Saturday, 21 January 2012

Welcome to general practice 2012

At McDonald’s they say, ‘Hi, can I help you please?’ The smile may be trained but its not hostile. 
At airline check-in desks they’re usually polite even if they don’t look overjoyed to see you. 
Even Royal Mail post offices have sharpened up their act. When its your turn at the counter they smile and then, after dealing with you they try and sell you their latest credit card deal.
None of these service outlets is ever as unremittingly unwelcoming as a GP’s surgery. 
The receptionist looks positively displeased to see you. You’re lucky if they merely glum, sometimes they can be grim indeed. The doctor or nurse are fine; they welcome you, smile and are polite. Its the general get up of the waiting area that I am complaining about.
The place is permeated by a culture of sullen tolerance, a forbidding lack of those finer elements of human exchange that is the stuff of a warm welcoming reception when a customer enters a shop.
Take the reception / waiting area, for instance. It  is full of stern sounding admonitions. The gentler ones tell you things they've decided you need to know but in a tone that says ‘ accept this or else’; the more forbidding ones are positively finger- wagging. They threaten consequences for acts you might never commit, but are assumed perfectly capable of contemplating.
Like this one.
Blood tests
If you have been told to come fasted for a blood test but have not fasted then your test will be cancelled and you will have to make another appointment.
Or this one (its still up in my GP's clinic - years after the scare was over)
Important notice about swine flu
If you think you have swine flu then you must not come to the surgery. Telephone the help line for advice on how you can treat yourself with simple remedies. Think about staff and other patients.
This one is plainly intended to put you in your place
Mobile phone use
Don’t use your mobile phone in the surgery. If your mobile phone goes off you will be asked to leave the surgery and take the call outside.

I can quite see the staff enforcing this rule with particular vigour when it is wet and cold outside. 
Even minor transgressions are not tolerated. This notice has no understanding of the legal concept of proportional response or of reciprocal rights.
If you are more than 2 minutes late for an appointment then there will not be time for the doctor or nurse to complete the consultation. Your appointment will be cancelled and you will have to make another one
And just as the needless unfairness of it all gets to your blood pressure and you start tspoiling  for a fight, you see this little notice that tells you how not to respond:
Our staff have the right to work in a safe environment. Aggressive behaviour towards staff will not be tolerated and may even be prosecuted.
Why isn’t there one simple sign that said, even if it was not sincerely meant, that said
to our surgery. We’re sorry that you’re not feeling well or in need our medical services.  We can’t promise an instant cure but we’re glad to serve, and with your co-operation, we’ll do our best to solve your problem.
General practices claim to be businesses but that seems to apply only to their billing procedures. When it comes to culture and attitudes towards us - their ‘customers’ -  they behave like the worst of Soviet-era state run bureaucracies.