Opinion  

As specialities fragment into subspecialities, so we remain the masters of the big picture, the renaissance men, the Corinthians, the puppet masters, able to pull the strings of our orchestra of specialities. The unfortunate logic to this is that as knowledge continues to grow we devolve from knowing a little about an awful lot to knowing nothing about everything.

I like to consider myself an 'executive' GP; I'm not hands-on, I don't touch, I believe in delegation, which is why I usually leave the task of making urgent appointments to my practice staff.

But after seeing my practice manager trying to remove her own kidney out of sheer frustration, I thought I'd better spend some time at the coal face.

Old Joe, along with a multitude of failing body parts and a liver the size of a small planet, was crippled with hip osteoarthritis, and needed urgent assessment for a total hip replacement. So I rang the hospital.

'Could you put me through to Mr X's secretary please?'

There was an answerphone message; 'I'm sorry, I'm not available on Wednesdays, please speak to Dora at appointments at the following extension.'

I rang the hospital again and I requested the appropriate extension; I was put through, there was no answer.

I rang the hospital again.

'That number isn't responding, could you put me through to Dora in appointments?'

'I'm sorry,' she said 'you have the wrong Dora, I'm Dora at personnel appointments, you need Dora at clinical appointments, oops, I've just remembered, she's off sick.'

I rang the hospital again.

'Can you put me through to Mr X.?'

'I'm sorry, his bleep isn't working, but I can give you his mobile number.'

I tried his mobile number; it chirruped gaily, but no answer came.

I rang the hospital again.

'This is Dr Farrell from Crossmaglen,' I said, coming the heavy, 'and before I come round to you with a meat-cleaver, I'd like to speak to Mr X or his secretary or someone on his team, or someone in appointments, clinical appointments, let me specify.'

'I'm sorry, it's just after 4pm, they'll all have gone home.'

Dr Farrell is a GP from County Armagh. Email him at GPcolumnists@haymarket.com .