DOCTORS SURGERIES IN 2020

THE DOCTORS SURGERIES TODAY 2020

There is something amiss at our Doctors surgeries as we enter the Third Decade of the 21st Century.
Doctors are overworked and cannot cope with the number of patients which they have on their books.
Demand from patients exceeds the supply of Doctors. Many surgeries have to cope with 7,000 people with every aches and pains imaginable and more Patients are in the Elderly group with lots of illnesses. There is a major gap in the NHS service and at  Doctors Surgeries level.
My previous article - Future Strategy of the NHS - suggests some solutions.
So, what is happening at a typical Doctors surgery today ?

My surgery lists quite a number of Doctors serving the Practise. However, many of them are Part Timers. Some leave the Practise to have children.
The Receptionists at the Practise cannot give you an appointment until they know, what days a Doctor is coming on duty.
So, they say, telephone at 8am tomorrow and we will see what appointments we have available.
The next morning at 8am, you telephone the surgery.
The automated telephone system then says.........
“ You are number 10 in the queue.”
How can that be ?

When you eventually speak to a human, you may be lucky to get an appointment. But, it may not be a Doctor you know.
Some time ago, the Government decreed that all patients will in future have a dedicated Doctor. I was given one but I saw the Doctor once. Every other time, I saw a range of different Doctors.
If you try to get an appointment some other time you are looking at at least 3 weeks.
So, as far as the surgery is concerned, you can suffer another 3 weeks and if you are referred to the local hospital, you can wait another 3 months. To be fair, if the Patient has say suspect Skin Cancer, you will get an appointment in 2 weeks.

Then, there is a very irritating action. The Receptionist tries to triage you....Please explain your problem ? Oh, I will get the Doctor to telephone you this afternoon. You ask...When ?
Reply....Any time ? Normally the Doctor will telephone you after 4.40pm so why cannot you be told...He will telephone you after 5pm. No waiting an afternoon for a call. Many older people do not have Mobile phones or computers.
What Doctor you ask ? I do not know at the moment is the reply.

Many of the illnesses can be diagnosed by a good Doctor within 5 minutes. Surely if a patient has suffered for example, with a blocked nose, and the patient who had suffered over the Christmas period, should be able to be seen by a Doctor before the situation gets worse.
Another example of the overburdened Doctors today, is when the Receptionists say “ Is it an emergency ?”
This is a technique for putting patients off wanting a quick and early appointment. How do they know if it is an emergency?  I am talking about medium level illnesses. It is not the job of the Receptionist to ask the Patient if it is an emergency.
If you say No it is not an emergency, they will offer you an appointment in 3 weeks time. Then, the Doctor might have to refer you to a hospital....another wait in most cases.

It is interesting to observe the attitude of some Doctors.
Most have a caring approach, appear kind and professional.
Others look at you as if you were a number on an NHS form.
Please can we have some nice smiles now and again.I have noticed that it is the younger Doctors who have the right attitude. The older ones look worn out and cannot bother to smile anymore. Time to retire ?

There are too many mistakes being made on prescriptions.
Doctors fail to cross check what is ordered leaving patients short of vital medicines. The Pharmacist then gets the blame. Recently, it has happened to me. Tablets have not been sent. Prescriptions have been lost. Medicines have been sen to the wrong Pharmacy.

There is room for improvements in the non hospital check ups.
If you telephone the 111 service, you will be dealt with by a person reading from a script. You will be asked many questions and after sometime, you might be told, go to Minor injuries at your local hospital. You have waisted valuable time.
So, you go to Minor Injuries and spend the next 4 hours in the waiting room. This appears to be an acceptable time by the NHS standards. It is not my standard of patient service.

Is all this poor service due to lack of money ?
To a certain extent, the answer is Yes.
However, I am convinced that there is room for improvement at our local Doctors surgeries.
Some areas that need investigation are -

1- We need more full time Doctors and Nurses.
2- Better Administration procedures.
3- Dedicated Doctors as announced by the Government.
4- Use of FaceTime video contact between Doctor and Patient.
5- Less triaging by Surgery Receptionists. More Patient oriented rather than Doctor orientation.
6- More specialist equipment for on the spot diagnostic usage.
In my surgery, only one Doctor is qualified to use Nitrous Oxide for a patient with sun damage.
7- Computer systems are old and slow.
8- More involvement of Pharmacists in early response treatment for many illnesses.
9-Penalties for non attendances at Appointments.
10- More Trainee Nurses to attend part time at Surgeries to deal with mundane minor duties - for example Blood Tests, Temperatures, Minor injuries needing dressings, Blood Pressure where no machine exists and so on. Trainee Nurses at University normally would welcome to participate with on the job experience.

I suggest an Internal Research Scale from 1 to 10 ......10 being Very Good and 1 being Very Bad.
However, there is room for improvement in patient care in the third decade of the 21st Century.

We cannot blame our dedicated Doctors and Nurses.

Doctors Surgeries procedures need an overhaul. Service levels seem to be on the decline.

But, who can do this ?  Can the Practise Manager take on this task ?
Can a Practise Panel be established ?

Someone must do the review. Or, just ignore the problems.