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Patients get in the way of our work



I’m halfway through morning surgery. And it occurs to me that all our current gripes about political interference, falling income, recruitment crises and so on are just a distraction from the real problem. Which is patients. If it weren’t for them, with their demands for referrals I can’t make, antibiotics I can’t prescribe and urgent admissions I can’t arrange, then I’d chug along fine, merrily ticking QOF boxes and counting my dements.

To redress the balance, I’m going list 10 things about patients that particularly annoy me. Not the hackneyed gripes about list-bringing, inability to swallow tablets or TATT, but the more idiosyncratic behaviour that, over time, reinforces my conviction that they’re a complete pain in the arse.

1 Couples who always attend together. Yes, there may be a good reason, like oppressive relationship dynamics, social phobia or the notion that a visit to my extended hours surgery constitutes a great evening out. Whatever. By the time I notice this pattern, it’s too awkward to ask why they do it. So they just carry on weirding me out.

2 Patients who leave a message for me to phone and who are then on voicemail. And who then phone back with an apologetic request for me to try again, only to be on voicemail. Again. It makes me want to leave the message: ‘I have far better things to do than play phone tennis so please stop wasting my frigging time.’ So I do.

3 Patients who refer to ‘sugar diabetes’. As if they know the differential, diabetes insipidus, but, after consideration, have rejected it as a possibility. So annoying.

4 Patients who, when I describe the side-effects of amitriptyline say, ‘I get those already’. Although, as dizziness and dry mouth are symptoms of anxiety, which is why I’m prescribing amitriptyline, at least it makes me right.

5 Patients who present ridiculously early. My personal record is a mother who attended with her two-year-old because of vomiting. Once. Half an hour earlier. I know I should have ‘explored her concerns’. But I’m not doing the sodding CSA, I’m just trying to survive.

6 Patients who say ‘emphysemia’. If you’re going to be ill, at least be ill with something you can pronounce properly.

7 Patients who say, ‘I can never get to see you’. As if that’s justification for unleashing half an hour of symptom hell.

8 Patients who come purely to tell me about a symptom that has disappeared since they booked the appointment, saying, ‘But I thought I’d come anyway’. Great. Any other symptoms you don’t have that you’d like to discuss?

9 Patients who attend to tell me the pharmacist is ordering their repeats too early/late or in too small/large quantities. Like I care.

10 Patients for whom I’ve just spent two hours completing a DES-approved Avoiding Unnecessary Admissions Care Plan who have the audacity to go and die. Especially if that involved an unnecessary admission.

Thanks for that. I had planned to walk into my still-full waiting room and kick each patient in the shins. Now I’ve catharted, I feel better. But I might do it anyway.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield