I started writing this article a lot earlier on in the pandemic. However, as we all know things are changing all the time and the number of face to face consultations are now increasing. However this article still feels relevant, as everyone needs to know that as GP's we are still here and ready to help. Things are modified and not like before , but we so desperately still want to be called.
The surgery is closed but the lines are still open. It sounds a bit like the lights are on but no one is home. However, GP's are very much home in the surgery.
The truth is, even though the doors of many surgeries across the nation were partly shut for a while and are now slowly opening. General Practitioners and GP registrars were still there on the other end of the phone prepared to help. Many trainee doctors had training and teaching sessions cancelled, so that they could offer extra sessions in the hospital and at the surgery. Those with previous specialty experience were recalled into hospital to help out with staffing shortages that COVID 19 caused.
During the peak of the pandemic we were there in a different kind of way, you could not book a face to face immediately, but we were still very much answering calls and working like gymnasts to change the way we worked, so that we could safely still manage acute and chronic medical health conditions.
The question is what did this look like? There seemed to be an impression in some of my friendship circles that because we were not seeing everyone face to face, we were somehow getting away lightly in the pandemic. On the contrary this is untrue. I have heard slurs of we didn’t deserve testing because we were not in the hospital setting seeing hospital patients, I have also heard slurs of GP's have come out of this very well. Yet there were a number of GP's amidst health care professionals who sadly lost their lives. This is really not the time to be colleague bashing. We are all in it together and facing pressures from various angles!
Meanwhile, many previous technological advances, which were in the pipeline were fast forwarded in order to enable us to optimize patient care during difficult times. This includes us learning video consultation crash course style and fine tuning our telephone skills to try and assess whether we really should be sending patients into hospital. We even got into teledermatology!
A typical day in the height of the pandemic was speaking to patients many of us had never met over the phone, not being able to examine them and trying to create the safest plan, that did not put patients at risk. We would have 4 hour sessions of back to back calls and a small time set aside to have a break within that. All non verbal and physical cues were stripped away for many assessments, as video consultation did not always work. This left us relying on the tone of voice, silences and what is not said to help us with our assessments.
For patients who didn’t speak English as a first language, we resorted to 3 way telephone consultations where we would first call the translating service, then they would call the patient, then we would wait with baited breath for the patient pick up( i later found out that sometimes the translation service number appeared as a number from outside the uk) and then we would have a three way translated consultation. For patients who were deaf, a similar kind of consultation also had to be set up.
We all know that 10 minute consultations were difficult to manage with patients face to face prior to the pandemic. However during the pandemic we have all found that telephone consultations in fact seemed to take longer.
In summary, the truth is no one got off lightly during the pandemic, all healthcare professionals worked tirelessly in their own way to keep the nation safe.
5 things I learnt as a trainee during the Pandemic:
1.Reassurance – it was and is still a scary time for many of our patients. Even though we know we are pressed for time, we must always take the opportunity to be kind.
2. Listen – when a patient calls, they have their plan of they want to get out of the consultation and what they want to tell you. The golden minute, of allowing them to talk uninterrupted still applies to telephone consultations.
3. Stay patient – after 3 and a half hours of calls, it is worth taking a 1 minute breather to take stock of how the morning is going. Be mindful in that moment and remember to be patient with everyone you encounter staff and patients alike.
4. Remind patients that we are still very much here to help them. Many talk about not wanting to bother us, many times concerns are serious and valid and need to be explored.
5. If you can’t deal with everything it is ok to offer follow up. Try to be proactive about this and book it there and then if you can. It takes the burden off those who are worried about calling the surgery and the barriers that they might face when trying to getting in touch with you.
Best Wishes the MR Revision Team.
Corresponding Youtube video: https://www.youtube.com/watch?v=yFmqTK9NpeQ&t=3s
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