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An insignificant event

'Hi Tony', it read. 'I’ve just copied a "Significant Event Audit Structured Reflective Template” into your personal folder on the practice computer. It’ll make it easy for you to analyse and document a significant event for your appraisal.'

She copied the same e-mail to my partner. He shrugged his shoulders and wondered where he would find the time to organise anything significant given that pantomime season is almost upon us. No problem for me though, I had one yesterday, the exact number required to fulfil the annual requirement.

SEA Title: Effusion

Date of incident: December 7th 2011

Description of event: Patient attended with express aim of shaking my hand and thanking me. [Background, patient had attended six weeks earlier with painless haematuria. Instead of fobbing him off with a course of trimethoprim and a pat on the shoulder I referred him to a urologist on an urgent basis. He – the patient, not the urologist – now has a bag full of urine strapped to his abdomen. And he has a hole where his bladder used to be. He is surprisingly happy with this outcome, which he believes will extend his lifespan considerably.]

What went well?: The handshake was firm and manly. The hug was effusive in an entirely non-sexual context.

What could have been done better?: He could have brought a bottle of Maker’s Mark along, perhaps with a couple of glasses and some ice in a Thermos flask.

How will this outcome affect patient care?– to be discussed with your Appraiser during your meeting.

Ta, and indeed, dah. Finito.

Except of course that making a diagnosis – albeit a barn door job – and shepherding the victim through the impenetrable depths of the NHS to the extent that he or she takes time out to thank you in person doesn’t count as 'significant'.

Forgetting to sign one of the sixteen pages that constitute Mrs Chapman’s repeat prescription when she hands in her request for her thirteen different pills that have to be sorted into individual weekly dosing boxes, that’s significant.

Blagging some generic diclofenac out of the on call bag after twisting your ankle rather than shelling out for the quarter-strength nonsense sold over the counter, that’s going to be very significant if the GMC finds out about it.

But reducing a grown man to tears of thanks – apparently isn’t.

Dr Tony Copperfield is a GP in Essex