Posted by: Tony Copperfield31 August 2012
According to Professor Amanda Howe, RCGP honorary secretary and GP in Norwich, GP appointments lasting 30 minutes should be the norm rather than the exception. Hmm, I know where she’s coming from - Norfolk, where the perception of ‘normal’ is distorted by the isolation, the flat landscape and the proximity of farmyard animals.
That aside, there’s a danger we’re confusing two different things: appointment time and consultation length. As any GP knows, they’re not the same.
Consultation length is the time it takes to deal with the patient. This varies from a few seconds (my personal record being a woman who mistook the dirt stuck to her foot as a possible melanoma) to God only knows how long. We give patients the time they require, mostly, including those who feel as though they could quite possibly continue their consultation for the entire duration of my life and who, even as I dissolved into dust, would be saying, ‘While I’m here...’.
The appointment length, though, is something else entirely. It’s simply a convenient unit of time that GPs use to organise their work. By pragmatically divvying up prime consulting space, we more or less balance out the epics with the quickies. We use the 10-minute slot as a tool, too – slicing problems into a sequence of consultations, or booking double appointments if we really want to wade through multipathological treacle.
And it does act as a subtle constraint for those who really do bang on. A 10-minute slot doesn’t entitle us to club them to a pulp – as they deserve when the clock strikes 20 – but it is a parameter we can highlight, particularly when the rest of the waiting room is trying to jemmy the door open.
The trouble is, the half-hour consultation drum-bangers will take away this flexibility and effectively railroad us into being a new breed of general physicians who only deal with complex cases. Sod that for a game of doctors. I need the odd pill check and sore throat to keep me sane.
Besides, consulting at half-hourly intervals would make my day 60 hours long. Either that, or the average co-morbid punter would have to wait beyond his prognosis for a spare appointment. Put that way, though, it doesn’t seem such a bad idea.