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Wednesday, 17 October, 2001, 07:56 GMT 08:56 UK
A day in the life of a GP
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Some GPs face long stressful lives
Many GPs say they are over-worked and want to leave the health service. BBC News Online examines a typical day in the life of Dr Ruth Carson.

0700: Dr Carson may get a rude awakening - from seven in the morning, she is expected to be on-call to deal with urgent calls from patients who have contacted the NHS Direct phone line.

She said: "If the phone rings after seven, your stress levels go straight up. It's not a nice start to the day."

0800: Just like any other mother with three children, getting them washed, dressed, fed and driven to school can be a trial in itself - but all the time, she is expected to deal with patients' queries on the telephone.

If the phone rings after seven, your stress levels go straight up

Dr Ruth Carson
"It's not always the easiest thing in the world to talk to someone about their medical problem when you have three children screaming in the back of the car."

0930: Dr Carson arrives at her surgery in Reigate. She is a single-handed GP, meaning that there are no other doctors working alongside her - and she cares for a total of 2,800 patients, a very high list size for just one GP.

She said: "Usually, there will be a full waiting room there when I arrive, but there will also be the receptionists trying to get me to do other urgent jobs, or fit more patients into the morning surgery.

"Very often, my stress levels will be soaring five minutes after I get through the door.

"A small number of my patients can be very rude. We had one patient today who was trying to get seen before anyone else with a relatively minor complaint - when I had one patient with terminal cancer who had an appointment in front of her.

"Whenever a patient is rude or aggressive, it means the patients afterwards don't get a fair deal, as I'm still calming down from it."

1130: This is the time that morning surgery is supposed to end - but it usually overflows by at least half an hour by the time paperwork and extra patients are taken into account.

Each patient should get a minimum of 10 minutes, and ideally 15 minutes. In some GP practices, much less time is the norm.

"On one occasion recently," said Dr Carson, "I'd been booked in to see, separately, four members of the same family in one ten-minute slot. You can't hope to do your best for people under these circumstances."

After morning surgery, there are still usually a couple of house-calls to make, and almost certainly a stack of paperwork, or even meetings to attend with other doctors in the local primary care group or bosses from the health authority.

The amount of paperwork is astounding

Dr Ruth Carson
"We don't usually take any lunch," said Doctor Carson.

"The amount of paperwork is astounding - lots of people send in a form which they say will only take 20 minutes to complete, but when you have a dozen of them, it's just not possible.

"Today, the DSS sent a maternity form back, saying that it all had to be written out in my own handwriting, rather than simply signed by me, or it wouldn't be accepted."

1530: Afternoon surgery lasts two hours, and is generally calmer than morning surgery.

However, even in a relatively affluent area like Reigate, Ruth and her staff face regular verbal abuse, and occasionally even physical assault, from patients or their relatives.

Even after this, she is on-call again until 8PM, advising and even visiting patients.

And it is not infrequent for her to have paperwork left over to complete at the end of the day alongside her own family jobs and chores.

2000: Even now, she often cannot relax.

"Very often I end up taking a basket of papers to bed with me.

"We might get 20 to 30 blood tests a day - each of which needs careful examination.

"It's a stressful life, and while I feel I give my patients a good service, it's not easy."

See also:

30 Apr 01 | Health
Health chief slams GPs' protest
28 Apr 01 | Health
GPs gear up for day of action
19 Dec 00 | Health
'Thousands more GPs needed'
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