Questions and Answers / GP Doctor Consultations #Guest Post


I would like to recommend a brilliant site called GP Doctor ( http://www.thegpdoc.com )who have kindly allowed me to share with you one of their posts. As a Receptionist you will all be very familiar with many of the questions below, and maybe even some that you have not come across or had the answer before.

I hope you enjoy it.

Guest Post

GP Doctor Consultations – Question and Answer Session
BY GP DOCTOR · MARCH 7, 2015

GP Doctor Consultation Q&A
Patients often have many questions about the GP Doctor consultation process and all of the questions asked below are genuine questions posed by patients. Hopefully it addresses some misconceptions about the GP consultation.

How long does my GP Doctor have to see me? It seems very rushed.

10 minutes. Realistically 7 minutes as the 10 minutes includes calling the patient to the consultation room, referring if required, prescribing and writing our notes (which is very important for your records so there is an accurate picture of your medical history which helps in future consultations).

Why not offer longer appointments?

There is already a recruitment crisis in GP and currently there are not enough GPs in the UK. If we offered longer appointment times, fewer patients would be seen in the day, contributing to longer waiting times for appointments.

Why have I been waiting to be seen? My appointment was 15 minutes ago.

The patient before you may have been very unwell with multiple complicated conditions requiring more time. Furthermore your GP may be running a little late if they had to discuss a patient with hospital specialists or had to deal with other emergency situations or telephone calls. It could also be simply that the patients seen before you presented with multiple issues that they wished resolved.

Is your time more important than mine that I have been waiting so long?

No GP feels their time is more valuable than the patient’s time. We do try to keep to time. However situations out with our control contribute to sometimes running late as also mentioned above.

I am only 5 minutes late. Surely this is not an issue?

Bear in mind that you may only feel it is 5 minutes. However if lots of patients attend late for their appointment your GP is then automatically running late for patients later in the day.

What if I have a list of things?

You may have a list. But if you tell me this at the start of the consultation, I may be better able to help you. Mentioning this at the last minute makes it more difficult as we may have spent a large proportion of time on only 1 issue.

I don’t come to the GP often. Surely I am entitled to have longer or discuss all my issues?

We try to discuss and manage as much as we can in 1 consultation. However bear in mind that there are other people waiting so it doesn’t mean I can solve all your problems in 1 appointment especially if they are more routine matters and you have, for example, 5 things you want addressed.

Years ago my GP had time to have some social chit chat. Why not now?

It’s not that your GP is not interested but is pushed for time and the next patient will already be waiting to be seen. We feel it is important to actively engage with patients and firmly believe that part of this is building a good doctor-patient relationship. Unfortunately due to time constraints we may not be able to talk to you for as long as we would like.

The waiting room only has a few patients in it. Surely the GP must not be very busy?

This shows an effective appointment system that is working well and not large queues still waiting to be seen.

Why can’t my GP see patients constantly in the whole day?

See the other related post “GP Myths – Appointments” which answers this question.

Why do you not know all my medical history when I come to see you?

It may be the first time you have met the doctor and he/she will not have had time before seeing you to go through all of your notes in any great detail. In addition it is better for us to ask you to get accurate information rather than just rely on the notes.

Have you read my notes before seeing me?

With anywhere between 5,000 – 15,000 patients we can’t know everything about your medical history off by heart. We probably haven’t had a chance to look at your notes in great detail before seeing you. However if we need to know more we can ask you or look at your medical notes during the consultation.

The GP called me back today. Why is he/she asking me what I wish to discuss?

We cannot assume why you are here. You may be attending to discuss something else and that’s why even if we have asked you to come back we ask at the beginning the reason for your attendance.

My GP is looking at the computer during the consultation. I’m sure he/she is using Google to diagnose me?

No we are not diagnosing you using our computer. We need to look at the computer for your medical notes. We also may use the computer to check doses and local guidelines regarding drug prescriptions.

Why is my GP asking me what is wrong? Doesn’t he/she know? I just want a diagnosis.

If your GP asks something similar to “What do you think may be causing your symptoms?”. It isn’t because he/she wants you to self-diagnose. You may have thoughts about what you feel may be causing your symptoms or condition. Everyone has thoughts about what may be wrong. If we know this we can answer questions you may have regarding this or to address misconceptions you may have. Furthermore it also helps us identify how much detail we need to give as you may already know a great deal about your symptoms/condition. If we don’t know what you think may be causing your symptoms you may leave the consultation feeling that your questions haven’t been answered or that you are adamant it is something else. We don’t want you to leave thinking “My GP told me I have X condition. I think I have Y condition”.

Why does my GP ask so many questions rather than just tell me what is wrong?

Most diagnosis by all doctors is reached from information gathered from the patient. Therefore it is important that we gather as much relevant information as necessary to do this. Investigations can be helpful to diagnose but remember most diagnosis is reached from talking to you. In addition we do not have access to immediate scans and blood results.

