I recently made the transition from hospital junior doctor to GP registrar. I was thinking as I checked my blood results on the computer the other day how much more efficient this process was than the end of day ‘chasing of the bloods’ in hospital. If all is normal, results can be marked as such and filed in the electronic record with a couple of clicks. If there are abnormal results, I can ask the staff to arrange a repeat or for the patient to come in to see me with another couple of clicks. And there is a clear audit trail.
Looking at, and acting on, laboratory results is clearly a medical responsibility, but the laborious copying of results into the ‘bloods folder’ to be taken on the ward round was not good use of my time as a house officer. Things had moved on by the time I was an SHO, and we often had a mobile computer to take on the ward round to check results, but there was still the time-consuming completion of request forms for the next day to be done by my house officer.
This isn’t the worst of it, as any junior hospital doctor knows; there are plenty of tasks that fall to trainee medical staff which could and should be done by clerks, porters, or other staff. One of my ‘favourite’ completely inappropriate uses of medical time in hospital posts was hand-delivering requests for investigations, when it is not possible to request them online or on the phone, and the internal mail is far too slow and unreliable to use.
Another was phoning round the wards to find out where my consultant’s patients had been placed in order to put together a patient list. As a medical SHO last year, I would sometimes phone every ward in the hospital I hadn’t been to that day to make sure no patients had been missed. Yes, it was my responsibility to make sure all my consultant’s patients were seen, but should I really have had to spend time ringing round: “Hi, it’s Debs, Dr Blogg’s SHO, just wondering if you had any of my patients tucked away on your ward?”
No wonder the recent coverage of the BMA’s cohort study, which traces the career progression of junior doctors who qualified in 2006, the year after me, shows that trainees spend more time carrying out administrative tasks than they do in formal training. Juniors in their first year of specialty training reported that they spent 66% of their time on clinical duties and 14% of their time on administrative tasks, which was greater than the time they spent in formal training in a clinical setting, at 13%.
Such poor use of my time would be unthinkable as a GP registrar. I have 12 hours of protected educational time per week, and when it comes to admin, my trainer tells me to delegate – I have got more important things, i.e. my training and patient care, to attend to.
Read the full cohort study.