What­sapp doc? The GP with a bulging in­box

Sin­gle-handed surgery is forced to ask for on­line sick notes be­cause of re­cruit­ment cri­sis in gen­eral prac­tice

The Sunday Post (Dundee) - - NEWS - By Janet Boyle Jboyle@sundaypost.com

‘ Af­ter eight months of not get­ting any suit­able ap­pli­cants, I re­alised we had to take con­sult­ing on­line

Afam­ily doc­tor strug­gling to cope with 5,000 pa­tients has told how she is forced to screen pa­tients by email.

Dr Sue Arnott was left to run her prac­tice on her own when her two part­ners re­tired and she couldn’t re­cruit any­one to fill the post.

While most doc­tors have to deal with around 1,600 pa­tients, Dr Arnott’s prac­tice, in Shotts, North La­nark­shire, has 5,000 peo­ple on its books.

In a des­per­ate at­tempt to cope, she asks pa­tients to con­tact her by email and ex­plain their is­sue.

More than half now log on to con­tact her. Dr Arnott then sorts those emails into dif­fer­ent groups – with some pa­tients of­fered an ap­point­ment with her, some with a prac­tice nurse, and some with a men­tal health nurse.

Oth­ers may be given ad­vice by email or a re­peat pre­scrip­tion.

The 48- year- old mother of three said she ad­ver­tised to find re­place­ment GPS, but said: “Af­ter eight months of not get­ting any suit­able ap­pli­cants, I re­alised that we had to take on board on­line con­sul­ta­tions.

“The al­ter­na­tive was to close the prac­tice.”

Dr Arnott’s prob­lem in find­ing new col­leagues is far from unique, with one in four Scots GP prac­tices strug­gling to re­cruit.

Dr An­drew Buist, chair­man of the Scot­tish GP Com­mit­tee of the Bri­tish Med­i­cal As­so­ci­a­tion, praised Dr Arnott for cop­ing with so many pa­tients. He added: “How­ever, on­line GPS could be dis­tanc­ing their pa­tients and I think a 10%to- 15% on­line con­sul­ta­tion rate would be ideal.

“On­line con­sul­ta­tions suit some pa­tients who have busy work­ing lives and can’t spare the time to at­tend surg­eries.”

Many fam­ily doc­tors are now ap­proach­ing re­tire­ment while younger ones have em­i­grated to Aus­tralia, New Zealand and Canada.

Dr Arnott’s on­line ser­vice has been run­ning for more than a year at the Burn­brae Med­i­cal Prac­tice.

She said 60%- 70% of her pa­tients are now log­ging on to con­tact her.

“They are all ages, and the el­dest is 81,” Dr Arnott said.

“This is how your fam­ily doc­tor could evolve.

“If some­one needs an ap­point­ment that day, they can get it.

“We don’t of­fer ones three weeks from now and pa­tients can still phone my prac­tice for ap­point­ments.

“We are not do­ing away with phone calls.” Dr Arnott does ad­mit some pa­tients have been sent to the wrong per­son in the prac­tice, but they will im­me­di­ately have a new ap­point­ment ar­ranged.

“That is picked up early and ad­dressed,” she added. “I will see the pa­tient the same day.

D es­pite not see­ing ev­ery pa­tient who comes through the door, Dr Arnott still works a 55-hour week and suf­fers her­self from rheuma­toid arthri­tis.

Of her hus­band, a re­tired po­lice of­fi­cer, she says: “I try not to take work home but my hus­band, Iain, says I am ad­dicted to my job.”

Dr Arnott has joined the on­line GP con­sul­ta­tion ser­vice, ask my gp, which pro­vides the on­line tech­nol­ogy.

It has been adopted by four GP prac­tices in Scot­land, in Mother­well and Ed­in­burgh, and an­other 20 across the UK.

It costs £1 a year for each pa­tient reg­is­tered at the prac­tice.

Dr Buist, 54, a GP in Blair­gowrie, added: “Around 25 years ago there was 63 ap­pli­cants for my job here.

“Now you would be lucky to get 10 and a few of them won’t be suit­able.

“It is not an at­trac­tive ca­reer choice for young doc­tors.

“The hours are long and work­load in­tense.” NHS Scot­land of­fers a £ 20,000 golden hand­shake to GPS tak­ing jobs in re­mote com­mu­ni­ties. They have to stay for two years to keep the cash.

Dr Arnott’s loy­alty to her com­mu­nity has brought her a prize for ex­cel­lence from the Royal Col­lege of Physi­cians of Ed­in­burgh in recog­ni­tion of her work in di­a­betes.

“My dad was a hos­pi­tal bio­chemist and warned me not to do medicine,” she said.

“He said it would be in­cred­i­bly hard work and he wasn’t wrong.

“How­ever, I love my job and feel priv­i­leged to make a dif­fer­ence to pa­tients’ lives.

“Some of them are a real joy and I can’t see me do­ing any else.”

The Scot­tish Gov­ern­ment said it was de­vel­op­ing a na­tional and in­ter­na­tional mar­ket­ing cam­paign for GP re­cruit­ment and has re­cently launched a GP Jobs web­site.

