What can you do in ten minutes? Send a couple of emails? Go to the loo? Grab a coffee? It seems crazy that this is how long we get to spend with a GP — often the first port of call for a health concern. With the profession in crisis and the public finding it harder to get appointments, it’s crucial to use that precious time to your advantage. In the 1970s, patients and GPs made do with a hasty six minutes. But things have moved on. We are all better informed and doctors and patients communicate better with each other.
People see their GP for different reasons. Some regard us as hard-to-see grumps who won’t give them what they want. To others, we are a vital lifeline, providing medical, social and psychological support to those who need it most, sometimes on a daily basis. In reality, we GPs are an eclectic, almost incomparable mix of general physician, minor surgeon, advocate, social worker, counsellor, signposter, administrator, risk assessor, public health guardian, confidante and quality assurance provider, dealing with many issues at once.
Here are my top tips to get the most out of us.
Turn up on time. GPs run late (see below), but if you are late, then your ten-minute slot has gone and it may mean a rushed or fruitless appointment.
Make sure you are seeing the right person. Most importantly, before making an appointment, it’s worth asking if the GP is the right person to see. For instance, your pharmacist can deal with many minor conditions and ailments such as hay fever, insect bites, dry skin, conjunctivitis, medication queries and sore throats. If the pharmacist thinks you need to see a doctor, she’ll tell you. Need a travel jab or advice on a smear test? Then you need the practice nurse. And if you feel you need to speak to someone about an emotional issue, then throughout England and Wales there is a service called IAPT (Improving Access to Psychological Therapies), which is a free talking therapy service. If you are unsure who to see, ring 111, which is available 24 hours a day.
So if you do decide you need to see the doctor, how can you get the most out of an appointment?
Feel free to bring a friend or relative. There’s no need to bring the whole family, but it can be helpful to have someone with you for support. Patients under the age of 14 should be accompanied by a parent or guardian.
Get it all out at the start. Sit down and get everything out. Write down what you want to discuss beforehand. If you have two items to discuss, list them at the beginning rather than saying, ‘Ooh, while I’m here…’ or, ‘There were just a couple of other things….’ If you list them at the start, the GP can plan out the time. Two items is reasonable, three is pushing it. Any more and it becomes difficult to cover everything thoroughly. Men, in particular, often don’t go to the doctor for years and save up several items. This is a false economy as we GPs are more likely to rush and make mistakes and you will leave feeling cheated and not listened to.
Get to the point. The quicker you mention why you’re there, the more time the GP has to deal with your problem. This can be quite difficult with emotional problems, as some people find it hard to open up, but as for the rest, it’s best to get on with it. The GP will tease out what he or she needs from you in terms of more information.
Bring your diary. First, you can jot down notes as an aide-memoire. Second, if you can tell us exactly what happened and when, that makes our job much easier. ‘I ate leftover takeaway on Sunday night, was sick on Monday, fainted on Tuesday…’ etc. And do tell the GP what you have tried, e.g. ‘I took paracetamol and it didn’t help…’ Being descriptive helps, too. There’s no need to stand and deliver your history in poetry, but because GPs listen to ‘stories’ all day, certain words to describe your symptoms may help us identify the problem more quickly. Is your pain dull or sharp? Does it burn or throb? Does your headache feel like a tight band or is it sharp and stabbing? What are you unable to do? Your narrative is surprisingly important. I remember seeing a 19-year-old woman who said she woke up vomiting, coupled with ‘the worst headache I’ve had ever had, doctor…’, followed by a lack of power in her right arm. I sent her to hospital immediately and a brain scan showed that she had suffered a large haemorrhagic stroke. Her diagnosis was in her story.
Be prepared to be examined. Dealing with symptoms over the phone can be risky and doesn’t save the GP any time, so if you have to come in to see us, please wear clothing that is easy to remove.
Ask questions. If you don’t understand something, ask the doctor.
Make use of the primary care team. The GP is only a cog in the large well-oiled machine that is a GP surgery. You’ll save him and yourself a lot of time if you pick the right part of that machine. Chasing a referral to the hospital? Ring the secretary. Need a blood pressure check? Maybe you could see the nurse. Need to see a counsellor? Ask reception if you can refer yourself. Worried about your toddler’s weight? See the health visitor first. Many services do not need you to see the GP.
Which brings me on to things that won’t help during your GP appointment.
Don’t expect us to solve everything in one visit. We live in a convenience culture, but medicine can be a complex business. Take chest pain — there can be more than 30 reasons why someone has chest pain and by carefully listening to you and examining you a GP may decide you need reassurance, treatment or more tests. Occasionally, you will need to wait for referrals to a specialist or try a treatment to see how you get on. Medicine, more specifically helping people who think they are ill, is an inexact human science and cannot easily be compared with other modern disciplines.
Don’t assume you can have what you want. NHS general practice was set up to deal with people’s health care needs. The rise of consumerism, medical advances and private clinics have meant that patients ask for some tests or procedures that aren’t clinically necessary or that there isn’t enough evidence to support with taxpayers’ money.
Don’t think that seeing patients is all a GP does. You may find your GP often runs late. This may be because she is on the phone to another doctor, admitting someone to hospital, or getting constant interruptions — home visit requests, prescription amendments, urgent messages about patients from relatives, safeguarding issues, calls from the hospital or coroner, queries from a pharmacist, urgent letters and results. If the doctor appears a bit browbeaten, it’s because she is constantly multi-tasking. If you feel you need more time, surgeries can occasionally offer double appointments. Surveys indicate that GPs and patients would like longer appointments, but until the national shortage of GPs is addressed this will be difficult to achieve.
Finally, please don’t ask us about your teeth — we didn’t go to dental school…