I think I’m suffering from information overload. Come to think of it, so are my patients – and the sad fact is they don’t even know it.
My information overload is a fact of life in primary care these days. There is literally not a week that goes by when some protocol, diagnostic or referral pathway doesn’t change in some way. I’m getting endless emails about how this or that service has changed and I need to request that test in this way or refer a patient to the Ambulatory Care unit rather than A&E.
In fact yesterday I actually tried to follow the new cellulitis pathway (version 5.3) for initiating intravenous antibiotics in an elderly patient who whose leg wasn’t improving on oral treatment. I phoned the ambulatory care consultant who, according to the protocol would assess the patient, arrange first dose IV antibiotic and appropriate domiciliary follow up for subsequent doses. At the end of the conversation I was told to send the patient to A&E!
Then it’s the patients who suffer from information overload and blame me.
More and more patients now seem to want to discuss multiple problems at every consultation. First it’s the sore throat they’ve had for three days and I go through the spiel about viruses and no antibiotics. Then it’s the leg cramps and I talk about fluid intake and exercise. Finally it’s the real reason they came and they mention, almost in passing, they have had chest pains for months and I am now running ten minutes late.
So, after sorting out the possible angina and deciding on a fast track referral to the Rapid Access Chest Pain Clinic they then turn round and ask why they aren’t getting antibiotics for the sore throat they mentioned at the beginning but have subsequently forgotten about my explanation.
You know, sod it, I’m sending you to A&E.
Dr Hadrian Moss is a GP in Kettering, Northamptonshire. You can tweet him at @DrHMoss.
