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.

*Oh yes...

See the post bellow yours?*

But the op is calling all the patients on the list the same day. Nobody is not being called back that day based on what the Receptionist has written down. The reason for visit is just affecting what order the op calls people back. So if it says "short of breath asthma flare" she will call them first, if it says "thinks has a UTI" she will call them back once urgent patients spoken to as likely to need antibiotics, if "needs letter for school about allergy" then she can leave that call until later in the day after unwell people dealt with.

We have just started with ask my gp and its great. Anytime i need an appointment i can put in a small description and request a specific person. Then you add more details and a pic if you want. Then they email or phone you back when they are open with an appointment. Each time ive done it i saw someone pre 9 am when i would have still been trying to get through on the phone beforehand

@alb1 after 9 months I have plucked up courage to make an appointment for what is now showing itself to be pnd......I have to wait a month to be seen!
Again, I appreciate the NHS is underfunded, but the courage it has taken to book that appointment is unbelievable, I can't describe how many times I have attempted to do it and failed and now I have to wait a month to be seen.

I hope their is some sort of automatic flagging up in the system for patients who have a learning disability or autism etc.

I don't think it is the priority thing it is more the way reception handle people that maybe giving over sensitive or what they perceive to be sensitive information ...often in a public area and with sneering or rude receptionists that is what most people have complaints about IMO

OP, have you just had a complaint made against you? You sound more angry with your paitents than I would think usual (yes, I'm a doctor too).

wish I’m really glad you’ve managed it, it takes a lot of courage. A month seems crazy though! But you’ve done the first step which is great, I hope things work out for you

She tried to diagnose her over the phone and in person. She would not allow a GP appointment nor would she allow her to see the nurse. My Daughter eventually collapsed and was taken to hospital where it was quickly discovered she had ecoli. The receptionist knowing the symptoms my Daughter was experiencing didn't help and I think it's dangerous to allow someone with no medical training whatsoever to be part of the decision making process when dealing with medical issues.
Utter rubbish. The symptoms of ecoli are very obvious. If you had not been able to get a same day appointment why didn't you just ask for the next available one? I'm pretty certain it wouldn't have been 3 months later!

How many people want to say to a receptionist, whether over the phone or not:

• I’m impotent
• I have a major coke problem and need help
• I’m feeling suicidal
• There’s a smell like mouldy fag ash coming from my front bottom

I mean, really.

The OP does need to show more empathy. I get why empathy might be in short supply, in such a dysfunctional system.

I agree that for most people giving a brief description is fine but for someone who is profoundly unwell mentally then they really are not always able to give a one line answer. I understand what you are saying but I think if someone says that they can't talk about their problem it should not be assumed they are being an arse.

HI OP

Interesting post. I can see why you have to work that way, especially if you are under resourced and if a lit of patients request an appointment for a normal virus or because they want anti biotics for a cold - it makes total sense to filter those people out

On the other side of the fence, I have to drop my kids at nursery at a certain time. Then I'm on the train to work. At my surgery they offer same day appointments mostly, but you have to call within a 10 minute window, which is when I'm on the train (and I imagine the vast majority of people who work in a major city in a 9 - 5 job). I'm not squeamish and I dont mind discussing most things on the phone but there are some things I'd be very uncomfortable everyone hearing. I cant get the earlier train due to nursery drop off times. I would struggle to get the later one as I know I'm already missing time out my day for the appointment I need later. I'd be a bit annoyed at your practice if I was put at the bottom of the list, it's not because I dont want the receptionist to hear but about 20 of my fellow commuters.

Do you think there is any sort of compromise that could be reached in those situations? What do the receptionists say if someone says sorry I cant say I'm on a train?

Thanks

My GP doesn’t operate a triage system, but a on the day system -tends to end up with a 8am rugby scrum on the phone/ reception. However if you go in afterwards and speak to the receptionist, detailing this issue they can depending on the issue add you to the emergency list. I did this last week, I saw a GP within the hour, and now I have a two week referral to the breast clinic!

Awful system which is why I often use a private GP or an online GP for anything sensitive.

