GP's receptionist

[LemonMeringueThreePointOneFour]

I got some blood tests back today which slowed slightly raised MCV and MCH. I know from past experience that sometimes if a test result is only just outside the normal range the GP isn't concerned and doesn't require a consultation or need to prescribe treatment.

So I spoke to the receptionist and said that I had slightly abnormal tests results and wanted to find out whether the GP thought they needed to discuss it with me (I was very careful with my wording and to speak clearly). She said, "We don't have any appointments today."

I tried again and said I wasn't sure that I needed one, but wanted to establish whether the GP thought it was necessary to see me. She said, "So you would like me to book an appointment?"

I tried for a third time and said that no, I didn't want to take up an appointment if it wasn't necessary, but would like to know whether anything should be done about my marginally abnormal test results.

Finally she got the message and went to check, then came back to say the GP didn't need to discuss (as I'd suspected).

WIBU? Was I unclear? I really felt like I was speaking a different language. They may have been busy at the surgery as I was on hold for about ten minutes - although when I've been in there I've noticed they don't really seem to react to the phone ringing.

They are generally a bit shit at that surgery (their rating is poor), but I was trying to save NHS resources and don't understand why my question was so hard to convey! Not a big deal, but I just found it a very enervating experience.

Oh, and if anyone could tell me what raised MCV/MCH means I'd be grateful.

I ring the doctors all the time about blood test results the receptionist usually says the doctor hasn't looked yet the doctor says carry on no changes to your meds or the doctor wants to talk to you. one occasion the doctor rang me the lab got my results and rang her immediately stating it was urgent my meds were upped I was very close to a thyroid storm that day!

@Elsiebear90

I’m a ex blood scientist, slightly raised MCH and MCV are nothing to worry about at all. I would just make sure you’re not drinking too much alcohol and you have a good diet, as these can be causes of raised MCH and MCV, and if you are deficient in anything or drinking heavily it can cause anaemia over time, but since yours were only slightly raised it is may just be normal for you (about 5% of healthy people have results outside of normal ranges). My RDW and lymphocytes are always slightly high and there’s nothing wrong with me.

Many thanks for the reassurance - I appreciate that.

No, I've hardly been drinking any alcohol as I don't tend to drink on my own. Maybe one or two units a week, often less.

@LemonMeringueThreePointOneFour

Yes, agree. I'll get flamed for this, but the public sector, at times, can have a difficulty with service delivery. We pay for the NHS through taxes, so it's not provided 'free' and the service should reflect this. There are a number of admin staff who are very good - others would not last 5 minutes in the private sector.

At my surgery we have Gp text messaging for people with mobiles which advise what action they need (if any) after being reviewed by the Gp
However there is an expectation that as an adult you have a degree of accountability and should follow up your results so the blood form asks you to ring if you don't want or don't have a mobile , they run a dedicated results line with clinically experienced staff where patients can ring for advice or clarification and to make appts, which frees up receptionists and also to contact vulnerable patients who may not be able to do any of the above
After all if you go to the Gp and are asked to have a test , why wouldnt you follow up on those results
It works really well

@sadpapercourtesan

Personally I would prefer GP receptionists to stick to booking appointments, rather than taking on a triage role they are not qualified for, and asking intrusive questions about medical matters.

I think you could have been a bit clearer - if you wanted her to ask the GP whether he needed to speak to you, you could have just asked her to do that.

Amen. Yes indeed, most of these people vary by degrees of awfulness and interference, and seem to think it is they who are the "Medical professional" And do just as you say. They also display a level of obtuseness which staggers belief.

[quote Keyring]@LemonMeringueThreePointOneFour

Yes, agree. I'll get flamed for this, but the public sector, at times, can have a difficulty with service delivery. We pay for the NHS through taxes, so it's not provided 'free' and the service should reflect this. There are a number of admin staff who are very good - others would not last 5 minutes in the private sector.[/quote]
Indeed. I can't think of many professions where those in the more senior/busy roles would thank their PA/admin assistant for booking in a meeting when a quick informal query would have resolved the issue.

They also display a level of obtuseness which staggers belief.

Clearly some PPs think I could have been clearer, but it did feel a bit obtuse when I started explaining for the third time what I was asking.

This is what happened at my surgery today. Ask My GP went on at 8am. It was planned for 3 GPs to be in work. The Locum didn't turn up so just 2 GPs with work for 3. The Ask My GP system crashed just after 9am and didn't come back until about 11.30am.

The queuing system for the prescription line malfunctioned so patients were being cut off after 2 rings. however some were getting through. I tried to ring the phone company on the main line but every time I picked it up to dial out a patient got through complaining about the prescription line not working. They were quite put out I couldn't do their order. If I did then it would delay me seeking help to get the phone line sorted. I'm not one to get flustered or stressed but by God I did today. There were only 2 Receptionists on duty and I worked 1 1/2 hours overtime to deal with the backlog of handwritten prescription requests.

