Thursday, 3 June 2010

Sun, Silence and Solitude

Usually, predicting how awful my day might prove to be is near on impossible, but not this week. With forecasts full of bright yellow circles on a background of beautiful blue, I can go to work with a smile on my face. Glorious sunny days bring glorius empty waiting rooms and a calm and civilized working day.

Yes, the world is a better place when the sun shines.

During open surgery yesterday morning I saw a grand total of three patients in three hours. Amazing. So whilst I quietly read through clinic letters, enjoying the novelty of a bit of time to myself, I pondered this question: What proportion of appointments are really necessary at all?

As doctors we like to believe that we should be spending our hours tending the sick, making heroic diagnoses and curing people left, right and centre. Thus my initial response to the question was; probably very few. I sneered at the predictability of the good weather phenomenon and imagined how much time I must waste on a daily basis seeing patients who don't need to be seen.

How arrogant. The real truth is that the role of a GP is much simpler than this. It is to provide basic medical care for our patients. To listen, to treat, to check blood pressures, to organise blood tests, to provide repeat medications. Of course much of this is not urgent. An appointment to collect your contraceptive pill can wait a few days, a visit to obtain treatment for acne can be put off. That's why my surgery was empty yesterday, not because I wasn't needed, but because my sensible patients chose not to sit indoors with weather as glorious as this.

It's lead me to a more basic realisation. Seeing a GP has to fit in around people's lives. Because so much of what we do as GPs is non-urgent, routine medical care, patients can't possibly be expected to take time out of work to attend. Much as I hate to admit it (a nine to five day is clearly preferable to any sane GP) our out of hours service really does have to improve and it looks like the new government feels the same.

Terrible news for me, great news for patients.


  1. I had a non-urgent, routine haircut at the barber's last week - I squeezed it in before my afternoon surgery started. He wasn't available at 7:00pm.
    I had a non-urgent routine meeting with my solicitor last year on a conveyancing matter for which I had to take an afternoon off. There were no appointments available after 4:30pm. I may have been able to negotiate a 7:00pm appointment, at a price - but probably not.
    The practice accountant's annual visit was always scheduled for an afternoon when the partners were booked out of surgery. Again, not available at 7:00pm.
    My car was booked for its annual non-urgent, routine MOT last month - again, this was at 9:00am on a Friday, there being no facility to take it in at 7:00pm, or at the weekend.
    I had a new washing machine delivered a few months ago - I was offered a range of times on line to have it delivered, but still had to identify a weekday morning or afternoon to be at home to receive it.

  2. Yes, but verruccas and broken fingernails are different - we absolutely must have a doctor on call for these things 24/7. ;)