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Receptionists ‘putting people off’ seeing their GPs

Wednesday, October 12, 2016 8:57
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(Before It's News)

“Receptionists may ‘put people off’ seeing their GP by asking questions about symptoms,” ITV News reports on a widely covered study carried out by Cancer Research UK.

The study is part of an ongoing project looking at reasons why some people don’t seek advice for potential “early warning signs” for certain cancers, such as:

  • a persistent cough
  • a lump that suddenly appears on your body
  • unexplained bleeding
  • changes to your bowel habits

With many cancers an early diagnosis increases the chances of a good outlook, and possibly a cure.

The researchers surveyed around 2,000 people in Britain. They identified a number of potential barriers to people visiting their GP. This included finding it difficult to see a particular doctor, getting an appointment at a convenient time and also a dislike of having to speak to a receptionist about symptoms.

While these barriers may delay diagnosis of health conditions, it’s important to realise this survey doesn’t prove that they are directly responsible for current cancer diagnosis and outcome rates.

Nevertheless, these issues need to be addressed and measures taken to make it easier and less embarrassing for patients to make appointments. This could be through asking fewer potentially sensitive questions over the phone, or by offering further training to practice staff to ensure patients are more comfortable.

An increasing number of surgeries now offer online booking services. Read more about GP online services

Where did the story come from?

The study was carried out by researchers from Cancer Research UK and was funded by the same organisation.

The study was published in the peer-reviewed journal Public Health.

Unsurprisingly this has been reported widely in the UK media and, possibly unfairly, the blame has been put on practice receptionists. While a large number of people reported this as a barrier it was not the one that came out on top.

Service issues, such as getting a GP appointment at a convenient time, were the major concerns. These types of issues may well be more challenging to address. 

What kind of research was this?

This survey was carried out to identify potential reasons, or barriers, to seeking help and promoting an earlier cancer diagnosis in Britain.

This was a good way of investigating barriers. However, surveys may be prone to bias – for example, responses are subjective and questions may mean different things to different people.

Responses also cannot be easily attributed as the direct cause for cancer diagnosis and outcome rates. Therefore these findings may not be entirely reliable and paint the whole picture. 

What did the research involve?

Adults aged 16 and over were eligible to participate in the survey. The researchers used a validated set of questions that were designed to assess awareness of cancer.

This survey is carried out every two years by Cancer Research UK via the Opinions and Lifestyle Survey (OLS), run by the Office for National Statistics (ONS) using a representative sample of the population. Interviews are computer-assisted and carried out face-to-face in the individual’s own home. Participants were considered to identify a barrier if they replied “strongly agree” or “agree” to questions about barriers to help-seeking.

The data used in this study were collected in October and November 2014. Statistical methods were used to analyse findings. 

What were the basic results?

The responses of 1,986 adults were analysed in this study, representing 54% of those eligible. The average age of participants was 53 years.

The most frequently reported barriers to help-seeking were:

  • difficulty getting an appointment with a particular doctor (41.8%)
  • difficulty getting an appointment at a convenient time (41.5%)
  • dislike of having to speak to the GP receptionist about symptoms (39.5%)
  • not wanting to be seen as someone who makes a fuss (34.8%)

Some of the less commonly reported barriers were finding the GP difficult to talk to (7.3%), not feeling confident talking about symptoms with the GP (8.6%) and finding it embarrassing talking to the GP about their symptoms (9.0%).

In general, younger participants and women were more likely to endorse barriers, as were participants in non-managerial occupations, full-time study or not in work. 

How did the researchers interpret the results?

The researchers conclude: “These findings add to the evidence on the barriers that may influence the public’s decisions around help-seeking in the event of a symptom and suggest that there may be different or broader barriers, in addition to the ones previously considered, which may be of particular significance for influencing the timeliness of help-seeking behaviour. Further exploration of these ‘new’ barriers and understanding of the extent to which the barriers are associated with actual help-seeking behaviour would be helpful to then inform the development of policy or other interventions to mitigate their impact.” 

Conclusion

This survey was carried out to identify potential reasons, or barriers, to seeking help and promoting an earlier cancer diagnosis in Britain.

The researchers identified a number of potential barriers to people visiting their GP, possibly delaying diagnosis of health conditions.

The researchers provide a very important limitation to their study which is that their results are based on a self-selecting sample responding to a hypothetical scenario and choosing their response from a pre-specified list.

Responses to statements such as “I have too many other things to worry about” or “I have had a bad experience in the past” are entirely subjective and could mean many different things to different people.

It is therefore difficult to fully understand the implications of these responses or apply this in a real life sense.

A large number of people were included in this study and the researchers have attempted to explore differences between various sub groups. However, of those that were initially invited to join the study only 54% participated.

The 34% that refused to participate may have done so as they have no issues with visiting their GP and this would have significantly altered the findings.

On the basis of this study alone, these identified barriers cannot be attributed as the direct cause for current cancer diagnosis and outcome rates. However, the fact that a large number of people felt there were significant barriers to seeing their GP is something that needs to be addressed.

If these findings are accurate, then measures should be taken to make it easier for patients to make appointments. Many surgeries now offer online booking services, which should hopefully make getting an appointment less of an issue.

Most importantly, you should never “put off” getting a diagnosis of a sign or symptom that may be a red flag for cancer, such as:

  • a persistent cough
  • change in bowel or bladder habits
  • a sore that does not heal
  • persistent indigestion
  • in women, unusual vaginal discharges and / or bleeding
  • in men, lumps or swellings in the testicles

Better some momentary embarrassment than a missed opportunity to spot a cancer in its early stages. Read more about cancer signs and symptoms.

Links To The Headlines

Receptionists ‘put people off’ visiting their GP. ITV News, October 11 2016

Receptionists ‘put people off seeing doctor’. BBC News, October 11 2016

Fear of being grilled by GPs’ receptionists keeps patients away. The Daily Telegraph, October 11 2016

GP receptionists ‘need to deal with patients more sensitively’. Sky News, October 11 2016

Do NHS receptionists put you off seeing your doctor? The Guardian, October 11 2016

Links To Science

Moffat J, Hinchliffe R, Ironmonger L, et al. Identifying anticipated barriers to help-seeking to promote earlier diagnosis of cancer in Great Britain. Journal of Public Health. Not yet available online

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