Don't be tempted to take shortcuts during consultations

THERE has been much recent discussion on the merits of the traditional ten-minute consultation, including calls in some quarters to extend this and for there to be a defined maximum number of appointments per day. A report from the Academy of Medical Sciences stated that GPs should provide longer appointments as presently it "does not give sufficient time for conversations about treatment options guided by evidence-based decision aids, or about the patient’s goals and priorities".

MDDUS adviser Dr Roopinder Brar, who is also a practising GP, believes that practices need to adapt to deal with increasing patient demands and a rise in the volume and complexity of workload.

"Many GPs don’t feel as though they have enough time to spend with their patients, particularly with those who present with complex physical, mental or long-term conditions," says Dr Brar.

"GPs still need to ensure safe practice. It is vitally important that GPs continue to use their professional judgement, work within their competence and don’t take shortcuts as a way of dealing with the time pressures placed on them. This could result in a patient being put at risk and increases the possibility of a complaint or clinical negligence claim.

"Most of us often want to help our patients by dealing with as many of their issues as we can. However, sometimes this is neither practical nor safe and it is important to recognise this.

"Doctors should not feel obliged to deal with multiple issues raised by a patient in one single appointment. It is important to explain to patients that it is not safe to address all their concerns at once. Where appropriate, they should prioritise, signpost and then arrange for the patient to make a separate appointment.

"Extended appointments can be arranged on occasions to try to work through complex issues and patients should also be reminded that every practice offers urgent appointments, where they can often be seen on the day for more pressing issues."

GPs are encouraged to explore practical solutions and work with patients to find a system that eases time pressures.

"Practices may want to offer telephone consultations where appropriate and ensure patients understand how to utilise other resources available to them, such as pharmacists, nurse practitioners and healthcare assistants," says Dr Brar.

"With limited appointments and increasing demands on the service, GPs and surgeries are naturally stretched. Whilst there may not be one solution to this problem, it is important that practices consider different ways of working in order to protect patients and their staff.

"The ability to delegate effectively can also ease the strain on doctors. GPs are of course best placed to perform certain clinical tasks or to review particular patients. However, it can be equally important to recognise the skills of a colleague. Other members of the primary care team can take on some of these tasks as long as they work within their level of competence and are appropriately indemnified.

"GPs work extremely hard and the pressures they face are very apparent. General practice has changed and whilst we recognise this, it may be time to change the way we work to ensure we continue to provide safe care for our patients."

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