RT Journal Article SR Electronic T1 Slaying the dragon myth: an ethnographic study of receptionists in UK general practice JF British Journal of General Practice JO Br J Gen Pract FD British Journal of General Practice SP e177 OP e184 DO 10.3399/bjgp13X664225 VO 63 IS 608 A1 Jonathan Hammond A1 Katja Gravenhorst A1 Emma Funnell A1 Susan Beatty A1 Derek Hibbert A1 Jonathan Lamb A1 Heather Burroughs A1 Marija Kovandžić A1 Mark Gabbay A1 Christopher Dowrick A1 Linda Gask A1 Waquas Waheed A1 Carolyn A Chew-Graham YR 2013 UL http://bjgp.org/content/63/608/e177.abstract AB Background General practice receptionists fulfil an essential role in UK primary care, shaping patient access to health professionals. They are often portrayed as powerful ‘gatekeepers’. Existing literature and management initiatives advocate more training to improve their performance and, consequently, the patient experience.Aim To explore the complexity of the role of general practice receptionists by considering the wider practice context in which they work.Design and setting Ethnographic observation in seven urban general practices in the north-west of England.Method Seven researchers conducted 200 hours of ethnographic observation, predominantly in the reception areas of each practice. Forty-five receptionists were involved in the study and were asked about their work as they carried out their activities. Observational notes were taken. Analysis involved ascribing codes to incidents considered relevant to the role and organising these into related clusters.Results Receptionists were faced with the difficult task of prioritising patients, despite having little time, information, and training. They felt responsible for protecting those patients who were most vulnerable, however this was sometimes made difficult by protocols set by the GPs and by patients trying to ‘play’ the system.Conclusion Framing the receptionist–patient encounter as one between the ‘powerful’ and the ‘vulnerable’ gets in the way of fully understanding the complex tasks receptionists perform and the contradictions that are inherent in their role. Calls for more training, without reflective attention to practice dynamics, risk failing to address systemic problems, portraying them instead as individual failings.