Re-Forms
One of the joys of my working life is the constant stream of forms I have to fill in , I am not being sarcastic .
The variety and sincerity of some of the absolute nonsense I am asked to fill out really does give me pleasure and hope for the future . Pleasure in a way that makes me inwardly smile how petty and risk averse people have become and hope for the future because when I finish this career I can start another one designing those forms for other professionals to fill out for no particular good reason.
Having promised at the end of the last article to keep things a little lighter I will, with this reflective and practical piece to help get rid of or deal with some extra work that none of us need, a reform so to speak.
Now I’m not talking about things like life insurance reports or holiday cancellation forms, both of which I can see a function to.However the layout and structure of those make it as difficult as possible to put relevant information in anywhere and also to leave as much ambiguity and wriggle room for the insurance companies as possible. “When did the client recover enough to undertake a significant part of his work ?” how many variables does that have in it ? ,but that is not for this piece.
The focus of this is all of those bizarre and to be frank ball aching requests for “ is the patient fit to do this, that and the other “. Now don’t get me wrong, should I have been sat around collecting pressure sores, counting my vast fortunes and generally plotting the down fall of the NHS then someone asking my opinion on whether they are fit to pick their nose or not would be a change but, they don’t call me Jeremy and my surname doesn’t rhyme with anything remotely as comical so funnily enough I do have better things to do.
I was asked this week, seriously enough whether a patient was OK to have reflexology as they were pregnant. My answers were colourful and varied and I am sure you can fill in a few yourself, has the patient walked on a pebble beach recently?, then I’m sure they will be fine , what the hell is reflexology? and why in gods name are you asking me? . If you are thinking of doing something to a pregnant woman you might consider dangerous enough to cause harm then don’t do it. If you are doing something you don’t think is dangerous then you are an adult make a decision, you don’t need me to tell you. But there is the crux, people, patients and society has been encouraged and disempowered in to a situation where risk management has been mistaken for risk devolvement. Before the abuse starts for knocking complementary therapies, personally I don’t care what works for the patient as long as it does them no harm, doesn’t fleece them for cash and they feel better after it.
And that is what all these forms are about individuals, companies and organisations not trying really to manage risk but to devolve it to third parties to say they have managed it . You will have multiple examples, is this person fit to
sky dive, walk up a hill in outer Mongolia, have reflexology, go to school, do PE , do a voluntary pubic hair removal, grow a moustache, act in a TV commercial, fart .
The list could be endless so in the spirit of positive general practice that abounds at the moment I thought I would share a form I have designed. This is to give out to any person who presents a form to be filled that you deem unnecessary and to be frank stupid. Yes I know all the arguments re charging patients a fortune to discourage etc but this is more fun and you can still charge !
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Thank you for asking the very very very busy doctor to fill out this really important form , for them to do this they need certain bits of information that are vital so they can assess the risk before they start the process . Either you but preferably the person who has asked you to get the original form done should fill it out . Failure to do so will result in the form not being done by the Doctor or saying they will get round to it but not saying which year .
Full name
Address
Date of birth
NHS number (you must find this without the receptionists help)
Full details of activity you wish to undertake giving :-
Complete cardiovascular outlay profile , altitudes, partial pressures of oxygen, weather conditions at the time, a comprehensive run down of flora and fauna in the area that may pose a problem, the time of day the activity is undertaken, how many times you are doing the activity, is it something you would let your children/parents do, does the daily mail think it’s a good idea,have your friends done it previously, will it affect availability of weekend appointments (irrelevant but gets brought in to everything) and anything else you feel may be relevant, please don’t ask what may be relevant that is you or the person who asked you to fill out the original forms decision .
Qualifications of person instructing you to get this form filled including GCSEs and primary school certificates
Full legal risk assessment of the activity
Full breakdown of the activity by a barrister including case law of all successful action against clients for this activity
History of documented evidence that anyone ever came to harm from doing the activity you are to undertake
An opinion piece (in no less than 3000 words) as to why you feel the need to ask me to fill this form and what you are hoping it will achieve (appendices and bibliography required)
A case study showing how a GPs opinion no matter how mighty would make any difference at all to the outcome .
Written undertaking that you, your colleagues or employees do not now and will never read the daily mail
Once all of the above is done (feel free to add as many points as you wish) then let the surgery have the completed information and we may then make a judgement whether we can fill out the original form, of course we will be charging by the minute and given the amount of information we need to read it will be a considerable fee .
Or there is an alternative that yourself or the person who has asked you to fill out the original form could actually accept that life has risks and just self assess those and take them like a grown up.
Thank you for your time and please don’t let us know the decision
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Fell free to nick the above and change as you wish. Now I’m not sure whether this will work or not but it will be fun trying and like all these things a variation of the ridiculous can sometimes help. Instead of form filling we could perhaps spend our time seeing patients, a reform we would all welcome but what would I know I’m just a GP.
feel free to contact/comment via twitter @imjustagp