The diary of a GP driven to despair

GPs are driven to despair by their heavy workload that contributes to the crisis in British operations


GPs are driven to despair by their heavy workload that contributes to the crisis in British operations

How heavy is the workload of a general practitioner? We asked one, based in the West Midlands, to keep a diary of her typical working day. . .

8:40 am

I am one of eight GPs who, along with four registrars (GPs in training), care for 17,500 patients – approximately on average for all UK practices.

Most appointments are issued on the day. I arrive a few minutes before the operation starts.

8:45 am


The doors will open. My first appointment is with a lady with debilitating migraine. First I check if she doesn't have a brain tumor, examine the back of her eyes and record her blood pressure.

She is on antidepressants, so standard migraine medication cannot be given. She can't have an alternative either, because she's asthmatic.

Her case lasts longer than the ten minutes that an appointment should last. I'm running late.


The second patient is a much simpler case, but I am further postponed because the practice assistant asks me to look at the skin lesion of a patient she is worried about.

It looks like an early melanoma, so we refer the patient to a local clinic with quick access to cancer.

Three further appointments – including a woman who needs a vaginal examination, which always takes longer than the allocated ten minutes.



Macmillan Cancer Support phone to discuss a dying patient who urgently needs medication at the end of their life.

It takes a few minutes to complete the recipes and the authorization form.

I find treating mourning processing and palliative care increasingly difficult and I often need a few minutes to refocus.



Two patients later, there is an unexpected case: an asthma that is disturbingly short of breath. He has no appointment but needs emergency treatment.

I give him oxygen and medication – and ask a care assistant to monitor him during the operation.

11:00 AM

I can only see three more people before I get interrupted again. Our receptionist struggles with calming a patient who wants a repeat prescription.

It would take too long to discuss the matter in my office, so I instruct the receptionist to deal with him instead.

One of the reasons why a record number of operations is closed is because many GPs change jobs because of their workload

One of the reasons why a record number of operations is closed is because many GPs change jobs because of their workload

One of the reasons why a record number of operations is closed is because many GPs change jobs because of their workload


Four more patients follow, including someone who has had two mini-bars and has to go to the hospital. I organize a referral letter and call A & E.



Sign a prescription script for insulin: & # 39; Patient forgot to order and leaves for vacation in an hour. & # 39;

Frustrating, this steals valuable minutes that could be used more productively.


Patient appointments should have been completed 55 minutes ago, but I still have six telephone consultations with patients who cannot complete the operation.

Each should last five minutes. Of the six, you worry me. A woman complaining about experiencing & # 39; dark thoughts & # 39 ;, does not answer my three attempts to call her. Concerned, I ask the team to keep trying.


The pharmacy has sent a client with learning difficulties that I can investigate.

She has shingles and I book her another appointment for a few days.


Morning surgery ends an hour later than normal, which is typical. I still have four complex tasks to fill in with the practice pharmacists, three requests for a sick report and three questions from our medical assistants about patients' blood pressure problems.


For that I often have to check notes, issue regulations and decide on further treatments.


Time for the & # 39; wetter team & # 39; – the part of the day that I look forward to the most. Being a doctor can be very isolating, so we meet each other in the library every day for a cup of tea and tackle recipes and questions together.

In total I sign 168 repeat prescriptions and I handle 35 prescription questions.



Time to start home visits. Fortunately, I only have one today: an elderly gentleman with respiratory problems caused by lung and heart disease.

He has pneumonia and heart failure. He could go to the hospital for treatment, but because he lives with his family, I know he's in good hands.

2:30 AM


Back at the surgery I have 80 blood test results to work through. I save 40, but leave the rest until tomorrow, otherwise I would be here until 8 p.m.

3:10 AM


Time for a quick lunch package.

3:30 AM

Next: review of the list of patients who have been referred to me. I give priority to four, and decide that the rest can wait a few days.

To be an efficient doctor, you need to know what work has to do and what can wait.


& # 39; In the evening the operation starts. I deal with a series of problems from a child who is a difficult eater to a man with painful genitalia and a woman who is allergic to hair dye.

I also see a victim of domestic violence. It is understandable that it will take some time for it to open up. She says her partner manages her money, so I refer her to the food bank and social services.

Another patient asks me about CBD oil, which contains a chemical found in cannabis.

Many people have read about this and are led to believe that it is a magic cure for any disease. It is not.

I have to tell two other patients that I am busy and they have to book a new appointment for the operation.


My last patient of the day does not show up. I should be annoyed because they waste time, but secretly I am grateful because I was so busy.

I finish the evening operation ten minutes late.

Finally, I read about 30 documents sent by the hospital, all of which require a series of actions – from assessing symptoms to checking scan results.


Time to leave. I have completed three health insurance policies and two reports on disability benefits plus a request from a prison asking for medical information about a patient, but these can wait until tomorrow.

I remind myself that while I'm exhausted, every day is worth it, since GPs have an overwhelmingly positive impact on patients.

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