Intended for healthcare professionals

Rapid response to:

Head To Head

Should GPs’ daily number of consultations be capped?

BMJ 2018; 361 doi: (Published 09 May 2018) Cite this as: BMJ 2018;361:k1947

Patient commentary

General practice needs radical reform, not tweaks like consultation caps

Rapid Response:

Re: Should GPs’ daily number of consultations be capped?

I believe the 10 minute consultation and sausage factory of seeing 40 patients face to face plus visits, admin and phone calls over a gruelling 12 hour day is what is killling off general practice. 20 years ago it may have been acceptable to scribble a script for antibiotics whilst eyeing the patient from the other side of the room then write a one word entry into the notes (and thus achieve the 3 minute consultation described) but I do not believe this is an acceptable way to practise any more. In 3 minutes you don’t have time to explain why they don’t need antibiotics or to checks vitals (as per guidelines for picking up sepsis). Sadly there is a macho attitude that still exists in some surgeries that doctors who can see 25 in a morning and not run late are somehow the superheroes of general practice. It is interesting to note however that they are often the GPs whom patients dislike and have the shortest waiting list to see.

In addition to this I believe it is what is putting trainees off becoming GPs (having spoken to lots of them) and why existing GPs retire early or can’t bear to work 5 day weeks any more or escape to another specialty. The bottom line is that practices should not be allowed to take on more patients than they can safely look after. Whilst as medics we are generally a hard working always trying to be helpful type, stretching ourselves repeatedly to see this number of patients daily simply props up an under resourced system, puts patients at risk, burns out existing GPs and puts off would be GPs. Patient age, expectation, complexity is increasing, as are the number of treatments on offer and litigation. I believe a safe cap on the working day would be a good start to encouraging a new generation into the profession as well as making patients and existing GPs safer.

Competing interests: No competing interests

18 May 2018
Kirsteen M Shepherd
GP locum and GP in A and E