‘My dad said to tell you,’ she says, ‘that his great aunt is one of your patients too, and she keeps going dizzy. Could you pop in to see her next time you’re passing?’
Just pop in? Next time I’m passing?
There I am on a visit to an elderly patient (chest infection, off legs) – as arranged with her son – only to discover that he’s not there and he’s told his daughter to tell me, while I’m seeing his mum, to visit his great aunt, too. A massive family tree is growing before my very eyes and I’m being asked to swing from branch to branch, sweeping up the infirm elderly as I go.
‘So could you, doctor? Could you just pop in?’
Pop in? POP IN?
I don’t do popping in. A visit is either necessary or it’s not. Usually not. I can’t remember the last time I popped anywhere. What’s going on? Have I mysteriously slipped into another space-time continuum? Has everything reverted from glorious technicolour to black and white? Am I, in fact, carrying a Gladstone bag, doing my rounds and, en route, sipping opportunistic cuppas made by solicitous old ladies?
No, of course I’m bloody not. Which begs the question, exactly what era of general practice do these people think we’re in, exactly? Jeez. We’re the 8-to-8, 24/7, 111 generation. I’m a consultant in family medicine, not some sort of ‘heals-on-wheels’ service. This son/nephew/serial visit-requester could have booked his great aunt an appointment online. He could have arranged an extended hour slot in the evening or on Saturday. She could have had a telephone consultation. She could have Skyped. In fact, he could have Skyped his great aunt falling in real time for me to play back in slow-mo to help me work out the exact cause. The possibilities are endless – although they definitely end some way short of ‘popping in’.
Don’t these people realise the pressure we’re under? Don’t they understand that every minute of every day is planned and accounted for? Doesn’t this man appreciate that when I’m not consulting, repeat prescribing, dictating, teaching, seeing urgents, QOFing, attending commissioning meetings, manually filling in CQRS, making phonecalls, wading through NHS 111 ‘communications’, wondering about federating and writing care plans for the unplanned admissions DES – which ironically is aimed at people just like his mum and great aunt who, by virtue of inappropriate ‘just pop in’ requests, distract me from that very task – then, yes, I might do a visit or two in a very planned, organised, focused manner, without a trace of popping, to patients who are housebound and sick and require my attention in a very specific way?
This is not a world where popping in happens.
I notice that, by this time, I’m staring into space and dribbling a bit, and the daughter is looking at me in an odd way. And I realise, too, that I really fancy a cup of tea.
‘Yes,’ I say. ‘I’ll just pop in. On my way back to the surgery.’
Dr Tony Copperfield is a GP in Essex. You follow him on Twitter @DocCopperfield.
20 December 2021
21 September 2021