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Saturday morning blues

03 Feb 2010

Copperfield hates the weekend sessions that cater only to the healthy middle classes – woe betide any local who actually turns up ill

Every couple of months I do a Saturday morning shift at our branch surgery on the outskirts of town.

It nestles between some nice new two-bedroom flats with IKEA kitchens and the council estate it was originally built to serve. The Saturday surgery thing is a politically motivated scam designed to offer GP access to the young, fit, childless, affluent floating voters who live on the posh side of the line into Liverpool Street.

My problem is that the PCT has insisted that there be a proper doctor on the premises throughout the session, which starts at 8am and grinds on until 1pm. ‘Proper' doctor is defined as ‘GP partner' – medics further down the food chain don't count.

So while the registrars, locums, assistants, nurses and receptionists come and go, Muggins here has to sit through the whole shooting match.

Plan A – some five-minute appointments at 8am and some more at midday, giving me time to slip off for a leisurely decaf latte and skinny muffin in the interim – was scuppered by the practice manager. To ensure my uninterrupted attendance she timetabled 18 appointments for me at 15-minute intervals.

Now I know that some of you bang on about the benefits of the quarter-hour slot. You can address the patient's unspoken agenda, you can delve into the depths of their psyche while adopting a concerned and supportive expression. Then, and only then, do you feel comfortable in handing out a prescription for salicylic acid gel to treat their verruca.

But as far as I'm concerned you can hold a patient upside down and shake them for seven or eight minutes at the most before you've got all the QOF money out of their pockets that you're going to get. Anything beyond that is purely masturbatory.

Once I've done the smoking nag, the smear nag, the chlamydia nag and the flu jab nag, coded them as ‘not depressed', entered a BP reading of 148/88 or less, recorded their ethnic background and put all the chubby ones on orlistat, I'm bored as shitless as they're going to be after their third or fourth dose.

I can't even slot in and torment a few walking wounded chavs to pass the time. Anyone from the Staffordshire Cross Estate without an appointment gets turned away – even the ones who might actually be ill. The PCT is adamant that these sessions are reserved for patients who might find it inconvenient to attend during the week. Nice, middle-class people who make appointments and have jobs to go to. Just like the people who work for the PCT.

People who are impolite enough to show up uninvited simply get what they deserve. Their complex psychosocial problems and tendency to somatise are deemed unworthy of a 15-minute Saturday-morning consultation. They must ring the out-of-hours service on their stolen iPhones and grovel for their antibiotics, opiates and sleeping pills.

But enough's enough. From now on, I'm rebranding the filing clerk as a ‘consultant wellness adviser'. ‘Consultant' trumps ‘GP' any day, but especially at weekends. She can hold the fort after midday – I've got a pub to go to.

Dr Tony Copperfield is a GP in Essex. You can email him at tony copperfield@hotmail.com

Copperfield

READERS' COMMENTS

Anonymous,
03 Feb 2010
Ever thought about a change of career? jill cooper
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Anonymous,
03 Feb 2010
Ha ha ha! One of your best, Doc Cop. Gareth Lloyd
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Anonymous,
03 Feb 2010
It was a bright Saturday morning and the sun glistened like a jewelled eye. He settled down contentedly behind his desk, happy that after years of bookwork and training he was able to use his knowledge for the benefit of mankind. That morning he saw people who were so harangued by families and bosses that they had no time to come during the week. He listened, not passively, but purposively and supportively. He nodded sagely, reflected back on their thoughts, mirrored their body language, counselled and advised on their concerns. Some were too ill to help and he said he would seek counsel from a higher authority. Others were the worried well and for them he provided hope, a gentle touch and a shoulder to cry on. After the morning was over the Reverend straightened the reredos and locked the main doors to the nave. As he stepped out into the street he noticed that the local GP was also leaving work. He waved but the doctor didn't notice him, his face was hooded and full of disappointment, his eyes sullen and fixed to the floor. Around his neck hung a stethoscope which for a wondrous moment glinted and shone in the sunlight like a radiant crucifix. Sadly, this illusion of salvation was quickly dispelled as the doctor tore it from him his shoulders and threw it into the back seat of his car. He then turned his back and trudged off in the direction of the local pub. Kev
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Anonymous,
04 Feb 2010
Betty, the bar maid, smiled radiantly and said: 'Your usual?' 'Make it a quadruple' 'You know, you look all-in. Wanna share it?' 'Share it? No, I need every drop.' 'No. I meant whatever's getting you down. You see, I've done a bit of counselling and may be able to help.' 'Well, Betty, I just hate working on Saturday mornings. It gets me down.' 'Yeah, I know what you mean. Me dad was a funeral director. He reckoned people who die at the weekend are just selfish an' they should plan ahead better and understand we're not available just for their convenience.' 'He's right, Betty. Give me another one of those whiskies. So what's he reckon the solution is?' 'Well, that's the problem. He dropped dead last Sunday. We called the surgery but they couldn't see him till Monday ' jill cooper
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Anonymous,
06 Feb 2010
Then the doc realised that he hadn't opened his paycheck - as he looked at the amount he smiled at himself and thought - what a luck fat cat i am - purrrrrrrr. amjed munir
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Anonymous,
09 Feb 2010
Sounds to me like you are a typical production line GP, going through the motions to justify your extortionate income, with little regard for patient care. Cynical fulfilling of QOF is my clue to this, surprisingly. Has it ever occurred that you may be doing harm? Or have you read the science lately about, say DM23 ?
Perhaps a change of career is in fact indicated. Ernest Berry
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Anonymous,
09 Feb 2010
Yes Mr. Berry. Let's ALL change career and leave the rest of you to it. I concur with that. Hazel Drury
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