Signposting – Have you got it right?

 

I accompanied an elderly friend to the hospital yesterday. She had to go to see the neurologist.

I went with her as a friend but to also support her as she is in a lot of pain and finding walking difficult.

Parking as in most hospitals was pretty awful; we were lucky to find a space and then made our way into the hospital with plenty of time before her appointment was due. We entered the large outpatients department and found that they had completely reorganised the main area. There used to be an information desk, this now replaced by a super new coffee shop.

There was no sign to direct us to the neurology department so I stopped and asked two maintenance men who were deep in conversation propping up the door. One of them told us we had to follow the corridor to the end through the double doors and turn right, into the new part of the building. So off we went.

We went through the double doors, and there were no signs of our destination. So I asked another member of staff, she sent us back the way we had come, and once again we ended up somewhere that certainly wasn’t neurology.

I then asked a 3^rd person who actually told us truthfully that they had no idea where it was, by this point my friend was starting to struggle with her walking, I sat her down and asked a 4^thperson. This member of staff asked me to follow her and she took me directly to the department which was situated right beside the two maintenance men who were still there chatting. I went back and collected my friend and we made our way back to check in.

We waited at the empty reception desk, still not confident that we were in the right department, and the time was fast coming up to her appointment,my friend started getting anxious as she does not like to be late.

The Receptionist finally arrived, apologised for keeping us waiting and asked her name. Thank goodness we were in fact in the right place – more by chance I might like to add.

I asked the Receptionist why there was a lack of signposting and she told me that there were several outpatients clinics held there on a daily/weekly basis and they would be unable to list them all, and often they change to other parts of the department.

So, Hospitals, large GP Surgeries and Health Clinics please ensure that your signposting is user-friendly and if for some reason if have not got a help desk, or you cannot put up the correct signs, please think of putting directions on the appointment letters, and perhaps appropriate training for staff in how to deal with patients/visitors when they are asking for directions. If staff are not fully confident that they know where the departments are, then tell the patient that, please don’t send them on a wild goose chase like we were yesterday.

Large buildings that have lack of signposting can often be confusing to the elderly and the disabled.

 

© 2011-2017 Reception Training all rights reserved

3. DNA and the Patient’s Experience

I have had several people contacting me regarding my posts on DNA’s.

The first blog I did was the impact DNA appointments have on Hospitals and Surgeries.

The second blog was in response to a comment made by a Reception Team Leader and how her surgery is proactive in dealing with this problem, which I might add I think is a great system.

This the 3^rd blog on DNA’s is from a patients point of view.

Someone contacted my regarding DNA’s and how this impacts on the health service resulting in people having longer waiting times for appointments.

This lady had a hospital appointment a couple of weeks ago, she realised the week before that due to unforeseen circumstances she was unable to keep the appointment the following Monday afternoon, and working in the healthcare sector knew how important it was to cancel the appointment and give someone else the chance of the appointment.

On the Wednesday the week before her appointment she tried to call the consultants secretary to cancel the appointment.

She was greeted with a recorded message saying that the secretary was on holiday and the secretary actually said in the recorded message there was no facility to leave a message. She asked that people call back on her return in 10 days time.

Obviously this would be too late to cancel the appointment. So this lady phoned the hospital and asked for outpatients department, the switchboard put her through and it rang and rang and no one answered. So she had to phone the main switchboard back again. She explained that no one was answering in outpatients, but she was put through again anyway – and again no one answered. So, she had to phone back yet again, she explained about wanting to cancel her appointment, before she could say much more she found she was put through to the “secretary” again, and heard the message she originally heard – and the fact she couldn’t leave a message!

She gave up at this point and left it until the next day when she tried again. She said that she was put through to several different departments, no one wanting to take responsibility for the call she was even told to phone the secretary on her return in 10 days time. She explained that the appointment was in fact in 4 days time and wanted to cancel it and not have a DNA against her name.

