Home Health I’m a GP and these are the reasons I fire a hundred people a month without even speaking to most of them.

I’m a GP and these are the reasons I fire a hundred people a month without even speaking to most of them.

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Dr Dean Eggitt, a Doncaster-based GP, says he doesn't speak to every patient he leaves work with.

Every morning when I log into my computer, I get a familiar message. It goes something like this: “Depression, one month please.”

This concise message is a request for what we GPs call a fit note, which most people call a sick note. I get four or five of them a day.

I review their notes to make sure the symptoms they describe are not new. If it is a recently developed condition, I will call you into the office for evaluation.

However, this is not usually the case. Most people who request sick leave have requested it in the past due to an existing health problem and will want to request one again in the future.

Dr Dean Eggitt, a Doncaster-based GP, says he doesn’t speak to every patient he leaves work with.

I pull out a pre-generated form, enter the patient’s personal information, their medical problem, and how long they want to be away from work.

I click Enter and that’s it. The document has been sent to the patient by email that they can deliver to their employer. It will allow them to be absent from work for a month and continue earning.

I don’t talk to the patient. In many cases I haven’t seen them recently and probably won’t see them for quite some time. But almost every good grade I get, I’ll pass this way.

Last week, Prime Minister Rishi Sunak announced plans to strip GPs of their power to dismiss people from work.

The measure is a response to the record 2.8 million people “economically inactive” due to health problems, the majority of whom live with chronic pain or mental health problems.

Shortly afterwards, MailOnline revealed that many GPs were routinely writing adjustment notes for patients they had not seen, and the news was met with outrage. But it didn’t surprise me in the least.

The truth is, in my own experience and that of my colleagues, greeting requests in this way has been routine practice for years.

We rarely reject a request for a fit note for a number of reasons: GPs are overwhelmed by unprecedented demand for appointments, a new digital system allowing patients to submit medical questions and requests by email, and a mountain of paperwork administrative and bureaucratic.

Of course, it would be ideal to see or at least have a telephone appointment with every person requesting sick leave, but given the large number of such requests we receive, it simply would not be physically possible.

From time to time, if I suspect I’m malingering and the sick note doesn’t match what I know about the patient’s health, I’ll follow up with them. But these cases are very few.

I just don’t have time to research each one.

Furthermore, we do not sign these notes because we cannot face the outbreak of a confrontational situation.

And so, unlike many of my colleagues who (I find it strange) were quick to claim that GPs were in the “best position” to issue suitability notes, I support Mr Sunak’s plan.

I am not alone. In fact, when the new policy was announced, my GP’s WhatsApp group chat lit up with messages from colleagues who were delighted to know they would no longer have to fill out these forms.

Because while GPs endlessly approve adjustment notes, few are happy with the arrangement.

GPs may pass on sick notes because they do not have time to assess each patient

GPs may pass on sick notes because they do not have time to assess each patient

One of the main reasons for this is that they are worried that patients will complain if they refuse to fire them from work.

Since 2013, GPs’ performance has been largely based on their performance in what is called the friends and family test: an anonymous survey that patients are invited to complete to say whether or not they would recommend their doctor. bedside to your friends and family.

GPs live in fear of poor ratings because they can influence the number of patients who register with the practice, and this affects the amount of funding we receive.

Upsetting patients by rejecting their request for an adjustment note could mean a negative score for friends and family.

It can also damage the relationship between patient and doctor, meaning that when they become seriously ill in the future, they may not want to talk about their problems until it is too late.

Many doctors also fear that denying them sick leave could put them in physical danger.

I sometimes receive requests for fitness notes from patients trying to exit court ordered community service and I will always call them into the practice for an assessment.

When they realize that I am skeptical of their statement, these patients may become aggressive, raising their voices and confronting me.

In this situation, it’s hard not to think about the fact that this person knows where I work and that my kids go to the local school down the street.

Is it worth taking a moral stand and rejecting your suitability note to put yourself and your family at risk of harm?

However, perhaps the simplest reason why GPs regularly review sick sheets is because we simply do not have the time to assess each and every patient.

GPs are seeing more patients than ever before. On average, there are four million more family doctor appointments per month than before the Covid pandemic.

It is a huge workload that we struggle to maintain.

And even after being seen, patients can still wait months to get an appointment with a mental health worker or pain specialist.

The uncomfortable reality is that simply approving adjustment notes on the spot reduces the GP’s workload while making the patient happy.

That’s why I (and most of my colleagues) think the decision not to take GP notes is a good decision.

Of course, there are still unanswered questions about how the plan will work.

Currently, we do not know who will handle requests instead of GPs. The only thing the Government has said is that they will be the responsibility of ‘specialized jobs and health professionals’.

It is also crucial that the measure is accompanied by more funding for mental health and pain services to ensure patients can receive treatment that allows them to return to work in weeks, not months.

But I am hopeful that the change will free up GPs to help more patients while ensuring that patients who are well enough to continue working do so.

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