Musings of a GP

I am a GP at a busy NHS practice in Greater London. During a busy day, I see around 40 patients for five to ten minutes each. People come in and see me with problems ranging from ear ache to high blood pressure and fertility problems.

I love my job but it is inevitable that the experience can sometimes be stressful – for doctors and patients alike. It is always a rush to fit everyone in and I can end up exhausted at the end of the day. Unfortunately, some patients actually make it harder than it has to be. A Reader’s Digest survey revealed that a majority of doctors are occasionally irritated and frustrated by the behaviour of their patients. Unfortunately, the doctors rarely say what is bothering them so it is hard for patients to know why their consultation is going so badly.

Here are some of my insights which might help bring some clarity.

1. I am always grateful when patients arrive on time and this makes me a nice, better doctor. Latecomers mean there is little or no chance of avoiding delays for other patients. This is particularly important when it comes to the first patient on the list, since arriving even 5-10 minutes late means you are already running into the next patients appointment time. We doctors are often running late, but I always explain the reason why – briefly – and say it with a smile. It doesn’t always work. I once saw a patient who became so angry at having to wait, that he was unable to discuss his problem once the consultation started. He had to come back another day once he had cooled off.
2. Politeness does pay off. This will help build up a good doctor-patient relationship which will hopefully be a long-standing one. If you are pleasant, your patients will nicer too. If you are rude, the relationship is likely to break down. Colleagues of mine have actually been physically assaulted by their patients.
3. Be prepared to listen. I like to hear my patient’s ideas – up to a point. I am always happy to see patients with Internet print-outs or newspaper cuttings, although my heart falls when patients come to see me waving sheaves of paper convinced they have multiple serious ailments. The vast majority of my patients are not suffering from serious or life-threatening illnesses.
4. Don’t be afraid to tell patients to rebook a further appointment to discuss another problem. Appointment times are short, so it is rarely possible to cover more than one thing at a time. On the other hand it is always possible to fit in other quick things such as a blood pressure check or repeat prescription.
5. With the increasing workload placed on GP practices, visiting time has decreased but I often have to spend extra time with lonely older patients who may be suffering from the effects of isolation. I’ll even have a cup of tea if someone is clearly in need of a bit of TLC.
6. I am always grateful to receive help from another health professional. For example, practice nurses are highly qualified and can deal with a wide range of problems such as immunisations, smear tests and many other problems. I’ll also suggest someone pops into see a local pharmacist. Team work is key in this profession.
7. GPs have different personalities just like patients. There are seven other GPs in my practice and we all need to concede a little to work smoothly together.
8. I prefer seeing patients who ask for me. The advantage is that I already know the patient’s medical history quite well and this can save time. A lot of my patients are women who want to be seen by a female doctor. It is much easier for a doctor to give results or make clinical decisions about problems they already know, rather than reading through previous notes or needing to take the whole history again.
9. Children are always welcome in GP surgeries but there are no crèche facilities in most, so sometimes it is better for patients to leave them in the care of a responsible adult.
10. At the end of the day communication and respect between patient and doctor is key to a long-standing rewarding professional relationship. I always remind myself that I have chosen a caring profession and my first role is to help and support my patients.