She got nowhere – so tried again on the Friday – the same run around.

Monday morning the day of the appointment she phoned the hospital and finally got put through to someone – she explained that she was unable to attend her appointment that afternoon and could they cancel it and ask the secretary to send her out a new appointment.  After taking the woman’s name said she would.

Two weeks went by and this lady had heard nothing so she telephoned the consultants secretary who was not back from her holidays – and to no surprise she found that they appointment had NOT been cancelled, she in fact had a DNA against her name, and the secretary did not get the message about her wanting another appointment made.

To say she was fuming was an understatement.

So, in order to get the DNA rates reduced it takes time and effort from all involved.

Patients have to be more responsible for cancelling appointments and this needs to be dealt with in a delicate manner.

Surgeries and Hospitals need to ensure that if a patient does cancel their appointment that it is recorded and cancelled and the patients does not received a DNA against their name.

Hospitals and Surgeries cannot moan about the amount of DNA’s they have unless they have a policy in order that will actually deal with this when the patients requests to.

And systems have to be in place that these messages are getting through to the right people.

The lady involved felt that no one wanted to listen to her – the operator just didn’t listen to what she was saying which resulted in her being put through to departments that if she had been listened to could have been avoided.

I would suspect that most patients after the first 2 or 3 phone calls would have simply given up trying to cancel the appointment.

Receptionist Training: Young Patients and Confidentiality

•  HOW CAN WE HELP YOUNG PATIENTS
• 

 It is important that a young patient feels confident to be able to
speak to a Health Care Professional in confidence.

 

Young patients also have the right to confidentiality! Often it is difficult when a young patient around the age of 15 years comes into the surgery alone. They often don’t want their parents to know that they have been to the Surgery. Often it is of a personal nature. So what happens when the Surgery need to get in touch with the young patient:

Do not phone the patient on their home phone (if possible)

This often leads to questions by parents as to why the surgery is phoning – especially if the patient has not told their parents they have been to the surgery.

Never leave a message on the home answer phone

Again, this will lead to questions by parents.

Use Mobile Telephones wherever possible.

It might be a policy of your Practice not to use mobile telephone numbers. But in the case of a young patient it is advisable to use a mobile number if you have one. This is one safe way of being able to speak direct to the patient – in confidence.

When is a good time to phone?

Ask the Young patient when would be the best time to phone. You don’t want to call when they might be in school or perhaps at home.

If a young patient comes in alone for an appointment

If a young patient wants to make an appointment and wants to be seen on their own please check with you Doctor/Supervisor/Practice Manager that they can be seen on their own. Your Practice should have guidelines on young patients.

At the time of the appointment check if they have a mobile telephone number – this will allow you direct access to the patient if you or a healthcare professional should need to contact them.

If Tests are being carried out

Make an appointment for them to receive the results. Normally we ask
patients to telephone for results – giving a young patient results can often lead to confusion and the correct procedures not taken. An appointment can give the Doctor/Nurse a chance to make sure they understand. It is amazing how many young patient do not understand medical terminology – I have had young patients believe that a “positive” pregnancy test means that they are NOT pregnant. Positive meaning it is good that they are not pregnant.  Do not assume that they understand – always clarify that they understand – explain exactly what the results mean. If as a Receptionist you are giving out a pregnancy result to a young patient and the test is “positive” follow-up by saying:

“Your pregnancy test is positive – that means you are pregnant – would you like me to make an appointment for you to see the Doctor”?    or

“Your pregnancy test is negative – this means that you are not pregnant”

When a Young Patient wants to book an appointment.

