Why aren’t doctor’s receptionists more discrete?

[BakedPotatoBeansCheeseColeslaw]

I’m waiting in the doctor's surgery this morning for something routine.

I woman has turned up wailing that she doesn’t feel very well and asking to see a doctor. The receptionist is doing the “triage” with her but it is extremely public. The woman herself is extremely loud but she’s clearly not mentally very well as she has announced to the room that she thinks she is having a nervous breakdown. However the woman on reception is practically shouting the questions.

I know this woman’s name, date of birth, first line of address and what medication she is currently taking. It’s all very embarrassing.

AIBU to think if doctor’s receptionists are going to ask questions about your medical problem, they should do so privately and not to a room full of patients?

Certain GPs specialise in things such as minor surgery, menopause, dermatology and then nurses do too - is it for the asthma nurse, sexual health nurse or bloods?

It’s faster for everyone and gets you to the right person to just answer the triage. All nurses and doctors aren’t the same.

Then there would be safety concerns. The entire reason why the screens exist - protecting them against members of the public - and why a lot of pharmacies will only have the consultation rooms available if there are more than two people working at the time.

Ha! If you think most people are going to know the last 4 numbers of their NHS number you are deluded.

Not nonsense at all.

The diversity of primary care now means different professionals have different skill sets and roles, even within a role.

Need an implant changing, your HRT or contraception adjusting, your asthma diagnosing or COPD reviewing? the receptionist will book you in with me, the specialist nurse practitioner.

Need a diabetic review? Off to my colleague, also a nurse, who is the diabetic specialist.

Need bloods, an ECG or your B12 injection? That'll be an appointment with our HCA.

Worried about some ongoing symptoms? Can I ask roughly what sort of symptoms? Oh a mole that's changed? let me find you something with Dr D, our GP who has a special interest (i.e. additional training and qualifications) in Dermatology. It's about a nasty cough and fever? Sure. I'll get you an appointment as soon as possible today with any GP.

Back pain, frozen shoulder or hip pain? The diagnostic physiotherapist for you. Oh the nurse said when doing your smear you need the Women's Health physio? Different person, let me book that for you.

Medication review? The clinical pharmacist will do that with you.

Help with filling in your PIP form, questions about support with your demented husband, problems with the housing association? Our social prescribing team can help with that.

Chasing a private referral, requesting a repeat prescription, need a copy of a hospital letter, wanting a firearms license? Our data team can help with that.

The bottom line is primary care has changed. The days of seeing a doctor for everything have gone. Given how much primary care has been decimated we just don't have enough GPs. And the government in all their wisdom allocates funding for practices but then says you can't spend it on doctors or nurses...

Also for the previous poster saying GPs now all work part time - many are women who want part time work like everyone else to care for their children. The nature of the work also means working 5 full days a week is unsustainable.

Mine's on my phone, they sent it to me via text when I needed it to get the NHS app. I appreciate that it would pose problems for people though. I wish I could just show the pharmacy the text they sent me to say that my presciption is ready and then they just check the address with me before they hand it over without me having to declare my name, address DOB to the whole waiting area. They could send a pass code with the text like a take away order.

You have to remember that a lot of people have disadvantages - low IQ, learning difficulties, low reading age, memory issues, brain injuries, addiction. And some people are just plain ditsy. Or they’re elderly or have special needs or they’re just not very smart.

A lot of people would just say ‘my what’ if asked that.

We have "healh navigators" at my surgery, they are another layer of staff that are apparently meant to guide you to the correct practitioner. Blood tests that used to be done at the health centre, which is walking distance from most patients' homes is now done at a centralised hub in the city centre so what used to take me a total of 30 mins (walk there, have blood taken walk home) now takes up to two hours of travel there and back for a 5 min procedure. All down to funding and commissioning changes for the latter with considertion being given to ease of access. My meds reviews are done over the phone; the pharmacist and I have never set eyes on each other in the whole time I have been taking these meds. She is very nice and helpful but I wonder if things get missed because there is no face to face interaction.

Quite. I personally don't really care who knows what, when I have been in those conditions. Nobody is really concerned with other people's ails, and don't give it much thought, I would have thought.

I'd gladly memorise mine if it meant never having to tell half the neighbourhood standing behind me in the queue my address or date of birth again!

