As a GP, I wish I could call time on the 10-minute appointment

I’m about to start morning clinic. My computer shows I’m already fully booked and extras are being added. It’s going to be a busy one but I am determined to keep to time today. My first patient is Mrs B. She’s 76 and has diabetes, chronic obstructive pulmonary disease, high blood pressure and arthritis. She doesn’t come to see me very often, though. She doesn’t like doctors.

8am – She has a 10-minute appointment

I call her from the waiting room and she slowly shuffles towards me using her walking frame. I hold the doors, while her husband supports her. She slumps in the chair and has to sit and catch her breath before she can talk. Two minutes have already gone.

8.02am – ‘It’s nice to see you Mrs. B, what can I do for you?’

She feels really short of breath and has been coughing badly for two weeks. Her inhalers aren’t helping.

I ask many more questions to make sure I’ve understood her properly, got all the information and checked for any red-flag symptoms. Then her husband interjects: “She keeps falling and we’re both worried that she’s forgetting things.” Those are two further issues I will need to explore.

8.05am – ‘Please may I listen to your chest?’

Minutes pass as her husband helps remove her scarf, coat and multiple layers of clothing. I perform my examination, then she tiredly re-dresses. I can see she’s really struggling.

I crosscheck the treatments I might prescribe for interactions against the 15 medications she is already taking.

I also note alerts on the screen flagging the need to discuss her weight, her cholesterol is high and her medication review is overdue. These are quality targets GPs are measured against.

8.12am – ‘You have a nasty chest infection and needantibiotics’

I turn to give her the prescription and find her crying. She is terrified I will send her to hospital again. I take her hand and spend a couple of minutes reassuring her. I go over how to use her inhalers again. I explain what to do if she feels worse and how to seek medical help.

8.15am – I’m already late

I’ve dealt with her primary problem but have I got time to address the two concerns raised by her husband? I have to do it now, if I don’t she might not come back – she really doesn’t like the doctors.

Both falls and memory symptoms are complex problems with numerous possible causes. I cannot solve either today but I gather more information and arrange further investigations.

They both thank me and get up to leave. Her husband shakes my hand. He is a brilliant carer.

8.22am – I’ve only seen one patient so far

I’m already running 12 minutes behind and I still have to complete my notes before calling the next patient.

I hope Mrs B was satisfied with her appointment. I know that I provided good care, even though I didn’t manage to tick off a single quality target.

A 10-minute appointment may suffice for a patient with only one problem and no other health needs, who can give a clear and concise account of their symptoms, and who is physically mobile.

In reality, the majority of my patients are elderly and have multiple coexisting conditions. They often have impaired mobility and memory, as well as communication difficulties, and don’t forget the wider social issues they often face.

I wish I had longer to spend with my patients, to understand them and their individual situations. I can see the value when I do. But while empathy is fundamental to doctor-patient relationships – and in fact relationships across the whole health system – it takes time.

11.50am – I call my last patient of the morning

I apologise because he’s been waiting nearly an hour. “Don’t be sorry, Doc, you’re busy,” he says. “I know that you would give me extra time if I needed it.”

Mrs B is a composite based on this GP’s experiences of patient care.

Suddy Davidson participated in the A Mile in My Shoes exhibit, developed by the Health Foundation in collaboration with the Empathy Museum, to shine a light on the contribution of the millions of people working in health and social care in the UK. You can read more about the project and listen toDavidson’s story here.

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As a GP, I wish I could call time on the 10-minute appointment