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Gold, incentives and meh

A day in the life - Dr Mei Ling Denney

A new series taking a close look at a GPs' typical working day, charting the achievements, the frustrations and those 'it could only happen to a GP' moments.

A new series taking a close look at a GPs' typical working day, charting the achievements, the frustrations and those 'it could only happen to a GP' moments.

 

 



06:45

I wake up at 6.45am when the alarm goes off and wonder how late I can leave it before getting up – I am not an early morning person. After a lie-in until 7am, I jump up realising I have to mark a summative assessment audit before work. I do this over breakfast, cheered by the fact that it is actually an original piece of work, and not about yet another QOF target.

08:00

Then off to work for a morning of patients. I work as a locum, so nearly every patient is a new face to me. The first challenge is remembering the surgery door code and computer passwords – of course, these vary from place to place, so I often have to beg forgiveness from the practice manager who has to tell me what they are yet again.

Despite my being a locum, Mrs Rodriguez has found her way onto my list once more. She speaks virtually no English and has multiple medical problems and a long repeat prescription list – and I know I'll be running late as a result. She demands a stronger prescription in broken English, waving both her HRT packet and her sleeping tablets at me. I try to negotiate a shared management plan using mime, and end up writing down all my advice on a piece of paper to be given to her daughter.

12:00

At lunchtime I nip out to buy an egg and cress sandwich, and eat this while taking a telephone call from a colleague in the Middle East who wants to discuss improving access to CPD for primary care doctors. The situation is muddied by politics, but at least the two of us feel we have a common agenda. After discussing a range of strategies, I put the phone down and spend the next five minutes sponging mayonnaise off my cardigan.

While driving off to be course organiser for the afternoon, Fran, the appraisals administrator, rings from the PCT (I am appraisals lead). None of the appraisers has done any appraisals yet this year, she tells me. What would I like to do? She suggests a stern letter and volunteers to draft it.

13:00

I arrive at the VTS and sift through the post (confused clinical supervisor, worried trainee, outraged trainer) and draft some replies. An ST3 GP registrar has problems with her e-portfolio – would I look at what she has done so far and say whether it's going to

be okay for a six-month review? I log on to my own e-portfolio site as educational supervisor and find all my trainees have mysteriously vaporised.

Another email to the deanery, at which point I discover that I have received 40 emails since daybreak. I scan down them quickly, only opening those with no attachments or those that look particularly intriguing. The group of vets with whom I have been running communication skills roadshows have sent me a flyer about updating my knowledge on small animal diseases, based at a Red Sea diving resort. I wonder if my own appraiser would approve.

14:00

The VTS session goes well, and we have a discussion about ethical dilemmas. I drive off home at 5pm to greet the family and bake a batch of brownies. My grandfather was a master baker so someone has to carry on the family tradition. While the brownies are doing their thing in the oven, I check my emails again – now 65 unanswered in my inbox. Groan. I manage to deal with 20 before I falter at reading colleagues' commentaries on the Tooke report, the Darzi review and so on and so on. Should I go through them all now, or press ‘delete all'? The timer pings, so I pull out the brownie batch and sample two for quality control.

19:30

Off to a friend's house for dinner. ‘Mei Ling, I'd like to introduce you to Jonathan,' she says breezily. ‘We may have met already,' we mutter, as we both realise we had a recent doctor-patient encounter about an intimate problem. Nevertheless, the soiree goes well, and we all have a splendid argument about the value of women in the home and work.

23:00

Back home I reluctantly check the emails again, now up to 90. About a third are about deanery work, a third are related in some way to the RCGP (mainly Clinical Skills Assessment), and a third are a sort of e-pick ‘n' mix. At midnight, I take my laptop to bed to peruse the revised schedules for a CSA training event I am supposed to be organising.

‘Very romantic,' mutters my husband sarcastically. Picking up this subtle cue, I decide whether an ethical framework could help me here. It doesn't, so I slip my laptop under the bed and decide to call it the end of the working day.

Dr Mei Ling Denney is a portfolio GP, a VTS course organiser, an appraisals lead for Peterborough PCT and an MRCGP examiner with international responsibilities Dr Mei Ling Denney

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