for being really fecked off with GPs

(135 Posts)
banana87 Wed 13-Mar-13 23:32:52

I understand that antibiotics do not work when you have a viral infection.

However, last week DD2 (15m) was clearly not right. I called GP and told them her symptoms (sleeping 17+ hours, bad cough, high fever, not eating). They told me (over the phone) that it was a virus. Wait it out. I waited 2 days and took her to see a private GP who immediately diagnosed her with a chest infection and prescribed antibiotics.

My SIL has been sick since end of last week. She is getting progressively worse (same symptoms as above other than sleeping!). She phoned GP Monday. He told her (over the phone) it was a virus, take paracetemol and wait it out. It got to the point that she felt her chest tightening and heavy so went in the next day (yesterday). He acknowledged that she was quite ill, but gave her an inhaler and said it wasn't an infection. She's worse today than she was yesterday and is now going to see a private GP.

Last winter my DD1 had persistent high fevers that did not respond to calpol or neurofen. We were in A&E twice and dr twice. Every time, "it's just a virus". After 6 weeks I had enough and took her in and said I wanted her to have blood tests as I was convinced she had cancer. Funnily, they gave me antibiotics even though "there is no sign of infection" and within 3 days the fevers were gone and have never returned.

Also last winter my then 5 week old baby had a high temp. I took her to the GP. "Just a virus". Next day, same thing and on call dr had us go straight to A&E where I was told "it's just a virus". Luckily a very good consultant was on call and thought it would be wise to do a chest x-ray "just in case". She had PNEUMONIA.

I understand that there are worries about antibiotic resistance. But what is the point in withholding antibiotics until one is so sick that there is no other option? In all of the above examples, antibiotics were or are currently being withheld needlessly. Why?

Murphy0510 Thu 14-Mar-13 00:08:50

It sounds as though you've had bad experiences. I can see why you are annoyed, but not all GPs are shit

CSIJanner Thu 14-Mar-13 07:16:56

Message withdrawn at poster's request.

Have you considered that the private GP will just give you whatever you want so that you come back next time? Why not just try another NHS GP?

Viruses can be worse than bacterial infection, just because you're very sick doesn't mean it's bacteria

Sirzy Thu 14-Mar-13 07:35:10

To be fair a lot of infections are viral, and even pneumonia can be caused by a virus.

This "just a virus" notion is rubbish "just" a virus nearly killed my son at 8 weeks old.

The thing that would annoy me is them trying to diagnose over the phone rather than the actual diagnosis.

FasterStronger Thu 14-Mar-13 08:05:16

You don't know that your first doctor was wrong. Being convinced your dc has cancer is way Ott....

idiuntno57 Thu 14-Mar-13 08:49:32

surely the point is that a virus won't respond to antibiotics.

Your GP seems to lack people skills but it is not possible to say they were wrong at the point of diagnosis.

As patients we crave a little bit of green paper when we leave the surgery.

YABU

Murphy0510 Thu 14-Mar-13 09:04:33

I agree with gettingtogrips. A private doctor will tell you what you want to hear and will prescribe you what you want. You only have to watch something like Portland babies to see that private healthcare providers totally pander around the patient.

Softlysoftly Thu 14-Mar-13 09:10:49

YABU you paid for what you wanted, doesn't mean it wasn't a virus.

In fact the fact your SIL has exactly the same symptoms makes it more likely a virus is at work as bacterial infections tend to be secondary (you get a virus and the bacteria take advantage of a busy immune system to sneak in). So the liklehood of the same virus followed by the exact same bacterial infection in the exact same way is slim surely?

There is every possibility that the virus would have run its course in the same timeline as your antibiotics "worked".

rollmopses Thu 14-Mar-13 09:15:03

FasterStronger, sadly, you are very wrong. My 14 year old relative was diagnosed with leukemia after a long viral, or so it was thought, illness, where symptoms, such as persistent fever, just didn't go away. No previous symptoms of any kind. Just a very long 'cold'. sad

rollmopses Thu 14-Mar-13 09:18:01

Without testing, no doctor can know if the illness is caused by virus or bacteria. Testing, however, can take time and it costs money.
Antibiotics are prescribed largely, by what GP think the cause might be, based on experience. They don't know though, unless they test.

