GPs should focus on being a GP and not being given more powers

[dikkertjedap]

Too focused on being managers and too little focus on their patients.

DD bluelighted to hospital, needed oxygen and anti biotics drip for pneumonia for more than a week. Before I called 999 (she was losing consciousness) - she had constant fever of 41 celsius in spite of maximum calpol and calprofen for over two weeks. She was seen by four different GPs who told me that I was over anxious and not too worry it was just a virus and it was normal for children to have high temperatures.

She was whisked through A&E straight to paediatric ward. Later on the ward I heard similar stories from three other mothers. Paediatrician said next time to follow my instincts and take her straight to A&E rather than to GP ... is this what the NHS has become? And if this is so, do we really want to give GPs even more power? Is my experience an exception?

[classydiva]

OMG real sorry about your DD thats atrocious, I hope you have put in a written complaint to your GP.

[babeinthewood]

YANBU I agree hun, they dont understand enough about health as it is. Their workloads are too high, and its far too common for them to assume us mums are over-anixous, ive taken to speaking to my HV or NHS direct now unless I can see my own GP who knows I only go when I have to.
Poor little girl :-(

[dikkertjedap]

Not sure about complaining. I discussed this with hospital paediatrician. She said that GPs cannot diagnose chest infection as it is really difficult to hear with a stethoscope. She said the only way to properly diagnose a chest infection (including pneumonia) is through an X-ray. The ambulance and hospital were very good. Ambulance radio-ed ahead and once arrived she had an X-ray within minutes before going to paediatric ward. X-ray showed severe pneumonia. Now back home with strong anti-biotics and open access to the ward (can go back straight away if there is a deterioration, but she is off oxygen now). Hospital needed every bed on ward as it is so busy.

[hairyfairylights]

I hope you (and she ) are ok.

Thing is, medical people can't know everything, and can't predict what will happen and how things will progress (as I have learned recently!).

[dikkertjedap]

HFL - agree, but surely, if a LO has fever of 41 Celsius for two weeks you refer them to check there isn't anything serious rather than keep saying oh, it is a virus ... I never trust them again, I would have lost her hadn't I called 999.

[alicet]

I can understand why you feel as you do.

Thing is it is often inredibly difficult to know which children are going to deteriorate and which are going to be fine (and the overwhelming majority have a simple virus and are fine). As you ahve already said there is immense pressure on beds and they can't possibly refer every child with a temperature.

Contrary to one poster who implied Gps don't know anything it is an incredible skill to use clinical skills only to pick out those who need specialist input - they don't have access to any blood tests or xrays that will come back the same day to help them. I am a hospital doctor and know I couldn't do their job.

For sure there are some shit Gps like there are people who are shit in any line of work but many more are fantastically skilled. This isn't one of those 'docs looking after their own' posts either.

Of course the Gps that saw your dd might have fucked up. No way of knowing from what you have said. But the fact that 4 all agreed says to me that it wasn't that obvious that your dd was seriously ill.

Helpful to talk it through I think, may be helpful to talk it through with your regular GP too. But try to concentrate on the fact that your dd got what she needed in the end and is getting better. If on reflection and on discussing this with whoever you need to (medical profession and others) you feel serious mistakes were made then by all means persue a complaint. But don't think this means that all GPs are crap. They aren't.

[babeinthewood]

My theory is when in doubt ring out of hours - simply because I once had a shoulder injury and the GP kept giving me pain killers, and telling me it was fine, I had xrays, nothing there, three weeks later and literally crying with pain, hubby phoned the out of hours, we went to see a locome emergency GP he told me he was going to try acupuncture on me. me and DH were like WHAT! but at this point I didnt care I was in so much pain, he stabbed me with this needle thingy and 2-3 mins later the pain dissapeared, and Ive had no trouble since. The problem was totally muscular. Im a bit sceptical of alternative therapies, but sometimes a random GP might just have the answer. My DSD has a temp of over 40 once and I couldnt get it down and NHS Direct sent a doctor out to me. The emergency doctors see more urgent stuff, so they know more IMO

[alicet]

babeinthewood that is just not true. The emergency docs (GPs who run the out of hours) are the same GPs who do regular surgeries during the day. You were lucky and I agree that if your regular GP isn't helping you should seek second third or even fourth opinions with other docs. But the out of hours docs aren't more experienced at emergencies - they are the same ones that work during the day as regular GPs

[CarrotsAreNotTheOnlyVegetables]

I agree with alicet - the emergency GPs are all regular GPs doing overtime - a friends DH does this regularly as the out of hours pays so well.

