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‘I can signpost you to the Pope if you prefer?’



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As far as I can tell, blurry-brained educationalists haven’t come up with a new ‘consultation model’ for at least half an hour, which must be something of a record.

Perhaps that’s because they’ve run out of Wacky Acronyms for New Consultation Structures (one of the few things they won’t acronymise).

But more likely it’s because the Groundhog-Day grind of coalface general practice means that, these days, the consultation structure pretty much defines itself. And this, inevitably, is how it goes:

Intro: ‘I’ve waited weeks for this appointment, doc – it’s easier getting an audience with the Pope than seeing you.’ This is now officially the commonest and crappest patient joke in primary care, having recently overtaken the standard quip to any coughing, snuffling or croaking GP of, ‘You should see a doctor!’ which has held the commonest/crappest joke #1 slot since 1948.

Mid section: This invariably consists of the patient explaining that the symptom they originally booked the appointment for has completely resolved, although they’d still like your opinion on it, and that in the meantime they have developed a number of other symptoms they want you to look into, and that there was something else they booked for which, having waited so long for an appointment, they can no longer recall but which does ‘remind’ them that they’re worried about their memory, so could you check that too? When you have done all this and are about to close the consultation, they remember what the other problem was they originally booked the appointment for. It will be tiredness or dizziness. Or both.

Outro: You are well into consultation injury time by this point, so you say you will book them another appointment to deal with that last issue. The problem here is the appointment screen shows you are block-booked for the foreseeable future, and any conversation about this will cycle you back to the intro of this consultation, causing a Groundhog Day within a Groundhog Day. The solution is to point out that you can fit them in with the Pope next week.

Dr Tony Copperfield is a GP in Essex