A question for GPs

[KillerSandy]

When you see or call a patient do you have their notes ready on your screen ? Will you take a few minutes to scan them before you say "How can I help you?" or do you not have time?

I think it varies. In an ideal world a GP will read your medical notes before speaking to you.

He or she should definitely be aware of anything major such as diabetes, severe mental illness, recent surgery, any significant chronic condition or allergy.

But in the real world, it's quite possible that the GP just phones you 'cold'.

So I would advise patients to always briefly draw attention to any significant medical history, even if you think it has nothing to do with the current issue.

I always check notes first. Makes it much easier if it’s a follow-up and makes the consultation more efficient if I’m picking up where one of my colleagues left off. I’ve also become a dab hand at speed-reading notes to get the gist quickly so it really doesn’t take long!

Will have at least skimmed the notes and read any relevant consultations in detail

Thank you for answering. I never know how to much say but yes I do agree that you have to be your own cheerleader with medical matters.

Always read them. Also useful to have a note of why you're coming which is why the receptionist asks you for this when you book. Then I can look at any other notes that have been made on this issue before and make a plan of action!!

I read the notes, check any relevant results
However - if the patient doesn’t pick up (which sometimes feels like most of my morning surgery) then I call back at the end of the surgery. If I’m calling back 8 or so patients it’s often a much more cursory glance at the notes to refresh myself. Some days it feels like I spend a lot of time looking at the bits for people who don’t answer so it’s a tricky balance.
Also some patients have very busy notes, and sometimes the reason for the consultation isn’t stated so you can’t read everything that might be relevant before starting the call.

Our GP receptionist phoned me to arrange a telephone appointment with a GP following some routine blood tests. Appointment was made. When the GP phoned me, first thing she asked was what the problem was. She clearly hadn't read the notes to see that it was her who'd asked for the appointment! I had to reminder her that she'd left a message to make an appointment re the blood test results.

I find they don't listen even during a consultation. When I tell them the symptoms, etc., first thing they do is ask questions that I've already told them the answers to. It's as if they're working from a script and only listen to answers to questions they ask. I.e. one time I said I had loss of hearing and pain in my right ear, and she asked which ear it was! Sometimes I think they're too busy concentrating on typing notes into the computer that they don't actually listen to what you're saying!

Mine don't. They keep suggesting medication I was on years ago that doesn't work. And they have this habit of prescribing the wrong amount despite being on it last month

Out of interest, does your surgery have fixed appointment slots for telephone appointments (like you do with face to face appointments)? If not, then hardly surprising that it seems "most" of your patients don't answer the phone when you call them, if your receptionist can't give them an approximate time to expect your call.

I was once very apologetically given an 8am appointment time and as it was a working day, I had to go into work early to be there by 8am so that I wouldn't miss her call. In the event she finally called around 11am when I was in a meeting with a client and couldn't answer it. When I finally spoke to her (had to re-arrange another with the receptionist), I mentioned the 8am appointment and she just laughed and said all the appointments were timed for 8am and that she just phoned patients as and when she could throughout the day and didn't even start work until 9am! So why did the receptionist make a thing about it being 8am?

Same here.

They keep trying to get me on to a statin. I've tried them several times over the past 20 years. If I look on the NHS/MyGP app, it's down under alergies/intolerances (can't remember the exact wording) with 4 entries each spaced a few years apart. Yet, every year on my annual review, they suggest that I take a statin and I have to remind them to check on the notes to see that I've tried 4 times and can't tolerate them.

Same with my penicillin allergy. I have to remind them whenever they are about to prescribe an antibotic, or whenever I'm having any treatment at a hospital, when they ask if I have any allergies. Surely penicillin allergy should be flagged up on the first/home page of the computer record, or front page of the paper notes!

It's fine for "normal" patients who can tell the doctor/nurse they have an allergy or intolerance, but what about elderly/confused/dementia patients who can't remember or patients with hearing issues who tend to just nod/smile to every question? They need proper protection and for that, they need their doctors/nurses to actually read the important parts of the notes!

@taxguru currently it’s a 3 hour window - but unlike your practice our patients are told it’s a 3 hour window! Generally I will call once, leave a voice mail saying I’ll call back in the next hour, then ring again at least 30 minutes after the first call.
After the second I leave a message saying sorry I missed you, please contact reception to re-arrange for a convenient time. If people call back that day reception let me know and I nearly always manage to call them back or have reception transfer them through.
If I’m not rushing for nursery pick up I go back through the list at 5ish and call everyone again, it’s more efficient because I’ve already reviewed their notes (twice!) and rebooking takes another appointment which we just don’t have.
I think we may move towards a shorter window, but the advantages to being able to have some flexibility are huge (I go though my list and my afternoon list in the morning and call everyone I think may need a face to face appointment or home visit first, rather than waiting till 4pm when there are no appointments to bring them in to).
If it’s something urgent / mental health / time sensitive / vulnerable patient etc I’ll obviously try more, or send a text they can reply to directly if they still want a call back, or give them a call the next day.
It’s not a perfect system but we review it every few months, and keep an eye on how many ‘failed encounters’ there are (not a ‘Did Not Attend’ because it’s not the patients fault).
Often there’s a note saying ‘please call after 4’ or similar which we respect. Tricky when patients ask for a call 1-2 because that’s my only gap in face to face bookings so I’m often visiting palliative patients etc.

Notes are available if they need to refer to them, anything like type 1 diabetic, mental health issues may appear on the home page, depends also if reception put reason for the call which usually they do.