Zara Aziz: Those times when only the GP will do

There are many phrases that we hear endlessly in the NHS, but none more frequently than 'go to see your GP'. Half of my Docman letters from the morning are from secondary care asking for further referrals.

Take this scenario, for example: patient is seen in glaucoma clinic by ophthalmologist, who notes a cataract in said patient and asks if GP can refer to cataract clinic.

Even more bizarrely: ENT doctor sees patient and asks GP to refer to audiology (which is situated next door to ENT clinic).

Feeling rather like a manager submerged under NHS red tape, I decided to do some telephone triage instead.

'I really must see you today, doctor, it's really important,' J says, anxiously.

'Is it your sick note? Although it would be nice to catch up with your Christmas news, I could do your note without seeing you today,' I say, fishing for clues. I can hear the the build-up of feverish children crying in the waiting room and I am loath to part with an urgent appointment for a non-urgent problem.

'No, doctor, I'll tell you when I get there,' he says, adding ominously: 'Can I have the last appointment of the day so we don't have to rush?' Knowing J's unpredictability (he is either after some orlistat or harbouring a deadly disease), I cave in.

Later, he strides into the room and brandishes what looks like a long bank statement at me.

'It's my credit card bill, doctor. It nearly gave me a heart attack and blocked all my stents, what with the shock and all. I said to the wife, no tree this year, just recycle the plastic one from the attic, and no presents for the dog. I think I've been hit by credit card fraud. We all know what banks are like.' He seemed genuinely upset.

I scratch my head, at a loss to offer suitable advice. 'Did you ring the bank to check the figures?' I finally ask.

'Of course. I told the bank there must have been a mistake, and how my anxiety had gone through the roof as soon as the letter hit the mat.'

'And what did the bank say?'

'See your GP.'

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

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