March 2021

Ten-minute GP appointments

‘Why don’t you have time to discuss all my problems?!’ is one of the most common questions I get asked along with ‘why can’t I speak to you about more than one problem?!’ This is subsequently often followed with ‘I never get enough time with you’.

Dr Ravi Brar

Now if it were up to me, I’d happily sit with my patients for 20-30 minutes discussing multiple problems but this a luxury that GPs don’t have. The average GP appointment lasts 10 minutes, however, in reality they are more like 6-8 minutes of actual consultation since the clock starts from the patient being called from reception and also includes the time for documenting, requesting investigations, completing referrals where needed, and also the patient putting their coat on to leave. In those 6-8 minutes, we have to get the history of the complaint, ask our specific questions, examine, explain the potential diagnosis, explain the potential investigations and management, all whilst ensuring the patient understands what has taken place and is expected of them. Is it therefore really a surprise that doctors rarely run-on time? To highlight the time constraints further, if I run on average 2-3 minutes late per patient, by the time I see my last patient, I could be running 40 minutes late!

Majority of my patients are now fully understanding of the constraints and follow my 5 simple steps to ensure that they benefit from their limited time with me. This has been adapted since changing to telephone consultations, however, we are slowly moving back to our face-to-face clinics.

Top tips for getting the most out of your GP appointment

  1. Make use of the digital era

COVID-19 has seen many aspects of life change, and GP consultations has been one of them where we have moved to more digital ways of dealing with patients. I recommend my patients make use of avenues such as eConsults – this allows me to have their history beforehand and patients can attach images of their skin concern that I can review before I call them. I still see a majority of my patients face-to-face and by having information before the patient steps into my room, puts me 4-5 steps ahead in my puzzle-solving.

  1. Be on time and ready

It is quite clear doctors are already pushed for time so by patients arriving late, it does not help the situation and in fact, it can mean that are not seen. Arriving on time not only helps patients settle and gather their thoughts but also, if appropriate, ready themselves for any possible examination e.g., remove extra layers. The last thing anyone wants is wasting precious minutes trying to get ready to be examined during the consultation.

  1. If possible, come without the kids

It is inevitable that parents get distracted by their young children and this can lead to them losing out on their own consultation time, but also lose focus on their concern.

  1. Don’t plan to discuss multiple unlinked issues

This is probably the most important. There is only so much a GP (or anyone in fact) can achieve in ten minutes. It is an unrealistic expectation that the doctor will be able to give patients the appropriate time needed to discuss each problem in depth and then also explain how to manage the conditions to a patient’s full understanding.

Managing any diagnosis takes time to ensure the patient has understood what they need to do at home. If the doctor is having to rush through problems, not only is it unsafe, it can lead to the condition not being managed in the best possible way. It can also lead to the doctor running late for rest of the clinic, which is not fair on the other patients.

Prioritise to discuss the most pressing and worrying concerns.

  1. Plan how you are going to tell your ‘story’ in the most effective and concise manner

It is important to be aware how a doctor conducts a consultation. More often than not, it will start by the patient being encouraged to tell their story and paint a picture. This is the chance to tell the doctor why the appointment was made. It is important to be specific and clear e.g. if asked “how long you have had the rash for?”, try to give a precise durations, “Doc, this rash started 2 months ago”, not “It’s been there for several months”.

The doctor probably only has 5 minutes to listen to your side of the story and for them to ask their prudent questions if they need to also examine. Thereby, a story that jumps around from one end of the scale to the other will only cause confusion and prevent patients getting the most out of their consultation.

A recent report by the Royal College of General Practitioners suggested that all appointments should be at least 15 minutes long1. Until this happens, please bear in mind that GPs are trying to do their best in the circumstances that have been provided and also want patients to get the most out of their consultation. So next time you go to see your GP, bear the steps above in mind.

Dr Ravi Brar

Find Dr Brar on Instagram here.

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