Choose and re-refer

Today I received a letter in the surgery post from our local hospital, telling me that we'd asked for a choose and book referral for Mrs. Jones (I know), but that unfortunately at the time there were no appointments available and so her details had been forwarded to the "Central Booking Service" at the hospital. It went on to explain that:

"When we receive a patient's details in this manner, we are unable to access their referral on the Choose and Book software, this is a national issue, rather than a [local hospital] one. We subsequently requested, on three occasions, for your practice to fax us a copy of your patient's referral letter but we had no success."

They had therefore discharged the patient, because without the referral (which we sent through Choose and Book and they couldn't access) they couldn't make an appointment.

I checked the system. We had never had a request from them for the original referral letter. So we had sent them a referral they knew they had but couldn't see, and they had made three requests of us which we didn't have and couldn't see.

I called the hospital. Much confusion: she had an outpatient appointment booked, despite the letter saying exactly the opposite. The reason I couldn't find their requests for faxes is that "normally we telephone with them".

I know our reception very well indeed, and they invariably answer phones quickly and pass on messages efficiently. With this sort of thing they wouldn't even do that - the referral would just have been reprinted and refaxed.

All a bit suspicious - although at least my patient has an appointment. Despite the system.

Rules for seeing your General Practitioner

Just a few guidelines.

(1) Courtesy
(1a) You are well advised to be polite to the reception staff. This is chiefly because they run the place, but also because they invariably tell me if you've been rude to them, and you will get short shrift from the doctors if you then come in and are all deferential sweetness and light to us.
(1b) Despite (1a), I am a polite person. Honestly I am. But if you've just spent six minutes telling me about your diarrhoea and vomiting, and then watched me carefully wash my hands after prodding your belly, don't offer me your hand to shake on your way out.

(2) Children
(2a) For some reason, every child that enters my office tries - and succeeds - to dismantle the scales. They unscrew the lid, and then try to pull the needle off which tells me how much they weigh. I don't like to ask you to rein them in, but they
(2a) Amoxicillin is not the answer.

(3) Sick notes
(3a) Do not ask for a reissue of a sick note you've lost. If you are sick enough to need one, you are sick enough to look after it properly.
(3b) Do not ask for a backdated sick note. If you were sick enough to have needed one three months ago last thursday, you were sick enough to have mentioned it at the time -and if you haven't been working for the intervening period, you've had plenty of time on your hands to come in and see the doctor.
(3c) Do not ask for a sick note if you are also claiming carer's allowance. You cannot simultaneously be so unwell that you can't work, and well enough to claim an allowance for looking after someone full-time.
(3d) You will not get a sick note "because I've always had them". I am interested in how you are right now, not in how you were seven years ago when you had your car crash / breakdown / stabbing / overdose.
(3e) I appreciate that your having not attended court / gone to a job interview / made it to your wedding / attended the birth of your child is inconvenient. It does not, however, mean I'm obliged to write you a sick note to "cover it" if I don't think you were so unwell that you couldn't make it.

(4) Hay fever: if you haven't tried an established hay fever medication, you will be trying that before I give you an identical one the drug companies have churned out to keep the patent alive (see also: gaviscon advance). There is nothing 'neo' about neoclarityn, and desloratadine is the same as loratadine. Yes, I know there are some people who respond to one but not the other - I blame regression to the mean.

(5) Contraception: yasmin is really expensive. If you haven't tried older pills we know more about, you will be. Please don't try to bully me into giving you it by saying you won't take another pill if I give it to you - if you want to get pregnant because you'd rather throw a hissy fit about your pill than try another one, that's entirely your choice, and similarly a convenient recollection of every pill side-effect you can remember from the packet just makes me think you're not telling the truth.

More to follow. Maybe.