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The Patient Participation Group (PPG)

The Patient Participation GroupDroitwich Patient Participation Group

Doctors are the only professionals who consistently exceed my expectations.  It was to support my doctors that I, Guy Thomas, joined my local Droitwich Patient Participation Group in Worcestershire, England.

Topics for Patient Participation Group (PPG)

A man walked into the doctor's, The doctor said:
'I haven't seen you in a long time.'

The man replied, 'I know I've been ill'.
Tommy Cooper

What Is a Patient Participation Group (PPG)?

A PPG is collection of ordinary people with a desire to make a difference to what happens in their surgery.  These are my reasons joining the patient participation group:

  • To support, help and boost the doctors.
  • A sense of wanting to give something back to the community.
  • Lobbying to improve services, for example, phone service, local transport for patients.
  • To let off steam about personal grievances concerning administration at the practice; then distil it into constructive criticism.
  • What happens in PPG meetings

Recruiting New PPG Members

Top of the agenda at any Patient Participation Group is to recruit more members.  Anyone can join.  To be precise, anyone can join a Patient Participation Group at their local surgery.  If your surgery does not have a PPG then you could form one!

One hidden benefit of going to PPG meetings is chatting with other patients.  You will discover services that you did not know existed.  In addition, talking over similar problems with ordinary people helps to put things in perspective.  Sometimes I have to admit that that my starting position was just plain wrong - the practice and the surgery were correct.  Occasionally every patient can see a problem, but the practice cannot, that's when the group can be at its most powerful.

One reason why PPGs can be so good is because they contain experienced people, thus they are qualified to make comments, because they have seen lots of different doctors' administrative systems.

Conversation Overheard in a Surgery (Not in Droitwich)

    Doctor: Are you on HRT?
    Patient: No, income support.

Exciting Times for Patient Participation Groups

While PPGs have been around for about 20 years, what's exciting about PPGs in 2010 is that attitudes, facilities and procedures are changing fast.  What's exciting is that PPGs can provide help with issues that practice administrators are too hamstrung to deal with, and make life a tiny bit easier for doctors who, frankly, have more urgent matters to attend to.

My own view is that general practice doctors are 'Gods' and the rest of us should do all that we can so that they can spend all their time doing what they do best - treating patients.  See the national Patient Participation Group

The Specialist

'What kind of job do you do?' 
A lady passenger asks the man travelling to Birmingham in her train compartment.

'I'm a naval surgeon,' he replies.
'Good grief!' splutters the lady, 'How you doctors specialise these days.'

Topics That Interests and Concern PPGs

  • Local hospital provision.
  • Physiotherapy.
  • Making phone contact with the surgery.
  • Availability of hospital x-rays.
  • Transport for hospital appointments.
  • More on what happens in PPG meetings

7 Things You Can Do To Help Your Doctor's Surgery

  1. Keep appointments - If you cannot make your pre-booked slot, then please phone and let reception know.  The doctor or nurse can then see another patient.
  2. Avoid phoning for test results in the morning rush hour.  It drives receptionists mad if you phone for non-urgent matters between (8:30 -11:00 am).  This is when really sick, and distressed patients are trying to get through to make a vital appointment.  Make it a rule to only for your XRAY or blood test results only after 11:00pm. 
  3. Read the surgery's literature.  Guy bets that if you research your Doctor's services you will find at least one that you did not know about.  My guess is that you will find one that is useful to you!
  4. Fill in patient questionnaires.  People only fill these in when they have a complaint.  Make your doctor and receptionists day by filling one in after you have had a good consultation.  Join your local Patient Participation Group.
  5. Most good doctors run late.  When I visit with any other professionals, I regard it as a personal insult if they keep me waiting.  However, with doctors I have come to realize that they may have just seen an emergency, consequently, my appointment has to be put back 30 minutes.  Guy has been very slow to learn this lesson.
  6. If blame must be found, then find the root cause.  I now feel guilty because I have shoot at least 3 messengers instead of talking with the person who instigated an administration system that I think is nonsensical.
  7. I do give general practice doctors god-like status when it comes to medical matters, therefore, it has been a great disappointment to realize that they are ordinary mortals when it comes to admin.  Incidentally, my friend Brigadier Jackson, who often tells me that none of his combat ready platoons ever passed a parade drill, reckons that no top doctor passes muster at form filling.  Guy is learning to deal with this fact of life, and brushing-up lines to 'chat-up' receptionists in order to clarify admin matters. 

