A 12-hour day for an established GP in a busy town starts at the nursing home.

PRACTICE NAME Fergus Medical Centre, Ennis, Co. Clare

ESTABLISHED Fergus Medical Centre was established in 1994. Dr Cox moved to Ennis from Carrigaholt in west Clare in March 1994. He took over the GMS list of the retiring GP Dr Frank Counihan. Dr Cox established the practice with his wife Dr Denise Crowley.

PRACTICE PROFILE The practice serves the largely urban population of Ennis town. Fergus Medical Centre also serves the surrounding townlands and villages and patients would attend the practice within a radius of approx 15 to 20  miles. 1600 GMS patients. 1800 Private patients

STAFF PROFILE 3 Doctors in all; 2 Full time GPs. 1 GP Registrar.1 practice Nurse. 1 Practice manager. 2 part time secretaries

SUMMARY OF DAY 117 Phone calls in and out by reception staff.

49 patients dealt with at the desk

Diary of Dr Tony Cox on a typical day at his practice.


8.15 am Nursing Home Rounds.

5 patients to see

man with urinary catheter leakage. Catheter changed

lady following a fall yesterday

lady with advanced dementia. Required review.

lady with diabetes and stroke. On Tube Feeding. Coughing. Needed review and antibiotics.

man with depression and anxiety. Medical review.

9.05 Female. Oral thrush. Prescribed medication.

9.15 Male. Medication abuse. Regular review and phased reduction in medications.

9.30 Female. Overactive thyroid. Atrial Fibrillation. Required monitoring blood tests and repeat medications.

9.40 Female. Shingles on trunk. Neuralgia pain. Needed new pain relief medication.

9.50 Medical Representative visit. Updates on COPD and Gout medications.

10.05 45 yr old male. Road Traffic Accident injuries to shoulder and neck. Continuing pain. Prescribed pain relief and referred to physiotherapy and to Pain Clinic.

10.15 Female. Left shoulder pain. Pain management and referral to physiotherapy.

10.30 female. Cough. Smokes 30 cigs per day. Referred for Chest X Ray. Brief Stop smoking intervention.

10.40 Male. Tiredness. Sore throat. Possible Glandular Fever. Blood tests taken.

10.55 Female. Letter needed confirming fitness to drive post Caesarian Section.

11.00 Female.  Depression.

11.15 Man. Groin Pain.

11.30 Man. Right groin Hernia. Referred to Surgical Clinic.

11.40 Male. Asthma.

11.50 Man. Driving Medical Exam. Fear of Bowel Cancer.

12.05 Female. Sleep problems. Medications reviewed.

12.15 Female. Colitis. Recent hospitalisation. Transcribed hospital prescription for high dose steroids.

12.30 Female. Concerned about possible ADHD. Referred to Clinical psychologist. Vaccinations for foreign travel.

12.45 Male. Urinary Flow problems.

12.55 Baby. Ear infection.

1.05 Young woman. Ear infection and cough.

1.15 Male. Painful and stiff neck.

1.25 Female. Umbilical infection.

1.30 Review and signing of repeat medications.

23 repeat medications completed.

2.00 LUNCH.

2.30 Phone calls to patients x3.

Referrals to specialist services x2.

Letters for patients x2.

4 additional repeat prescriptions dealt with.

2.50 Male. Unbooked Emergency attendance. Head injury & seizure. Referred to A&E.

3.10 Female. High Blood pressure.

3.25 Girl. Constipation.

3.40 Male. Rheumatoid arthritis. Psoriasis.

3.55 Baby. Tonsillitis.

4.05 Male. Foot problem. Unbooked attendance.

4.20 Female. Infected Caesarian Section wound. High fever. Rash. Referred to hospital.

4.35 Young female. Back pain. Hand injury.

4.50 Female. Underactive Thyroid. High Blood pressure.

5.00 Male. Verruca for freezing with liquid nitrogen.

5.15 Girl. Abdominal pain.

5.25 Male. Back pain.

5.40 Phone call re blood test results.

5.45 Male.. Phone call re MRI scan result.

5.50 Female. Phone call re starting osteoporosis treatment.

6.00 Repeat medications x 8 reviewed and signed.

6.10 Letter written to solicitor re patient’s medical notes.

6.20 Review of all the blood results downloaded today. 111 results in total.

Phone calls to those patients whose results required action.

7.10 Female. phone call re MRI ankle result.

7.15 Male. phone call re Chest X ray result.

7.20 Private Medical Attendants report completed for male. Review of full patient file and summary of the key entries.

8.00 Lock up premises. Tidy Surgery and waiting area. Update daily accounts.

8.05 Drive for home,