The only way to beat a target is to cheat

If we rheumatologists want to increase our new:follow-up ratio we can

  • Count DEXA scans for osteoporosis as new referrals and not as tests
  • Pull all the simple stuff under the rheumatology label (eg all the back pain patients who go straight to our physio service – after all, we supervise it)
  • Book requests for earlier appointments as new patients (after all, it’s a new letter!)
  • Abandon the “SOS” (“give us a ring in 6 weeks if it’s not better and we’ll see you again”) system which patients love and is highly effective – and get the GP to re-refer
  • Discharge everyone and ask the GPs to refer them back – which they will have to do

If we want to meet 18-week targets we can

  •  List patients awaiting tests as “watchful waiting” (which stops the 18 week clock) rather than “awaiting tests” (which doesn’t)

I am aware of many who play such games. It’s sad that we waste our time inventing ingenious ways of beating the system instead of relaxing at home, doing research or writing letters to “The Times”.


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