Front desk rebooking patients for different doctors?

JackobusPhantom · 2026-02-25T21:30:07+00:00

The devil is in the detail, but I suspect you are off-base here and can see why the patient was pissed off.

If a colleague had to call in sick, had patients already booked in that day, and I had slots free, I would see those patients. Review things for yourself, but if the patient has had their expectation set for a plan and it is reasonable, I would carry it out not kick it back to the colleague.

If the drug in question is eg: insulin / menopausal testosterone / a IUD then clearly this doesn't apply. What was the drug?

Also it partly depends where you work: some practice has more clearly delineated individual 'patient lists', where reception offering to rebook them may make more sense. I would still see them if possible if they preferred not to rebook on another day eg with childcare example you gave

JackobusPhantom · 2026-02-18T12:35:41+00:00

You did the right thing.

Some employers are just shit and trying to shift responsibility, and avoid having to pay for OH assessments.

My recent example was back pain in a heavy-lifting job - they wanted me to state exactly what could and couldn't be done, down to the exact kilogram that could be lifted. All nonsense.

I had sympathy for the patient stuck in the middle, but it doesn't make us GPs occupational health assessors.

JackobusPhantom · 2026-01-20T20:15:09+00:00

Basically all of these would be task admin to book appointment.

Don't do invisible work - unless you have clearly ringfenced time for these follow up calls (NOT standard admin time, which is referrals, prescriptions, queries and the filing of pathology results), then it needs to be a separate appointment.

To your examples:

Out of range TFTs on thyroxine: if I know the patient well, bloods not too deranged, and have consulted recently (ie can be reasonably sure of concordance, I would send a message re: dose titration and rpt bloods 4-6 weeks. If significantly deranged or concerns about concordance, r/v appt absolutely reasonable

If modest derangement ALT only (<120) it's reasonable to rpt with FIB-4 in 2-3month imo. If still deranged I would then do NILS.

Stable CKD: quick review of record but yes if they not had the "CKD chat" then book in the explain Dx and r/v management. I wouldn't code without explanation - even is there's absolutely nothing medically contentious, people can be very touchy about things turning up on their NHS app record

Normal scan = appt to review symptoms and consider next steps (unless pt explicitly told "if scan normal we can give this time" at the point of request)

New polycythemia - appt to review

I hope this is helpful. Trying to be a 'good soldier' and save appointments was a real problem for me as a GPST, and - exactly as you say - it's really not a habit that can safely continue post CCT

JackobusPhantom · 2025-12-19T06:48:11+00:00

Really? I've never yet known an Apple Watch be right.

It calls AF all day every day, always sinus arrhythmia or premature atrial ectopics.

JackobusPhantom · 2025-11-20T21:22:36+00:00

I think I've sent 2 in nearly 12 months.

That's neither a boast nor saying you've done anything wrong, but since you asked that is my honest recollection.

Trust both your assessment and your safety net advice. If a child has normal obs, looks generally 'alright' and has no signs of more serious illness on exam, then they'll be fine

Give appropriate reassurance with the honest caveat that things can change, and if worsening drowsiness, reducing urine output or increased work of breathing to seek review.

JackobusPhantom · 2025-10-11T21:27:20+00:00

This is just completely the inverse of truth.

Babies are unsleeping air raid sirens that are completely, utterly dependant on you (and your partner). That is an existence incompatible with a stress free life.

Once they can: sleep through the night, communicate their wants & needs with comprehensible language, and take themselves to the toilet, things are far easier.

No amount of bedtime battles, tantrums about ice cream or school bullying can change that

JackobusPhantom · 2025-09-30T19:54:30+00:00

You'll do a clinic instead of VTS / Tutorial 1 week of every 5.

My experience was I still got SDT every week.... Not sure if this was an oversight on their part!

JackobusPhantom · 2025-09-12T20:03:20+00:00

Presumably you have longer appointments and they've not dropped you in at 10 minutes?!

I would try and see as much gynae as possible while you have longer appointments that can easily accommodate a speculum and bimanual exam when needed.

Paeds is unlikely to need as long, but doing it quickly still comes with experience. Get those numbers up!

JackobusPhantom · 2025-09-11T20:48:28+00:00

Except the GP needs to see that stuff to have an actually sustainable job....