My GP looks at a book for drug doses. Why?

We can’t remember all drugs doses and sometimes have to look these up. It’s better to be accurate if we are unsure. In addition there are multiple doses for children depending on their age.

I have been asked to come back for a follow up. Should I?

Yes. If your GP feels you should attend again to review your condition it is important to do this. This will also prevent asking for an emergency appointment in case things haven’t improved. If your GP has asked that you come back in a few weeks he/she may also want to see how your condition is evolving or discuss blood results that you have yet to have done.

I came back a few weeks later and another GP said I had something else? Was I misdiagnosed?

Not necessarily. Symptoms evolve. We can only base our diagnosis based on what you present with at the time of seeing us. Symptoms and conditions evolve over time.

I came about my sore foot. Why am I having my BP taken or asked about smoking or if I am up to date with my smears?

We may try to opportunistically help with health promotion. You may not attend to see us often and it may be the only chance we get to discuss these areas which can help improve your health.

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Beyond Courage #Guest Blog


No parent should outlive their child. The pain of loss and grief is too much to comprehend. Life taken as such an early age – this is the most heart-moving stories that I have written since starting my blog.

I want to share with you the importance of patient care; it not only extends to the patient, but to family members of the patient. Care good or bad can often be left with such an impact in someones life.

My cousin Chris her husband and their only child Andrew moved to Australia in 1989.

Andrew was diagnosed with Chondroblastic Osteosarcoma on his 21st Birthday after a pathological fracture. For 15 gruelling months he underwent 10 operations including major surgeries to initially replace his cancerous left fractured femur and knee-joint. He went through 16 round of chemotherapy, ending with the amputation of his left hip and leg and ultimately his young life at 22 years and 3 months.

Chris has kindly offer to write a guest blog highlighting some of the patient care that has had in some way had an impact on her – to share how vitally important patient care from the Reception staff through to the nursing staff.

Chris is in the process of writing a blog on this subject so dear to her heart and the link is:

http://www.beyondcouragelancashire.com

and she has also written a book on her journey with Andrew through Chondroblastic Osteosarcoma “Beyond Courage”

The book insightful and greatly moving, “Beyond Courage by Chris Lancashire” does not only let readers experience the admirable courage of a man whose prime of life came to a sudden halt, but it also sheds more light into osteosarcoma and its intricacies.

Thank you Chris for sharing your story with us in the hope that everyone ultimately receives the care that they deserve.

Guest Blog : Beyond Courage

by Chris Lancashire

Thank you for inviting me to your Blog.

My background is in health, and I have worked both in the private and public sectors, in England and Australia over a period of 35 years.

On a personal note, I am a mother who went through the health system, when my son Andrew was diagnosed with Chondroblastic Osteosarcoma, a rare bone cancer, predominantly of the young teenagers and young adult. He passed away in November 2008 at the age of 22 years old.

I feel qualified to say, that the health systems are set up to help, assist and care for the vulnerable, fragile and sick patients that seeks care. Most of the time, the health system does well. Other times, these very systems that are placed to provide these care, failed to deliver these care, to the patients.

It is not the systems, that we constantly have to remind ourselves. The healthcare system is run by people. It is the very people in the healthcare system that actually provides that care.

Travelling with my son on his cancer journey is the toughest role firstly as a mother, and as a health professional. Protecting and caring for him in any way possible is the ultimate. I knew he was confident with the multidisciplinary health care team looking after him. More so, he knew I was able to be there for him, with my background as well as being his mother.

Somehow along this already difficult journey, there were situations and experiences that would make this journey even more difficult. It is at times like these that we always look at the human resources and education within the healthcare systems that can only be improved.

There were several nursing and reception issues, and experiences that also made me reflect on why these staffs was there. I would like to share here with one of this experience.

When Andrew broke his left femur, his contact with the first hospital, was an unforgettable and unpleasant experience. This was on a Saturday, the same day when he broke his left femur. Although Andrew was there for 36 hours, and pending him being transferred to the second hospital, where his orthopaedic surgeon was, it was a long 36 hours. He was in extreme pain, due to his fractured femur, which now had looked like a hugh balloon on his left thigh. Andrew was very drowsy due to the massive morphine injections given to him, very frequently according to the nurse. His left thigh (where the fracture was) was propped up with rolled up pillows underneath, to give the left thigh support. He was bed ridden, on his back and not able to move much, without the fractured ends of his femur grinding together.

Being extremely drowsy, due to the opiates, he was not taking much in the way of diet. His body temperature was up, so he had a high fever. They were no other forms of fluids ordered.

I visited over the Sunday with his dad, and we didn’t see any doctor to explain anything. We knew he was to be transferred when a bed was available at the 2nd hospital. However there was no treatment plan while Andrew was there, as such. When asked, the nurse who came in infrequently told us Andrew was having his frequent morphine injections and waiting transfer.