Luckily our test result line goes on later and the action for results are there for the Receptionist to relay. If there is no answer it's because something has gone wrong with the results inbox then the GP would have to be asked, but not immediately. It's not the Receptionist's fault if the answer is not there and as people like to point out we aren't medically trained to discuss blood results or anything else.

I worked in both the public and private sectors for some year each and this" public sector is leas efficient" argument doesn't hold water.

YABU, because by asking the GP to review your results you were effectively asking for an appointment, but just being obtuse about the process.

So were you expecting the Receptionist to note down your levels, then relay them to the doctor, then relay back to you what the doctor said?

Wouldn't it have been easier and less prone to mistakes or human error being made for you to just talk to the GP yourself, in a phone appointment?

@MaggieFS

YABU, because by asking the GP to review your results you were effectively asking for an appointment, but just being obtuse about the process.

Well exactly! Either way, the GP has to note the results and relay an opinion back to you. Why you wanted the Receptionist involved as well I have no idea.

@LemonMeringueThreePointOneFour

If the test result is normal, ours justs sends a text that says "test result normal, no further action required".

How eminently sensible!

Wow what a good idea. My surgery never notifies you of any test results so you have to ring and check. You could assume they would ring you if there was a problem, but I’m never quite sure of this and they always seem vague when I ask.

@MaggieFS

YABU, because by asking the GP to review your results you were effectively asking for an appointment, but just being obtuse about the process.

My gp reviews the blood test results as they come in and marks them accordingly no action needed or action needed if I dont ring in they text me or write a letter asking me too occasionally I get messages on my prescription no point in wasting time on an appointment if its not needed

There aren't just doctors hanging about to look over blood results when a patient calls in. You should have booked an appointment to discuss the results.

YABU imagine if 50 people ring with just a minor question for the Gp but don’t actually want to do this via an appointment. They wouldn’t be able to get anything done. Especially naive to ring for a non-urgent issue after a 4 day weekend.

@Theunamedcat But this hadn't happened in the OP's case. So rather than book an appointment which could have been a two minute phone call at a time which suited the GP, she spent blooming ages clogging up the phone line trying to request something which obviously didn't fit within the structure of how her surgery works. Not saying the surgery couldn't do it better, they obviously could, but I can't see why the OP has had to make such a saga out of it.

@UhtredRagnarson

This really sounds like a non event tbh OP

Totally!!

I think the OP was entirely reasonable. As a patient you can't be expected to interpret the results, hence her having to call the surgery.

My work means that I give advice to people too - I don't just provide information without interpretation - otherwise I wouldn't be doing my job properly.

It would be great if all surgeries responded with an email or text message with regards to blood results and whether they were in an acceptable range or not and if a further appointment was required. Unfortunately most don't.

In this case op you were being awkward even if you don't think so. If the gp has not commented on your results to say no further intervention was necessary then the receptionist would not be able to relay it back to you, so the fault lies there. Instead the receptionist would have to book the gp's time to take a look at your results and decide, they won't just do it out of the goodness of their hearts, in between consultations that overrun and all the other work they have to do. In this case you needed at telephone consultation booked for the gp to allocate time to look at your results and tell you that they were fine.

I agree with you that this isn't efficient use of time but if the gp had responded to your results in the first place the extra steps wouldn't have been necessary. Sometimes receptionists do have to bear the brunt of a GPS incompetence or oversights. I am not a gp receptionist but do have a lot of contact with them through my own job.

Raised MCV (AKA mean corpuscular volume) and MCH (AKA mean corpuscular hemoglobin) means the presence of enlarged red blood cells. This combination is most commonly indicative of a vitamin B12 or folic acid deficiency. However, there are other potential, less common, causes of this combination.

Hth.

So much like the experience I had recently where I had had a telephone appointment, asked to come in for an examination, a bit slow to arrange it, called to book and ended up speaking to a receptionist who insisted I needed a telephone appointment. I very politely made the point that I had already had one and had to be examined and another telephone appointment was a ridiculous waste of everyone's time and what on earth would be said in the appointment "hello, you need to come in" - "I know" - end of call. Completely blank - like I was speaking a foreign language. I actually really wonder if it's the same receptionist

@Keyring

I think the OP was entirely reasonable. As a patient you can't be expected to interpret the results, hence her having to call the surgery.

My work means that I give advice to people too - I don't just provide information without interpretation - otherwise I wouldn't be doing my job properly.

The issue is not whether the OP needed the results interpreted.

The issue is whether they should have got the Receptionist to run around, or spoken to the doctor themselves.

Don't know why people are being harsh. It was obvious what you wanted, you weren't asking for an appointment. I don't blame you checking, they've messed up my blood results before so reasonable to ask.

@Umbivalent

So were you expecting the Receptionist to note down your levels, then relay them to the doctor, then relay back to you what the doctor said?

Wouldn't it have been easier and less prone to mistakes or human error being made for you to just talk to the GP yourself, in a phone appointment?

No, I wasn't expecing the receptionist to note down any medical details as the test results would have been on my records which they could access on their computer.