A breach of my patient confidentiality

[think about it]

Jim,

 

I'm a Practice Manager, this is a difficult one to be fair.

 

I agree with what's been said before, although there's no need to make your written complaint a masterpiece, I'd accept a concern on a crumpled up serviette if the patient felt strongly enough to put pen to paper.

 

Conniff has asked the key question, know what you'd like as a resolution when you go in, explain your concerns and then let the PM speak to those involved. I understand the sensitivity of any procedure, but when you deal in it all day every day it can lose it's edge a little bit. We talk openly and freely about every aspect of our patient's care amongst ourselves, it'd make a difficult job harder if we didn't. So, sometimes we can be a bit flippant about something that is genuinely worrying to others. It's never from a place of badness and I think what's happened here is just that, a throw-away comment. And, you're right; it shouldn't have happened and when it did it could have been handled better, something which on reflection I'm sure the nurse involved will realise.

 

Is it a full blown breach of confidentiality? I'm not sure, I'd take guidance from our concerns support staff if this were me dealing with it and certainly before responding to you fully or reprimanding those involved with any formal sanction.

 

Rightly or wrongly I'd imagine that this sort of thing happens far more often than it ought to, in fact I've probably done it myself in saying to a patient 'Oh, you're here for your flu jab Mrs.X, go on through and the nurse will do it now.' in reception whilst others were in ear-shot.

 

I think I can understand how you felt, on reflection that may change for you as you examine and discuss it more. I think it's certainly a development point for everyone in primary care.

[think about it]

Just re-visiting this after a bit of thought and an interestingly similar part of a discussion with a patient this morning. They weren't happy with who they were seeing for whatever reason which they wouldn't elaborate on and like you, said 'well I'll just wait to be seen by x'. Unfortunately, X was completely fully booked already, was running 15 mins behind and had two extras put in to avoid having to do some home visits. I simply couldn't get this person in front of X in anything like a reasonable time.

 

General Practice is, for want of a better phrase, running on fumes sometimes when it comes to capacity and resource to see people. We're not being deliberately obstructive, in fact it's far 'easier' to give patients what they're asking for when we can, it's never our intention to antagonise a situation but we do have to be realistic. Sitting and waiting is one thing, but for an hour or more? No, I'd think it best to re-book, come in and start afresh.

 

Sometimes reception staff gather an almost comical reputation, I'm yet to encounter one of these mythical dinosaurs either as a colleague or in my own extensive experience as a patient. We are gatekeepers, we're given the challenging job of dealing with people when they're feeling their worst. I joke sometimes with patients about not asking how they are, they wouldn't be here if they were feeling any good. But, it's that perhaps that's too friendly, too familiar and not quite as professional as some people would like. We're a small, close-knit community and our waiting rooms bustle like the local coffee shops as people catch-up while they wait; I love that about our practice. But, it doesn't work for everyone.

 

I think now, having re-read your post a few times that you're rightfully very disappointed. I'm certain that the nurse involved will be upset to learn that she's made you feel like that and I've no reason to doubt that my colleague in your practice will address those concerns for you. It makes no real difference when there was a smear clinic being held, likewise it's well understood that almost all ladies are subject to routine screening but I can understand that you didn't want to be 'wearing the t-shirt' as you went in. I think it's been a poorly thought out attempt at humour with someone, especially a male, to say "don't worry, I didn't call you, I know you're not here for a smear test..." which should have ended in them both giggling a bit and saying "too right..." but has left you feeling exposed, it was poorly thought out - if at all and abysmally timed. The response from the nurse seems to indicate that she didn't share your level of concern with what she felt was a throw-away comment to alleviate someone else's embarrasment for going into the room when it wasn't their name that was called.

 

Sometimes it's best for us just to say sorry yet when you reached reception I fear it was already too late, so when they were unable to accomodate your requests things went from bad to worse. Go and sit with the PM, it's only by getting feedback that we can realise where the team can develop. Whilst this isn't like posting your full medical records to your employer without your consent, discussing them with your friends in a pub or leaving them on a bus you're understandably disappointed and I'm sure the PM will be interested to listen and understand.

[think about it]

@smellyjim69 any chance of an update? How did you get on?