Shakirasma Thu 14-Mar-13 09:21:07

YABU

GPs absolutely do have to adopt a "wait and see" attitude, because most infections are viral, antibiotics will not work on them. Not only does the liberal use of them cause resistant bacterial to develop, many people don't realise just how nasty antibiotic medicines are, you don't want to be taking them needlessly.

What I don't like is the phone consultation. Ok for a follow up, but patients should be examined physically, as some bacterial infections have specific signs, like pus and rashes, which could be diagnosed immediately.

FasterStronger Thu 14-Mar-13 09:29:33

rollmopses - my comment was in the context of the OP, it was not meant generally.

lyndie Thu 14-Mar-13 09:34:21

I think in the first case you should have been seen and assessed but likely your child didn't need antibiotics, the private GP will give you what you want to be sure you keep returning. They have no budget restrictions or targets and are under no scrutiny to prescribe appropriately. The same with your SIL. With your other child you had tests, no sign of infection and after 6 weeks got antibiotics? How do you know it was the antibiotics that worked rather than the child got better on their own? With your baby, especially at 5 weeks things can change rapidly - any very young baby with a fever should be assessed in hospital.

Sidge Thu 14-Mar-13 09:34:53

Bacterial infections usually have a fairly clear presentation - not always admittedly but if a patient presents with a cough, runny nose, low grade fever and yet has a clear throat, ears, chest and is managing fluids then it's probably a viral illness.

IME as a patient and a HCP people are told "It's probably a virus - try x, y and z and *if it doesn't get better or gets worse then come back*"

Also remember that GPs will see dozens of people per day or week presenting with the same symptoms as viruses do the rounds; however IMO babies and small children should always be seen and not receive a telephone consultation.

banana87 Thu 14-Mar-13 09:36:18

It wasn't just one GP. It was several, and over different practices. I agree that the "wait and see" attitude is necessary to prevent over prescribing, however when said patient comes back again and again with the same problem, it's time for tests.

And no, I wasn't wrong in thinking about cancer, high fevers for no reason can be one of the first signs. She had also lost so much weight.

Saving money can sometimes kill people, and the current attitude in general that everything is a virus (without first examining a patient) is careless. I know my GP practice are not the only ones who do it, and they are definitely one of the best practices I have been with.

LadyPessaryPam Thu 14-Mar-13 09:38:31

rollmopses you are right, they guess, or they have extremely good eyesight to see bacteria or viruses!

In the UK the guesses go

1. It's a virus, take paracetamol, drink water and rest, come back if you are still ill in 1 or 2 weeks

2. OK it may be bacterial, have this broad spectrum cheap AB, usually amoxicillin, come back if you are still ill in a week

3. OK it may be a different bacteria, have this different AB, usually erythromycin , come back if you are still ill in a week

4. OK You need to see a specialist......

YABU but children and babies should always be seen and not diagnosed over the phone. I find it surprising that a GP didn't pick up on pneumonia - I thought that they could pick it up with a stethoscope. DD1 was sent to hospital when her doctor listened to her chest and said it was pneumonia. They did a chest xray afterwards to see how bad it was.

Private GPs do tend to over prescribe in order to keep the patients happy.

banana87 Thu 14-Mar-13 09:41:12

Just to add that in all my examples, we were presenting with more worrying symptoms such as high fever, persistent cough with tightness in the chest, and severe fatigue. I had the same illness, however with no fever, cough that was easily controlled with over the counter medication, and was able to get on with things. What I had was viral, what my dd had and what my SIL has has turned into something more sinister that needs medical treatment.

Sirzy Thu 14-Mar-13 09:44:48

But high fever can be a sign of a viral infection to. It always amazes me how many people belive they know better than medical professionals!

(I am not saying mistakes aren't made but in this situation I am not sure mistakes were made)

banana87 Thu 14-Mar-13 09:45:01

"Weeks" can kill. MIL who saw a different GP was fobbed off for weeks for a backache that they diagnosed as siatica. Couple of months later she was diagnosed with kidney cancer. The tumor was so large it went from her kidney to her lungs and she died 3 months later. If a patient is getting worse they should be given a few days, not a few weeks before receiving treatment.

Sirzy Thu 14-Mar-13 09:45:10

And for persistant cough with chest tightness then giving an inhaler is probably the best course of action.

banana87 Thu 14-Mar-13 09:46:49

Sirzy, common sense tells me that if you get sick, you tend to get worse and then get better. Viral illnesses usually last a week. If you are getting worse and worse rather than better, especially as that week is coming to an end, surely that mean its not "just a virus"??

