A Last Post

I constantly read about the daily traumas experienced by our practice managers, so I thought I’d look down memory lane at my own career as a practice manager and let all those memories merge into one day. I well understand recent threads on the Practice Index forum about moving goalposts and being the piggy in the middle, but also how a manager needs to understand the baggage that others carry around with them which dictates their behaviour.

The daily priorities in a GP surgery shift according to the time of day and the demand for attention. It takes a concentrated effort on the part of every member of the practice to provide a prompt and smooth-flowing service. Single-mindedness is key to getting things done efficiently and effectively.

Has anyone switched?

My day always started in a flurry the moment the phones were switched to daytime mode and the surgery doors were opened. The constant ringing in the ears is the first irritant of the day. But then a receptionist hasn’t turned up; she phones in to explain that there’s some kind of family crisis. Something to do with an ailing dog! There’s a bell ringing at the reception desk as someone tries to draw attention. Another phone call comes in from a doctor who’s expected to start a session at 8:30. You’ve guessed it; she’s sick. Part of a pattern that gnaws at the other doctors. A couple of staff set about phoning 15 patients to make alternative arrangements. This is when a de-stressor comes in handy – time for a penalty kick at those moving goalposts!

22 in the queue!

From a patient’s point of view, the ‘irritant’ is the opening phone message that goes on and on and on. Eventually you can press 3 to select the appropriate extension. But then, ‘shock horror’, the message changes to tell you what position you are in the queue. I once heard an announcement that told me I was 22^nd in the queue. For the staff answering the calls, the requests range from an immediate appointment (“I’ll get the doctor to ring you”) to test results (“Ring again after 2pm”) to repeat prescriptions (“Sorry, we don’t take requests over the phone”). For those wanting an appointment, the receptionist asks politely why, then appointments are offered and refused and the poor receptionist feels like exploding. Nothing is convenient.

I’ve seen him in the car park!

Patients are starting to arrive at the reception desk, each with a different problem. The poor receptionist has her first tricky customer of the day; a voice is raised and demands to be seen are made. A queue develops and a second receptionist saves the day. A woman asks to see a particular doctor. “I’m sorry, he’s on holiday.” “No, he isn’t,” she retorts, “I’ve seen him in the car park.” Oh, sugar lumps!

Why do we have to have patients?

The day is still young and a patient collapses in the waiting room. A rushed phone call to the duty doctor produces the ‘knight’ of the day and the patient is whisked off into the treatment room. It’s the first time our oxygen cylinder has been used. It works. The ambulance arrives and the crew enter the building, wheelchair in hand. At the same time a rather overdressed mouthy woman addresses the reception desk loudly, complaining that she can’t get past the ambulance with her flashy sports car. “It’s an emergency, you’ll have to wait.” Another one with baggage! She’s parked in a doctor’s designated parking spot too. I feel a complaint coming on. I hate complaints. Rarely do they have any merit, but they still have to be dealt with promptly.

Did you miss me?

The receptionist with the ‘family crisis’ arrives, asking whether the team has missed her – no word of being sorry for her lateness and the stress she’s caused her colleagues. The staff all disappear for coffee, no doubt to hear the shaggy-dog story from the late arrival. They all grumble but I bet they’re as nice as pie to her. Getting my own back, I give her the task of cancelling the afternoon session for the absent doctor. I decide to give a day’s extra leave to all the staff who turn up every working day. The inclement winter weather means that few this year will get an extra day. Meanie!

Don’t tip the bottle!

A delivery arrives. It’s the liquid nitrogen, still steaming from a loose top. It finds its way to the treatment room, carried gingerly by a reluctant receptionist. I used to collect the flagon myself from a local vet’s, holding the bottle between my legs to stop it tipping over in the car. Where was ‘elf and safety’ then! A patient arrives for cryotherapy, acknowledged by a too observant receptionist who notices the large facial wart and announces loudly, “Have you come for the wart clinic?” Give me strength.

It’s lunchtime at last

What joy! It’s a celebration of some sort today and sandwiches and cakes arrive, as do a bevy of never-seen-before community nursing staff, all tucking in. I nervously enter the common room to receive my retirement gift, Bob’s Fancy Pen. It’s my leaving day after 13 years in the practice. I’m off, but not before I’m told that there’s a leaking roof. Must be tears of joy at my departure!