10 things to know about your GP
In this article, we will describe 10 things to know about your GP.
1. Your doctor would like to give you more time
- Most GPs provide 10 minutes for an appointment. Although this might not seem very long you must remember that this has increased over the past 20 years from a typical 7.5 mins per appointment, and from even shorter appointments before then.
- GPs can choose to offer longer appointment times – but there is a balance between length of appointment; and how many appointments they make available. This is obvious when you think about it – do you offer fewer, longer slots, or more, shorter ones?
- What would you do? Depending upon your reason for attending, 10 minutes might be more than enough time, or woefully inadequate:
- Got a sore throat? You might be in and out in 5 minutes
- Hearing voices and suicidal? You might be in there for half an hour, or probably longer.
- If you already know you are going to need more than 10 mins, ask reception if you can have a longer slot called a ‘double appointment’ (20 minutes).
2. Your GP does not like lists of problems
- Let’s clarify this. GPs encourage people writing their issues in advance will they think it will help them.
- However, noting point one above, if you have 10 minutes and pull out a list of 5 problems, this is pretty stressful for your GP – more importantly they will not be able to deal with all of them in a 10 minute appointment.
- Were you expecting 2 minutes per problem? Its important to be realistic; and prioritise what you want from your doctor.
3. If you arrive 10 minutes late, you have missed your appointment
- I.e. If you are 10 minutes late (or more), then you are not just late, your appointment slot has come and gone. The next patient is now due, and will have taken your slot. Remember that the impact of being late is not just on your doctor.
- The GP may be prepared to finish their surgery late in order to see you; but what about all the other patients who have booked in and arrived on time? If you arrive late, you are causing hassle to all the people around you in the waiting room.
4. Your GP is not telepathic
- That would seem pretty obvious, right? People may think their GP will know what they are worried about, which of their problems is a priority for them and what are their hidden fears.
- A good doctor will explore all of this with you, but you can short-cut this – by being up front about what is on your mind.
- If you are worried because you think your rash or lump might be cancer, then say so.
- If you want to exclude some rare condition because your mother had it – again, let the doctor know.
- Try not to leave your main problem until the end. You would be amazed how many people get through the whole consultation; and then, at the end, say something like “while I’m here, can I mention this chest pain I’ve been getting?”
5. Your GP is a specialist
- They have just specialised in being a generalist!
- Don’t make the mistake of thinking that there is a hierarchy of doctors, with GPs at the bottom and hospital consultants at the top.
- Your GP will have spent a minimum of 5 years in GP training AFTER medical school. They are experienced doctors qualified to look after you.
- Sometimes people think that going to A&E means you get to see a ‘proper doctor’ – remember that a junior doctor in A&E is likely significantly less experienced than your GP, and may be in the second year after they qualified.
- Most doctors think that being a good GP is the hardest job a doctor can do.
- If you are concerned that you might need to see a specialist, then talk this through with your GP.
6. Your GP is self-employed
- Did you know this? Why does it matter? GP partners own the business of the practice and are ‘independent contractors’ to the NHS. Many members of staff at the surgery, including some of the doctors, will be employed by the partners, and receive a salary. There are implications of this approach:
- To fund the practice, your GP receives a set amount of money per patient per year to provide all of their care. It doesn’t matter whether you see your GP every week all year, or don’t attend for 5 years; your GP gets the same amount of money for looking after you.
- The amount of money your GP earns varies from practice to practice (they are all individual small businesses) but the average is around £140 per patient per year. This is really good value (less than 40p per patient per day), particularly when you consider this is the money the practice receives to provide all the services and pay all the staff including the doctors.
- Your doctor’s surgery is contracted to provide certain things, and not others. It’s worth remembering this as this is why you will sometimes be asked to pay for things.
- In simple terms your GP is contracted to provide medical care, but not to do things outside of this such as the multitude of letters they are asked to sign. If ANYONE asks you to ‘get a note from your doctor’, you should really question this before heading off to the surgery.