I take your point and I think the increasing reliance on technology is making it even harder for many people to access care. I renew my prescription online via the practice website and there must be people who lack the wherewithal to do this. I already mentioned that my surgery no longer does blood testing on site, there used to be a whole suite of treatment rooms on the second floor for various things including phelbotomy but commissioning changes meant the service was moved to a central hub in the city centre. If you need bloods doing the surgery sends you a text with a link and you have to book via this. in the past you would just pop upstairs book an appointment on the desk (thats all been closed down now), get seen a few days later . Now it takes at least a week to arrange an appointment that takes me nearly an hour to get to. They don't make it easy, it will all be about cost cutting i guess .

I have been thinking this a lot recently too. Particularly in things like mental health where the sheer nature of the difficulty often makes it hard for people to follow things up and engage in processes.

I’m pregnant and all my maternity care is via the MyChart app. There is no other way of finding out when your appointments are, or contacting your midwife. Nobody really told me this either, I had to go looking for the information myself.

Whereas before they had to follow you home…..

There's an assumuption that everyone has a smart phone with loads of credit (or can afford the bill), have internet at home, can use a keyboard, live somewhere reasonable where they have privacy. There is also an assumption that everyone can download stuff, fill it in and rerturn it as an attachment i was sent a chart via a link for me to record blood pressure readings on. I'm more than competent with computers but what about those who aren't? I think that homeless people are even more excluded by the reliance on tech for accessing health care. My practice is in a deprived area and to their credit they are well aware that tech can be a real barrier to getting the care you need and they do help people who struggle. However they do make it clear that they prefer you to contact them online or via the app.

Mostly because receptionists work in reception, a space not meant for privacy

They do the best they can given the constraints they work under and the additional work they have to do because the NHS doesn't have enough GPs

The woman wasn't in the right state, but you can ask to speak in private with the receptionist.

If you thought it was inappropriate, you could complain to the practice manager on behalf of the patient.

I told the receptionist at my doctors that I'd like to speak to the practice manager. The receptionist wouldn't let me see her and said she's probably gone home or to the other surgery... I said it was a matter for cqc and massive breach of confidentiality. She told me to put it in writing for the practice manager but wouldn't give me the email address 😒 told me to write a letter instead.. I have another ladies test results on my nhs app , her full name, address and phone number! Receptionists seem to need to know everything before you're allowed to speak to anyone else.
You are definitely not being unreasonable

We use all our 13 rooms for clinicians for appointments. There is nowhere to take patients if they want to discus things privately. We donot take phone calls at reception desk, that's done in the back office area, noone in reception can hear

I’m impressed your surgery still has a discussion with reception-patients at all. Ours are all online bookings & triage, with some permitted to do it over the phone. Nobody gets to be triaged face to face any more.

I too was mentally unwell and went to Gp for support. I didn’t mind the receptionist but the Gp stood there watching me getting distraught offering no sympathy. There response go to A and E. Then A and E send you back to Gp part of hospital as all you needed was sympathy, listening ear and advice. We are all one world mentally ill or not.Yes it’s embarrassing hearing what people say but mental illness is part of life.

I remember my mother being horrified when the receptionist (who did have a particularly loud voice IIRC) confirmed that she was there for a smear test. "She could just have confirmed my appointment with the nurse" she said - it did really upset her. She was getting on a bit then as I recall - my mum, not the receptionist.

I’m not embarrassed for myself. I’m embarrassed for the poor woman who had her crisis announced to the whole town

I have issue with the NHS -the awful care my Dad recoived in last years of his life was not care more abuse and their "care" nearly killed me and my last child.

But the receptioints have the least power - and GP surgeries are independently run and frankly complaining to practise mangager unlike most of the NHS tends to get results IME.

You can also - area dependent because I have lived in area with not enough GP pratcises - move pratcises - more easily than you can change hospitals or most NHS services.

If you have specific problems with your GP receptionist complain - I and many other did at least GP and things changed.

Same at mine, they prefer you to make an appointment online where you fill in a form with a description of your issue/symptoms and it gets tiraged or you can phone, but they prefer you to use the app/website . The days of walking in and just asking at reception for an appointment are long gone. I had not had to see a GP for over 7 years and when I did become unwell about a year ago i got a real shock at how much had changed.

Hrft but got the gist.

I agree its awful whenever you have a screen between you and the conversor I really struggle as the sounds are muted abd I have hearing issues.

I seem to recall from various TV shows they had a phone to phone screen communication system in US prisons, would that work better?

Might need to be self sanitising though....

Yes, but it doesn't mean there isn't a better way, just that no one's bothered to change because we've always done it that way.