Funny Statements Made by Doctors  (Not in Droitwich)

  • While in the emergency room, she was examined, X-rated and sent home.
  • Rectal exam revealed a normal size thyroid.
  • The patient lives at home with his mother, father, and pet turtle, who is presently enrolled in day care three times a week.

Doctors' Phone Service - Guy's B�te Noire

I say again, doctors are the only profession that exceed my expectation.  At the other extreme, phone systems consistently disappoint me.  This is because I can remember the halcyon days when if you phoned the doctor's surgery, or a hospital, you got through to a real live telephonist.  It's interesting that that really important services, such as the 999 emergency, still employ a real telephonist.  All other services bamboozle me with their recorded messages, befuddle me with options, and then more often than not, cut me off once I make my selection.

Until a doctors' surgery provides a real live telephonist I will never believe that they truly put their patients ahead of procedures and performance targets.  I am not sure if it makes matters better or worse that all surgeries are equally cowardly, in that they all hide under the excuse that everyone else provides only a recorded options menu service.

To step back, and take a reality check: there are 2,000,000 + people unemployed in Great Britain, would it not better everyone if 5,000 of them were employed as surgery telephonists, rather than drawing unemployment benefit?

Doctors' Phone Service - Plan B

It seems that at least for the short-term we have to accept a recorded message service.  Taking a shot at a surgery's phone service is an easy target.  What can we do to make it better? 

  • Research, and put into practice, every little improvement that individual receptionists have uncovered.
  • Ask patients what they would like.
  • Test alternatives.  Why do we have to have out-of-date or inappropriate messages?
  • Experiment with soothing useful messages.  'If you are phoning to make an appointment for someone else, it will help our receptionist if you have their correct spelling of their first name and last name'.
  • I am sure that patients have a rich seam of suggestions on how to make an automated system better.  (Why do they have to start at 8:30?  What would happen if the lines were opened at 7:30?)
  • Consistency with phone options. For example press 1 is always for emergencies, 2 for today's appointments etc.
  • As this phone service is a topic I have though a great deal about, I would welcome comments and especially suggestions from other patient participation groups.
  • See more on surgery phone appointments service.

Surgery Receptionists

Those surgery receptionists are literally at the front line.  As holders of the keys to the appointment system they control who sees which doctor, and when.

Where the interests of the patient and the doctor coincide the role of receptionist must be satisfying, however, where the demands of the patient are in conflict with what the doctor wants, then the job must become taxing.  Another source of conflict must be when the interest of the doctor and patient coincide, but the surgery does not have the capacity, thus the receptionist has to make some unpopular prioritizing decisions.

In recent years receptionists have adopted a more pro-active approach by introducing the phrase 'medical emergency' into negotiations for making an appointment.  What I ask is for them to provide alternatives to 'phone back tomorrow', when an appointment request is not a medical emergency.

Letter to the Times on a Related Topic

We're not doctors

Sir, Dr Rebecca Scorer (Letters Feb 11 2010) suggests that GPs' difficulties with out-of-hours calls would be manageable if they were confined to genuine medical emergencies, but how are the medically ill informed to distinguish between an apparently serious and urgent condition and one that can safely wait for within-hours assessment - call the doctor?  Ron Plowman, Bromley, Kent.

Key Question - Am I Worrying Too Little, or Too Much?

As a patient I ask myself,  'Do I underuse or overuse the precious time of my general practitioner?'  Perceived wisdom states that one should not provide a shopping list of complaints to one's doctor.  However, on giving the topic deeper thought, is the crucial factor the length of time for that one appointment.   Because logically it is more efficient to discuss 3 minor matters at one consultation, rather than making 3 separate visits.

On the one hand, if none of the items on the shopping list is critical, then perhaps nature will provide its own cure and a visit would be unnecessary.

On the other hand, the doctor may say, 'if only you had come sooner with that skin lesion, then we could have removed it with a simple freezing treatment, but as you have left it so long, now you are going to need surgery'.

As amateurs, but people who regularly observe our own bodies, we make he best call.  However, sometimes we get it wrong.  Should doctors hint to patients that their visit was so trivial that they should not have bothered them?

Contact Guy Thomas


Appendix - An Alternative Medical Dictionary

  • Artery - The study of paintings.
  • Cauterize - Made eye contact with her.
  • Colic - A sheep dog.
  • Dilate - To live long.
  • Enema - Not a friend.
  • Urine - Opposite of 'you're out'.


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