MillyMollyMandy78 Thu 14-Mar-13 09:47:11

Sorry YABU antibiotics do not work on viruses , only on bacterial infections, which have specific symptoms. Also, many people actually feel very unwell after a course of antibiotics, as they fight good bacteria too. So it's not just a case of saving money or building up immunity, if a doctor gives out antibiotics unnecessarily tyhey can actually make the patient feel much worse.
It does seem odd that your gp made a diagnosis over the phone and i agree he needs to work on his people skills.
Also agree that the private gp was just keepin you happy so u would come back. Many private gps are just nhs ones picking up a few extra shifts and they get paid seriously big bucks to pander to their patients so they return eg giving unnecessary medication, ordering tests that just aren't needed ... But if the patient wants, the patient gets!

Sirzy Thu 14-Mar-13 09:48:18

the virus that nearly killed DS got worse between days 5 and 7 and then got better slowly from there.

Not all viruses follow the same course.

And DD's pneumonia was just a cold 48 hours before. Infections and viruses can set in very quickly and unpredictably.

lyndie Thu 14-Mar-13 09:54:19

It's not all guesswork between viral infection versus bacterial either - tools like Centor criteria are used for tonsillitis for example.

digerd Thu 14-Mar-13 09:56:34

A chest infection is a chest infection. Doesn't matter whether caused by a virus or infection. It is now an' infection'.

However, most chest infections in adults will be cured by their own immune systems within 4-6 weeks. People with immune disorders will probably need help with ABs.
I've had some terrible chest infections after bugs which caused high temperatures. I always waited as long as I could, but sometimes did get ABs from GP as was really ill and went on for too long, and they worked.

pyjamalover Thu 14-Mar-13 10:00:55

Testing huge numbers of people with (mostly) self limiting illnesses would be a massive waste of nhs money, when clinical experience and knowledge of most likely bug is usually sufficient.

You have had a few bad experiences though, telephone diagnosis has risks though, and I hope anyone doing it says come in if it doesn't settle, no drs have crystal balls sadly!

Ginformation Thu 14-Mar-13 10:08:38

YABU

UK NHS GPs practice evidence based medicine, there are guidelines to follow but its not as simple as following a protocol, it takes clinical experience and judgement. Withholding inappropriate antibiotics is not a money saving exercise, it is a safety exercise and as a dr I am responsible for my prescribing.

As other posters have said, being diagnosed with a viral illness is not the same as being dismissed, ignored or fobbed off. Viruses can be serious, but antibiotics will still not work (unless a secondary bacterial infection occurs, and this is by definition a few days later). The treatment for most viruses is supportive (fluids, temp control) and this can be done at home without a prescription.

Telephone consultations certainly have a place, but I always ask young children to come in for an examination.

PenelopePipPop Thu 14-Mar-13 10:12:18

Erm your SILs case is just bronchitis which is mostly viral and will get better of its own accord even if it is bacterial (otherwise before the invention of ABs no one would ever have reached adulthood). Even if your private GP gives her antibiotics the antibiotics will probably not be what makes it better. It will get better anyway and the fact that she takes ABs at the same time will be a coincidence.

I get bronchitis 3-4 times every winter. A hangover from childhood asthma. It is knackering and very unpleasant so I do sympathise with your SIL. Maybe some of my bouts would clear up faster with ABs. But I wouldn't dream of taking them just to find out because I am young and healthy and will recover just fine without them.

Antibiotic resistant bacteria kill people in large numbers and they are going to kill more and more people in the future. Mainly older people who are already a bit frail and young babies whose immune systems are not mature enough to cope without them. Babies like your DD when she had pneumonia last year...

LadyPessaryPam Thu 14-Mar-13 10:19:47

Add to this mix the stress most people are feeling about their employment security and it's really very toxic. No one wants to be ill for extended periods when the axe is swinging at work.

2rebecca Thu 14-Mar-13 10:51:18

Why do you presume that the doctors who gave the antibiotics were the ones who got it right? I can see that in the case where the baby had a CXR that showed achest infection antibiotics were indicated but the others just sound like one doctor's advice v anothers.
Viral illnesses (and most bacterial upper respiratory infections) go with time. It sounds as though the infection was just nearing the end of its life when you got the antibiotics.
I agree that private GPs want you to come back so are more likely to give antibiotics whether you need them or not. If you want antibiotics every time you get a temperature stick with the obliging private GP, just don't be surprised if you get a serious bacterial infection and it's antibiotic resistent.

