askmyGP has been operating for over a year now, long enough to have clocked up a couple of failed practices. That hurts, obviously, and I’m not going to name or blame anyone, but try to draw out what we have learned.
The strange thing in both was not that it didn’t work, but that it did work, or rather the GPs feared that it would work. They were struggling with access, making patients wait 3 weeks for an appointment or take pot luck with the receptionists at 8am on the dot.
Patients act entirely logically: “here’s a way to get help from the doctor, online, I can explain the problem and they’ll get back to me.”
GPs act entirely logically: “these patients are jumping the queue, not fair to others who’ve had to wait 3 weeks, or try for 30 minutes on the phone. We haven’t got time to deal with them, so we won’t, so it’s unsafe for them to think they will get help.”
All entirely logical. Result: nothing happens, no change. Another example of the gulf between technical change and adaptive change.
Technology is an easy bolt on, adaptive change means we the people have to do things differently. The result can be stunning improvements in service and productivity, as we heard last week, but it makes demands, there are no shortcuts.
We have masses of enquiries about askmyGP and I always ask why they are interested. Invariably, they want to solve a problem and the problem is overwork, too much demand and too little GP time. It’s always a big problem, one they have struggled with for years and it’s getting worse.
Then I ask, “Do you want it to work?”. They asssume it’s a silly question, obviously they want it to work. Then we talk about what that means, how if they wish over 40% of demand could shift online, saving them hours of GP time. But it will only happen if they give a great service to these patients who have put work in themselves to help the GP (and they are quite willing to do so).
I find it strange that having explained to me the enormous size of their problem, some are surprised that they think they can solve it with a tiny little tweak. Yes, we have those users who are happy to put askmyGP on the website, keep it quiet, take in a few handfuls of submissions each week, and very little happens. They won’t make a dent in their problems, but that’s a choice.
Yet this week I’m more hopeful than ever. We’ve recently introduced another question on our Leading Change Questionnaire, asking about the burning ambition for the practice. Answers are confidential, but let me tell you that the yearning to serve patients, the community, the ideals of general practice are stronger than ever.
Bring on those burning ambitions. We can do it together.
PS If you are on Twitter, look out for GP Journal Club #gpjc next Sunday 20/3 at 8pm, discussing the BJGP paper on telephone triage. Follow me on @harrylongman, why not also follow @askmyGP for latest patient feedback.