How to go to the doctor: A GP’s guide for patients

Questions to ask yourself, and tips to remember, before visiting your GP


“GP campaign urges basic questions before trip to doctor”

This headline in The Irish Times is a sign of the pressure being felt by GPs at present.

It relates to a campaign launched by the Royal College of General Practitioners in Northern Ireland. The new 3 Before GP campaign, which has been advocated by a working group made up of GPs and patients, urges people to ask themselves three questions before booking a GP appointment.

These are: can the problem be self-treated, is advice available on a reputable website, and could treatment be sought at a pharmacy.

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Family doctors are under immense pressure at present. In the Republic, they are struggling with a 38 per cent cut in funding introduced by former minister for health James Reilly. At the same time, many services have been decanted from hospitals without accompanying funding, while extending free GP services to under-6s has also driven demand. Allied to these additional service demands has been a shortage of GPs as many older practitioners retire and with newly trained doctors opting to emigrate rather than establish practice here, something of a perfect storm is shaking the very foundations of general practice at present.

The 3 Before GP campaign got me thinking about how difficult this must be for patients. Having waited longer than they wish for a medical appointment people are faced with making the most of a 10- or 15-minute appointment with a time-poor GP.

Here are a few tips that might help:

* When phoning for an appointment give as much information as you are comfortable with. Saying you are attending for a flu vaccine as well as a specific complaint will help the practice streamline your time with the doctor and practice nurse.

* Before your appointment, write down a list of things you would like to discuss with the doctor. Then prioritise this list to reflect the reality that there may not be time to deal with all your concerns in a single visit.

* Bring a list of prescribed medicines and their dosages with you to the consultation. Include any over the counter medications as well.

* Rehearse your story before you go in to see the doctor. I find this very helpful before my medical appointments. It helps you work out your priorities and increases the chance of a more coherent description of your problem. There is evidence that if you can speak uninterrupted for 90 seconds, you are likely to have a more satisfactory interaction with the doctor.

If a doctor’s explanation isn’t making sense, be quick to say, “I don’t understand”. If you are still in doubt, repeat back to the doctor what you think was said, which will invite further clarification.

Honesty

Be honest about lifestyle issues such as alcohol or cigarette consumption. If you are struggling to follow a treatment plan, say so.

It may be helpful to bring someone with you to the visit. As well as offering support, they will likely remember more of what the doctor says than you do. But do not allow them to talk over you and take over the consultation.

If you are attending with urinary symptoms, bring a sample of urine. This will make for better use of consultation time.

Health system factors, which are outside a doctor’s control, such as lack of time, not having enough space, teams left short of essential colleagues, and computer systems and other equipment malfunctioning, all mitigate against connecting fully with you, the patient.

If there was only one improvement which Minister for Health Simon Harris could make to the health service, it would be to introduce (and adequately resource) minimum 15-minute appointments for GP consultations.

Irish e-patient scholar Marie Ennis O Connor has written a helpful blog (on powerfulpatients.org) about making the most of a doctor visit.

mhouston@gmail.com