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GPs buried under trusts' workload dump

I'm the victim of a drone attack

Copperfield

copperfield duo 1500x1000px

copperfield duo 1500x1000px

I had the equivalent of one of those drone near-misses when doing my day duty triage stint the other day.

The drone, in this case, being the sound of a woman’s voice on the other end of the phone going on lengthily and floridly about how ill she is.

I’m unimpressed even before I call her. She was seen only yesterday by a colleague: ‘Fever, sore throat, malaise O/E Well, all obs NAD, Dx viral’. Now, according to the message, she is ‘No better’. Really? An URTI lasting a whole 24 hours?

The context has timewaster written all over it, too. Multiple attendances, numerous DNAs and a summary peppered with soft psychiatry. You know the sort.

So here she is on the phone not only no better but, apparently, ‘One hundred times worse’. And using that annoying breathy/whispery voice that some patients think a) approximates to laryngitis and b) prompts action.

I only agree to see her because I think the rollicking she needs about minor illness will be more effective face-to-face

I only agree to see her in my afternoon emergency clinic because I think the rollicking she needs about coping with minor, self-limiting illness will be more effective face-to-face.

So I do. And I think, this will be fun. Until I see her, that is. She actually looks a bit pale and wobbly. With a temperature of 40 degrees Celsius. And a pulse of, blimey, 132. And a systolic of….er…My diagnosis is rapidly shifting from ‘pathetic’ to ‘septic’.

One ambulance and a mopped brow later I’m thankful that we didn’t both end up in a mangled metallic mess on the drone-buzzed runway.

I’m still wondering what the moral of the story is, and I’m still not sure. Probably something about don’t make assumptions, play safe, listen first and judge later, etc etc. In other words, don’t be me. But that’s easy for you to say.

Dr Tony Copperfield is a GP in Essex

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Readers' comments (14)

  • Perhaps if she paid you a fee at each visit you'd be happy no matter how trivial or serious the presentation was!

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  • The moral is that medicine cannot be done over the phone or on an app. See the patient, take a history and examine them. This model has served us well for thousands of years.

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  • Once Babylon is sued once, it will all come crashing down...

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  • it is actually, for once, an argument against continuity/partnership. WE can and do become complacent. 111 etc with their torturous pathways would pick up the red flags and send ambulance. Of course there will be great delay because they have sent 1000 other ambulances that day,

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  • Agree there is absolutely NO substitute to seeing patients face to face when they are ill, and in fact it is- as this story shows- sometimes dangerous for both patients and doctors not to...

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  • Perhaps as well that you saw her in your afternoon surgery, when her presentation was markedly different from your colleague's findings; seen in the morning that might not have been apparent, and she could have been told off, not admitted?

    A;ways worth telling them to 'come back if it's not getting better'.

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  • We’ve all been there! Well done for seeing her. I agree that the moral of the story is keep an open mind. Seeing and examining is also pretty fundamental!!

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  • So difficult these days, when everybody contacts us for any slight sniffle, or for d&v of 30 minute duration. We can't possibly see everyone. Patients lie (usually exaggerate their symptoms, but sometimes go the other way). 111 are no use whatsoever. Pharmacists not much better.
    Difficult times, Indeed.

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  • I think if patients say they feel awful, I’d see them. Unbearable ear pain, cough that won’t go, d and v etc usually safer to triage, but feeling dreadful, although relative, needs a set of obs and a GP’s F2F assessment.
    It’s also why I think online consults should be for chronic illness vs acute presentations. Well done though you saved a life

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  • Maybe Tomorrow, you have said all that needs to be said. Full stop.

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