Phil finds when the system is down he's left almost as clueless as his patients.
Wednesdays are never a good day. I'm on call, for a start. It's also the day Sunderland uses to hold most of its postgraduate meetings, turning an already absurdly truncated lunch hour into a hollow fiction. And for some reason I don't understand, it is the day many of my most depressing, complicated and time-consuming patients choose to darken my doors.
Today was shaping up to be a classic. I was staring blankly at my morning surgery, which contained several names that are only uttered quietly, in shocked awe, by our practice staff, and never at all at full moon, when suddenly the screen went blank. The computer system was down. Again.
It is embarrassing how dependent we are on computers, these days. If they don't work, we know NOTHING about our patients. And oddly enough, the patients themselves are almost no help at all.
The patient call system wasn't working either, so I phoned the office and asked them to send down the first one and hit
a major problem. The woman now sitting in front of me was a very familiar face, but without the computer screen I simply could not remember her name. And in the circumstances, this was an extraordinarily difficult thing to admit. So I didn't.
I got as far as the prescription (hand-written) before the problem became acute.
I suddenly thought of a crafty way out. ‘How do you spell your surname again, exactly?' I said, pen poised. ‘J.O.N.E.S.' she said. And she gave me a withering look.
Another girl needed an antibiotic prescription. ‘Are you allergic to any antibiotics?' I asked her, as I was writing the script. ‘Not a thing!' she replied brightly. ‘You're definitely not allergic to penicillin or penicillin-type drugs?' I asked, just to be on the safe side, as I wrote out five days of amoxycillin. ‘Nope! Fine with all of them!'
Two hours later when the computers came back on, I noted with a certain weariness that instead of the usual single alert about penicillin allergy, her records flashed up no less then three about penicillin and two about amoxycillin. And of course the mobile-phone number we have for her gave the sadly familiar ‘number is not recognised' recorded message. Maybe at this very moment she is the size of a barrage balloon on some intense therapy unit. No doubt I'll find out soon enough.
Another patient insisted I give him a 50mg dose of gabapentin – which doesn't come in 50mg doses. I told him they don't do 50mg of gabapentin, and he became offended. ‘I see the box every night, don't I? Do you think I don't know what I'm talking about? It's a neuropathic painkiller, my neurologist says I can't do without it!' Nevertheless, I persisted in my refusal to prescribe a non-existent dose and he left in high dudgeon.
My defence organisation advises me that it is better to see a patient with no access to notes than not to see them at all, but five out of 14 patients this morning placed me in a position where I might have been liable for clinical negligence.
I've written to my computer supplier today enclosing a bill for all our wasted time. I await their reply with interest.
Dr Phil Peverley is a GP in Sunderland
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