked and lo and behold they were there. His infection count ended up being quite high and he needed more IV antibiotics but he might have missed that because we couldn't get past the gatekeeper who thought she knew better than the drs and nurses who'd been looking after DH for a week.

Yes OP I am suggesting in order to follow the GMC Good Medical Practice guidelines you should not have this system in place as it discriminates against those with communication issues, and if you don't know all of the presenting health issues you can't possibly be "triaging" properly.

So in your system someone tells the receptionist what is wrong, they write it down and three drs put the information in order and decide who to ring first. They then phone everyone and make appointments for those who need them. Unless you are diagnosing a lot of patients over the phone, which sounds pretty dodgy as you can’t examine them, how does this multilayer system save time?

We don’t order the patients by priority - it’s an entirely mental process, nothing is written down.

Regarding saving time, the ‘2nd’ and ‘3rd on’ doctors doing triage take these calls in their room. So when they come across patients who need to be seen immediately, they can call them in straight away and see them themselves.

Also, we save about 4/5 of our appointments for people off the triage list. But lots of things don’t need an appointment (e.g. renewing a sick note). Therefore, it makes far more sense to first call those who we know will need appointments so they can be booked in that same day. If we called all the patients who didn’t need appointments first, then appointment slots would have passed unused.