Over the years, I’ve experienced some pretty outrageous patient behaviour. Patients who’ve pinched practice-headed notepaper, fabricated illness and doctored sick notes. A patient who chose to consult with me because, in her words: ‘You’re a bit less crap than all the rest’.
Patients who’ve deposited unwanted pets in our waiting room (specifically, a dog and a pink gourami). A patient who secured a day duty slot for emergency contraception because she’d had an unprotected shag on a bench outside the health centre five minutes previously. And patients who have deposited a turd (probably human) on the doctors’ staircase, scrawled ‘F**k you nob-head’ above the main entrance and urinated (caught on camera) on my car, though, admittedly, not all on the same day.
But all that counts for nothing on the ‘sheer audacity’ scale compared to what I have just discovered. Which is that certain patients – and we now have three separate corroborated cases – are booking appointments for themselves a month ahead. So what? So this: these patients, by their own admission, are not ill or needing a doctor in any way, but are so aware of the difficulty in booking appointments that they are doing this on a ‘just in case’ basis.
This is the appointment equivalent of panic buying. And it has the same effect, with these contingency consultations (or, if you will, contingultations) serving only to exacerbate the problem they try to circumvent.
Yes, it’s incredible, but I’m not making it up. And what happens if these patients remain perfectly well by the time their appointment comes around? Apparently, they offer it to friends or family. Or maybe, who knows, they try to flog it on e-Bay.
What next? Maybe the cognitively-sound but appointment-savvy will start asking for referral to the memory clinic on the basis that by the time they get a slot, they probably will be dementing.
Frankly, I don’t know whether to view this behaviour as shameless and reprehensible manipulation of the system or an ingenious proactive solution to a genuine crisis of GP provision. At least, if it makes them happy, they might stop pissing on my car.
Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield
READERS' COMMENTS [4]
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taking the piss literally …
If this catches on we’ll be making a flood of referrals to the gender clinic for people who suspect they may start questioning their gender identity in the next 3-5 years.
Well, newborns at borth registration are allocated NHS number and NI numbers just in case they need them in the distant future for an illness, or in case they actually start work, so maybe we should see Registrars also giving them referrals to STD clinic and CAMHS at the same time, in case they need them before they are 16?
Great read.
Actually in 2019 – a girl, lets say called Amy – who smartly booked two (*2*) appointments for herself online one week apart. The second was actually for her boyfriend – who wasn’t registered and she was going to cancel and give it to him (!!). Add that to the black book – “patient choice agenda” on steroids. We are apparently now taking future bookable appointments 12 months in advance – peri – seasonal blues and post-party-summer holidays: for panic attacks, loneliness, plain boredom and Christmas IBS. They have all been taken. All the July slots are taken also for moles – that haven’t really changed but Emily said she got hers looked at and fungal toe nails before the holiday to Malaga. And the September 2022 slots are taken – just in case NICE releases an ADHD update and that hits the Daily Mail – that GPs delay diagnosis, ignore patients and that is the cause of everything in the UK.
In the end, NHSE – maybe should think at a board meeting or “strategy initiative group event” to try to DEFINE A PATIENT – because at the moment primary care is wading through a sludge of millions of PUBLIC (not patients – a clear difference Professors and “leaders” – one, is where you are irrelevant and a mere human to society, the other you suddenly get a diamond crown, red carpet, choices, evangelical respect within the space of a doors width, and countless apologies, hypocritical pillars like “autonomy” and yes, the opportunity to leave faeces, complaints, breadcrumbs and foul ugly words on public servants and carers with a reply within 14 days required and slap on the staff beleaguered wrist) – the PUBLIC who have some warped infinite access to professionals trained in a sub-speciality – yes, you’ve treated them as a gutter of grey everythingness for empty life, lack of responsibility and modern Amazon Prime-style Deliveroo demand: that does not mean it is right, which is very clever of you still, a professional manipulated battering ram of humans (who will leave soon) to keep the PUBLIC at arms length from the policy makers and elite in the White Tower.
https://www.theguardian.com/society/2022/jan/25/as-a-doctor-you-want-to-help-not-explain-why-patients-must-suffer-one-gps-diary-of-this-winter-of-discontent