significant events

If a practice discusses 6 "significant events" in a year at its plenary meetings, it attracts a certain payment for so doing. And this is what we did today, or 3 of them anyway. One was particularly frightening (thank God it did not involve me) Apparently a patient rang in to enquire whether her scan result was back yet, and as the story went, she was told by an (as yet) unidentified receptionist that as it was late coming back to us it "was probably all right anyway"
At this point I exclaimed: "That's terrible"

It gets worse. It then emerged that the patient didn't visit the surgery for several months, until the facts eventually came out in an unrelated consultation. The result unfortunately indicated an early cancer. Perhaps the doctor should have spotted the result and contacted her straightway... Amazingly, no formal complaint was ever made about this clear failure of duty of care, and thus the episode is closed. A scapegoat was needed, however, so we decided it was probably the receptionist who had left our employ some time ago, but who was working here at the time of the incident. The doctor involved bravely admitted his own part in the disaster, after which we moved on to other events, which I am relieved to report were pretty small beer by comparison.

You might think financial inducement should not be necessary for a practice to engage in this sort of self-examination, but the fact remains it has been effective. Practices are now more efficient than they have ever been, and this is is partly due to the clever system of bonuses that are awarded for reaching higher standards of excellence in a wide variety of criteria. It's sick, but it works.