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FILLERS: David Jeffrey Memorable patients: Those who sit and wait BMJ 2001; 323: 362 [Full text]

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The respect of society

Ted Oplotny   (24 August 2001)

Those who sit and wait may also pay!

David Gill, D W Walker, D C Craig, J C Calder   (24 August 2001)

Yes, but..........

Tim Heywood   (31 August 2001)

The respect of society 24 August 2001
Ted Oplotny, Ship's Doctor cruisers Send response to journal: Re: The respect of society	Duffernt groups of society are treated(attended) differently. The more honorable & respected are served better and sooner. The measure of respect is the money assigned to pay the "servants" of the particular group & and respectively the attention the group receives. Probably the Vets get better pay & more respect than GP's in that particular society. Or could that be that the priorities of the nation are messed up by their leaders? My Best Regards to those who keep attending humans for the miserable rewards, Dr. Ted, former GP & anaesthetist.
Those who sit and wait may also pay! 24 August 2001
David Gill, Practice Pharmacist Castlegait Surgery. Montrose, Scotland, D W Walker, D C Craig, J C Calder Send response to journal: Re: Those who sit and wait may also pay!	Jeffrey points out in his endpiece ( BMJ 2001; 323: 362 )that the process of the "patient journey" at the practice was smoother, better and more patient oriented at the local vet than in a medical practice. No comment is made about the consultation itself, and we presume that both patients had a satisfactory conclusion to the event. As a practice our philosophy is for clinicians to collect their patients from the waiting area personally, but we are aware that many other practices locally opt for the more stessful public address system. This endpiece, although light hearted does deliver a serious point about how we as professionals choose to manage our patients. Jeffrey does not mention if the medical practice attended by the human patient was an NHS or private establishment, we have a suspicion that the standard of the "journey" may have been comparable if both facilities were funded on a similar basis. It may be therefore that althought the observation is accurate, a direct comparison is not possible since private and public practice operate under inherently different pressures.
Yes, but.......... 31 August 2001
Tim Heywood, GP Hagley Surgery, 74a Worcester Road, Hagley, DY9 0NH Send response to journal: Re: Yes, but..........	So recognisable was his description of her surgery, I read David Jeffrey’s recent endpiece with some considerable personal discomfort, as I had a strong suspicion that his wife was a patient of mine. I was pleased to discover that it was not our service being described, but also interested, because I had made the same comparisons between my Surgery and the local Veterinary Surgery when my own cat had been unwell. I had found consolation in the argument that, as a public service, the NHS does not have the same laws of supply and demand that the private sector vets have. If a vet’s workload rises, I thought, then so does their income. With that they can employ more vets without the approval of the veterinary equivalent of the Medical Practices Committee, and thus maintain a similar level of service no matter what the demand. My consolation was stolen from me, ironically on the day before I read the endpiece, by a friend not employed in healthcare at all. He pointed out that the law of supply and demand has to work in the NHS, because it is a universal law that has to work everywhere, but I was looking at it from the wrong viewpoint. I had said the law doesn’t work, because I cannot increase the supply just because the demand increases. But in the world of business, if the demand increases and the supply does not, the price rises. This integral part of the supply and demand law is already working in the NHS. Granted, people are not paying money to see me (yet), but the cost, in terms of time spent in the waiting room, quality of public address system, length of consultation, time spent waiting for an appointment, hospital waiting lists etc etc, has been rising for as long as I can remember. In the months and years to come, particularly if the greater part of GP opinion decides to resign their NHS contracts next April, the public, politicians and the profession will have to negotiate how this price is to be paid. It will be many years before we are in the position our veterinary colleagues are in and simply take on new staff. Given that, the price must continue to rise for as long as the demand does. Would David Jeffrey be happier with the status quo, or would he prefer his wife “sees my receptionist for the bill on the way out, please”? Yours faithfully, Tim Heywood, General Practitioner.