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View from the front desk: life as a practice receptionist

1 September 2006

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Pat Pinchess
Receptionist, Phlebotomist and Admin Clerk

Pat has been a receptionist at Abington Medical Centre for
10 years. During this time she has learnt quite a few skills, including phlebotomy and taking blood pressure, as well as the general receptionist duties. Pat has written quite a few poems over the years for doctors and staff on special occasions. She also enjoys drinking wine, sunbathing and playing with her granddaughter

What is a medical receptionist? Are we dragons, as some people seem to think, breathing fire and brimstone over patients and doctors alike? Or are we more like octopuses, with our ability to use two hands to do eight jobs at once, while thinking of three more?

“Dragons” seems to be a commonly applied term. I do hope that is not the impression we give. I think we’re in the pink; at least that’s the colour of our uniform blouses. As each day dawns we don the uniform and stagger to work, not knowing what the day will bring. Will it be Mrs Smith with her long list of medication requirements, or someone wanting an appointment at 8.30pm on a certain night? Perhaps someone wanting a home visit, because she is waiting for the gasman to arrive; or can the doctor come at a certain time because they have a hair appointment they do not want to miss? Or will it be that all-important phone call, where the patient is critically ill and you need to get a doctor now?

The practice
The Abington Medical Centre, where I work, is a large, modern surgery, built in 1991. It is situated in a health complex, with a dentist, an optician, a private sports clinic and a pharmacy all onsite.

The surgery building is a hexagon shape, with the waiting room in the middle and all the consulting rooms around the outside. The reception area and administrative offices are off at a right angle, which allows for sound to travel. Our practice manager’s office seems to be the conduit for the travelling sound and she can hear all that goes on in reception, even if we are chatting too much.

We have 12,900 patients – the list is rising – and are extremely busy. To keep it functioning properly we have a large administrative staff looking after eight GPs. We are also a training practice, so we usually have one or two registrars spending 6–12 months with us. We often form a bond with the registrars, and it is very sad to see them leave at the end of their training. Of course, there are some who we are glad to see the back of!

The stress factor
Life is very stressful for a medical receptionist, far more than I think people realise. At our surgery, we cope with stress by rotating stations in the mornings and afternoons. So in the morning you might be on switchboard duty, while in the afternoon you could be taking messages, on the front desk or perhaps on the appointment phone.

Each position can be very hectic and brings its own problems. Why is it, for instance, that when you are really busy at the front desk trying to book in a long line of patients, you get the one at the front who can’t remember whether she has an appointment today or tomorrow and doesn’t know who it is with (in the end she has not only got the wrong day but the wrong week)?

When on the appointment telephone and flicking through all the appointment screens, you are offered a wide selection of dates and times because the timing does not suit Mrs Fussy. And then guess what? She decides to take the first one offered after all.

On the enquiries telephone, how do you explain to an irate husband that you cannot disclose his wife’s medical information? And, no, not even confirm she has had a blood test. You then try to stay calm, even when he is getting more and more irate.

Then, when on switchboard duties, you are trying to sort out whether the caller actually does need a visit and no, the doctor does not normally bring today’s newspapers with him.

Furthermore, we are a very large and busy surgery. When we have all eight doctors in it gets a little crowded in our waiting room, which is made worse by little Johnny deciding that it would be much more fun to run around the waiting room shrieking his head off instead of sitting quietly reading. We all breathe a sigh of relief when the last patient has been seen and we can take stock and enjoy the peace and quiet. Well, at least until the next surgeries start in an hour’s time.

The open access surgery we offer started a few years ago as a solution to all the extra appointments that appeared at the end of morning and evening surgeries. The patients seem to like it as they can come in the morning or the afternoon and wait to see a doctor. Some don’t even mind waiting for over an hour; they seem to find plenty to keep them occupied watching the rest of the patients in the waiting room. We asked, in our patient surveys, whether this facility is still useful and the vast majority of patients said it was, and that they wanted to keep the system. This is no wonder: sometimes we have between 20 and 30 patients a day, and it has even been known for us to have more than 70 patient appointments in one day. Generally, we have two GPs and a nurse doing the open access, but on Mondays we have three GPs and a nurse.

