The Prescription

Following on from yesterdays blog I mentioned that many GP’s
have their own specialities in different areas. This can be very beneficial to patients at the practice and can often avoid having to be referred to a consultant at the local hospital.

One of the GP’s that I worked with Dr Paul was a right character. I have written about him
in previous blogs:

The Urine Sample  and

The Million Pound Cheque

Both are very funny and well worth a read.

I always enjoyed working with Dr Paul, he was fun, always time for a joke or two, and he
would always find time to answer any questions that we Receptionists might have
had. He was also extremely professional.  I learned a lot from him over the years that I
worked with him. If I ever a question about a certain drug, an illness that a
patient might have or just routine medical questions he would always explain it
in such a way that was easy to understand and he always made it interesting. I
have a lot to thank Dr Paul for – he was such a great mentor and very dedicated
to his job. He was the newest partner into the practice and also the youngest –
a breath of fresh air.

Dr Paul was always very popular with the patients – they liked his young outlook –they
liked the way he took time to explain everything to them and always gave them
the time they needed. But on the downside of that he surgery ALWAYS run late – and I don’t mean just 10 minutes late – often his surgery would run late by an hour or more. But what he did say was the most important patient at that moment was the patient that
was sitting in front of him – and that he would always give them the time that
they needed. And the patients all knew this – and those that thought the sun
shone out of him accepted that and would quite happily wait the hour or so to
see him. Of course there were the odd few that would not be happy – but if we
could we would always pre warn people just how late he was running. This went
against all the local Primary Health Care Trust guidelines that said that each
patient should be given a 10 minute appointment.

It could at times be frustrating for us the Receptionists – because if he was on a late
surgery (the evening surgery) we could quite often be there until way after our
finishing time – sometimes an hour late – as we had to ensure that everyone was
booked in and seen before we could shut up the Reception area and go home.

Dr Paul worked as a pediatrician (a Doctor that works with children) before joining the practice – and often would work shifts in the local children’s hospital. He was just great with the children – they used to love going into see them and he was just fantastic with
them – not many of them come out of his surgery without a sticker, or something
else that he might have had in there for them. He had so much time for the tiny
ones of the Practice.

And of course the parents loved him too, they loved him because he was great with the
children and they loved him because he talked TO the children and not over them
– he was just great with them.

One thing that did make me smile – when a child around 8 or 9 would go in with their mum or dad obviously unwell they might have a virus, flu or an infection. He would
give mum the prescription if the child needed one but he would also give the
child a prescription too – but what he would write on it would be something
along the lines of :

“This allows Billy Jones a week off tidying his bedroom due to him having a throat infection”


“This allows Elly Howard a week off doing the washing up due to her having a virus”

 The children would come out of his surgery clutching their “prescriptions” and mum or dad would come out with a smile on their face. What more could you want after
seeing the doctor? Medicine in itself!

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

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?

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