Beware the post-lunchtime GP: they’re dangerously low on empathy
By the afternoon, exhausted and irritable doctors are making poor decisions, and mistakes are piling up, a survey has revealed
Patients should avoid seeing their GP in the afternoon because doctors are so overloaded that they are drained of empathy by lunchtime, a survey suggests.
The research found that more than half of UK family doctors think they are working above safe limits, with some dealing with more than 100 cases a day.
GPs said the overload was putting patients at risk, with fatigue leading to increasingly poor decisions, mistakes and irritability.
The polling of 1,681 GPs by Pulse magazine found that on average they were dealing with 41 patients per day, while reckoning that 30 was a safe number.
One in 10 reporting dealing with 60 or patients daily – double the safe limit. One GP said: “There is a point where I feel cognitively drained; after about 20 patients there is not an iota of empathy left.”
Another GP, Dr Jonathan Harte, said the risks to safety grew as the day went on. Describing his workload on the day of the snapshot survey, he said: “By lunchtime I felt on the edge and risked missing urgent tasks and contacts, thus affecting patient safety.”
Dr James Howarth said he had dealt with 124 patients on the day of the poll. “This workload creates patient safety risks. There are risks around having multiple patient notes open because we’re helping a nurse out with hers, or we’re 30 minutes late so we see the next patient while finishing the notes of the last,” he said.
“We might forget consultant details, plans and actions, or prescribe for the wrong person, use the wrong labels on blood tests, and so on.”
In the previous week he had sent a blood test using the wrong patient details because he was extremely busy. “I spotted it in time, but how many do we fail to spot?”
The majority of the cases were face-to-face appointments, with the data also covering home visits, and phone and online appointments.
The survey found medics were working an average 11-hour day, including eight hours of clinical care and three hours of administration. The poll asked family doctors about their experiences on a single day, February 11. Just over half said their workload that day was beyond safe levels.
Professor Helen Stokes-Lampard, chairman of the Royal College of GPs, said: “In my own practice recently, I had a 12-hour day and 100 patient contacts. GPs across the UK will tell similar stories.”
Prof Clare Gerada, former chairperson of the royal college, said the workload left GPs at increasing risk of missing potentially deadly diseases, such as cancer. “You could miss a result or misread a letter, or you don’t focus on the right symptom or ask the right question.”
She suggested that tired doctors were also less likely to show compassion to patients. “You might end up being rude to a patient and then get a complaint, because when you’re tired you become irritable.”
The UK government has pledged to recruit 5,000 more GPs by 2020, but has admitted the target is unlikely to be hit.Research from Europe suggests GPs see 25 or fewer patients per day.Dr Nikita Kanani, the National Health Service’s national medical director for primary care, said: “We already know that general practice is under pressure, which is why investment in local doctors and community services is increasing by £4.5bn, helping fund an army of 20,000 more staff to support GP practices as part of the NHS Long Term Plan. But we are also aware that almost nine out of 10 salaried GPs currently work part time.”– Telegraph Media Group Limited (2019)