Working as a GP brings another challenge that is rarely seen in hospital practice ...regular, heavy paperwork! 

Tasks fly at you at the speed of naught and before long one starts flustering and "To do" lists keep on getting longer.

I faced this problem early in my ST3 year as more work and responsibility tends to come your way...you are almost the finished product. Or so are seen to be by your colleagues . I remember being very late with a few things and had many tasks sitting in my tray / emails / Systmone.

During one of our tutorials, I requested my trainer to help me with this. Not only because he was my trainer, but also because his time management was impeccable . The result was a 30 minute tutorial that helped me a lot. He actually drew a nice line diagram to help me understand my own priorities. 

I have tried to recreate the same here. The tasks are labelled according to Urgency (U) and Importance(I).  If something is thought to be less urgent, it gets graded U and most urgent gets graded UUU and so on with the Importance.

Have a look and see if you can incorporate this into your work life. The Urgency and Importance of tasks will vary from person to person and also depend on your work environment .

9:20 am : Meeting finshes....topics included a new patient survey, admin staff retirement and resignation, new salaried GP payscale, problems with the new building, tax bill, etc...all in all this was an intensive meeting

9:20 to 12:30 pm : patients...the usual suspects

1:00 pm : visit-  one today

1:50 pm : back from visit, sign prescritions, sign tax return, lease papers, look at a complaint letter, check pathology results 

2:30 pm: hungry...heat lunch and eat whilst chatting with colleagues 

3:00 pm: patients....the usual suspects ( and some unusual ones)

5:30 pm: sign prescriptions, change patient survey, talk to Nurse Practitioners baout 2 cases

6:00 pm : go through scanned letters, make a couple of referrals, send tasks to admin staff about results, etc

6:45 pm : document afternoon visit

6:50 pm : 2 reports to do

7:00 pm : one report done, too tired to do the other one

7:05 pm : Drive home

This was a quiet day...no emergencies, nothing went wrong.....

I held it against the light and studied it...reminded me of my hospital days and it actually felt good looking at the film. As GPs, we access the written reports but never get to see the films. There is something highly satisfying about viewing the actual film...maybe it is a sense of control...I don't know. I hope one day we will be able to access the actual films on our computer. It can only be a matter of software upgrade.

Coming back to my patient, I was able to reassure her that her x-ray seemed fine and she seemed pleased. So was I....

These are the hands
That touch us first
Feel your head
Find the pulse
And make your bed.

These are the hands
That tap your back
Test the skin
Hold your arm
Wheel the bin
Change the bulb
Fix the drip
Pour the jug
Replace your hip.

These are the hands
That fill the bath
Mop the floor
Flick the switch
Soothe the sore
Burn the swabs
Give us a jab
Throw out sharps
Design the lab.

And these are the hands
That stop the leaks
Empty the pan
Wipe the pipes
Carry the can
Clamp the veins
Make the cast
Log the dose
And touch us last.

I chanced upon this app on my iPhone and downloaded it. It is called Sleep with Andrew Johnson. It is good and I would recommend it. Many patients have iPhones now a days and at £1.59, this definitely beats a prescription for z-drugs or just a leaflet.

Baffling, really. The college Journal for GPs  seems to be always full of primary care research in Netherlands. Innovait, on the other hand, has valuable discussions on topics such as competence in children, hayfever, etc that are so practical. 

I need to resubscribe to it.

I have given my number to a few patients. Without exception, these have been palliative care patients or their families. Most of them have never contacted me. Some have ....usually to inform me of deterioration, or to get some advice. I have been asked / requested to attend only once but I could not.

I think a good ground rule is to let them know that for emergencies they should contact the OOH service or DNs. Also let them you that you might not be able to visit out of hours.

Giving your number to patients with mental health problems is a definite no no in my opinion as it could make them dependent on you and is not the best practice.

Also , are you prepared to take work home with you ?

Any thoughts?