A spokesper­son added: “This ac­tion sits along­side a new GP con­tract to sta­bilise in­come, re­duce work­load, and im­prove pa­tient care – and we aim to in­crease the num­ber of GPS by at least 800 over ten years to en­sure a sus­tain­able ser­vice that meets in­creas­ing de­mand.”

Any­one with can­cer should not have to spend seven months seek­ing a di­ag­no­sis Teacher’s ill­ness missed de­spite tests and scan

A young maths teacher has re­vealed how his bone can­cer was missed for seven months de­spite a se­ries of vis­its to his doc­tor.

Chris Fair­ley, 30, suf­fered from a painful back but re­peated vis­its to his GP left the can­cer un­di­ag­nosed.

He had blood tests which “proved in­con­clu­sive” and even an MRI scan.

But his part­ner, Kirsty Yule, 26, a mid­wife, claims med­i­cal staff looked at the wrong area of his body and did not fo­cus on lo­cat­ing the source.

“I un­der­went a se­ries of blood tests but they proved in­con­clu­sive,” said Chris, from Cum­ber­nauld.

“I was re­ferred to a rheuma­tol­o­gist and waited for four months for the ap­point­ment.

“Even­tu­ally, I was just told I was some­one who had to live with back pain.

“How­ever, I feared it was some­thing more se­ri­ous and per­sisted.”

The cou­ple say that an MRI scan missed the can­cer.

The tu­mour was even­tu­ally sus­pected by a rheuma­tol­o­gist who re­ferred Chris for a scan at an­other hos­pi­tal.

The tu­mour was con­firmed by this scan and Chris was re­ferred to the Beat­son can­cer cen­tre in Glas­gow.

Di­ag­nos­tic tests con­firmed the tu­mour was in his hips and that the can­cer had spread to his lungs.

Chris was dev­as­tated when he got the news but said he was de­ter­mined to re­main up­beat de­spite the huge bat­tle he will face.

“I had got a di­ag­no­sis at last, but knew I had a con­sid­er­able fight on my hands to beat it,” he said.

“I have un­der­gone chemo and now face eight more chemo and 35 ses­sions of ra­dio­ther­apy to beat the can­cer.

“The doc­tors have told me that it is pos­si­ble to sur­vive this and I am hope­ful of a good out­come.

“Any­one with can­cer should not have to spend seven months seek­ing a di­ag­no­sis.”

Kirsty said: “I am hugely up­set that Chris’ can­cer was not di­ag­nosed ear­lier.

“I feel that vi­tal signs were missed. The first blood tests were in­con­clu­sive.

“We have met other pa­tients with bone can­cer who also took months to di­ag­nose.

“It is wor­ry­ing that many peo­ple are not di­ag­nosed ear­lier.”

Chris is be­ing sup­ported by the Bone Can­cer Re­search Trust.

Re­cent re­search by the trust re­veals that one in four pa­tients have waited more than seven months for a di­ag­no­sis.

Wor­ry­ingly, 13% took more than a year.

The re­search also re­vealed that 26% of pa­tients made seven or more vis­its to their GP or other health­care pro­fes­sional be­fore be­ing di­ag­nosed.

Chris’ maths teach­ing ca­reer is now on hold as he un­der­takes his bat­tle to sur­vive.

He can’t drive be­cause of the can­cer and Kirsty has gone part-time at her mid­wife jobs to sup­port him through­out.

The cou­ple feel Chris’s missed can­cer is a se­ri­ous train­ing is­sue for doc­tors.

They want more in­vest­ment in teach­ing GPS and hos­pi­tal spe­cial­ists to di­ag­nose and treat bone can­cers ear­lier.

Kirsty said: “We have met other peo­ple whose bone can­cers were not di­ag­nosed when they should have been.

“Greater em­pha­sis on train­ing GPS and hos­pi­tal doc­tors is needed to di­ag­nose bone can­cers much sooner.”

Zoe Dav­i­son, head of re­search and in­for­ma­tion at Bone Can­cer Re­search Trust, said: “We found the sur­vey re­sults wor­ry­ing and we’re keen to en­sure that the dis­ease is di­ag­nosed at the ear­li­est op­por­tu­nity.

“Med­i­cal stu­dents re­ceive no for­mal train­ing on pri­mary bone can­cer dur­ing their med­i­cal ed­u­ca­tion.

“There can be a lack of aware­ness of the symp­toms among GPS and other health­care pro­fes­sion­als.”

Lynn Mack, NHS La­nark­shire Can­cer Ser­vices Man­ager, said: “We ap­pre­ci­ate that this has been an anx­ious time for Mr Fair­ley.

“A de­fin­i­tive di­ag­no­sis of bone can­cer de­pends on com­bin­ing in­for­ma­tion about what bone is af­fected and which part of the bone is in­volved.

“It is dif­fer­ent for each in­di­vid­ual pa­tient, de­pend­ing on their symp­toms, and in­volves a range of scans and biop­sies.

“We would en­cour­age Mr Fair­ley to get in con­tact with us di­rectly to en­able us to ar­range a meet­ing or to in­ves­ti­gate any con­cerns.”

Can­cer pa­tient Chris Fair­ley with part­ner Kirsty Yule in Cum­ber­nauld last week

Dr Sue Arnott of Burn­brae Med­i­cal Prac­tice in Shotts

Chris Fair­ley and his girl­friend Kirsty at a wed­ding be­fore his di­ag­no­sis

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