GP Dr Michael Poplawski uncovered some fascinating trends after tallying up and grouping all the complaints his patients presented with during a random week earlier this year.
Let’s imagine I gave you a crystal ball to predict what illnesses or problems your patients will be coming in with over the next week, month or even year. What action would you take based on what you found out? If you discovered that one in every five patients were presenting with a skin complaint, would you prepare in advance for this? Would it be worth sending your GPs on a skin update course? Or even hiring a GP with a special interest in skin? What if a fifth of the consultations were mental health-related? Could you hire a psychologist that your reception team could triage patients to, thus freeing up precious GP appointments and also saving waiting times for patients?
Alas, crystal balls don’t exist (and I’m not sure I would even want one). But prospective audits do! On a random week in May 2022, I tallied up all of the presenting complaints that patients came to me with and split them up into specialties. I also made a note of the management of the patients, so what I actually did for them. Finally, I counted how many referrals I made and also how many patients I admitted into hospital.
Out of the 76 patient contacts I had that week, 16 contacts – or 21% – were skin-related. In second place was mental health with 15 contacts (roughly 20%) and in third place were various ENT related symptoms at 13 contacts. Musculoskeletal (MSK) conditions made up 12.5% of contacts, and this is despite our area paying for a First Contact Practitioner that our reception team can send patients to for managing MSK conditions without having to see a GP first. Fatigue, also known as Tired All the Time (TATT), was also a common complaint, making up 4.4% of contacts. Lastly, around 10% were related to women’s health, including menopause. This pleased me since I’m a male GP and I often think female patients choose female GPs if they are available. I personally have taken quite some time to really understand treatments options for the menopause.
In terms of management, prescribing medication was the commonest form of treatment, which I did so for 42 out of the 76 contacts, around 55%. For 28 people, I gave advice. Making a referral came in third place, with community referrals e.g. physio, counselling, podiatry, audiology accounting for 12 out of 76 contacts – about 16% – and routine hospital referrals accounting for 10 out of 76. There were also two admissions that week and those poor patients were actually pretty unwell.
I would highly recommend a simple prospective audit like this one to help you tailor the services you want to provide to your patients. I also feel that, by better understanding the presenting complaints of your patient population, practices can more easily target where there needs to be upskilling, which will not only improve patient outcomes and patient satisfaction but also make your life easier as clinicians and practice teams.
I love skin (I even wanted to go into dermatology before deciding to become a GP) and I also have an interest in mental health. So, when those consultations come my way I feel fairly confident (within reason of course).
As Dr Ghosh said in Abraham Verghese’s novel Cutting For Stone: ‘The unexamined practice is not worth practicing’, so let’s take off our stethoscopes for a second, take a step back, and start counting.
Dr Michael Poplawski is a GP in Greater Manchester, and a GP Tutor. Access his YouTube channel at www.youtube.com/c/gponthemove
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