There are several things take into consideration when a young patient comes into the surgery to book an appointment:

•  The young patient may not want their parents knowing that they are going to see the doctor.
• Young patients are often nervous about seeing the Doctor.
•  It might have taken a lot of guts for them to come in to book the appointment – maybe it might be of a sensitive nature – something that has taken them time to come in about. So don’t scare them off before they have a chance to see the Doctor/Nurse.
•  Always try to fit them in when it is convenient with them – if they don’t want their parents knowing it won’t help giving them a tea time appointment – parents might ask questions to where they have been.
•  Offer an appointment straight from school – or perhaps in their lunch break. Ask the young patient when it would be best for them to come to the surgery.
• If you feel that the young patient is nervous see if you can fit them in there and then (if you have a surgery going on) – often they will book an appointment and not attend – their nerves get the better of them and they do not come back.
•  If it is a male young patient try to book them in with a male doctor and a female doctor with a female patient. This will help if the appointment is of a sensitive nature.
•  If the young patient comes to the desk with a friend – you can always mention that the young patient is welcome to bring their friend in with them to see the Doctor. They sometimes appreciate the support from a friend.

And most important – Young patient have the right to confidentiality – if they are old enough to come on their own then they should have the respect of confidentiality like any other patient. Sometimes Parents get to know that the young patient has been to the see the Doctor and will phone the surgery to ask what they have been in for – you do not have any right to give out any information. So be very careful. If young patients wanted their parents to know they were seeing the Doctor they would have told them.

Make sure you have the correct training in a situation where a parent calls the Surgery and asks why their child has been seen in the surgery. It may happen so be prepared.

Receptionist Training: Young Patients and Confidentiality

• HOW CAN WE HELP YOUNG PATIENTS
• 

 It is important that a young patient feels confident to be able to
speak to a Health Care Professional in confidence.

 

Young patients also have the right to confidentiality! Often it is difficult when a young patient around the age of 15 years comes into the surgery alone. They often don’t want their parents to know that they have been to the Surgery. Often it is of a personal nature. So what happens when the Surgery need to get in touch with the young patient:

Do not phone the patient on their home phone (if possible)

This often leads to questions by parents as to why the surgery is phoning – especially if the patient has not told their parents they have been.

Do NOT leave a message on the home answer phone

Again, this will lead to questions by parents.

Use Mobile Telephones where possible.

It might be a policy of your Practice not to use mobile telephone numbers. But in the case of a young patient it is advisable to use a mobile number if you have one. This is one
safe way of being able to speak direct to the patient – in confidence.

When is a good time to phone?

Ask the Young patient when would be the best time to phone. You don’t want to call when they might be in school or perhaps at home.

If a young patient comes in alone for an appointment

If the patient is very young please check with you Doctor/Supervisor/Practice Manager that they can been seen on their own. Your Practice should have guidelines on young patients.

At the time of the appointment check if they have a mobile telephone number – this will allow you direct access to the patient if you should need to contact them.

If Tests are being carried out

Make an appointment for them to receive the results. Normally we ask
patients to telephone for results – giving a young patient results can often lead to confusion and the correct procedures not taken. An appointment can give the Doctor/Nurse a chance to make sure they understand. It is amazing how many young patient do not understand medical terminology – I have had young patients believe that a “positive” pregnancy test means that they are NOT pregnant. Positive meaning it is good that they are not pregnant.  Do not assume that they understand – always clarify that they understand – explain exactly what the results mean. If as a Receptionist you are giving out a pregnancy result to a young patient and the test is “positive” follow-up by saying:

“Your pregnancy test is positive – that means you are pregnant – would you like me to make an appointment for you to see the Doctor”?    or

“Your pregnancy test is negative – this means that you are not pregnant”

When a Young Patient wants to book an appointment.

