As you know, dear reader, I am trying to reduce the time that patients have to sit in the waiting room. I got a bit bogged down yesterday, but this morning I managed to keep the consultations moving along while keeping the punters happy and (I hope) providing reasonable care. I was lucky that there were few complex problems and no new severe psychiatric illness, but I was still pleased that I managed to reduce my average consultation time to 12 minutes.
I am discovering that it is possible to make effective interventions without taking forever about it. One woman asked for some antidepressants to help her cope with the stress of her schizophrenic son's current flare-up, as they had helped when she took them a few years ago. I explained, tongue only partly in cheek, that I was happy to prescribe them but that I was not allowed to do so unless she filled in a depression questionnaire first. Thus is the clinical acumen of the GP with over twenty years' experience strait-jacketed by guidelines from the ivory tower. The questionnaire duly revealed that she was mildly depressed, which came as no surprise to me. As we talked she told me that he is her youngest son, and she cannot come to terms with being unable to "make it right" for him. We talked around this for a short while, and she told me that the mental health team have been asking her for years to attend a carers' group - did I think this would help? I was only the catalyst, but I felt that I had helped her to articulate her feelings of inadequacy in the face of her son's illness, and to make up her mind finally to attend a carers' group. Three minutes well spent, to contrast with the two minutes wasted on the questionnaire.