- Because they are small businesses, they bear any increasing costs themselves. Rising indemnity fees (insurance against being sued) have to be paid by the doctor themselves. A doctor working only 2 days per week can be paying £6,000 per year on indemnity insurance.
- Why does this matter to you? Because if they are paying £6,000 on that they are not spending that £6,000 on another receptionist, or nurse, or another doctor. The higher the costs, the less likely the surgery is to be able to add in additional services.
7. Your GP wants the best for you
- If your GP decides not to refer you to hospital, or not to prescribe anything, or not to investigate you, it is not because they are trying to be difficult – or trying to save money (don’t forget, their take home pay is not affected by these things). It’s usually because they don’t feel you need any of the above.
- They also understand, probably better than you, the risks associated with over-referral, over-treatment and over-investigation.
- This is about keeping you healthy, investigating when appropriate, and treating when we need to.
- But, if you were hoping for an x-ray, mention this; and have a calm conversation with your doctor about the pros and cons of doing that.
8. Your GP is not taking part in a medical drama
- When you watch the TV, watch out for the doctors in a medical drama. 9 times out of 10, they get the diagnosis right, first time. But this is not real life.
- Many conditions are not at all obvious at the start, and time is the only sensible way to start to differentiate between them. GPs often get criticised in the press for not picking up serious illness: ‘I attended my GP 3 times before they referred me with cancer’. In reality, serious illnesses often present initially in the same way as mild, self-limiting illnesses.
- A cough, for example, can be caused by many things, from a simple viral infection to lung cancer. The patient who presents to their GP with a cough that they have had for less than a week is unlikely to get a chest x-ray on the first visit; but if it has failed to settle after 3-4 weeks, then that’s a different story. Remember this is all complex stuff.
9. Your GP may play golf (or computer games!), but not in their lunchbreak
- There is a traditional view of GPs, that they see a few patients in the morning; a couple of visits, then are free until evening surgery at 5pm. Plenty of time for 18 holes in the afternoon?
- This view is out of date. Most GPs see 18-20 patients in morning surgery (starting at 8am), followed by visits of checking blood tests whilst having lunch, and then a further 18-20 patients in the afternoon (finishing at 6pm).
- There will also be phone calls and lots of paperwork. This done before and after this already long working day. Some GPs go home, have a bit of dinner, then do more paperwork and emails.
- Paperwork is an essential part of patient care, but takes time. It consists of:
- Looking through the results of investigations (blood and urine tests and x-rays, for example) that have been ordered – and acting on abnormal ones
- Reading letters from consultants, acting upon these letters (consultants frequently give actions for the GP to undertake)
- Signing prescriptions. This is one of the riskiest things that GPs do. Be aware of this and don’t be upset if there is a query over your medication; this might just mean that the GP is taking the trouble to check that this is safe for you and won’t kill you)
- Arranging investigations and referrals from the previous clinic. There is not enough time to do them in the clinic.
- The waiting room may be empty, but that doesn’t mean the GPs are all putting their feet up. A lot of patients seen every day – and a lot of decisions are made.
10. Your GP has entrusted their reception staff with an important job
- And that job is not to make things as difficult as possible to make an appointment! The receptionist’s main job is to deal with enquiries, and book appointments – and generally ensure all is running smoothly. They are not medically trained, but they will have a really good understanding of the services on offer.
- Don’t forget that everyone who works in the surgery is covered by the same confidentiality clauses. You can trust that the receptionist is NOT going to be talking about you to others.
- Increasingly doctor’s surgeries include clinics run by nurses, physios, pharmacists and more. If you ring and insist on an appointment with a doctor, without explaining that it’s because you have a bad back, you might have missed out on seeing the physio – probably a better option for you.
- If you are polite and friendly to reception, they will be polite and friendly to you.
Summary
We have described 10 things to know about your GP. We hope it has been helpful.
