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GPs go forth

How long? Seemingly the hardest question to answer

Dr David Turner

Dr david turner duo 3x2

Dr david turner duo 3x2

‘How long have you had these symptoms?’

‘Oh, quite some time’

‘So how long would that be in actual time?’

A furrowing of brow and brief silence follows, then a declaration, pronounced with gusto:

‘Oh, a long time.’

You scream inwardly and begin the usual benchmarks. Did they start before: Summer/Easter/Christmas/the last World War?

The most important piece of information we need while taking a medical history, after the actual symptoms, also seems to be the most elusive. There is no end of detail about the conversation with the cashier in the supermarket or the length of the queue in the post office, but an inquiry into how long a patient has had their problem is answered in every way except numerically.

However, I realised recently we GPs are just as bad.

‘How long will I have to wait for my scan/outpatient appointment/operation?’

‘Well, probably some time’

‘So, are we talking weeks or months doctor?’

‘Well… I honestly would be guessing but I’d say months rather than weeks.’

The reality is the NHS is all or nothing, it’s a two week wait cancer referral, or an eternal wait at the bottom of the list, at best. At worst, your referral is batted back to your GP after a couple of weeks because they hadn’t included a copy of your serum rhubarb level. Unless you tick a box for cancer or heart disease, how long you will wait in anybody’s guess.

It’s fantastic that we see people with suspected cancer or heart disease within two weeks, but there is an enormous amount of pathology outside of these two categories which causes significant pain and distress, worsened by the uncertainty of us being unable to give the patient a ball park idea of how long they will have to wait to be seen.

So Matt, forget your apps and IT for a minute and do something useful, by forcing trusts to give accurate and up to date information in a timely manner to patients about waiting times and stopping the practice of hospitals bouncing referrals back to GPs because some tiny and usually irrelevant detail is missing on the referral form.

How long do you think we will have to wait for this?

Dr David Turner is a GP in North West London

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Readers' comments (11)

  • David Banner

    So, so true!!
    I’ve long marvelled at the patient concept of “a while”, which is clearly a specific measure of time that is common knowledge to everyone except GPs .

    “When did your headaches start?”
    “A while ago”
    “How long precisely?”
    “Oh.....a good while”
    “Is that days, weeks or months?”
    “Oh, longer than that, quite a while”
    “Oh no, not that long!”
    “3, 6 or 9 months?”
    “Hmmm, not sure, it’s been a good while though”

    We should give these people state secrets, not even the KGB could extract any useful information from them. Well, they might, but it would take a while...

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  • It’s like trying to extract an arrival time for my in laws... when exactly is mid morning?

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  • Health systems can only fulfil at best 2 out of the 3 variables - affordability, universality, quality. We have an ideologically universal health care system, and we're broke. Hence, the quality suffers, i.e. rationing. I'd suggest we go for affordability and quality, i.e. what the free market provides through competition. It would provide near universality, and we could encourage altruism, and social virtue to provide the rest.

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  • Christy,
    missed the point there a bit mate!

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  • |DrDeath | GP Partner/Principal|14 Feb 2019 3:18pm

    Really? Or you're missing the deeper point about having to ration limited resources like consultant time to see 'non-urgent' but equally distressing issues...

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  • "It started when I got back from holiday, a while ago".
    My reply-"I wasn't there with you, was I? Do me a favour, and help me out here. Give me a number, and choose from the 3 options-day,week,year…".

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  • my favourite: "how often do you use your blue inhaler?" "only when I need it"

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  • well... it would have been Wednesday because we'd just come back from Aunt Marjorie's house - she's the one with the lung problems who was given weeks to live 5 years ago... no it wasn't - that was Tuesday because we went to Aldi first - their gammon is fantastic at the moment... etc., etc., etc...

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  • How long? "since I was younger"; "when the doctor referred me"

    Has it changed over time? "I have good days and bad days"

    How often does it happen? "there's no pattern to it"; is it hourly, daily, weekly, or monthly? "yes"; "it's all the time, you know, it comes and goes"; "My symptoms last 2-3 days and happen many times a week"; "it's at least twice a month"; and at most? "I just told you, at least twice a month"

    Any treatment? "no... just tablets" which ones? "little white ones with a line across" or "tried everything but nothing works"; how long did you take the treatment "I completed the course"

    Is there illness in the family?"no"; are your parents alive and well "no, they're dead"; I'm sorry, what happened? "Oh, nothing serious"

    It's like a playing "Just a Minute" only here the rules are to speak for as long as possible without communicating any information. Though as a general rule, the vaguer the history the less likely a serious cause.

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  • Patients and politicians go to the same school of evasive answers.

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