There are several things take into consideration when a young patient comes into the surgery to book an appointment:

•  The young patient does not want their parents knowing that they are going to see the doctor.
• Young patients are often nervous about seeing the Doctor.
•  It might have taken a lot of guts for them to come in to book the appointment – maybe it might be of a sensitive nature – something that has taken them time to come in about. So don’t scare them off before they have a chance to see the Doctor/Nurse.
•  Always try to fit them in when it is convenient with them – if they don’t want their parents knowing it won’t help giving them a tea time appointment – parents might ask questions to where they have been.
•  Offer an appointment straight from school – or perhaps in their lunch break. Ask the young patient when it would be best for them to come to the surgery.
• If you feel that the young patient is nervous see if you can fit them in there and then (if you have a surgery going on) – often they will book an appointment and not attend – their nerves get the better of them and they do not come back.
•  If it is a male young patient try to book them in with a male doctor and a female doctor with a female patient. This will help if the appointment is of a sensitive nature.
•  If the young patient comes to the desk with a friend – you can always mention that the young patient is welcome to bring their friend in with them to see the Doctor. They sometimes need the support from a friend.

And most important – Young patient have the right to confidentiality – if they are old enough to come on their own then they should have the respect of confidentiality like any other patient. Sometimes Parents get to know that the young patient has been to the see the Doctor and will phone the surgery to ask what they have been in for – you do not have any right to give out any information. So be very careful. If young patients wanted their parents to know they were seeing the Doctor they would have told them.

Make sure you have the correct training in a situation where a parent calls the Surgery and asks why their child has been seen. It will happen.

Helping Patients With Learning Disabilities

People with learning disabilities are a small proportion of the population; however evidence suggests they have greater health needs, in relation to hearing and visual disabilities, hypertension, chronic bronchitis, epilepsy, cerebral palsy, gross obesity, spinal deformities, skin disorders and mental health.

Patient can often feel intimidated and often feel confused and may be happy to let their carer speak for them.

They might often see the Doctor or Nurse but leave the room without having communicated what the reason was for attending the Surgery. In addition to these problems many people with learning disabilities may not be able to understand written instruction which can cause them some distress.

Areas to be Considered

Communication

• Use clear short sentences
• Check the patient’s comprehension of the conversation by asking questions that will clarify that they have understood.
• Give clear information. It might be necessary to explain in more detail because of the patient’s level of understanding.
• If it helps the patient write instructions down.
• When asking the patient asks a question please give them time to reply.
• Direct the question at the patient rather than just to their Carer.
• Use good body language and eye contact at all times.
• Make them feel at ease.
• Do not rush them.
• Give them your full attention.
• Most of all give them time.

Appointments

• Consider booking a longer appointment to give both the GP and the patient time to communicate.
• People with learning disabilities may become anxious in a crowded and noisy waiting room, so appointments booked at quieter times of the day might ease anxiety.
• Some people with learning disabilities may find it difficult while waiting for their appointment; this may be overcome by booking at the beginning of the appointment list.
• Continuity is important to people with learning disabilities – if they gel well with a certain Doctor or Nurse wherever possible please try to book them with that Doctor/Nurse.
• Always give an appointment card for their next appointment; please do not give it verbally.

Know Your Patients

A good receptionist will know her patients – and will understand the patients especially those with special needs. She will know exactly the needs of the patient and will endeavour to do her utmost to ensure that the patient has a good experience when coming to the Surgery and this begins at the front desk.

 

 

When The Doctor/Nurse is running late.

When a patient books in at the reception desk and you identify that the Doctor/Nurse or other healthcare professional is running more than half an hour behind schedule PLEASE inform the patient before they sit down.

No one likes to be kept waiting, but everyone would rather be told and given the option to wait or re book another appointment.

Lack of communication can often lead to a complaint or even worse someone getting aggressive.

When a patient comes to the desk you could say:

“I apologise but Dr Smith is running about 35 minutes late this morning – he had an emergency / visit to do. Would you like to wait or would you like to re-book another appointment?”

By doing this you are giving the patient a choice. If they choose to wait then they can not come back to the reception desk after 25 minutes and complain – which they more than likely would have done if they had not been informed.

1. It also gives the patient a chance to go to the paper shop/car to get something to keep them occupied while waiting.
2. They might want to make a phone call to tell someone who they are running late.
3. They simply might need to go to the toilet.

