How to get the most out of your GP consultation

Arranging an appointment at your GP surgery can feel challenging!  Dr Harriet Doyle explains how the system works and how to make the most from time spent with your GP.

When arranging an appointment you may find that you have to wait for the phone to be answered only to discover that the receptionists aren’t able to offer you the appointment you’d like, and the next available slot seems an awfully long time away. And then when you arrive in the waiting room you may see a sign telling you that you should only discuss one thing with the doctor and make another appointment if you have multiple problems. And you only have a 10 minute slot to tell your story.  Many patients feel hurried by this short time frame, and it can be tough for the doctor too.

In 10 minutes your GP has to engage with the current problem which may be complex, deal with ongoing conditions like diabetes, offer interventions such as how to stop smoking, and listen out for a hidden agenda - the reason you might have come, but haven’t felt able to raise. So its no surprise that there are calls for GP appointments to be extended to 15 minutes even though this would mean seeing fewer people; GPs in the UK often see 40 patients a day, and sometimes more, although many EU countries say 25 a day is a safer workload. In the last 5 years there has been a 13% increase in face-to-face contacts and a 63% increase in telephone contacts, however this increase in workload has not been matched by a transfer in the proportion of funding or staff.

So how can you make the most of your appointment time?

Explain to the receptionist why you have rung. This may include brief information about the condition you would like to discuss with the doctor.   All receptionists are experienced and able to prioritise your request as appropriate, particularly if your symptoms are serious. Or it may be that another member of staff is better able to deal with your needs.

Your GP will start with an open question such as ‘what brings you here today?’. This is an invitation to tell your story. Evidence suggests that if you are allowed to talk uninterrupted for 90 seconds, you’ll be able to share the key details which will allow your doctor to make a diagnosis. This may be backed up with a few specific questions, an examination and some basic tests. Doctors are trained to listen out for ‘red flags’ that may indicate that you have a serious underlying problem.

So if you say you’ve had unexplained weight loss or a new breast lump, expect further detailed questioning and urgent referral for investigations and a specialist opinion. Other diagnoses are made by recognising a pattern of typical symptoms that suggest a particular cause, and then confirming the diagnosis with examination and tests. Don’t feel you need to be to be too clever. Some people will look up their symptoms on the internet, find a diagnosis and then mould their story to fit - but the ‘best historians’ just tell their symptoms as they are.

When it comes to the examination you need to be prepared to show the body part that you are concerned about. Try and make this as easy as possible - for example nail varnish makes it impossible to examine for a fungal nail infection and removing skinny jeans is always tricky if a rash on your leg needs to be checked, similarly with make-up if acne needs to be looked at.

If you would like a chaperone during your examinations, then that can easily be accommodated. All GP surgeries offer chaperones, so feel free to just ask. Don’t feel you need to apologise; you may feel embarrassed but your GP won’t. The most important thing is to be clear and open about your concerns so they can be assessed appropriately. It is also fine to bring someone with you for support, or another pair of ears but remember this is your story so don’t let them interupt.

Bringing additional observations with you can also be helpful. You may have a blood pressure machine at home recording weekly results and these can be really useful for the GP.  Likewise peak flow measurements, weight changes, blood sugars, the date of your last period or a list of allergies can also add valuable information if they relate to the problem you want to discuss.

One final thing; please be understanding if your doctor is running late. Almost certainly this will be due to something beyond their control; there might have been a medical emergency, or an earlier patient may have been recently bereaved, or been told they have cancer. On these occasions it is important that a GP is able to spend a bit more time helping them through a possibly life changing moment.

Dr Harriet Doyle

Tavyside Health Centre

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