A 6 30 pm appointment

BMJ 2008; 337 doi: (Published 12 November 2008) Cite this as: BMJ 2008;337:a971
  1. James Malcolm, general practitioner, Market Drayton Medical Practice, Shropshire
  1. bigfelly{at}

    What do you currently do at 6 30 pm—finish your paperwork?

    I had some annual leave at Easter and needed a haircut—not having had one since the New Year. I asked for the latest available appointment and accepted 6 30 pm. I’d never had a haircut at that time before. Usually it’s a race and a juggle to squeeze it in at lunchtime amid all the other hurly burly of daily GP work. It’s almost the only time I sit down and do nothing for 30 minutes.

    Parking in the town centre car park was easy at 6 25 pm (different from the maelstrom of 2 pm). The salon was just as busy as usual. My hairdresser said she had worked a full day and was extending her working week because she couldn’t fit in all her clients (patients). She’d been at the salon (surgery) for about three years, and most, if not all, appointments were repeat cuts (her own list).

    After paying, I walked out on to the main street at 7 pm. It felt different. Normally I would now rush to the car to continue the rat race. But I didn’t have to tonight. I stood still and looked about. It was dusk.

    Most of the other shops (x ray , path lab, medical secretaries, etc) were closed. The pub opposite and a take-away were open, of course (for emergency food and drink). A cashpoint light flashed (24 hour access to emergency money). I walked back to the car, past the restaurant that usually had untouched white tablecloths at 2 pm, but now was alive.

    General practitioners are to work extended hours for routine appointments that may include consultations starting at 6 30 pm. The services offered by GPs and hairdressers are both essential, though there are some differences between the professions: whereas health intervention in men generally increases with age, their hair intervention often decreases.

    So routine predictable (hair doesn’t talk) activity can occur successfully in the evening, but subjectively feels different to this “service user.”

    We wait to see whether routine, complex, evening GP consultations are successful, when other necessary health services are closed. Perhaps by the time of my next haircut I will have had a quite different experience as a “service provider.”


    Cite this as: BMJ 2008;337:a971

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