"Triage tyranny"

The triage system has numerous pitfalls.

On all the occasions I have asked for an appointment because I thought I needed the doctor to see me face-to-face I have been given an appointment. On the one or two occasions when I just wanted some advice about something, that is just what I got and the doctor agreed I didn’t need to be seen. What does this show? That patients have far more common sense that we are credited with, that we know our own bodies and have a pretty shrewd idea of when we do actually need to be seen in order to get a diagnosis or treatment. In any case these days, most people have researched the gamut of possibilities online, and probably tried some over the counter remedies, before they even make contact with the surgery.

Once or twice I have gone into the surgery, either because I’ve been passing or because I couldn’t get through on the phone, only to be told that I had to go away and await a phone call. I have then gone home, received a phone call almost straightaway and been told to come back in. What a waste of my time! Why couldn’t a doctor or nurse have done some basic face-to-face triage and saved all our time – as well as the cost of calling? Maybe I should have just sat in the waiting room with a mobile. I agree with some others here that the triage system is only for the benefit of doctors and admin staff, and not at all for that of patients.

On other occasions I have apparently had call-backs, but I have not been able to answer them in time. Because the surgery number is withheld when dialling out, it is impossible to identify missed calls as coming from them. This is not an issue I have with my dental surgery and I’m sure it can be overcome with a simple technical fix. If you can’t answer the call when it comes in, you are effectively at the back of the queue again and have to ring reception and wait several hours all over again. Just don’t let this happen on a Friday afternoon if you can avoid it, otherwise you may still be waiting on Monday.

I agree the triage system also puts the onus on patients to be assertive and forceful in order to be seen. Those who are not so may find their symptoms are ignored or minimised and not get the face-to-face appointment they actually need. What safeguards, if any, have been put in place to help more vulnerable patients in this respect?

Another problem with triage is where you are likely to be at the time of the call-back. If you are at work and suddenly get a triage call, you find yourself obliged to discuss your personal problems in front of your colleagues. It’s just not practicable to find a private space on demand like that.

What patients really want is not to have to jump through numerous bureaucratic hoops before being seen and to be given some options about when they can be seen. This system does not achieve this. How about a mixed economy with more bookable appointments and a walk-in hour at the beginning or end of the day when patients are seen in order of arrival?