Zara Aziz: 10-minute appointments are redundant

'Why did you choose general practice?' asked the keen-eyed medical student as we neared the end of my morning surgery.

When I was at her stage in training, I too had completed a GP placement, but mine was in a practice that had little in the way of room in the traditional sense - it operated from two cramped consulting rooms - or staff.

However, what impressed me then, and even more so now with the benefit of hindsight, was the GP who worked there. He had taken a rather convoluted route into general practice and had been working in his challenging surroundings for years, yet displayed compassion and good humour.

Some years later, as a newly qualified GP, I acquired a long-term locum post in an old mill town in northern England.

I was happily oblivious to what I didn't know in my Johari window, and the patients were still believers in the 'doctor knows best' ethos, ever mindful of the yellowing sign hanging on the peeling wall that said in bold letters: 'Due to time constraints your GP can only deal with one problem per consultation.'

We ran open surgeries that ended when all the appointment requests for the day had been granted, yet the most I ever saw on a handful of occasions was 18 patients in the morning.

I am told some GPs still run open surgeries, but the reality is, most of us have to operate triage of some sort to check demand. This is a double-edged sword, because when the patient finally reaches you, they bring with them a multitude of problems.

When Betty has waited two weeks to see me for her anxiety (what with the Easter holidays and part-time working), I am not going to ask her to rebook when she asks for her asthma review to be done at the same time.

Her 10 minutes were up 20 minutes ago and I start to get a little anxious myself. But the days of being obsessive about running surgeries to time have long gone; our patients' needs are changing and the 10-minute appointment is pretty much redundant. Nowadays it's all embracing change, warding off stress and cynicism, and remembering why I chose general practice in the first place.

  • Dr Aziz is a GP partner in north-east Bristol.

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