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Grappling with GP IT inefficiencies

Secret Trainee

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Over the years, I’ve got used to moving from one hospital to another or different departments within the same hospital. The more things change, the more they stay the same…

A lot of the clinical IT systems are the same in different hospitals and even if not, some general rules apply in terms of efficiency and speed of getting things done. For example, instead of porters, using a pneumatic tube system to get bloods to the lab for processing quickly. And seeking out the radiology registrar or consultant to discuss a case in person – because it’s less easy for them to tell you ‘no’ face-to-face than from the end of the phone.

I’m now in my first ever GP rotation since medical school where none of these rules apply. It is very different and I’m really enjoying it. I feel like a medical student again in terms of the breadth of medicine that I need to learn and get to grips with. As far as I’m concerned this is a good thing and perhaps a sign that I was getting stale in hospital medicine.

The other thing that’s reminiscent of being a medical student is how apologetic I feel for asking questions of my trainer. I know that it’s his role, and he is very nice and keeps telling me off for apologising, but I see how full his appointments are. A request to double check a rash that I think is guttate psoriasis feels like it must be a massive inconvenience to him.

I’m struggling to deal with the inefficiency with IT and processes that come alongside it

The biggest shock to the system has been realising how inefficient I am. This is partly down to not knowing enough clinically. I was expecting and can cope with that.

What I’m struggling to deal with is the inefficiency with IT and processes that come alongside it. None of those acquired tools I’ve gained from hospital medicine help. Should I code a problem that has the prefix ‘C/O’? What do I code if the diagnosis isn’t clear yet? What I think it is? The presenting symptoms? What is the best way to create and auto-populate a referral letter to orthotics? Or the most practical way to set reminders of jobs that I need to complete when test results arrive? I’ve heard conflicting things within the practice already on some of these topics – so I’m going to have to work it out for myself for now.

I suspect the reason I haven’t had any teaching from our VTS days on the topic of clinical systems is because there are lots of ways to skin this cat. There’s also the issue of not being able to practice on EMIS at home. Still, I think it would be a good topic for a trainer or training programme director to tackle.

Without 10 years of clinical primary care experience, the easiest place that I can make up time in my consultations right now is with the technology. More time with Mr Dummy looms…

Secret Trainee is a GP registrar in England

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Readers' comments (2)

  • What a great article. None of us know is the answer. You can be the best consulter and diagnostician in the world, but if you dont have robust systems for dealing with admin you can get in big trouble.

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  • Every practice does things differently: my advice would be to ask you trainer - and suggest the practice should have a "Coding/EPR handbook for Trainees" - to be updated when SNOMED is fully operational!

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