On Monday, I visited Andrew early around 0800 hrs, in case there was news of his transfer, so that I could organise and packed some of his things. I checked with the receptionist at the nurses’ station, to see whether I could visit him, giving her his full name. She checked on her computer and said, ‘Yes, you can visit. The nurse is with him at the moment, assisting him in the shower.’ My heart started racing, thinking that was not possible. He could not even move. He was almost semi-conscious most times due to the effect of pain relief. I rushed into his room. I saw him lying flat on his back, alone. He was drowsy, but awake and in pain. He had already pressed his call bell, nearly 20 minutes before. Andrew liked his wristwatch on him most times, so he knew it was a while since his call. His breakfast had arrived, and it was placed on his bed table, which was at the foot end of his bed. I saw my son, helpless and in pain. He couldn’t even reach his bed table to get any drink or his breakfast. I had to go and find the nurse looking after him to let her know of Andrew’s pain.

The receptionist made no effort to apologise. By this time, I had made this experience of my son and I known to the nurse in charge that morning.

Patients have a right to receive care, nursing, medical and all forms of holistic care whether in hospitals, care facilities or home. Even the most basic care such as human empathy, compassion and kindness. Too often, we blame these healthcare organisations and facilities for not meeting these fundamental, basic human needs and right for care. We sometimes forget that these very facilities are staffed by people who deliver care at the frontline. For me, I believe, it needs to come from the individual, and everyone that has been given the privileged to be in that position. It is a very humbling position to be, not a position of power or ignorance.

Thank you for allowing me to tell my story.

In honour of my beautiful son Andrew, I have written my book called Beyond Courage by Chris Lancashire. All proceeds from the sale of the books go towards medical research into finding an improvement treatment, and cure for Osteosarcoma. Please feel free to check out the book, and website of the same name.

 

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In memory of Andrew Lancashire 

 

© 2011-2017 Reception Training all rights reserved

Guest Post / Practice Index / GP Practice Managers Forum


 

Guest Blog

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by Practice Index in GP Practice Management forum

Did you know that we have a dedicated GP Practice Managers’ Forum right here, with over 500 Practice Managers from all over the country already signed up and actively chatting? Registration is free and takes moments, so get involved here – you’re minutes away from joining a community of like-minded individuals all over the UK for advice, tip-sharing and general discussion.

Topics already active are as broad as experiences of verbal abuse at the reception desk to problems with unauthorised cars in the car park, CQC inspection experiences to thoughts on text alerts. And, of course, a whole host of more light-hearted topics, you’ll have to see for yourself, plus a useful Marketplace board for those looking to buy, sell and swap things – work related or not. There’s also a board for putting equipment tenders out and an area for resource-sharing. Users are welcome to contribute to and initiate brand new discussions on the forum. This is your forum, so let us know if there’s something you’d like to see on there and we’ll do our best to accommodate you.

JOIN THE DISCUSSION ON OUR WEBSITE   http://practiceindex.co.uk
FORUM SIGN UP PAGE: http://practiceindex.co.uk/gp/forum/index.php

As well as offering a private messaging function and personal inbox for all users, the forum exists to provide Practice Managers with a protected space within which to discuss the varied – and often controversial – issues surrounding their careers and the NHS as a whole. The forum is deliberately not Google indexed, so discussions cannot be accessed from a Google search and can only be seen by signed-up members of the forum. We think it’s really important for those working in your positions to have access to outlets like this – a safe place for chat and even, we daresay, a bit of a laugh. Sometimes this is just as important as anything else – we know that!

So why not pop in and introduce yourself? There’s a board set up especially for newcomers called Introductions, so this may be your first port of call once you join. Or just sign up and have a nose around – there’s plenty being debated on there right now, and we’d love for you to get involved.

Guest Blog: Make Someone Happy – Julie Bissett, Practice Managers Magazine


I would like to thank Julie Bissett who is a freelance journalist and editor of Practice Management Magazine for her guest post

 

Make someone happy

Julie Bissett asks what better way to improve your patients’ day than with a smile and some good humour

‘Smile if you’ve had it lately’ – these were the words on a bumper sticker my father slapped onto the back of our Ford Escort during the 1970s. I believe it was promotional merchandise for a local garage advertising their servicing provisions. Not a man given to crude innuendo, I was mortified at dad – and the sticker’s – suggestive tone. Dad, meanwhile, thought this even funnier than the cheeky message it conveyed to car drivers behind us.

We may have missed a trick here – what a fabulous tagline for a GP practice! Or maybe not…

But the real point is that, firstly, we all love a laugh and, secondly, we all welcome a smile, especially when stressed. On a bad day, the meeting of patient and GP receptionist can seem like the paradox of immovable object versus an unstoppable force – and, surely, something’s got to give?

