Name: Dr Mike Rossiter
Role: Consultant in sports medicine and part-time GP Principal and Partner in Hampshire/Wiltshire border
I get up, have breakfast, pack a light lunch (I have to watch what I eat!) and let the dogs out before going off to Reading to do a (private) sports medicine clinic for the morning for my practice, All Sports Medicine. I have an NHS clinic in sports medicine but the majority of my work is currently in the private sector as the NHS is struggling to accommodate this type of work.
I arrive at The Circle Hospital, Reading after a 50-minute commute, during which time I’ve sung along to the car radio to wake myself up and tried to remember what I have planned for the day.
I arrive with what I think is 15 minutes before my first patient, only to remember that I’ve agreed to squeeze somebody in early.
I log onto the computer with endless passwords and see my extra patient. Unlike general practice, I have 30 minutes to see a new patient at the sports clinic, and 15 minutes to do a review. My patients are referred to me from GPs, physiotherapists, podiatrists or orthopaedic colleagues with musculo-skeletal problems or illnesses related to sport or exercise.
The clinic is new and well equipped, so I am able to provide on-the-spot investigation with Ultrasound, on-the-day X-ray and MRI with results on PACS. I also do NHS and private referrals and investigate for exercise-induced compartment syndrome, which takes an hour.
The clinic offers new and innovative treatments - we have an ESWT (Extra Corporeal Shockwave Therapy) machine to treat chronic tendinopathies, as well as access to PRP (Platelet Rich Plasma) injections for these conditions as well.
I take a quick break between patients to check emails about my general practice work and phone colleagues to update on patients seen. I also get voicemails from Rugby and Soccer Physios to see if I can see one of their players ‘now’, who has injured themselves and ‘needs scanning’ to see if they are fit for the weekend.
I finish the morning clinic and prepare to leave, and put my ‘GP hat’ on for the afternoon and evening. I have been a partner for 17 years but been part-time (five sessions per week) for 10 years.
I phone up the practice, unless they have phoned me first, to check if there is a home visit I can do on my way.
On the way to the surgery, I receive another call - this time from the GB hockey team physio (I am the CMO for GB & England hockey): ‘please could I see one of the players before they leave on tour and have I checked the medical equipment that is going with the team and the doctor?’
My role for the hockey team means I have to appoint suitably qualified doctors to travel with the senior men’s or women’s team to destinations where medical facilities may be poor and/or illness frequent. The team normally travels with a fully equipped trauma bag, suture kit and box of commonly used medication, which all has to regularly checked and updated, plus all medication used logged for audit)
Having done a home visit, I arrive at my practice. I log on to the system and go through letters and pathology, and also answer phone messages that have been left for me by patients.
I am just about to start afternoon clinic when a medical student pops her head round the door to say she’s supposed to be joining me this afternoon.
I have a quick chat to ask where she is from, what year she is in and what she wants to specialise in. I warn her that, although this is a GP clinic, the majority of my patients have musculo-skeletal problems (I am ‘the specialist’ within the practice). She looks a little apprehensive as her anatomy and orthopaedic knowledge ‘is not great, but it would be really good to get some experience’.
Within 10 minutes, I realise that she, like most other students, has almost no musculo-skeletal anatomical knowledge and very few practical skills in this area either. Students are normally ‘away’ for this attachment or don’t appear to cover this area at all.
Another phone call from the hockey team. This time I let it go to voicemail – I’ll answer it later. I’ve now sent my student off to see a patient on her own and report back to me.
I do hour of minor surgery, involving removing skin lesions - a reminder that not all doctors like surgery, as the student looks a bit pale. I demonstrate a joint injection - sometimes I do these in a minor surgery appointment but mostly they are squeezed into a normal 10-minute slot.
I send the medical student home and answer the voicemail from the hockey team. This time it is a player who wants to take a medication and wants advice to see if it is on the banned list. There is also another message from my sports medicine secretary about a patient being added to tomorrow’s clinic.
Although the messages are a distraction, they are important to answer to ensure I offer a good service to my patients and athletes. Life used to be much busier when I was also head doctor at London Irish Rugby and had to field calls regularly (pun intended) about another player who has broken or twisted something.
Having said that, I regularly receive calls from physios I have worked with in the past who are now attached to other clubs in other sports and want some advice and/or someone to be seen (urgently as always!).
I then drive two miles to my other surgery to start an evening clinic. By working back-to-back sessions, this allows me to do more sports medicine clinics
Evening clinics are usually quite nice as there are no phones coming into the practice after 18.30, so less disturbance. As usual, patients comment that I am hard to get an appointment with - they call me ‘the bone and joint man’. Most have usually been internally referred to me by my GP colleagues or nurses. About 70% of my caseload is now musculo-skeletal. I enjoy seeing other problems but realise that I am in danger of de-skilling so have to ensure that I keep updated in CPD in these areas.
I started ten minutes late and finish 15 minutes late. As always, I want to leave with a ‘clear desk’ so spend another 30 minutes finishing paperwork and phoning a couple of patients.
At home (a mile’s drive from the surgery) there is a resigned look from my wife, and my dinner sits cold on the side. Even the dogs give me a look of ‘and where have you been?’ I apologise for coming home late, and reheat the dinner.
Later, I go to my study to answer emails from colleagues in sports medicine, and from students at Bath University where I am a tutor in the distance learning sport & exercise diploma.
Bedtime. The run I had been planning to take tonight will have to wait until tomorrow when I have a half-day.