FIPing - Fetching in Person - allows the doctor to loiter outside the waiting-room and survey his next patient through the crack in the door

Why do some doctors buzz you, while others fetch you in person?

Ever since the invention of electricity, buzzing has been the norm for doctors who consider it far too secretarial to fetch patients to and from the waiting room. Early intercoms were not best known for their voice quality, and patients were left to guess whether they were being summoned, based on the number of syllables Dr Nick was asking for. eg "Mr/s Hmhp- hum, to Dr Nick please." If the surgery boasted a Dr Dick as well, then the intercom was doubly confusing.

So why hasn't it been replaced?

Because doctors never ask patients for feedback, and patients were until recently too respectful to volunteer it. So most of us are blissfully ignorant of our communication failings. To be fair, modern intercoms tend to go through the practice telephone network and are of much better sound quality, the only drawback being that if you consult with the receiver slightly off the hook, the whole waiting-room gets to hear about Mrs Miggin's creamy discharge.

Lovely. And what about fetching in person?

FIPing has always been popular with doctors who are into the personal touch. The early eye contact and reassuring smile can do much to assuage the anxiety of embarrassing itch. FIPing also allows the doctor to loiter outside the waiting-room door and survey his next patient through the crack. Mr Bishop is doing handstands in the toy corner but assumes a chronic world-weariness the moment a doctor appears. Why?

Why?

I don't know, I'd need to gather more information. But the beauty of FIPing is that you start observing patients immediately, from the moment they try to get out of those ludicrously low bucket seats. Do they look sick? Can they walk properly? How will they fit that double buggy through the door without chipping the paintwork?

Should the doctor walk in front or behind?

I usually see if the patients can pass me in the corridor - as much to suss out my level of fitness as theirs - but a colleague of mine is convinced he can dictate the pace and style of his consultations by the manner in which he leads the patients to his room. A leisurely stroll if he's not too pushed for time, a brisk trot if he is. I've seen a video of this and the brisk trot looks a lot as though he's concealing a tuberous vegetable about him, but there may be something in it,

So FIPing gets your vote?

On the whole, yes. It's particularly useful if someone's left an unfriendly aroma in your room and you need to clear your head. But also, patients seem to like it. If they're seeing a familiar doctor, they can pack in an extra minute by addressing the bunions on the stairs. And if it's a new doctor, they can decide whether to bring up psychological issues (eg the impending trauma of Easter with the in-laws) or stick to the tennis elbow.

And it cuts down on mistaken identity?

Yes and no. If the doctor is minimally articulate, then FIPing is more reliable than an intercom. But for new and amnesiac doctors, it's a source of constant embarrassment. Say your next patient is Mrs Thomas, aged 50. When you get to the waiting-room, there are four women fitting that description. So who do you bestow the all important early eye contact on? And what if you saw her only last week and haven't the faintest recollection what she looks like? Your only option then is to stare at the linoleum, which makes Mrs Thomas think you're not the least bit interested in her. Also, if none of the women is Mrs Thomas, you can spend a long time staring at the lino. Ten minutes is my record.

Any other drawbacks?

Successful FIPing depends as much on the geography of the surgery as on the style of the doctor. If the waiting-room's on the ground floor and Dr Dick is on level six, you can't expect the poor man to rush up and down the stairs every six-and-a-half minutes. When I worked in such a surgery, I could never get down the stairs anyway, because they were blocked with patients who'd collapsed on the way up. I ended up examining patients over the banister on level three. The other problem with FIPing is that it leaves you no time to do anything in between patients.

And what exactly do doctors do in between patients?

See next weekn