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Why running late has us running on empty

Why running late has us running on empty

Dr Copperfield on how long a 10-minute consultation can really take

Why do I always run so sodding late? I’ve analysed one typical consultation to find out:

Element of consultationTime taken
Check of notes prior to calling the patient in, just in case when I ask her how her husband is, she says ‘dead’30 secs
Walk to the waiting room because the automatic call-in display has frozen on a ‘Have you got chlamydia?’ public information message again30 secs
Walk back from waiting room1 min (slower because I’m having to keep pace with my 80-year-old patient and also answer her questions about whether or not she needs chlamydia screening, which I’d have thought not, although this is Essex, remember)
Listen to harangue about how long she had to wait for this appointment1 min
Listen to harangue about how long she has been kept in the waiting room1 min
Listen to loaded comments about how nice it is to ‘actually see a GP at last’1 min
Gnaw my knuckles over the last 3 mins1 min
Respond to her query, ‘How are you, anyway, doctor?’1 sec
Argue over how many of the list of six problems she has brought today we can reasonably deal with5 mins
Discuss how we have spent so long reaching agreement that we might be able to deal with four items that now we only have time for three2 mins
Discuss and assess her three problems15 mins
At her request, check her BP5 mins, allowing for it inevitably being up first time and so needing repeating
At her request, check her weight3 mins allowing for the fact that she insists on me converting kg into imperial
Deal with QOF pop-ups3 mins
Deal with IIF pop-ups3 mins
Remind her about flu jab and listen to various spurious arguments from her as to why she won’t have it, including but not restricted to, it all being about us hitting targets (true) and how she got flu from the jab last year (not true)5 mins
Deal with medication usage review pop-up3 mins (20 secs per medication)
Respond to her comment that she has read that she’s supposed to be on a statin by ‘exploring her beliefs about what determines future health, assessing her readiness to make changes to her lifestyle, undergo investigations and take long-term medication, assessing her confidence to make changes to her lifestyle, undergo investigations and take medication, informing her of potential future management options based on current evidence and best practice, involving her in developing a shared management plan and checking that she has understood what has been discussed.’10 mins
Wait for her to ask, ‘Well, you’re the doctor, you tell me’1 sec
Tell her to forget it 1 sec
Agree to issue her repeat prescription while she is here1 min
Swear because my computer has crashed2 mins
Reboot my computer4 mins
Re-do the repeat prescription1 min
Clear pop-up reminding me to co-prescribe a PPI because I’ve prescribed an NSAID, even though it was topical ibuprofen30 secs
Listen to her say, ‘Anyway, that’s not why I came, it’s about my urinary incontinence’ and start the consultation over15 mins
Print form and label bottle for urine test3 mins
Explain to her how to do the test, where to drop it off, how to get the result, what to do about the result, how to get a follow-up appointment because it’s so difficult to get an appointment3 mins
Safety net all of the above3 mins
Say goodbye1 sec
Seek and eventually find air freshener2 mins
Deal with same patient poking her head back around the door mid-spray saying, ‘While I’m here, what was the result of my last blood test?’2 mins
Write up notes in patient-comprehensible and inoffensive way5 mins
Have a little lie down2 mins

Total: 1 hr 44 mins and 33 secs. So, that’s your answer. I run late because the 10-minute consultation lasts almost the length of my entire surgery. Next patient, please. God, no.

Dr Copperfield is a GP in Essex. Read more of his blogs here



Please note, only GPs are permitted to add comments to articles

Paul Hartley 30 January, 2023 11:56 am


David Mummery 30 January, 2023 12:25 pm

Totally brilliant 🤣

Pamela Barcella 30 January, 2023 5:03 pm

So true :)))

maura fleming 30 January, 2023 6:31 pm


Dr No 30 January, 2023 9:19 pm

Hey Tony – truly inspired. The “20 seconds per medication” the high point. Oh and the air freshener moment… we’ve all been there. I reckon you’re actually one of those docs the patients all love, who really do go the extra mile, who will gamely take 4 problems on at once, who really will do all that crap you listed above. When you and me retire, General Practice is truly dead. Keep smiling.

neo 99 30 January, 2023 9:57 pm

It’s hard if not impossible to practice medicine satisfactorily in UK NHS general practice. The absurdity of the 10 minute appointment needs to be consigned to a bin. 2 minutes for the patient to walk down to your room, 6 minutes consultation time for 3 or more problems and 2 minutes to record notes which now need to be an essay from a medicolegal perspective.How much more can you add on to the consult? We are now dealing with increasing complexity and multimorbidity, push back from secondary care and increased. medicolegal risk. It is the 10 minute consultation with its limitation which is a core reason for stress and burnout. You really can’t do the job properly! Minimum appointment times should be 20 minutes now, However given the workforce crisis and the politically unpalatable trade off with volume and access, along with contractually needing to provide appointments to “meet the reasonable needs of the patients”, this will never happen. We are our own worse enemy. We will keep plugging away despite the unacceptable risky position and continue overrunning clinics, doing quick fixes (which doesn’t help the patient or GP) and trying the impossible. The job as it is, is a complete turd.

Sally Watkins 31 January, 2023 11:05 pm

Hilarious but very true!

Joanna Bayley 3 February, 2023 10:38 am

May I recommend a chart, converting kg to stone, in large font, right in front of your scales? Not only does it save you doing the conversion yourself, but it buys you valuable note-recording time while the patient argues with the chart and scales that “That can’t be right”.