2rebecca Thu 14-Mar-13 10:55:10

Where did the "viral illnesses usually last a week" myth come from. There are many viruses, cold viruses, flu viruses, the polio virus, AIDs, chicken pox and they all last different lenghts of time.
I think if you have a respiratory infection for over a week it's wise to see your GP, but if she says it's a virus then why not believe her and just review things in another week?
Why all the trips to A&E rather than the GP as well?

Sidge Thu 14-Mar-13 10:57:52

Viral illnesses usually last a week

No they don't. They can follow different patterns. Some viral illnesses can last 4-6 weeks.

banana87 Thu 14-Mar-13 14:00:05

I absolutely do not like to give my kids (or myself) antibiotics. They cause a whole host of problems while treating infection. Saying that, if there is a clinical need for them then I do not think they should be withheld to "wait and see".

I do not believe for a second that I have given them to my kids (the very few times) needlessly. In the instance of my dd last year who had ongoing fever for months, we were directed to a&e twice by NHS direct, and when I took her to the GP months later I asked for blood tests, not antibiotics. Antibiotics is what I got because guess what? That's the cheaper option.

dikkertjedap Thu 14-Mar-13 14:18:47

I agree with you, I have terrible experiences with NHS GPs (not all, but by far too many).

No, private doctors don't give you just what you want, but they use their skills to get to the bottom of things and money is less of an issue.

My dd nearly died due to the negligence of an arrogant GP. She had life threatening pneumonia in both lungs - she was basically drowning and the GP for a whole month having fobbed me off saying it was just a virus with weeks of 40 degrees fever not responding to medication and telling me I was over anxious, wasting precious NHS time and that I would be struck off it I dared to bring her in again with the same symptoms - that was the afternoon she was blue lighted to hospital as she had stopped breathing and had sats of 85 sad sad sad and now has severe scarring of both lungs)

Second time round, similar symptoms we went private. Paediatrician checked her out, took temperature, took her SATS, ordered an X-ray on the spot - diagnosed pneumonia and treated it, checking her every three days to check she was responding to the antibiotics. V. expensive, but well worth it for us.

Now in the Netherlands she became ill, similar symptoms, GP straight away ordered X-ray at local hospital as was concerned about her SATS (95). She mentioned that SATS and respiratory rates are good predictors of presence of pneumonia and that she wanted to positively exclude it through an X-ray rather than prescribing heavy duty antibiotics just in case.

So I do think that some NHS GPs are just incompetent/uncaring, but many are probably just trying to control their budgets. sad

pansyflimflam Thu 14-Mar-13 14:35:53

Banana, blood tests for what exactly?

banana87 Thu 14-Mar-13 16:47:41

For cancer. See here: http://www.bechildcanceraware.org/child-cancer-info/child-cancer-symptoms/

My friends son was fobbed off for months by their GP and he had leukemia. People need to educate themselves. Persistent fevers and weight loss need investigating. And we're talking it all starting in December and me requesting further testing in march. Hardly an overreaction on my part.

landrover Thu 14-Mar-13 17:05:23

Here we go again, doctors obviously are always right about virus s. That s the first thing they say, coz that will get rid of you for another week!!!
They did that with my 14 month old daughter, 3 doctors all said she had a virus, 3 consecutive days, but hey !!! it was sorted, she died the 4th day from meningitis !!! I would demand antibiotics every time, im sorry if you all think different but what gets me is that gp s take no notice of the fact that you know your child best!!!!

YABU

Bacterial infections are often secondary, and GPs do not have a crystal ball.

Instead of going from a telephone appointment to a private GP appointment why didn't you just ask for a face to face with your NHS GP?

If you had multiple instances of being seen by different doctors within the same hour and getting different diagnoses then I'd agree with you.

But illnesses are dynamic and can change quickly, particularly in young children.

We are veterans of GP/hospital/Ambulance circuit thanks to dc's underlying illness, and you have my every sympathy because watching them ill and having the responsibility of having to deicde when to take them in is stressful. No doubt about it.

But, you seem to be misunderstanding about illnesses and how they affect the body... Which is probably why you see a doctor!