My new practice has a ‘ring at 8.30 am’ system which is great if you’re alone, have privacy and time to re-dial multiple times. I work full time, so Im usually at work where there’s no privacy to discuss my bowel/bladder/menopause issues. You’re not allowed to just turn up (tried that). The online booking system never has any availability either.

Ive also witnessed GP receptionists giving out confidential and sensitive information either over the phone, in person or whilst chatting amongst themselves about patients. There is no private area and they seem to think that because they sit behind a glass screen, we cant hear them talk about Pamela Ward’s rectal prolapse.

I really don't think it's appropriate to ask patients to discuss their private and confidential medical issues (which may be embarrassing or personal) in front of other patients in an open plan reception area. And then "punish" them for not doing so by calling them last and potentially not offering them a same day appointment.

It's also not ok to insist that a patient discusses these issues with anyone they don't wish to, and again punish them if they don't.

My surgery does not require us to do this so I can't see why it is necessary to abuse patient's right to confidentiality and their right to share their personal information with whom they wish.

I tried to book an appointment last week via the automated booking system and the first available was 2 weeks later. I phoned to speak to the receptionist, told her what was wrong with me and asked if I needed an urgent appointment or should I just wait 2 weeks. She booked me in for the sit and wait slot that same morning. My symptoms turned out to be caused by extremely high blood pressure so going in that morning was needed. If I hadn't told her my symptoms and waited 2 weeks I might have had a stroke!

Seriously, what do you expect us to do?

Sort out the practice systems so it runs more efficiently.

Apparently it’s beyond my surgery though.

OP, have you just had a complaint made against you? You sound more angry with your paitents than I would think usual (yes, I'm a doctor too)

No, I haven’t. 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.

We’re currently 2 full time receptionists down and struggling to recruit more. Which of course means that it’s going to take a lot longer for patients to get through when they try to call us.

OP- have you made sure the lay out of your reception area ensures no one has to discuss their symptoms in front of other patients? Ours have this triage system, and a great big open plan reception and waiting room. It's awful and gives the impression that people should be grateful for an appointment, not entitled to one.

I do wonder how long the GP system in the UK can last. DHs company is introducing virtual private GP service, you just book it via email so dont need to loudly tell people what your issue is over the phone/in public and then a doctor will Skype you.

This is expensive, but middle class people are just giving up on NHS GPs if they can get private access. I worry it'll end up like dentistry, where while you might be entitled to state provision, in many parts of the country unless you can pay, you dont get access to care.

The triage system is a sticking plaster to cover the fact you dont have enough appointments to cover the need.

wishmyname well done for making the appointment - sorry you have to wait so long but hang in there

No, I haven’t. 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.

Sounds like your system is not working.

"OP you are being VVU. Sometimes it takes every scrap of courage a person has to go and see their GP and the thought about having to explain something, anything, twice is just too much to bear, however brief. I agree that isn't rational, but it is how human beings function. If you don't understand human vulnerability and emotional needs you are not cut out to be a GP."

Completely agree wit this! Sadly too many doctors in my experience forget that they are treating people.

My previous doctors had this system and I found it awful, I have autism and can't express myself well on the phone, having to do it twice meant I rarely rang up and when I did I often found myself just having a telephone consultation or a nurses appt when I needed a doctors as I didn't explain my symptoms well enough to get an actual appt.
I'm at a doctors now where I can online book or ring up and ask for an appointment no explanation needed and found it much better.
I think for some groups of people, like those with autism or learning difficulties or social anxiety it's not the best, likewise for 3mbarrising problems

This system obviously has it's problems, but it's a symptom of the immense pressure GP surgeries are under. They are all trying to find the least-worst way of managing too much demand for the available appointment numbers.

If you had 20 same-day appointments available and 60 patients requesting an urgent appointment, how would you determine who receives one?

First come first served? GP calls everyone back to triage? Mix of both? There isn't a perfect solution.

I've been a patient at a first come first served and I think that was hardest if you were actually unwell as you had to phone repeatedly at 8am on the dot, once I phoned 56 times (!) to get through as DH was too unwell to do it himself. One call he could have done, but not 56.