So there I was in the taxi when I had a ‘Eureka’ moment: I saw the future of general practice.
Not the one foreseen by the RCGP in its recent document, I should add. I was reading this simply to give myself an excuse to stare fixedly at my phone, rather than engage with the driver in Brexit-banter.
And what I read was that the ivory-tower masterplan is 15 minute appointments by the year 2030. Yawn. Cue, quite correctly, the statement-of-the-bleedin’-obvious that we can have 15 minute appointments now, if we want. The obvious downside being that, if patients want 1.5x as long with the doctor, there will only be 2/3 the current number of slots, so they will have to wait 1.5x as long for an appointment. And 1.5x a long time is quite possibly never, which might not be a bad plan, given the powerful political point it would make.
Autolink siphoning money from the patient’s account using some Hancockian hi-tech wizardry
But I don’t actually want 15 minutes per patient if it implies that each appointment is going to be a multimorbidity, polypharmaceutical moan-fest. I like the odd quickie to spice things up, but they don’t take 15 minutes, do they? So perhaps, instead, we need something novel and nuanced. Such as length of appointment being proportional to wait. Insist on seeing me today and you’ll get one minute. But if you’re prepared to hang on six months, well, you can have a whole day consulting on a chaise longue plus an intimate examination of your choice.
At this point in my musing, the taxi ride came to an end. I looked at the meter, and that was when I had by lightbulb moment. It was staring me in the face. Of course! After all, the ten minute appointment would be fine if patients actually stuck to ten minutes. And if we can’t have an actual trap door opening when time’s up, we need a metaphorical one. A meter! A charge for every minute they go over their allocated slot: a penalty of £5 per minute, escalating to £10 per minute after 15 minutes. That would soon put a stop to ill-focused rambling, requests for repeats, ‘while I’m here’s and so on.
I’d suggest we have the meter prominently displayed in the consulting room and beamed through to the reception area as a warning to other punters, with an autolink siphoning money from the patient’s account using some Hancockian hi-tech wizardry. And for any patients reading this: no refunds for quickies.
Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield or follow him on Twitter @doccopperfield