They would be reluctant to do any of the 3 above if they did not know they were in for a wait – they would sit there waiting to be called in at any minute.

If the patient cannot wait for various reasons, it gives them the opportunity to re-book at a time suitable to them. By patients booking another appointment it will lessen the already late and give the Doctor / Nurse a change to catch up.

Always try to defuse any potential complaint. It is always better to try and solved a situation sooner rather than later.

Always look ahead.

Receptionist Training: Young Patients and Confidentiality

•  HOW CAN WE HELP YOUNG PATIENTS
• 

 It is important that a young patient feels confident to be able to
speak to a Health Care Professional in confidence.

 

Young patients also have the right to confidentiality! Often it is difficult when a young patient around the age of 15 years comes into the surgery alone. They often don’t want their parents to know that they have been to the Surgery. Often it is of a personal nature. So what happens when the Surgery need to get in touch with the young patient:

Do not phone the patient on their home phone (if possible)

This often leads to questions by parents as to why the surgery is phoning – especially if the patient has not told their parents they have been to the surgery.

Never leave a message on the home answer phone

Again, this will lead to questions by parents.

Use Mobile Telephones wherever possible.

It might be a policy of your Practice not to use mobile telephone numbers. But in the case of a young patient it is advisable to use a mobile number if you have one. This is one safe way of being able to speak direct to the patient – in confidence.

When is a good time to phone?

Ask the Young patient when would be the best time to phone. You don’t want to call when they might be in school or perhaps at home.

If a young patient comes in alone for an appointment

If a young patient wants to make an appointment and wants to be seen on their own please check with you Doctor/Supervisor/Practice Manager that they can be seen on their own. Your Practice should have guidelines on young patients.

At the time of the appointment check if they have a mobile telephone number – this will allow you direct access to the patient if you or a healthcare professional should need to contact them.

If Tests are being carried out

Make an appointment for them to receive the results. Normally we ask
patients to telephone for results – giving a young patient results can often lead to confusion and the correct procedures not taken. An appointment can give the Doctor/Nurse a chance to make sure they understand. It is amazing how many young patient do not understand medical terminology – I have had young patients believe that a “positive” pregnancy test means that they are NOT pregnant. Positive meaning it is good that they are not pregnant.  Do not assume that they understand – always clarify that they understand – explain exactly what the results mean. If as a Receptionist you are giving out a pregnancy result to a young patient and the test is “positive” follow-up by saying:

“Your pregnancy test is positive – that means you are pregnant – would you like me to make an appointment for you to see the Doctor”?    or

“Your pregnancy test is negative – this means that you are not pregnant”

When a Young Patient wants to book an appointment.

There are several things take into consideration when a young patient comes into the surgery to book an appointment:

•  The young patient may not want their parents knowing that they are going to see the doctor.
• Young patients are often nervous about seeing the Doctor.
•  It might have taken a lot of guts for them to come in to book the appointment – maybe it might be of a sensitive nature – something that has taken them time to come in about. So don’t scare them off before they have a chance to see the Doctor/Nurse.
•  Always try to fit them in when it is convenient with them – if they don’t want their parents knowing it won’t help giving them a tea time appointment – parents might ask questions to where they have been.
•  Offer an appointment straight from school – or perhaps in their lunch break. Ask the young patient when it would be best for them to come to the surgery.
• If you feel that the young patient is nervous see if you can fit them in there and then (if you have a surgery going on) – often they will book an appointment and not attend – their nerves get the better of them and they do not come back.
•  If it is a male young patient try to book them in with a male doctor and a female doctor with a female patient. This will help if the appointment is of a sensitive nature.
•  If the young patient comes to the desk with a friend – you can always mention that the young patient is welcome to bring their friend in with them to see the Doctor. They sometimes appreciate the support from a friend.

And most important – Young patient have the right to confidentiality – if they are old enough to come on their own then they should have the respect of confidentiality like any other patient. Sometimes Parents get to know that the young patient has been to the see the Doctor and will phone the surgery to ask what they have been in for – you do not have any right to give out any information. So be very careful. If young patients wanted their parents to know they were seeing the Doctor they would have told them.

Make sure you have the correct training in a situation where a parent calls the Surgery and asks why their child has been seen in the surgery. It may happen so be prepared.

The “Stick It” and My Credit Card

I had an appointment today to see a consultant – It was a private appointment – something that I had to get sorted sooner rather than later and going private was my best option.

The hospital was small the staff very friendly. The consultant went through everything and his secretary gave me a date for my operation – 2 weeks time.

Armed with all the necessary paperwork I headed over the Bookings Office. The clerk took all my details, and asked for an initial payment of 125.00.

I gave her my credit card – she then said that payment would not be taken until the day of the operation.

She reached for a “stick it” and promptly wrote all my credit card details down on this little piece of sticky paper. But why not put it on a proper form to be added inside my file.

My heart sank – although I use “stick its” a lot – I certainly would not have used it in this instance. I didn’t feel happy about leaving my credit card details on this loose sticky piece of paper. I was actually gob smacked that this method was used in taking all my details
of my credit card.  My thoughts went to my blog on “Taking a Message” http://wp.me/p1zPRQ-54 dated 20.7.11

In the blog I actually advised against using such a thing for the taking of messages or anything of importance – and to me my credit card was certainly important. This piece of sticky paper so easily could be lost with all my details on it.

Quick thinking – I spoke up and said that in fact I would prefer to pay by a cheque – which I did – and thankfully the small sticky piece of paper was torn up by the clerk.

What are your thoughts on taking messages on “stick its” do you think it is a safe enough?

“I want an appointment NOW”

Before I started working at the Surgery I thought a Doctor
was just a Doctor. If you were ill you would go and see one of the Doctors that had the nearest available appointment. I soon learned how wrong I was.

We had 6 GP in the Practice that I first started working in.
Each and everyone one of them was different in many ways. Some patients would get
along better with one Doctor more than the others – and the same with the
Doctors – some patients for whatever reasons just used annoy the Doctors– but given
the professionals that they were never showed that side to the patients.

In my first few weeks I used to wonder why some patients
would only see one pacific Doctor and would wait up to a week for an appointment
with them – and the patients would climb the walls if their Doctor was on
holiday or fully booked – you would have thought that the patients world had
almost come to an end – they would just refuse to see anyone else.

There was one occasion when a patient phone for an
appointment to see Dr Stafford – I explained that Dr Stafford was not in surgery that day and was fully booked for several days ahead and then he was on holiday the following week. I offered the patient the next available appointment with another Doctor in the practice. The patient was   not happy. I could sense his blood pressure going up and that was over the phone. He explained that he HAD to see Dr Stafford THAT day as it was URGENT. I explained again that Dr Stafford was not in surgery that day and I would put him in with the Doctor that was running the surgery for “urgent” appointments that day – he was having none of it. He then started shouting at me down the phone – accusing me of “refusing” him an appointment adding how he had found me rude and unhelpful. (I might add I was never rude at any time to him)

I had to make sure that the patient understood that I was
not refusing him an appointment – but just not able to give him one with the
Doctor of his choice. I calmly repeated that I could give him an appointment
that morning with Dr Paul but the patient continued to shout down the phone to
me. I politely asked the patient not to shout – and explained that I was trying
to help him – he was having none of it – and his parting words were “so that’s
it then – you have refused me an appointment – so it’s on your shoulders if I
die then” and slammed the phone down.

Unfortunately we did get some calls like that – but thankfully
they were very few and far between. The first couple of times that happened I
worried myself sick. But soon learnt that as long as I was clear in my words
and offered the patient an appointment to see a Doctor there was not a lot more
I could have done. It was the patient’s choice not to take the appointment
offered to him.

