The Nation's Health

GPs: Take Note

"GP's with varying amounts of experience acting like muppets"

Everyone has a GP. We call when we are ill and are normally greeted by a receptionist with far too much power who tells us there are no appointments. If we eventually get an appointment and are still ill enough to need it, we have our 5 minute conversation with the Doc! Invariably they listen to our ailments for a few minutes then write a prescription for some antibiotics, send us for a blood test and/or advise us to come back if the problem persists. For the vast majority of us this works; if it doesn't, the GP will try something else. It's a big guessing game of 'the most likely'. Working for the ambulance service however I get to see a different side to the GP surgery. I get to see them when they need an ambulance. Rest assured it is not every surgery, there seem to be certain ones that attract more ambulances than others. From an EMS perspective a number of GPs abuse the service, the same GPs who are being put in charge of running the NHS. In the 6th instalment in the 'Take Note' series i've compiled a list of don'ts for GPs who like to call an ambulance. By no means am I suggesting I know best, I don't, my 6 months of 'death by power point' is no match for their 7 years at medical school; I do however know the difference between someone who needs an EMERGENCY ambulance and someone who doesn't. Just sayin'! Bearing that in mind, I hope that some GPs read and take note of the following:

  • Don't leave seriously ill people in the waiting room.
  • Don't call just because it's Monday morning and you are busy. We are too!
  • Don't call just because it's Friday afternoon and you want to go home.
  • Don't call because it's 18:30 and you want to go home.
  • Don't call for chest pain and leave alone in a side room.
  • Don't call for 'chest pain' just to get a quick response for your panic attack.
  • Don't leave seriously ill people in the waiting room.
  • Don't call for meningitis and not treat it.
  • Don't wait for the ambulance to start CPR. It's not beneath you.
  • Don't call an ambulance for a patient you have not yet seen or spoken to.
  • Don't say "It's above your pay grade". Ever.
  • Don't leave us to guess what is wrong with your patient.
  • Don't leave seriously ill people in the waiting room.
  • Don't refer to 'medics' and then not refer to medics.
  • Don't call because you are running late with your appointments.
  • Don't book an ambulance for a patient well enough to get a lift or taxi.
  • Don't call an ambulance and say 'within 4 hours'. That isn't an emergency.
  • Don't leave your receptionist to give the hand over.
  • Don't leave seriously ill people in the waiting room.
  • Don't refuse to come out. If hospital was appropriate we would be there.
  • Don't call for a CVA without checking blood sugar! The slurred speech is a hypo!
  • Don't call for 'diabetic problems' without checking blood sugar.
  • Don't leave a patient on their own when they are peri-arrest.
  • Don't call for a panic attack. It isn't an emergency.
  • Don't leave seriously ill people in the waiting room.
  • Don't talk down to me.
  • Don't give me sarcastic answers to my questions.
  • Don't leave someone having a heart attack alone.
  • Don't call for someone having a heart attack and not give aspirin or GTN.
  • Don't roll your eyes when I ask you a question.
  • Don't leave seriously ill people in the waiting room.
  • Don't tell me I HAVE to take a patient somewhere they are refusing to go.
  • Don't call if your patient has a cold. It's a cold. They'll get over it.
  • Don't call the DIB and low oxygen levels then not give oxygen.
  • Don't call us for an asthma attack and not treat it.
  • Don't leave your asthma attack unattended.
  • Don't leave seriously ill people in the waiting room.
  • Don't lie to me.
  • Don't leave us to guess what room you have hidden the patient in.
  • Don't tell us a stretcher is required when you have stairs.
  • Don't tell us a chair is required when your patient has a cut hand.
  • Don't call us to a head injury and not put a dressing on.
  • Don't leave seriously ill people in the waiting room.
  • Don't leave a letter that is completely unreadable.
  • Don't call an ambulance for a patient who has refused hospital.
  • Don't call an ambulance and not tell the patient we are coming.
  • Don't call an ambulance and not tell your patient why.
  • Don't send a patient home in their car and then call 999 for them.
  • Don't leave seriously ill people in the waiting room.
  • Don't call for anaphylaxis and not give adrenaline.
  • Don't call for a hypo and not give glucose or glucagon.
  • Don't leave a 95 year old with a pulse of 28 alone. CPR is inevitable.
  • Don't say it's immediately life threatening when it clearly isn't.
  • Don't call an ambulance when one has already been and referred on to you. The patient will still refuse hospital. You need to visit.
  • Don't leave seriously ill people in the waiting room.
  • Don't ask your receptionist to call an ambulance and not say why.
  • Don't say 'MI' on the phone unless you have ECG proof. It's just chest pain.
  • Don't send a patient with chest pain home and then call an ambulance there because you are closing for lunch. Seriously. Bad form.
  • Oh, and for god's sake, get a bloody defibrillator! If Tesco can have one, a GP surgery can have one.
GPs have a very difficult job to do, they really do. They have to see and treat everyone for every possible medical condition and they are hugely oversubscribed. I do think though, that this is the case because most refuse to work outside of Monday-Friday 08:30-18:30. This causes the Monday backlog and the Friday rush. Outside of those times we are left referring to a skeleton staff of OOH GPs who don't have the time to see everyone. And I did say most! There are some brilliant GPs who do regular home visits, give great handovers and are everything you want from a GP. Maybe if GPs worked unsociable hours as part of their £100,000 salary some of the pressure would be relieved. In the meantime, being sensible about who requires an ambulance would go some way to easing pressure on the already bulging A & E departments. If the GPs are to be in charge of the NHS they'll have to stop looking after themselves and see the bigger picture. Then again, what do I know, I'm just a stretcher monkey and this is way above my pay-grade!

As always, if there is any I have forgotten, leave it in the comments and i'll add!

Click the Take Note photo at the top to see the other posts in the series!