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Are GP receptionists too scary?

Dr Fiona Cornish argues some receptionists can be over-protective of GPs, but Dr Mohammed Saqib Anwar says their fierce reputation is down to patient perceptions

Dr Fiona Cornish

YES: Stoical patients are easy fodder

The reality of our understaffed service means we cannot provide enough appointments and patients struggle to see a GP. Our only option is to share the load. This is where receptionists enter the story.

Over the years receptionists have gained a terrifying reputation, being described as ‘dragons’, ‘battleaxes’ and ‘Rottweilers’ – often with justification. While this behaviour may be protective to GPs, research has suggested that being forced to discuss symptoms with a receptionist is one of the main factors putting patients off seeing a GP.1

Cancer Research UK’s GP expert Dr Richard Roope has said ‘anything that might prevent people getting symptoms checked needs to be overcome’. A potentially delayed cancer diagnosis is an obvious source of patient complaints.

We have all experienced the patient who needs to see the GP after all

Receptionists are not health professionals and are not in a position to make decisions about patients’ health. And while they deserve medals for the abuse they sometimes receive, we need them to remain polite at all times.

In 2016 NHS England pledged that £45m would be invested over five years so every practice can help their reception and clerical staff play a greater role in care navigation and signposting. However, we must be careful not to spend a disproportionate amount on trying to avoid seeing patients.

The danger is this may normalise over-protective behaviour. We have all experienced the patient who does need to see a GP after all. Patients do not always come with neatly processed symptoms, and vague undifferentiated histories such as lower abdominal pain or tiredness might indicate early cancer.

Stoical patients who don’t want to make a fuss are easy fodder for the fierce receptionist. They will obligingly wait another week, while their potentially dangerous condition progresses.

The bottom line is that GPs are in an invidious position, as are receptionists. No amount of care navigation and signposting is a substitute for a well-staffed GP service.

We have to work with our patients to make navigating the service as manageable as possible, by training our receptionists to be approachable and realistic. Like us, they are aware of the potential risks of refusing to provide appointments.

Dr Fiona Cornish is a GP in Cambridge

 

dr anwar mohammed saqib square ed maynard 32

NO: GP receptionists are unfairly maligned

GP receptionists are the stitching that holds together the very fabric of a practice. They perform a role that is massively underappreciated and oft challenged with rising demand, increased expectations and a dwindling workforce. If we think the job of a GP is difficult, let us spare a thought for our receptionist colleagues.

If an estimated 340 million consultations take place annually with a GP,2 how many interactions take place with the receptionists?

Describing something as ‘scary’ suggests it causes genuine unease or fear. In the context of a GP practice, if we accept the implication of the above question, that means accepting that our receptionists are making patients feel afraid, anxious or even terrified.

The real question is why receptionists are perceived to be too scary

I find that difficult to accept. When a receptionist is unable to help a patient as much as they would like, that can create conflict. Patients’ interpretation of their situations can lead them to malign GP receptionists as a form of psychological projection on their part.

This perception can be compounded by receptionists’ lack of control over their work. One study found they often had little time, information or training to prioritise patients as expected. They felt their roles were made difficult by protocols and by patients trying to play the system.3

Another found GP receptionists’ demeanour could be a form of protection for themselves, to help them avoid emotional burnout.4 From the moment the surgery opens to the minute it closes the receptionists offer open access to all comers, with little respite.

We know strain is a response to imbalance between demands on the individual and the resources they have to deal with those demands.5 And we know the demand for primary care services far outstrips our supply. So, the real question we need to ask is why receptionists are perceived to be too scary.

I have come to realise that the job of a GP receptionist is an emotionally demanding role that entails a myriad of tasks. These include scheduling appointments, managing the workflow of patients, dealing with complaints, protecting the vulnerable, prioritising access, preventing gaming and rationing the allocation of a finite resource. Our receptionists need our support, not our criticism.

Dr Mohammed Saqib Anwar is a GP in Leicester

 

References

1 Nash S. Having to talk to receptionists about symptoms puts people off seeing GP. Pulse 2016

2 NHS England: A Call for Action 2013

3 Hammond J et al. Slaying the dragon myth: an ethnographic study of receptionists in UK general practice. Br J Gen Pr 2013;63:e177–84

4 Ward J, McMurray R. The unspoken work of general practitioner receptionists: a re-examination of emotion management in primary care. Soc Sci Med 2001;72:1583-7

5 Bakker A, Demerouti E. The Job Demands Resources model: state of the art. J Manag Psychology 2007;22:309-28

 

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Readers' comments (10)

  • Reception staff are massively undertrained and underpaid. They are also hugely underestimated and under appreciated. Some of the become dragons so they can cope with the crap they have to deal with. They are heroes and they should be treated as such.

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  • Spot on WTF a lot of patients are scared,aggressive,demanding and not very nice to deal with.With the outright assault we are under and the poor rates of pay after many year of underfunding the reception staff are heroes.Unlike our leaders who are donkeys.

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  • Wait until you become a patient yourself and experience the 'Rottweilers' approach delivered to you by the receptionists, then you will understand where the reputation of 'dragons', 'battleaxes' or 'Rottweilers' has come from!

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  • Lots of people are abusing the system. It's not a 'psychological projection' but simply people demanding things right here and now and they don't take no for an answer. Let us stop pandering to this. GPs and receptionists are heroes that are maligned repeatedly in the media. This is unacceptable

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  • Heroes to a woman my team. I wouldn’t do their job for a gold pig. Any job where you deal with an over entitled public is purgatory these days. The problem is a societal one. For instance, when did it become okay for patients to call you “mate”, and when did we become so afraid to challenge this?

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  • I have a very high regard for receptionists. The amount of abuse they get from nasty patients can be soul destroying.
    I have been a patient myself and although I felt that the receptionist I spoke (whilst trying to make an appointment) to was slightly abrupt, I did not take any offense as I suspect I was the hundredth person calling that morning. If you take the time to train up your receptionists properly, they won't be "overprotective" but "protective".

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  • doctordog.

    They are the true gatekeepers, and being ‘piggy in the middle’ means they often cannot satisfy the patients or the medical staff. It’s a difficult job and we all know those who have a knack for it and others who do not.

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  • I just printed out the comments and showed to reception. They take so much utter crap every day that I am amazed that carry on. Then CQC put us in special measures which hardly helped morale. I think they do an amazing job and I am guilty of complaining about my messages and extras rather than thanking them for the hard work that they do. I'm heading out to buy them some fairy cakes for tea.

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  • I value my receptionists and it is the system as previously noted which gives them a bad name. I think it is time we stopped calling them receptionists as what they do is so vital and they perform a variety of roles to keep the practice running.
    I thought of calling them Doctor Assistants like Dental Assistants. Any name suggestions are welcome.

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  • The receptionists are doing a very difficult job coping with the demands. Everything needs to happen yesterday. THis is the result of a free system working against GPs. There is zero control on demands and poor support. NHSE answer to a struggling service is not more funding or support but more complaints driving people out.

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