‘If I die, it's your fault': Life as a GP receptionist in Britain's broken health system
I could see the white foam at the edge of his mouth. As he ranted, his face was red and his teeth were clenched and he was moving closer to the partition. Genuinely, he looked like a cartoon character, like when they get consumed with rage. As a GP's receptionist, I'm not easily intimidated, but he terrified me. I hit the panic button under the desk.
This was a guy who'd phoned the surgery that morning to ask for his fit note to be extended. I didn't have an appointment to give him that day.
When I'd said it would need to be tomorrow, the abuse had started. 'You have no right to tell me I'm not getting my note,' he said, calling me horrible, horrible names down the line. Then he said: 'Just you wait, I'm going to come down and see you shortly,' and hung up the phone. I didn't really think anything of it because you get those threats sometimes – I'd say five or six times every single day, I'm called a name or sworn at. F---ing b---- is a favourite, or the C-word.
But something in his voice made me and my colleague lock the door to our office, just in case. Then the gentleman appeared at the desk. I think if that door hadn't been locked it could have been a very different scenario. Thankfully the police came quickly, but I was shaking for the rest of the day.
'I've had to develop a thick skin'
I work in a relatively small practice in the north of the UK with little over 5,000 patients. Since the pandemic, the demand for appointments has probably doubled, I'd say, and with it the abuse we get on the front desk. I've had to hit the panic button only twice before, but I've had to develop a pretty thick skin to the daily verbal abuse. On reception we are the front line. I don't like the C-word but I was more sensitive when I started. Now, the regular name-calling, it just bounces off.
What I don't like are the threats. My colleague got told recently when she couldn't give an appointment: 'F--- off, I might be dead next week and it'll be your fault.' I've had that a few times. I had it on a Friday afternoon when a patient wanted to see the doctor to arrange medication, but it wasn't urgent. They said: 'Well, if I die, it's your fault.' And I thought, why say that to somebody? I've got to go home at the end of the day, I'm a person as well. I wouldn't dream of saying that to anybody. Your stomach kind of does somersaults and it stays with you. It stayed with me all that weekend when I was trying to spend time with the kids.
Your tolerance builds up but some days, it can cut deep, and I think to myself, 'I'm only trying to help you.' My husband knows nine times out of 10 just by looking at me when I come in whether it's got to me. He'll say to the kids, 'Just give Mum half an hour to de-stress.' I'll go to the bedroom and shower, put my comfies on, usually it'll take just 40 minutes and I'm all right after that, but I have also sat down with him and cried.
I'd say a lot of the increased demand we face is driven by the need for fit notes now, and a lot of the abuse, too. Generally people want them for mental health, or for a bad back, a bad hip, either because they can't work, or need to claim benefits. The number of fit notes our doctors do on a weekly basis is ridiculous. On a Monday, we'll get 25 or 30 calls for them to be reviewed, then it's 20 or 25 every day for the rest of the week, and we're a relatively small surgery.
'Monday morning is like going into battle'
The other thing that often angers people is when I ask what their problem is. I don't need all the details, I'm only asking to check whether it's an emergency, or if they need to see the nurse, or the physiotherapist, rather than the doctor. It goes 50-50 – patients tell you far too much, or they really don't like it, and those people can become abusive. The other day, I was told I was a 'f---ing nosy b----'. I didn't argue.
It can be well worthwhile asking. I had someone the other week demanding an emergency GP appointment and they had a verruca. They were signposted to the pharmacy but weren't happy.
A Monday morning does feel like going into battle, needing to get your armour on. I usually get in for 6.40am to get on top of emails and prepare. Receptionists have a lot of admin too; I'll have 100 doctor letters to read on a Monday alone, usually 400 in a week.
There'll be three of us across three phones and I'll say to the others just before 8am, 'I don't want to press the button.' It's like, what are we going to get today? Then it's constant for an hour across the three phones, and on one for the rest of the day.
I have every sympathy when people are struggling to make appointments, I really do. I want to give them; I want to treat people like I would my own grandfather. When I phone my own surgery, I face the same issues. We genuinely need more GPs – actually, we need a new building; it doesn't have space for more. On a Monday morning, appointments will be gone in 30 minutes, and waits for routine issues can be two weeks. I know it's normal for people to get particularly agitated when they're in pain or anxious, too.
If I have somebody on the phone who is obviously unwell, they will get dealt with that day. I know that if it's someone who doesn't come to us very often and they obviously felt they were ill enough to phone, they need to see a doctor.
We do get the frequent fliers, though. The people who phone us every second day, where it's almost like a hobby. And they always seem to get through first, I don't know how they do it. But I get too that people are suffering more health anxiety. That seems to have been worse since Covid.
I honestly love my job, which I realise sounds surprising. I've been doing it for the best part of a decade and have a great relationship with so many of our regular patients. I'll go above and beyond for them. I've delivered prescriptions to people who can't get out. You get emotionally attached; I've been to patients' funerals before.
Sometimes, when I can see that the carer of an ill patient needs to talk, I'll bring them into the office and allow them to let out how they're feeling so they can go back with their game face on. Reading a doctor's letter and realising a patient has cancer is very, very hard.
All the same, I can't produce appointments from nowhere. I get people's frustrations, I do, but my colleagues and I do genuinely want to help. And we're only the people on the front desk.
As told to Emily Retter
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