One of the drawbacks of having a patient participation group (PPG) is that it only takes one subversive for the whole practice to come crashing down. Our PPG spent its first meeting deciding whether to be a ‘group’ or a ‘forum’. Forum was considered more formal and weighty by the majority, but the UK Independence Party supporter objected strongly to it on the grounds that it was ‘too Latin’ and we should be choosing something English. ‘Besides, a forum never did Pompeii any good.’ So group it is.
Meeting two was convened to discuss a collation of the patient feedback questionnaires. Patients were generally satisfied, more so with some doctors (female) than others (not female), and the common complaint other than not being able to get through on the telephone was not being looked at by the doctor who seemed far more interested in his (or her, but usually his) computer screen. There was a lengthy discussion on the importance of making yourself au fait with the electronic records in order to make an accurate diagnosis, but several patients were well-read enough to suggest that chasing for missing QOF points often leads to inappropriate screen time and a perception of disinterest.
So what should be done? The doctors, quite reasonably, suggested putting it as an action point at the next practice meeting and moving swiftly on to the next item on the agenda. But one patient (let’s call him Brian) thought he had a better idea:
‘Why don’t we play peek-a-boo?’
‘You know. That game you play with kids. You hide behind something and then pop out and say "peek-a-boo!”and everybody laughs.’
‘Why would we want to do that?’
‘Well if the GP’s hiding behind a screen, just pop your head round and say "Peek-a-boo” and you’ve broken the ice, had a laugh, and he’s looking at you.’
Unbelievably, the PPG decided this was an excellent idea and sanctioned a pilot study of ‘peek-a-boo’ whenever a GP didn’t establish eye contact when the patient enters the room. Not every GP found this amusing (particularly the older men), but it was remarkably effective. So much so, that at the next PPG, they decided to start running a book in the waiting room as to how long it took each receptionist to smile. The results were displayed on a chart in real time and before long, all the receptionists had abandoned their default scowls and started to smile, albeit through gritted teeth.
The practice could probably have coped with this, but Brian had barely started. Next he produced bingo cards for patients to take into consultations. Every time a doctor said, ‘There’s a lot of it about’, ‘It’s probably a virus’, ‘You’ve got a bit of a bug’, ‘I think that’s one for the nurse’, or ‘We don’t do sick notes anymore’, patients would diligently cross them off until they had a full house.
Patient participation reached new heights when Brian got patients brave enough to sing their symptoms to the doctor. ‘I’ve got a bit of a problem down below!’ has far more gravitas in the style of Pavarotti, and a woman with premenstrual syndrome did an excellent impersonation of Bonnie Tyler. Soon, patients were miming their symptoms, offering to arm wrestle their GP for a fit note, putting on silly walks for the hell of it, and bringing in items for show and tell. One woman brought in a garden gnome as a chaperone, an elderly man came in with his umbrella up and refused to put it down, and an accountant unpacked his Russian dolls on the doctor’s desk and then bit the head off the smallest.
Brian has now been asked to leave the practice and is apparently creating mayhem in the local polyclinic. But his legacy lives on and his ideas have been shaped into a guideline for getting your doctor to look at you. As I write this, Mrs Ferris is standing on her head and trying to sell me double-glazing in the style of Freddie Mercury. I wonder how many QOF points I can claim for that?G
For details of Dr Phil’s tour and DVD, visit: www.drphilhammond.com
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