Dr Jo Coldron explains how the medical receptionist now plays a key role in helping patients to receive the care they require.
The medical training of a GP is long and varied and along the way I’ve tried my hand at surgery, anaesthetics, emergency medicine, general medicine, paediatrics, remote expedition medicine, psychiatry….. the list goes on. As a remote medic for a few years I got an even more varied training than some of my colleagues and can add physiotherapy, pharmacist, researcher, radiology, nursing, lab technician, mountain rescue, diving and environmental medicine and tropical medicine to my list. I’ve enjoyed every single medical field that I’ve had exposure to. However, one specialty in the world of modern GPs that I wouldn’t like to do, and therefore have huge respect for, is the role of my colleagues on the front line – our receptionists.
There has been a lot of change in that most visible of roles in the primary care team. When we think of receptionists perhaps we classically view them as administrators, undertaking office and clerical duties, or, perhaps more infamously, as gatekeepers controlling access to the doctors. However, as well as all these more administrative duties the modern receptionists now fulfil three important clinical roles:
- Triage and care navigators
- Repeat prescription duties
- Relaying test results and messages from the doctor
The most critical of these clinical roles, and the one that is expanding most rapidly is that of triage and care navigation. Often as the first medical contact for our patients in a time of need, sometimes dire pressing need and extreme distress, receptionists need to be able to quickly make an assessment of what that patient needs and how best to guide them through what is now an extremely complex system. They are trained to ask about and recognise symptoms of conditions that need urgent 999 care such as stroke and heart attack, as well as more minor illnesses that can be managed by pharmacists. Their position at the point of entry to the healthcare system means they are the most accessible member of the care team and have significant influence on the patient’s perception of their care. However, this can also mean that they are frequently exposed to the frustrations of patients, sometimes experiencing verbal and even physical abuse which we, the doctors, tend to be much more protected from.
We all know that primary care has changed rapidly over the last decade. As part of that evolution it is now impossible for a GP surgery to run on a system of pre-booked appointments only. In this age of hugely increasing demands on community care, where the management of many chronic and acute illnesses that used to be cared for in the hospital setting, are now managed by GP surgeries, we have to fully realise the potential of all our clinical staff. To do this we have a whole range of ways of seeing doctors and nurses, from the pre-booked appointments to allow continuity of care and follow up, to the urgent call-back and visit in significant acute clinical needs. Receptionists are less the gatekeepers, holding back patients from the doctors, allowing them their calm afternoon clinics and rounds of golf (I think those days ended a long time before I joined the specialty) - and much more the enablers of this fluid responsive clinical day that squeezes every minute of time possible from the doctors and nurses to get the job done as well as it can be for everyone in the community who needs us.
Receptionists are the advocates of our patients – the voice of the patient within the practice - and as such have a central influence on patient outcome, safety and satisfaction. As the front line of information gathering and dissemination they are bound by the same rules of data protection, non-prejudiced care and confidentiality as any of the doctors and nurses. There are now many more questions at that first telephone call to the practice than ever before, but if the receptionist is able to get an idea of the problem and the urgency then they have the skills and ability to be able to guide patients through to the most appropriate medical contact.