An appointment system in a practice with immigrant patients.

Abstract

In the group practice of which I am a partner patients have been seen by appointment for over six years. We adopted an appointment system when the two previously separate parts of the practice joined on 1 January 1962. It was essential to do something of this nature because of the shortage of space in the waiting-room. The premises now used by the group were those originally occupied by a single-handed general practitioner with a list of 1,600 patients. The space available was barely adequate for his needs. We were able to convert two rooms into extra consulting-rooms, so that at any one time three doctors can now consult, but there was no one room bigger than that used as the waiting-room. Unless we had two waiting-spaces, which would have been difficult to administer, we had no alternative but to restrict the number of patients waiting to be seen at any one time. In that the waiting-room, which has seats for only 12 people, has rarely been full to capacity, and patients no longer have to wait in the street outside ; and in spite of there being three doctors,'each seeing up to 12 patients an hour ; and notwithstanding the fact that some patients (children always) come accompanied by at least one relative, the appoint ment system has worked. I have described elsewhere the mechanics of our system of arranging appointments (Carne, 1963). We in our group believe that patients should, whenever possible, have choice of doctor. Even more important, we believe that one doctor should normally treat every member of each family. Most important of all, we aim to arrange our bookings so that each illness episode is dealt with by the same G.P. To assist the recep tionists (we need two working full-time on a shift system plus a full-time secretary) we have colour-coded our appointment cards, and we colour-code the family medical record envelopes where one member of the group deals with their personal problems. A high proportion of the patients in the practice are immi grants (Carne, 1967). Some of the social difficulties, with particular reference to the poverty of their housing, have been described elsewhere (Carne, 1962). It was therefore thought worth while to study the utilization of an appointment system by such patients.