With the average GP consultation lasting just 10 minutes, we’ve been investigating how you can make the time count – and what your doctor is really thinking when you’re in the consultation chair. We interviewed 15 GPs – from newly qualified doctors to those with a lifetime of experience – to gather their tips and know-how.
1.Love your receptionist
The old-fashioned view of receptionists acting as guard dogs to keep you away from your GP is outdated. Try to think of them as your ally in finding the person most skilled to help you. As one GP explained: ‘I see between 30 and 40 patients every day, and a good 10 to 20% of them I didn’t need to.’ By telling the receptionist what your appointment is for, they can ensure there are fewer wasted appointments. And don’t hate them for asking ‘is it urgent?’. It may be the question that many of us dread when we ring for an appointment, but we’re likely to be misinterpreting what’s being asked. The receptionist does not expect you to be the judge of how serious your illness is. That’s the GP’s job. They are really asking if you’re OK to wait for the time it takes to get a non-urgent appointment.
2.See the right person for your treatment
Extended surgery hours and rising demand for appointments mean that these days there’s less ‘my GP’ and more ‘my healthcare team’. The receptionist knows the GP’s specialisms and so can help you to avoid wasting GP appointments – for example, by directing vaccinations to the travel clinic, and cholesterol checks to the healthcare assistant. It’s most useful to see the same GP on subsequent visits when you’re dealing with unresolved problems, or if you have multiple chronic illnesses. One GP likened these patients to vintage cars – that they should always go back to the main dealer to be maintained. It’s not so important to see the same GP when you’re pretty healthy with an acute or urgent short-term illness. The GP likened these ‘fix-it’ patients to modern cars – usually OK at any garage.
3.Think like a GP
When your GP asks ‘how are you today?’ they’re not making small talk. What they really want to know is the main problem that will be the focus of the consultation. When they ask ‘what were you hoping I’d do?’ this is not the GP’s way of telling you that they haven’t got a clue. They are trying to understand what expectations you have so they can best meet them. Are you looking for reassurance, treatment or just acknowledgement? There’s also a well-worn cliché that your GP hates nothing more than a patient clutching a list of numerous ailments that all need to be addressed in 10 minutes. However, many GPs actually told us that if you share your list at the beginning, and it’s short and to the point, then it’s often welcome. But be realistic – asking about several ailments means you’re likely to need more than one appointment.
4.Prioritise your symptoms
What your GP finds most difficult is the ‘hand-on-the-doorknob’ scenario. They’ve spent nine minutes discussing your verruca, and now, as you pull your sock back on, you mention something that’s raising red flags and can’t be left. So prioritise before you arrive: what’s the most important thing affecting your health right now? Share it right at the beginning so the GP can focus your consultation accordingly.
5.Get to the point
Include a summary of why you’re there in your first sentence. The GP doesn’t expect you to come with a diagnosis, but they do need to know your symptoms (think: ‘I’ve got a cough and a fever’, rather than ‘I think I might have a chest infection’). Avoid vagueness (‘a really bad headache’) and try to describe how it is feeling. Tell the GP what you’re hoping and expecting from the consultation (Reassurance? A certain medicine? A private referral?), and if you’re worried you may have something serious. Otherwise, you’ll leave without an answer to your main questions. One GP reflected what many told us: ‘You’ll often hear it from relatives, who say, “Dad came to see you, he’s really worried that he’s got multiple sclerosis or something”, when you know that isn’t a possibility… but as they haven’t brought it up themselves, you haven’t been able to allay their fears.’
6.Give a recap
If you’re at the surgery for a follow-up on test results, give a 10-second précis of why you’re there (for example ‘I’ve been feeling very tired, and so you organised tests to rule out anaemia’). One GP said: ‘Patients seem to think that we’ve had half an hour to read their whole 50 years’ medical notes, and we haven’t. We’ve literally opened the notes and called them in.’
7.What happened, when?
It helps if you can establish a chronology – what order things happened in, and over what period of time. This can help GPs rule out some things and point to others. A useful question the GP might ask is when you last felt well. Avoid too much extraneous detail (‘it started on a Friday night when I was watching Gogglebox…’). But do say if big life events may be affecting your health.
8.It’s OK to suggest treatment ideas
If you’ve read about a new drug that you’d like to try, write down some of the specifics of what you’ve read to share with your GP. But remember that many drug trials are reported by the media at very early stages (sometimes even during animal trials) and long before they’re available for NHS use.
9.Check your understanding
By the end of your appointment you should have agreed a way forward, and it’s the GP’s job to make sure you’re happy. But it could be helpful to repeat back what’s been discussed and agreed, as well as the next steps (for example, ‘I think what we’ve agreed is that you’re going to do X, and I’m going to do Y?’). The GP should also do what’s known as ‘safety-netting’. Here the GP makes sure you know what to do if, for example, things get worse or you get certain symptoms. This is the time to check that you understand this and ask any questions (for example, ‘what should I do if…?’), or check the possible side effects of any medication.
10.Raise small concerns early
You’re perfectly within your rights to see another GP if you’re not convinced by what you’re being told. You can change your GP or surgery if you’re not happy. You can also complain, but do think about sharing your concerns first with the GP or practice manager before escalating things to a body such as your local Clinical Commissioning Group (in England, or equivalent bodies in other parts of the UK). As one practice manager told us: ‘It can be quicker and more effective for everyone for me to drop everything and spend time with an unhappy patient, rather than deal with a protracted formal complaint.’ And last but not least, a final time-gobbling bête noir that most GPs mentioned is the patient who has to unwrap to be examined, even in the heat of summer. Wear clothes that make examination easier – for example, loose trousers to show the GP your knee.
Read more: http://www.which.co.uk/news/2017/08/10-ways-to-get-the-best-from-your-gp/ - Which?