But what I would do was document the call – I would make a
brief record on the patient notes that he called for an appointment with Dr
Stafford, was offered another Doctor due to Dr Stafford being fully booked and
the patient refused. I always put the time the call was taken too. I learned
very quickly to always cover yourself in any such incidents. If in the event
that something had happened to the patient – and he had told someone that I had
refused him an appointment where could that have gone? So I always documented
anything that I felt could come back at a future date.

Then I slowly began to see why some patients preferred to
see some Doctors more than the others. Each Doctor had their own area of expertise.
We had one Doctor that was fantastic when it came to anyone that had a bad
back. Another was excellent in skin conditions another on sports injuries and
one that was excellent with children – he actually still did some work in the
local  pediatric hospital. A lot of GP’s actually do clinics in their areas of
expertise in local hospitals.

It then made sense to why certain patients would only want to see one Doctor – and I could see the logic behind it.

And there were also some patients that for whatever reason
did not see eye to eye with certain Doctors in the Practice and would point-blank
refuse to see them. Difficult when at times these Doctors would be the only one
with an available appointment. Just like my story above.

One piece of advice I would give new Receptionists over the
years was when someone did have a go either over the phone or at the front desk
to try to not take it personally – because the angry person was not actually
directing their anger at them personally it was directed at the “Receptionist”
and if any one of us was standing there they would have had exactly the same
complaint. I found that this helped me in the earlier days when I felt that
they were shouting at “me”.

And to remember – patients are not customers. Patients are
often in pain, worried about themselves or loved ones, frightened or at times might
have a mental problem – and all Receptionists should remember this at times
when patients show their anger – I am not saying it’s right  – but we do have to take it into
consideration.

That Rare Free Appointment

The events described in my blog are based on my experiences as a Receptionist and Manager. For obvious reasons of privacy and confidentiality I have made certain changes, altered and fictionalised some names and aspects, but my blog remains  of life as a Receptionistand Manager working within the Healthcare Sector.
 

Who would have guessed that first day in my new job as a Doctors Receptionist how my life would change? This was the first day to the start of my new Career.

I started on a Monday morning almost 16 years ago. Anyone working in a GP Surgery will all know that Monday mornings are really busy. At times busy beyond belief. Patients that have been sick over the weekend all wanting to be seen – that same day people who have run out of medication needing an “urgent” script all wanting to see the Doctor urgently.

I was assigned to another Receptionist Jackie on my first day – I followed her around like a shadow – and I have never forgotten her kindness or patience over the weeks showing me the never-ending tasks and jobs that had to be done.

I was just gobsmacked at the volume of people coming to the desk, the fact that the phone did not stop ringing for the first 3 hours and how all the receptionists were running around like headless chickens doing 2 or 3 things at once. I have never been in a Reception environment where it was so manic.

The senior Receptionist Jane was what you would call “a dragon” yes I am afraid she was one of those few that certainly won that title. She was nothing more than a bully which I like others before me was about to find out over the coming months.

I had only been there about an hour when she told me to answer the phones – I didn’t have a problem with that as I have always worked in roles where I used the phone a lot. But what I didn’t bargain for was the amount of people who all wanted appointments THAT same morning.

As I said before we still used an appointment book – everything was put in pencil – easy to be rubbed out in the event of cancellations etc.

I had to keep asking my guardian angel Jackie what I should do as there were just no appointments slots spare – something that on the day was a rare as elephant’s eggs!!!

Jackie would take over the phone – sometimes fit someone in at the end of one of the Doctor Surgery and other times take messages or put the caller in with an appointment later on in the week. I wondered how on earth she “knew” who needed what.

I was horrified at the amount of people who were requesting urgent appointments and how cool and calm the Receptionists were when dealing with the requests.

