Patients told- only one illness at a time, please

Family doctors have put up signs in surgeries banning patients from discussing more than one ailment per appointment.

The aim is to hurry along consultations so that GPs can meet government requirements to offer patients appointments within 48 hours.

Doctors argue that appointments run behind schedule when they are confronted with the “worried well” reading out lists of sometimes frivolous medical complaints, often researched on the internet.

The Department of Health condemned the restriction and said it should be withdrawn. It said GPs, who earn an average of £110,000 a year in England, were paid enough to make time to listen to patients who have more than one illness.

The department advised patients who encountered the restriction to complain to their local National Health Service trust: “There is record investment going into GP practices and the public who pay for the NHS rightly expect the service to respond to their needs and concerns.”

The Royal College of General Practitioners acknowledges that the restrictions are widespread. It is aware of surgeries putting up notices saying, for example, “One appointment, one problem, remember others are waiting” and has advised its members to take them down.

Sunday Times reporters found the restrictions in operation in Islington, north London, and Deal, in Kent. A member of staff told a patient at the Queen Street surgery in Deal that she should seek a second appointment if she had more than one ailment. The surgery could not be reached for comment this weekend.

James Whitticase, a GP in Poole, Dorset, said he disagreed with the policy and that patients should be allowed to raise all their ailments because they may not know which one is the most serious.

“A classic example would be a patient saying, ‘I have a rash on my neck, I have an ingrown toenail, etc, etc and, oh, I also have crushing chest pain’. We obviously want to focus on the chest pain but that is how patients sometimes present their illnesses,” Whitticase said.

“If patients are only allowed to discuss one issue, they may say the illness that is really bothering them at the moment is their ingrown toenail.”

Critics of the policy also point out that the role of the family doctor is to care for a patient’s health in general and not focus on single conditions.

The British Medical Association defended the restriction signs: “If they try to cram too much into one appointment it doesn’t work well for either the current patient or the later patients who may have to wait.”


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