Friday, June 22, 2012

Communication is the problem to the answer... *

The Blobshire General Hospital
London Road

Dear Dr Jest,

Your patient, Miss Archer attended our unit today.

Presenting complaint;                            Personal


Diagnosis;                                             29E: Gynaecological Conditions – other

Treatment:                                            511: Medication – oral


So ran the letter that wung (or is that winged, wang… er…) its way to my electronic in-tray yesterday. It seems all those hours spent on communication skills at the Big Hospital are not practised in the far flung frozen wastes of Blobshire, or at least not in their General Hospital.

You have to give them some credit I suppose. They’ve managed to compile a discharge note and forward it to the right GP at least, but sadly it’s of approximately no use. At least not as a clinical communication anyhow. What this is, in effect, is a glorified invoice. 

You see Blobshire is some distance from our own dearly beloved Ambridge, and our paymasters are unlikely to hold a contract with them for services of any kind, "personal" or otherwise. So if Miss A felt the need for medical attention whilst there on a visit, her treatment will have to be paid for, after the fact, by our own PCT sending a wad of fivers to the Blobshire Acute Trust. To do this our PCT will require evidence of treatment being carried out, which is where we came in.

Disappointingly even the codes are no help. Our 29E is “Pain- Sensation- other” and makes no mention of any gynae’ problem, all the codes before and after it having to do with various types of limp. And on our system 511 doesn’t even exist, so I’m really none the wiser. Sadly as it appears Miss A was not assessed at all, and had no outcome recorded, I can only imagine what happened to her a few nights back on the mean streets of Blobcester.

Still all is not lost, I missed off my absolute favourite bit of the letter. Without, so far as I can glean, the font being so devoid of expression as to make irony improbable, any hint of the same, the communiqué concludes thus:

“If you require any further details, please contact us on the above number.”

* You all know what's on offer by now. EVCHN to the first correct attribution.


Anonymous said...

Well as a consultant geriatrician, having done all my discharge summaries personally in the last 10 years, tried very hard to make them succinct and informative, and accurate ((cutting it down in length to 1 A4 sheet took as much time as writing the whole thing) and get them out in under 2 weeks. I have now been told that my GP commissioners want a discharge note the same day; when I stated that it would have to be a ward junior who would probably write inaccurate things, I was told that they just wanted the discharge medication and never bothered to read what else was written.

Anonymous said...

Excuse my bad grammar...

Nails UK said...

The things we do for love - 10cc

Doctor Jest said...

Dr Anon-- Welcome! It seems your CCG has gone native all too quickly, prizing speed over content. Tho' it may speak to the quality of discharges proffered by others in your locale. But speedy info about meds, especially new, changed or discontinued, is a huge help. Still a well crafted and comprehensive letter is always welcome here. I reckon it won't be too long before they have to change their tune. Nil desperandum, eh? (And not to worry over the whole grammar thing-- not a strong observance in these parts anyhow.)

Nails-- Yep, you nailed it! (See what I did there?) EVCHN to you, and welcome.

Melode Kang said...

I saw your blog and thought your stories were a pleasant read. I wanted to introduce you to, a platform for physicians to connect with patients from all over the world to answer medical related questions. Here is also an interesting one you might want to be check out:

steveg said...

That famous Manchester Band - 10CC and the track "The things we do for Love"

Recorded at Strawberry studios in Stockport, if that helps any?



steveg said...

Oh bugger, I've just seen I was beaten to it - sorry!

Doctor Jest said...

Melode-- glad you like the ramblings, but I fear your comment is a little "adverty". Not something I have the time for I fear. Sorry.

Steveg-- Perhaps a little late but certainly not "a dollar short" as they have it over the water. EVCHN to you sir, for effort and all round Northerliness.