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A faulty production line

Information overload

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I think I’m suffering from information overload.  Come to think of it, so are my patients - and the sad fact is they don’t even know it.

My information overload is a fact of life in primary care these days.  There is literally not a week that goes by when some protocol, diagnostic or referral pathway doesn’t change in some way.  I’m getting endless emails about how this or that service has changed and I need to request that test in this way or refer a patient to the Ambulatory Care unit rather than A&E.

In fact yesterday I actually tried to follow the new cellulitis pathway (version 5.3) for initiating intravenous antibiotics in an elderly patient who whose leg wasn’t improving on oral treatment.  I phoned the ambulatory care consultant who, according to the protocol would assess the patient, arrange first dose IV antibiotic and appropriate domiciliary follow up for subsequent doses.  At the end of the conversation I was told to send the patient to A&E!

Then it’s the patients who suffer from information overload and blame me.

More and more patients now seem to want to discuss multiple problems at every consultation.  First it’s the sore throat they’ve had for three days and I go through the spiel about viruses and no antibiotics.  Then it’s the leg cramps and I talk about fluid intake and exercise.  Finally it’s the real reason they came and they mention, almost in passing, they have had chest pains for months and I am now running ten minutes late.

So, after sorting out the possible angina and deciding on a fast track referral to the Rapid Access Chest Pain Clinic they then turn round and ask why they aren’t getting antibiotics for the sore throat they mentioned at the beginning but have subsequently forgotten about my explanation.

You know, sod it, I’m sending you to A&E.

Dr Hadrian Moss is a GP in Kettering, Northamptonshire. You can tweet him at @DrHMoss.

Readers' comments (1)

  • Vinci Ho

    The global picture has really changed in the last few years and one cannot say this is not directly related to the austerity measures . We have become the firefighters as more 'fire' is started in various parts in the community because other colleagues providing care have their resources taken away. Protocols and pathways are written by a panel of human beings . It is difficult to know how many of them are still living inside an ivory tower and how many of them have a political agenda. At the end of the day , one will have to throw the protocol out of window if it is not practical to an individual situation . In fact safety could be compromised on following these 'instructions'.
    We need more time as well as continuity for our patients .10 minutes appointment is ludicrous . But this government would not change on this tough stance of austerity ..........
    Read the news about mental healthcare budget cuts yesterday and the National Audit Office(NAO) 's critical report about the government on real time social care spendings.

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