allan harris <[log in to unmask]> writes
>unwilling to bring them to the centre.
>How do others tackle this problem? Is it widespread?
Decision process:
1. Does the patient need to be seen ? (regardless of where)
2. Have I clearly offered a time to be seen at the base?
(hopefully in a positive fashion - "bring the patient here in 15
minutes and I will see him" or "I will make space to see you at the
surgery in between patients")
3. Have I given the parent/patient time to sort out transport?
4. Is there any reasonable chance of explaining the system to
the caller without either of us retreating further into our corners and
creating a no-win argument?
5. If the patient does need seeing, and the caller is not
amenable to reason - I go, see the patient and then (this is the bit
requiring balls of steel) explain it was unreasonable and an abuse of
resources to demand a visit, that the patient would not have been harmed
by coming to the surgery, but that there may now be seriously ill people
waiting for a doctor because of this. If they are not my patient I
inform them I will be telling their own GP it was an unnecessary visit.
Now the kinder part of me sees that many people do not have the
intelligence to see the difference between clinical and social need - if
they are really really thick there is just no point in even trying to
explain - the only *rule* here is to be safe, and it has to be
*positively alright not to visit*.
There are also those who really do have financial problems, or no
friends, neighbours, etc. If I am honest then sometimes I may have
refused a visit just to make the point, then sat in the base, watching
TV, or talking - that's just mean.
I admit to being irritated by "I'm a single parent family" and "I have
other children" - the hours my husband works I too am often effectively
a single parent family, and I too have other children - that is choice,
and one cannot make your choice then expect someone else to pick up the
tab. If either of these is proffered as reason for not coming to base, I
am automatically antagonised so being fair is much harder.
I suppose, after all this waffle, the only *rules* I try to stick to is
be safe and be fair.
--
Katie Law
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|