Sassy

It may be tough to do – but a smile really does conquer the toughest of customers’ attitudes. We all need something to positively trigger our thoughts, senses and actions when we’re feeling fraught, ill or worried – and nowhere is this more relevant than at the reception desk of a GP practice.

In the increasingly competitive world of healthcare, a practice now needs to promote itself in the same sassy style as an advertising campaign might, for it cannot afford to get left behind, remain staid and prescriptive, or, indeed, come under fire in an increasingly ‘TripAdvisor’-esque world of online healthcare feedback forums.

A front desk team is a GP practice’s shop window that needs to welcome its audience – the patients – with a massive desire for them to be on side in an environment hugely pressurised. It’s you, the receptionist, often taking the brunt of the day-to-day demands on a practice. Many people demand your time – from GPs and practice nurses to pharmacists, specialists and hospital consultant PAs.

There are equipment suppliers to consider, recruitment agencies on your tail and protocols to adhere to and to remind everyone else about, also. You handle referral letters, prescription requests, and doctors’ letters. Patients –whether on the phone, in an email or face to face – should live up to their name while you juggle all this and more, shouldn’t they?

KISS principle

The KISS principle (keep it simple, stupid) – the acronym used by designers and engineers – translates well into the medical arena. Without meaning to offend, we should all strive to reach the lowest common denominator when communicating; not because we consider our patients incapable of understanding the science behind the mechanics of their care but because we all lead busy lives and bullet-point information is the perfect way to ensure we convey – and they retain – knowledge we expect to be squeezed into brains already jam-packed with ‘stuff’.

Look at life around us and consider what works and what we now instantly recognise – and why:
• Golden arches means ‘fast food here’
• A flashing SLOW DOWN sign means that: slow down in a built-up area
• And a beautifully shot retro TV ad of a truck ploughing through the snow with Coca Cola on its side can only mean that the Christmas ‘Holidays are coming’.

A smile could be YOUR practice’s very own marketing icon – it’s very difficult to remain angry when anyone smiles at you. It’s a reminder that we’re all human – even tricky patients and much-maligned doctors’ receptionists. It’s simple idea; it may also prove great marketing – but, most importantly, it’s a healthy option for us all.

 

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Guest Blog: How to Diagnose a Difficult Patient #Practice Index


 

I would like to thank Practice Index for their guest post. Practice Index is a site where GP Practice Managers and surgery staff can go and read reviews of suppliers and add their own. Suppliers are then ranked according to feedback received making it easy to find reliable and trusted companies.

 

 

How To Diagnose a Difficult Patient

Blame Dr Google or the ‘era of entitlement’, but the difficult patient is on the rise and they’re costing your practice dearly – and not just financially. GPs with a high number of problem patients – or ‘heart-sinks’ as they’re best known in the profession – are less likely to report feelings of job satisfaction, and more likely to feel burned out. More often, it’s the doctor-patient relationship that needs to be assessed rather than merely the gripes of the patient, and we’re here to help.

Tell-tale symptoms

Studies suggest that most GPs will have around eight ‘heart-sinks’ on their patient list. A problem patient is one who – for whatever reason – impedes the GP’s ability to establish a therapeutic relationship. Someone who refuses to assume the typical patient role, and who may have ideas and beliefs contrary to those of the caregiver. Typical problem patients are men and women over forty, often with marital or other family problems. Sometimes they are isolated in their domestic situation, and may have co-existing depression. New GPs inheriting a patient list can often spot a problem patient a mile off: bulging medical file and appointment / referral / investigation list as long as their arm. A study in the 1950s separated problem patients into the four categories below, and it seems not much has changed…

  • The dependent clinger
  • The entitled demander
  • The manipulative help-rejecter and
  • The self-destructive denier

Relationship surgery

Interestingly, doctors polled in the seventies painted a portrait of the ‘ideal patient’ as one who was trusting, non-complaining, compliant and undemanding. Patients who were perceived as not being seriously ill but complaining, emotional, and uncooperative were often discharged from care early or referred to psychiatric care. Could it be that some of these attitudes remain today, and that part of the problem lies in a GP’s perception of their patient?

 Know your team

As a practice manager you will know better than anyone that GPs can often fall into a number of personality brackets – more of that in another post soon – and it’s your responsibility as overseer to manage personality clashes between doctor and patient. Is the problem actually being exacerbated (or created) by the insecurities of a new doctor, or one with too much on her plate at home? Is it a GP who won’t seek second opinions, or one whose tolerance levels need checking? Talk to your GPs about their patient gripes and see whether the problem can be alleviated by their own perceptions.

…And if all else fails, try encouraging them to book with a different GP next time. Perhaps one with a specialism in their area of need.

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Guest post by Practice Index.