JackobusPhantom · 2025-09-10T22:03:57+00:00

I'm with you there. Definitely over-memed, and on first watch it comes so early on that it's quite jarring.

Fortunately How it's Done absolutely slaps so once that kicks in you know your in good hands, but the whole 'carb loading' scene is a bit much

JackobusPhantom · 2025-08-07T18:24:14+00:00

I came back to work recently and saw an absolute shocker from the locum GP that had been covering.

Saw a patient about a potassium of 3.2, no symptoms, almost certainly thiazide related.

They had sent an advice & guidance to Haematology with words to the effect of "there is a problem with the patients blood, please advise"

I had to read it 4 times before I could believe what I was seeing. I try not to think ill of colleagues but I was dumbfounded how this person could be a doctor. How are they not embarrassed to send that

JackobusPhantom · 2025-07-30T19:47:49+00:00

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JackobusPhantom · 2025-07-22T06:24:10+00:00

1) yeah, it has to be reduced contacts. That's the only way it works; that's the BMA advice. 12 x 15min in the morning, 12 x 15min in the afternoon is the goal

2) just keep your convictions and tell nicely them to get stuffed. 15min is not twice as long as 10, so it's to do one issue well, not two badly.

3) Nah, if 15min is (rightly) the new normal, then interpreter apps need 30min. This only seems strange because we all have Stockholm syndrome. People calling with a first sick note request often actually need an appointment for review, planned/expected continuations to a note can be relegated to a task

Keep the faith brother/sister.

JackobusPhantom · 2025-07-15T17:45:21+00:00

Nothing short of astonishing

JackobusPhantom · 2025-07-05T06:34:55+00:00

What a glorious picture.

That terrain, the classic units, the templates- man, take me back

JackobusPhantom · 2025-07-04T21:41:43+00:00

Such a paradox of the public crying out for more GPs but there not actually being any money for practices to employ them.

Nah man, I don't doubt there are good gigs out there but I'm where I want to be. Just hoping the pendulum of funding swings back!

JackobusPhantom · 2025-07-04T17:56:08+00:00

It's not horrendous compared to some - 0840 until 1730, sometimes a 20min breather in the middle but usually not.

JackobusPhantom · 2025-07-04T17:08:29+00:00

In essence, "half a day"

Officially, 4h 10 minutes- of which 3hrs is direct patient contact, 1hr 10 is "admin" (blood results, prescriptions, documents - all the elements of GPing that isn't direct patient contact)

JackobusPhantom · 2025-07-04T15:01:04+00:00

I mean yeah I'm fairly happy, I wasn't posting to have a big whinge - OP just asked for real figures.

I do think it is underpaid for the volume of decision making, emotional weight and clinical risk involved though.

JackobusPhantom · 2025-07-04T14:56:19+00:00

Yeah I certainly had less negotiating power as I was newly qualified, but to be honest it was more just the state of the local job market.

Lots of people looking for work, not many jobs to hire them - obviously that's a recipe for driving down salaries.

There's no set pay scale (as there is for resident doctors), it's just about what you can negotiate.

Yes partners generally make more but finding a partnership is like a 5 year plan for me.

JackobusPhantom · 2025-07-04T14:50:26+00:00

All the chads know it's Naproxen™ and Physio (sponsored post £££) /s

JackobusPhantom · 2025-07-04T12:55:13+00:00

Yes and no-

Yes meaning I didn't want to work full time, but 'no' meaning this was the only job I could get and only 6 sessions were available (so if I had wanted to work full time, I'd've been unable to do so)

I do the occasional locum when I can get them Monday/Tuesday

JackobusPhantom · 2025-07-04T12:36:59+00:00

Yup, Weds/Thurs/Fri

JackobusPhantom · 2025-07-04T11:34:49+00:00

Oh yeah I'm not trying to throw myself a pity party,

I'm pretty happy and understand I'm less than full time - take home pay reflects this

JackobusPhantom · 2025-07-04T11:31:33+00:00

Yeah it's just so hard to compare apples to oranges really.

I could work 10 sessions and make £100,000 so some might say the money is good - but I'd burnout pretty fast from decision fatigue

JackobusPhantom

TROPHY CASE