Multifaceted approach
Our practice philosophy for staff is to encourage everyone to be multiskilled. This enables receptionists to do other things, breaking up the monotony of being in reception day in, day out. Reception staff are responsible for recalling patients for smears and chronic disease clinics, and processing electronic pathology results. We have also developed our skills in other areas. Some of us do phlebotomy, routine blood pressure clinics, as well as eyesight tests for the retinopathy eye camera. Patients from the local hospital visit the surgery for these routine tests, which eases the pressure for them. We also run a new patient medical clinic.

The practice partners decided to develop the role of the receptionist some years ago, and one of the ideas was for receptionists to be taught phlebotomy. I never imagined I would be able to stick a needle in a person and draw blood, but I did master the skill and I thoroughly enjoy it. The patients have accepted this dual role of receptionist/phlebotomist, and quite often when I am on the front desk a patient will come out to book an appointment for a blood test and will say to me, “Book me in on your day will you, love?” One of the drawbacks to doing the blood clinic is that patients think that while they are in a clinical room they can ask clinical questions. So they often ask me about rashes and spots, which they start showing you – very quickly I tell them I am not medically trained before they start to reveal the embarrassing areas.

Switchboard was the position that frightened me the most, because you don’t know what to expect. People are not always clear; they are often frightened, tearful or angry, and they themselves are not always sure what they are asking for. You can usually bet that you’ll speak to a patient who can’t quite get to the point and rambles on just as the duty doctor is trying to talk to you about an entry in the visit book.

Patient and staff relationships
However much we try not to get involved emotionally with patients, there are occasions when this is very difficult. We have some lovely patients, and it is very sad to see them deteriorate and can be very upsetting when they pass away.

Of course, not all patients are pleasant and we do have our share of patients who are rude and abusive. They want their prescription now, they want to see the doctor now, and they see us as standing in their way. I have been called various names during my time in the practice, ranging from something mild, like “bovine”, to something unprintable. Fortunately the partners do not tolerate such rudeness to us, and depending on the severity they will remove a patient from the list immediately if they have been very aggressive in their manner.

However, we have great patients who far outnumber the unpleasant ones. At Christmas we are given so much chocolate, biscuits and wine that we have a lucky dip and everyone goes home with a present. In January we are all on a diet!

I must not forget to mention those all-important people: the doctors. Our surgery was rare in Northampton, in that until recently we only had male GPs, although the occasional registrar was female. Now, we have three salaried GPs working here. I wouldn’t want their job for all the tea in China, but, although they have their “moments”, there is not one you couldn’t go to if you had a problem.

Enjoying the challenge
I have worked at the Abington Medical Centre for 10 years since 1 April. The girls would probably say that was an omen, as I do seem to be the one who makes people laugh. I am also the resident poetess; on special occasions I can be found with pen in hand and a rhyme running through my brain. Recently, our senior partner retired and we had a lunchtime “do”. He is retiring to France, so I thought it appropriate to ride into the room on a bicycle hung with onions and garlic, wearing a beret, silk ribbons around my neck, striped low-cut jumper, leggings and red high-heeled shoes, to the tune of ‘Allo ‘Allo! Thank goodness he has a sense of humour.

I used to work part-time, but now I have increased my hours and work four full days a week. I also have the added responsibility of being admin assistant to the fire-breathing practice manager. That is the impression she gives, but she too is someone you could talk to if you were upset. I think over the years many of us have sat in her office with a problem and a box of tissues. I have had different jobs in the past, but not one I have enjoyed as much as this one – even if sometimes a glass of wine is a welcome sight when I get home.