Day four was a good day with a later start than usual. Good sleep is always an amazing way to start a very informative few hours. Our first lecture was about Birmingham’s General Practice system which provides primary care for patients. Primary care is provided in communities for people making their initial approach to receive advice or treatment from medical professionals. Primary care includes general practice, community pharmacy, dental, and optometry services for the public. The lecture focused on general practice in the U.K. which is funded buy the National Health Service (NHS) and provides primary care for patients.

The concept of general practice and other aspects covered in the lecture about the system in the U.K. interesting as it is quite different than the U.S. The first thing they covered was the amount of patients that each General Practice office has, and the nurses that were present said their office has 18,000 patients which is vastly different than the number of patients a general practitioner in the U.S. would have. Due to this volume of patients, there is a triage system that patients need to go through to get an appointment or receive help from their practitioner. However, they said that you can normally get an appointment within two weeks as long as you are willing to wait on the phone for your turn to answer a series of “triage” questions on the phone from the receptionist. They explained how this system helps the office to make sure they are prioritizing the patients that are most in need and being as efficient as they can be. The nurses that were with the presenters work at a general practice office and they were telling us how they are only allocated 10-20 minutes with patients based on the patient and what they are in for. For example, vaccinating a child would give them 20 minutes, whereas just taking vitals or assessing the needs of the patients would only be 10. I learned how this system can cause issues if patients need more than the time they are allocated as the nurses are not generally allowed to go outside of their time window as they need to provide care to many other people. They said patients sometimes even leave without what they need because they need to make another appointment to get more time with the healthcare workers. The presenters touched on how this is helpful to the practice as each patient visit makes them money and if they make people come in multiple times for shots they could give in one sitting or multiple examinations, it may be harder for the patient to access quality healthcare that is efficient for them. This is very different than America as healthcare workers, especially in these kinds of environments, are not on as tight of a schedule. They are often able to provide you with whatever kind of examination or treatment you may need no matter what you came in for if they have what they need on hand. I came to understand how stressful it must be to be a nurse in a general practice office as the schedule they are on is very tight and I’m sure they often do not feel like they provided patients with what they needed as they genuinely did not have the opportunity to.

The final thing that shocked me about today’s session was the amount of time it takes for paramedics to come when there is an emergency. They stated that because the demand is so high, ambulances often take anywhere from to to twelve hours to arrive on the scene of emergencies. One of the women told us a personal anecdote about her mom dislocating her hip on New Years Eve and then having to not only wait twelve hours for the ambulance, but an additional twelve hours to get a bed in the hospital. This conversation made me realize that free healthcare doesn’t necessarily mean better healthcare because the lack of payment makes for a larger demand as less people are deterred by having to pay. It made me compare what I am used to where people often have access but no means of paying due to lack of insurance or insurance that won’t cover things. Due to these issues, I think Americans tend to think it would all just be easier if it was free. However, learning about this made me realize that it may not be the case and it was interesting to have that dialogue of what is good and bad about the payments or lack thereof in both systems.

Here are some pictures from my day at BCU South City and dinner with BCU students who visited Pittsburgh in September. It was so interesting to hear their thoughts about Pitt!