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GPs buried under trusts' workload dump

Rude receptionist oblivious to hints about behaviour

GP's advice

Are you expecting too much of her?

A few months ago we appointed a new receptionist, a woman in her late 50s. She is our only staff member from the most prevalent ethnic group of our patients, and we thought her ability to speak several Asian languages would be an asset. But this has not proved to be the case.

She lacks interpreting skills and is abrupt and rude to patients. She says she cannot attend external training courses because she looks after her grandchildren. When the practice manager showed videos of receptionists behaving unprofessionally at a staff meeting, she laughed, apparently unaware she was looking at her own behaviour.

We do not want to dismiss her. Recruiting staff to our inner-city practice is difficult, and we are afraid she will present herself as a victim of racism if we discipline her.

I wonder whether your expectations of this woman are realistic. Too often, practices (and other small businesses) take on multilingual staff and expect them to act as informal interpreters in addition to their designated jobs, often unpaid and without any extra training.

In a medical setting, such informal interpreting can be dangerous.

If you would like your receptionist to interpret for patients, you must arrange for her to learn interpretation skills, and amend her job description and rate of pay to take account of this extra responsibility.

Maybe the prospect of increased status and a pay rise will overcome her reluctance to go on courses ­ these should count as work time anyway. If she will not train you should forbid her from interpreting.

Her attitude towards patients is a more serious problem. Perhaps her status as a senior woman in her own extended family is such that she is unaccustomed to keeping her tongue in check. If so, group training sessions where role-play videos are shown to all the staff will seem irrelevant to her.

She will have to be spoken to directly. This will not be easy, and your practice manager clearly knows this and is trying to avoid confrontation.

If you extend special consideration to one person because she belongs to an ethnic minority group, other members of staff may have reason to claim that they are being treated in a racist manner. If your receptionist's behaviour does not improve after a verbal warning, this should be followed up with a formal written warning.


GP's advice

Ask ACAS to help you avoid racism

Before you take action it is worth contacting ACAS. They can offer advice on how to avoid racism becoming an issue. Part of her initial attraction was her apparent language skills, so by definition it was likely that you would recruit from an ethnic group, making a racism case more difficult.

Her behaviour may be partly cultural as well as personality based. Given her age this may prove difficult to tackle. Disciplinary action is likely to have a negative impact. There are several possible approaches. The first is via an annual assessment. A practice manager could tease out these issues and help your receptionist formulate her own development plan. This does, however, assume a degree of insight, which you have found lacking so far.

The next approach is to look at in-house training again as she can hardly avoid this. Ask your PCO for names of trainers who can visit your surgery. Direct role-play may be more revealing. Put your receptionist in the patient role with a difficult receptionist. She may see her faults more clearly.

Sooner or later a patient complaint is likely. This could be a more powerful catalyst to help her modify her style if dealt with in a positive manner.

Finally there is always the sideways move to a clerical role, reducing patient contact. You could look (more carefully and explicitly) for interpreting skills the next time you recruit.

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