When your GP is not seeing patients, they are often busy doing other important work. Don't forget though, just because they are not doing a surgery, they may still be seeing patients, either on a home visit or maybe doing some minor surgery or carrying out a medical examination.
The GPs always have a lot of administrative work - it sometimes feels like an uncontrollable avalanche!:
After each surgery there are always referral letters and other correspondence to write. Writing letters to hospitals and other health and social care agencies has become an increasing part of the job. We also have many private certificates and reports to write for insurance companies, employers, DWP, DVLA etc
Each day we have prescription requests from 160 or more patients, a lot marked 'urgent'. These all need checking to ensure essential monitoring has been carried out, the hospital has not changed anything and that there are no interactions or contraindications. Some of the are printed, some are sent electronically and others go to third party suppliers. It takes around 3hrs for the doctor doing that day's prescriptions to sort all this out safely (and a staff member another 3hrs to organise them all, ready for the doctor).
Each day every doctor receives electronic test results from 10 - 20 patients and it takes around an hour to look at these, check against the records and arrange for the patient to be informed (often phoning or writing to the patient ), adjust the medication, refer to hospital, request more tests or whatever action is required.
Every day we each have a number of telephone calls to patients resulting from hospital letters received requiring action or calls from patients asking for advice. We encourage patients to call for simple enquiries , rather than make an unnecessary face to face consultation. The Duty Dr may deal with 20 or more such calls each day but each doctor has their own to deal with as well. We also have other telephone calls to and from other agencies such as the hospital, care homes or social servcies.
Each day around 100 letters about patients are received (such as discharge summaries, outpatient letters, contacts from social care, from private doctors, from patients , from DWP, DVLA, insurance companies etc). These are increasingly delivered electronically, though many still have to be scanned. One doctor each day has to view all of these and many require further actions, such as contacting the patient, booking some tests or maybe referring elsewhere. This can take a couple of hours to sort out.
We have a lot of practice administration requiring detailed searches of our computer database to report on progress towards various targets we are set by NHS England and the CCG and CQC requirements.
We have regular meetings within the practice teams and with the multidisciplinary teams sharing care with our patients (nurses, health visitors, palliative care team etc) and meetings with external bodies such as the Harness, our GP Network and the CCG as well as other internal team meetings each week to attend to management of the practice, building, staffing, finances and so on.
We have mandatory training requirements each year to maintain our fitness to practice - such as Infection Control, Resuscitation, Safeguarding etc. We also have an annual appraisal which requires us to attend education sessions and personal study.
Some of the GPs have commitments outside the practice such as part of the NW London Whole Systems Integration and the Complex Patient Management Group, one GP sits on the board of the local hospice and one is IT lead for the CCG and sits on the panel of the National User Group for the GP software system we use and teaches at the local medical school. More meetings!
Sometimes we have time for lunch!
Lastly, not all the GPs are full-time any longer. It has become an increasingly stressful job and some of the GPs at this practice have been working for over 25 years and feel increasingly fatigued and under pressure, with long hours , often late into the evening and weekends and increased fire-fighting, trying to patch together a fragmenting NHS and social care system. And with more and more stress put on practice budgets and more and more complexity and lack of support from the NHS. All around the country GPs have been retiring early or cutting back and some of the GPs at this practice have reduced their hours in order to remain fresh and enthused and see their families more often.
So, whilst we may not always each be available for consultations, please don't think we are out on the golf course, as sometimes depicted in certain newspapers!