A registrar survival guide: …surviving heartsink patients

Don’t reinvent the wheel

Every practice has them: the frequent attenders, the somatisers and the just plain frustrating. When a doctor joins the practice, open season begins among them. The chance of a new listening ear becomes too tempting a possibility to miss. Many new GPs, enthused and with knowledge-overload, find themselves trying to invent the wheel, when gently polishing the hubcap would be better. 

Be prepared to listen 

As with almost all consultations, heartsinks will have an agenda to be settled and you must be prepared to listen. As it isn’t possible to earmark all these patients, a cursory glance through the problem summary and last couple of consults is a good habit to get into. 

Allow the information splurge 

Allowing the initial information splurge that many start with is good practice as there may be several problems. Try to give priority to the problems which concern the patient the most and suggest a separate appointment at a later date for the other problems.

Be prepared to emphasise the fact that there are other patients in the busy waiting area.  

Keep cool 

Care must be taken not to brush over red flag symptoms. Be consistent in history-taking and note-keeping.

Be prepared to ask for opinions from your GP colleagues. Keep cool, keep smiling and don’t be down-trodden. 

Dr Barney Tinsley is a salaried GP in Bradford. He qualified as a GP in August 2005

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