Columnist Dr Katie Musgrave considers whether the crisis in general practice is down to the fact that too many patients present with trivial concerns
It has gradually dawned on me that at least half of what I do is totally and utterly pointless. Sometimes it’s actually downright ridiculous, and I’m left wondering if it would make any difference if I wasn’t there.
Is it just me, or does the frequency of trivial consultations seem to be increasing exponentially? Is it the switch to remote consultation, or perhaps a post-pandemic reaction?
Take the patient who called up last month complaining that they felt hot in the sun.
Or the one who wanted to discuss why they felt faint if they missed lunch.
Or the one who’d had a rash, which had disappeared, but they were worried it could come back.
Or the child who was unwell with a fever, but the parent wasn’t sure if it might be serious, because they hadn’t picked them up yet from nursery.
I could go on for a long time. I spend an awful lot of time talking to people about ridiculous things. I had better not though, as someone might report me for insensitivity to the GMC.
But then again, the GMC frequently appears to target well-meaning doctors caught up in a dystopian nightmare. Still, sometimes I think it wouldn’t really matter if the GMC came after me, as half of what I do is totally pointless, and it would make practically no difference if I didn’t do it. Ironically enough, if I was suspended by the GMC, I might actually find myself doing something more useful with my time.
Was it better before Covid? Did people contact us about less trivial matters? Granted, we still had our ‘regulars’, but at least I felt I might do something vaguely useful, such as check a blood pressure and notice a mole. I also got to know patients personally, who might open up about their underlying issues.
Not now. I just trawl through an endless stream of inane phone calls, feeling like I’m missing the crux of the matter, but lacking the time to bring in the people who really need to see me. Some GPs say a bulletproof triage method is the answer. But having worked within such a system, it struck me as simply another way of sifting through a depressing mountain of dross.
But it’s got me thinking, is the crisis in GP numbers actually a confected nonsense? If half of what I do (and I’m pretty sure it is) is totally pointless, then surely a mildly concerted effort to incentivise patients to consider whether a GP appointment is truly needed might make a huge difference?
This winter is almost certainly going to be another shocker: with chaotic, dangerous and undignified scenes unfolding in emergency departments. I hope neither I nor any of my loved ones need urgent care.
If we could solve the GP crisis, might we also significantly improve the situation in out-of-hours care and emergency departments? And then little old ladies might not be left for 10 hours waiting for ambulances, and they might not be transported to hospital on bin lids, and all manner of atrocities might be avoided.
Still, I better not think too hard about that. Because this patient is worried about why their hair is greying more at the front – and they really need my full time and attention.
Dr Katie Musgrave is a GP in Devon and quality improvement fellow for the South West