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Letter: Ghost practices are haunting us

Letter: Ghost practices are haunting us

One Pulse reader reflects on how general practice’s eerily empty waiting rooms are leaving GPs at the receiving end of abuse from patients

Dear Pulse,

I was recently watching the music video for ‘Ghost Town’ by The Specials when a thought entered my mind. Have you noticed anything a bit strange about your GP surgery lately? Specifically, about the waiting room and how it’s pretty much always empty? 

If you go into virtually any GP surgery in the country, you’ll see the same thing: one or two people sitting in the waiting room; rows upon rows of empty, unused chairs; and a few patients milling around outside, staring at their phones and looking confused. Welcome to the ghost practices, where there are tumbleweed waiting rooms with scarce evidence of human life. 

Things look a little different in A&E, though. Bodies are strewn across corridors and waiting room chairs; patients lie down and sleep on the floors; piercing wails emanate from behind partially closed curtains; and staff run around drenched in sweat, clearly struggling to meet demands.

What impression does this give to the general public? It fits the narrative of ‘lazy GPs’ and ‘dedicated, hard-working hospital doctors’ that’s being bandied about. Of course, all of us in the profession know that GPs are working hard, it’s just that we’re now staring at a computer screen trying to decipher a blurred photograph of half an armpit that has been sent to us, instead of consulting in person.

We have tuned into what feels like 100% telescreen medicine, and it’s not doing anyone any good. There are probably many reasons behind the evolution of these ghost surgeries, including the rise of digital medicine and e-consultations; patients thinking they might need to take a bit of time off work to see a doctor; electronic prescribing; telemedicine and phone clinics; and patients being too scared to sit in a waiting room in case it’s made from RAAC concrete.

All I can say is that it doesn’t look good. Especially when compared with emergency departments. Regarding the law, there is a famous quote about justice that is now regarded as a self-evident truth:

‘Justice must not only be done, but must also be seen to be done.’

This dictum was laid down by Lord Hewart, the then lord chief justice of England in the case of Rex v. Sussex Justices, [1924]. Maybe the same applies to general practice:

‘General Practice must not only be done, but it must also be seen to be done.’

Do you remember the good old days before the Ghost Town?

Yours faithfully,

Dr Burnt Out



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

Sam Macphie 20 September, 2023 6:34 pm

Hahaha, you’ve not got many ‘Ghost patients’ registered at your place? or maybe they don’t want to come
into a waiting room to spook you during daylight hours? The F2F appointment system is perhaps just a fleeting
apparition to them that needs ghost investigators to sort out and exorcise? Nice story.

Decorum Est 21 September, 2023 12:46 pm

Appointment systems emptied the waiting rooms before Covid. Our efficiency has come back to bite us!

Jonathan Heatley 21 September, 2023 2:52 pm

Spot on! I was thinking the same thing recently. Phone consultations are brilliant for some things and super efficient, but seeing the patient in the flesh is often the only safe and effective option. There is definitely not enough F2F currently, and its not helping our deteriorating image.

Dr No 23 September, 2023 8:23 pm

The public want F2F. Really, I too am a F2F fundamentalist, qualifying as I did pre 1990. Remote consulting especially telephone, is not more efficient. It more CONVENIENT for the patient but WORSE clinical medicine. And to do it safely is MORE time consuming than F2F. Back to F2F. Ditch the IT crap. You know you want to.

Truth Finder 26 September, 2023 11:02 am

Agree. It is dangerous to do pure telephone consultations and justice must be seen to be done. My waiting room is full.

Thomas Rigby 4 October, 2023 6:04 pm

I agree, that’s public perception.
In reality, we reverted to F2F as soon as the restrictions were lifted. We moved to 15 minute appointments too. We are now much less likely to run behind. Surely this is more respectful to our patients than arrogantly keeping them sitting for 20-30 minutes whilst trying to squeeze in extras at one minute intervals at the end of a surgery. That’s why our waiting room was full before.

In theory, there should only ever be a few patients in the waiting room if all clinicians are running to time.