All those years at the coalface. And yet, for a proud PDP-wielding professional like me, it’s still a learning process.
Today’s lesson taught me why I always run late. I’d assumed the explanation was that my patients are particularly old, polysymptomatic or require much turning upside down and shaking to get those last few QOF points out.
But no, it’s much simpler than that. It’s the corridor. Or, rather, my position in it. Because, today, a computer virus scare meant I had to change to a different consulting room much closer to reception. And the result was a revelation: patients appeared promptly, as if teleported from the waiting room, I ran to time, and my knuckles remained unblanched.
In retrospect, this should have been obvious. My room is at the very end of the corridor of a huge building and, no matter how proactive I try to be in calling the next patient, there is always a good deal of thumb twiddling before they arrive. This is hardly surprising. The journey from waiting room to my surgery is so long that various incidents can and do occur to patients along the way.
It’s the sort of blue-sky thinking end-of-corridor doctors are forced into
Such as: getting lost, forgetting where they are, forgetting why they have come, meeting friends and having a chat, having to stop for a rest half way, forgetting which doctor they’re meant to be seeing, falling over, going to the wrong room, having a panic attack, developing new symptoms en route in addition to the symptoms they originally booked for, stopping for a bite of lunch and, occasionally, dying.
If the patient is very elderly, the transit time actually exceeds the consultation time. It would be unfair and somewhat repetitive to insist these patients book another appointment because of this. Instead, what I do is call elderly patient ‘A’, then immediately also call younger subsequent patient ‘B’, knowing that B will lap A, so B will arrive, be dealt with and be sent packing before A finally pitches up. When you get really good at this, and you recognise a sequence of progressively less frail patients on your appointment list, you can actually use this technique for anything up to patients A, B, C, D, E and F, if you get your timings right.
It’s a high risk strategy, but it’s the sort of blue-sky thinking end-of-corridor doctors are forced into. The draining effect of all this frustration, brinksmanship and clockwatching probably explains my worsening caffeine habit. Which is a bummer, because the coffee room’s right at the other end of the corridor. And there’s all those dead bodies to climb over.
Dr Tony Copperfield is a GP in Essex