A day in the life of a GP

/

Sometimes you can’t see the wood from the trees. A day in General Practice can leave your head spinning. Imagine talking to more than 30 different patients about their problems and dealing with over a hundred pieces of health related admin including urgent referrals, incoming hospital letters and blood test results. Little wonder that recent calculations have shown that working 3 days as a GP i.e. 3 morning clinics and 3 afternoon clinics, will generate enough work to fill 37.5 hours. Essentially 3 days as a GP is ‘full-time.’

It doesn’t need to be this way. There are so many efficiency measures to be made, without sacrificing the patient-doctor interaction. Let me take you through the day and show you where med tech could step in…

The Day Begins

08.30: Get into clinic early to deal with urgent admin, including bloods accumulated over the days I’m not in. Also see many normal blood tests (usually two to three different sets per patient). Lots of clunky double clicking and selecting from drop-down menus to add a comment or action on each.

Solution: A simpler method of releasing normal bloods. No drop-down lists! Could a swipe feature (like that used in Tinder) help? Or maybe a red/green button feature that can easily ‘finish’ normal bloods?

09.00: Clinic begins. Up to 18 patients in 10 minute intervals. Phone calls as well as face to face. Numerous tasks stack up including:

  • Emergency referrals (including cancer 2 week wait forms)

  • Routine referrals to hospital clinics

  • Queries that need to be run past a speciality doctor e.g. a consultant

  • Prescription requests with tailored delivery e.g. sending to a pharmacy different to the one listed by the patient

  • Completing documentation from the clinic

  • Sending patients information leaflets/other documentation via text

This is standard clinic work and needless to say, I can’t get this all done in the 10 minutes allocated to each patient. Some referrals take consideration e.g. the cancer referral process and requires ‘cross-checking’ to other admin members to make sure they’re sent correctly to the right hospital administrator.

Other administration can be very time-consuming e.g. booking hospital appointments means interfacing with the NHS e-RS system, which is clunky in itself and then requires downloading appointment information and texting this to the patient.

The above systems, especially where interacting with external software systems e.g. e-RS or using specified, partly filled referral forms, can be very frustrating.

Solution: There has to be a better way here. One thing that really gets me is that specific referral forms don’t accept (my fairly comprehensive) medical notes, and I often have to copy and paste information and results into the referral document. A better mail-merge type process must be possible? I hate having to scour blood results and enter them manually, could this not be automatised and the last relevant blood dated and entered for reference?

Ideally, I just want to be able to say ‘computer, refer this patient to …. clinic and send them confirmation of their appointment to the patient’ and for this happen. I’m hoping that in the days of AI, this becomes a reality, making clunky referrals and letters a thing of the past.

12:00: Admin +/- home visit. Admin includes more of the above, along with hospital letters, which I have to read and action. I am also sent upwards of repeat 50 prescriptions to analyse and authorise. Given that these are patients I may not know, I have to look up any complex requests and make sure they’ve had relevant monitoring bloods or health checks. If they haven’t I have to send them reminders to have this done and maybe even reduce the supply of medications given.

Solution: Prescriptions can be an incredibly complex and time-consuming affair, especially as safety stakes are so high. I understand the medical need for a clinician to check this, but I feel work could be improved by having an easier way to message patients about their reduced supply. Messaging templates help, but maybe there’s a coding fix that would allow me, with a press of a button, to send a message +/- reduce the issued supply of medication, rather than for me to have to change everything manually.

14:00: Do it all over again for the second session of the day.

***

This seems like a grave simplification of what I do and where I could see health tech improving the life of a GP. Even more revolutionary ideas are in the works e.g.Tortus, an AI that records, transcribes and summarises a GP-patient consultation, but simple steps like the streamlined documentation and mail merge, would help until these measures fall into place.

At the very least I recommend GP practices complete a time tracking audit of their staff e.g. Harvest or Clockify, such that they can see where the time-sucks lie and how to improve the working day. Ultimately, time is the most precious resource we have and to spend it on needless admin, is a sin that med tech could absolve.