I think just about all GPs do a certain amount of out of hours work.

I think it was more a case of getting a fresh pair of eyes on the problem.

[eToTheiPi]

I have the opposite experience. Out of hours sent me to A and E, 4 hours of waiting and no treatment and no drugs available. Apparantly only my GP could refer me for the scan (which was 20 yards down the corridor). Saw GP following morning, had tablets I needed and no scan required. Cured within a week. I love our GP practice(sp?) the other one in town doesn't have as good a reputation despite being far more modern. Unfortunately it can be the luck of the draw. Hope all is well now.

[PocketMouse]

I understand why you feel the way you do, I really do, your GP's advise sounds shocking. Definitely put in a written complaint. Try and get something in writing from the consultant at the hospital.

On the other hand, if my DS had had a temp of over 40C for more than 3-4 days, and it wasn't easing with max ibuprofen and paracetamol I would have taken him to A&E.

Sounds like you have good instincts. Listen to them.

Very glad your DD is alright x

However, I doubt that this is to do with management? GP's generally (in my experience) do everything they can. Maybe I'm just lucky with our surgery.

[PocketMouse]

adviCe, sorry.

[PocketMouse]

"YANBU I agree hun, they dont understand enough about health as it is. "

Sorry, but that's a ridiculous statement to make.

[dikkertjedap]

Thanks for all the replies. It has been an incredibly hard and stressful time and dd is not out of the woods yet, hence the open access in case she deteriorates (not sure how it would work in practice as paediatric ward was totally full when we left, with trolleys in a kind of improvised waiting room type area with children including little babies waiting for a space on the ward).

I found that the doctors in A&E and on the paediatric ward took dd's temperature much more serious, they seemed shocked that she had had such a high temperature for two weeks and had not been referred for tests. When they inserted the antibiotics drip they took bloods at the same time for testing. Opposite to where my GPs are based is a small community hospital with X-ray facilities (only open during normal working hours), so the GP could easily have referred me to them.Each time I left the GP I felt that they thought that I was a nervous mother and I definitely didn't feel they took my concerns seriously. At no time did they take dd's pulse, or anything like that (ambulance people said that she had a very very high heartrate). The only thing the GPs did was checking her temperature and listening to her chest and then sending us away again. I just feel that they are not very patient focused, more focused on doing all types of campaigns to get probably extra funding rather than the day to day grind of looking after ill patients. Also, they have not once come out, but always require me with a very ill child to go to them. I feel very tired and very disillusioned, but obviously grateful to the hospital.

[Beavermum]

Just wait they (GPs)are going be given nearly all the NHS budget from 2012 decisions about all care and services!!

[dikkertjedap]

Beavermum I agree, I think that this is a totally wrong decision, GPs should look after patients and not have these responsibilities because imo even the looking after patients bit they are not doing very well. I definitely don't think they will act in my interest or feel that they represent my (or my family's) needs. They will possibly get a hold over hospitals and I fear that this will be bad news.

[alicet]

OP when they were listening to your dds chest they might also have been listening to her heart and could get her heartrate from that. Also clearly your child was very ill when you went to A&E so it would have been a lot easier for the docs their to appreciate this. Some of the signs might not have been present when she was seen by your GP so it might not have been obvious to them, even if it seems as though it should have been.

What I would say (from what you have posted) is to trust your own judgement as her mum. If after seeking medical attention from either A&E or your GP you are not happy and feel they have missed something stand your ground. Either there and then, so to insist on a referral to paediatrics (or a more senior padiatric doctor depending who you are seeing) or take them back elsewhere (so to out of hours if you are being discharged from A&E or to A&E if your doctor is trying to reassure you.

One of the things that most sticks in my mind from being a medical student doing paediatrics is to take the parents concerns seriously as they know their child far better than you.

The worst that happens is they think you are neurotic. I can live with this. A GP once said to me when I was apologising for taking ds2 in with, essentially, nothing is 'There is a very fine line between being neurotic and neglectful. I know which one I would rather be'

Easy to say all this in hindsight of course, and also easy for me to say it when I have some medical knowledge and understanding of how the system works, but trust yourself next time. YOU are the expert in your child.

Fingers crossed she continues to make a safe recovery