Believe you me I soon got used to it – it’s a skill believe you me. You could have someone demanding an urgent appointment only to find out that it is something that could wait until there was a free appointment, or you have someone who asks for an appointment that day but when told that you are fully booked does not push the matter any further – but over the years I have learnt that the person that does not push for the appointment can in a lot of cases be the one that needs that “urgent” appointment more – it’s a skill to
try to find out without asking too many questions to why the “urgent”
appointment is needed. People are all so very different – and the only way you
can find out what it is they need is to ask!

I know a lot of people don’t agree with the Receptionist asking the caller what they need the appointment for – but please believe me it does help to ensure that the people who need to see the Doctor urgently do get the appointments. Some patients are adamant that they do not want to tell the Receptionist why they want to see the Doctor and that is fine – as we do appreciate that there are some personal matters that they only want to discuss
with the Doctor. But, but asking why the appointment is needed can help
everyone. Sometimes an appointment is not always necessary – maybe taking a
message and passing this onto the doctor for an answer will be sufficient.
Perhaps someone needs an urgent repeat prescription and again taking a message
could avoid another appointment being used. It can help everyone if we ask “can
I ask what the problem is please” when an urgent appointment is requested.

Being behind the reception desk you do get to see both sides. The Doctors are supposed to see around 16 patients every morning and again around 12/14 in the afternoons (Surgeries do work differently so these numbers are not set in stone). But I can count on one hand the amount of times that a Doctor would see his or her quota. Doctors always had “extras” put in atthe end of their session – these are where the “urgent” appointments were often
placed.

We would also have the people who would phone in for a home visit either the patients themselves or someone on behalf of the patient.

Again it was important to ascertain why the visit was needed. The Doctors always wanted to know what the visit was for so they could prioritise their visits and visit the ones that were very sick or vulnerable i.e elderly or very young.

It never ceased to amaze me in all the years that I worked in that area the amount of people who would phone for a home visit when it just was not needed. The excuses were many. People would phone for a visit to ensure that they got seen that day. If the weather was bad they didn’t want to come out and expected the doctor to come to them, and there were times when the doctor would call to visit the patient only to find that they were not “back” from shopping or the hairdressers. Yes, they could go shopping or the
hairdressers but not go to the surgery to see the Doctor.

So, it was important that the patients that were sick, housebound were the ones that got the visits.

We had to try to keep the visits to a minimum – because each visit could take the doctor over half an hour or more to do – getting from one address to the other and seeing to the patient – just think of how many people could have been seen in surgery in one half hour?

Some people think that because the Doctor only has a 2 or 3 hour surgery in the morning and a 2 or 3 hour surgery in the afternoon that is all they do. But that is so far from the truth.

After their morning surgeries they have to attend to a large volume of paperwork. Go through their daily post, fill out insurance forms in all shapes and sizes – and this is a never-ending task then it’s onto their daily visits.

They then come back to do an afternoon surgery and if they are the doctor that is on duty that afternoon they could have several more visits to do either before their afternoon surgery begins or after their surgery has finished – with the usual “extra” urgent appointment added to their surgery list.

On top of this the Doctors have targets to meet – so teams meetings often have to take place on a weekly basis. Hard to believe that a Doctor has targets to meet – but they do.

But for me the one thing that I never could understand was the amount of DNA that every surgery across the country has to put up with. And it’s not only Doctors Surgeries that have to put up with this its Hospitals too. What is a DNA you might ask – well this stands for Did Not Attend (appointment).

For every appointment that is filled means that someone else
has missed out. So might argue that they might make an appointment a couple of
weeks ahead and are better by then, ok buy please cancel the appointment so
someone else that is ill can use it. On the other hand we quite often get
people who DNA when they have been one of those patients that have requested an
“urgent” appointment only that same morning!

Appointment systems in every Practice were always an ongoing saga – Practices would often change their system hoping that one day it would work well for everyone. But today 16 years on – I don’t think it’s a whole lot better. Do you?

© 2011-2017 Reception Training all rights reserved