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Irrelevant nonsense

Phil is swamped by tick-box reports that don't actually say what's wrong with his patients

Phil is swamped by tick-box reports that don't actually say what's wrong with his patients

It's coffee time, but my coffee is slowly going cold. I'm working through a pile of paper. I find it odd that, in a paper-free practice, I am presented daily with an increasing wad of crap, now an inch deep.

I used to get a slim bunch of letters from consultants and junior doctors, each a single side of A4. The majority would be worth reading. Now those letters are swamped by the new stuff. There are letters (and I use the word in its loosest sense) from the walk-in centre – each a sprawling three-page computer print-out, of which maybe 30 words are relevant.

There are five-page assessments from chiropodists, questionnaires from the CPN that meander over eight sides... The less important the encounter, the more I get sent.

When I joined this practice, I would get a single green A5 slip when a baby was born, telling me the date of birth and whether it was a boy or a girl. Now I get three sides of bumf plus a two-page questionnaire that is a futile attempt to guess if the mother will get postnatal depression.

There are 40 or 50 ticky-box questions. I've never read it in detail – not once. What's the point? The women in question have all had a baby in the previous six hours; I've been with my wife throughout the birth of three babies and one thing I know for sure is that you won't get any sensible answers from a woman at that particular point in her life.

I only want to be informed about abnormal stuff. If a new mother yelled she was going to call her child Damien, spat blood on the neonate and called him the spawn of the devil while her conjunctiva went scarlet as she laughed hysterically, I would appreciate a note from the midwife.

Otherwise, the old A5 slip will suffice.The cardiology discharge form takes the biscuit. They had the grace to ask if their new discharge letter was acceptable – five computer-generated A4 pages on which there is no human intervention other than a few dozen tick boxes, a list of new drugs, and an illegible signature.

Why they bothered to ask my opinion I have no idea. Despite writing several times pleading 'no, no, no, write me a letter and tell me what's gone on in English, or someone will die!', all I now get is a mass of ticks and crosses.

There are pages of negative findings. But it stands to reason that people don't have most illnesses. I want to know which ones they do have.'So have I had a heart attack, doctor?' says my newly discharged cardiac patient.

'Buggered if I can work it out,' I reply, handing over a sheaf of blurry fax paper. 'If you can tell, let me know.' All this has occurred more or less simultaneously with practices moving to scanning letters into the computer.

If it hadn't, we just couldn't cope with this torrent of irrelevant nonsense. Each patient's notes would require a skip. But cyberspace is effectively infinite, so all this tosh fits in somehow. A new member of staff has to be employed to make it so, but in it all goes.The information doesn't come out as easily, though.

'About that angiogram, doctor. Have I got hardening of the arteries or what?' Ten minutes later, after retrieving screeds of administrative waffle and nothing of any value, I have my answer. 'It says here,' I tell my patient, 'that you didn't have a DVT, and you have only a 20 per cent chance of post-traumatic stress disorder. Isn't that great?'

  • Dr Phil Peverley is a GP in Sunderland and PPA and MJA Columnist of the Year

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