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
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. Despite 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, askmyGP, 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.”
After eight months of not getting any suitable applicants, I realised we had to take consulting online
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.”
Anyone with cancer should not have to spend seven months seeking a diagnosis Teacher’s illness missed despite tests and scan