X-post landrover

I'm very sorry to hear about your daughter.

landrover Thu 14-Mar-13 17:14:35

Thankyou Sue Flay xxx
Ten years ago now but doctors still missing the signs of meningitis, not always a rash unfortunately xxxxx You bury the pain and then an op comes up with this and brings it all back xx

LadyPessaryPam Thu 14-Mar-13 17:39:16

dikkertjedap can you explain the Netherlands system please? It sounds better than ours. I assume it's basically free at the point of use?

poozlepants Thu 14-Mar-13 17:49:08

The difference between the private GP and the NHS one that saw your DD was that the private one actually saw the patient. If you want treatment for a cough you would need to actually see your doctor in person so they can listen to the patient's chest. They aren't likely to prescribe antibiotics over the phone unless you have a medical history that warrants them.

crashdoll Thu 14-Mar-13 18:41:47

Saying that, if there is a clinical need for them then I do not think they should be withheld to "wait and see".

You are not the person who decides clinical need though. You did not train for 7 years at medical school. That's not to say that GPs don't fob people off but you sound very dramatic.

RoseandVioletCreams Thu 14-Mar-13 18:52:07

i am worried about pnemonia,

how do you know when to call docs with baba? has a nasty chest, how long do we wait for?

FasterStronger Thu 14-Mar-13 18:59:40

Rose - you need proper advice from a medical professional, not MNers, however well its meant.

How about ring NHS Direct or do you have a local Walk in Centre?

Sirzy Thu 14-Mar-13 19:02:36

Rose if your worried then seek help its always best to have things checked out. With DS he is prone to pnumonia so i know when his temp goes up chances are that is what the cause is unfortunatly.

dikkertjedap Thu 14-Mar-13 19:05:11

Lady - I have only just moved here, so don't know the system extremely well. The only thing I know that it is hugely expensive, apparently it is even more expensive than the US. Everybody is obliged by law to take out private health insurance, the rates for the basic insurance is set by the government and government also determines what is included. There is quite a high excess charge which applies to all insurances as it is also determined by central government.

However, it is very easy to get an appointment, even at short notice.
Hospitals look very clean and airy and waiting times seem quite short. However, there are horror stories of doctors not washing hands and unnecessary surgery so they can earn more (so it is not all good!).

So far, the service we have received here is comparable with our private paediatrician in London and clearly a lot cheaper than the Portland Hospital.

We had terrible experiences with the NHS I am afraid. Uncaring and incompetent staff not just on one occasion and in just one place but on many occasions in different places. I find that NHS GPs are more budget driven than patient oriented.

Rose a lot depends on the age of the child. Key indicators are fast and laboured breathing, not very responsive, bluish lips and nails, coughing but not always, etc. etc. and child doesn't need to have all these symptoms.

Unless swabs were taken you still can't be sure whether it was a viral or bacterial infection. Viral illnesses can last a lot longer than a week!

I do agree that phone dx is crap though. Had this last week with ds1 who was diagnosed over the phone with an allergy. Turned out to be a virus which then led to a nasty secondary bacterial infection. Correct dx of a virus would not have prevented the secondary infection but it would have stopped me sending him into school with a highly contagious viral infection!

RoseandVioletCreams Thu 14-Mar-13 19:12:28

ok dikker,

I have called out of hours - I think her chest needs listening too anyway, but no other symptons in terms of the laboured breathing etc.

you poor thing, so sorry to read about your DD, its terribly worrying when you cant trust the system to help you.

what i dont understand though, is gp's being budget driven, if they let a problem fester it will cost them more in the long run anyway?

RoseandVioletCreams Thu 14-Mar-13 19:15:05

Landrover, so so so sorry to hear of your daughter.

crashdoll Thu 14-Mar-13 19:47:56

what i dont understand though, is gp's being budget driven, if they let a problem fester it will cost them more in the long run anyway?

It will fester if it's a virus and there's not a lot anyone can do about it.

dikkertjedap Thu 14-Mar-13 19:49:05

to World Health Organisation accepted respiratory rates in children by age group - you basically need to count the number of exhalations during exactly 1 minute (I tend to repeat it a few times to make sure I get it correct)

Other check is the capillary refill test (also known as nailbed test)

However, Rose if unsure it is best to take your dc to A&E at least there will be paediatricians there, better than OOH in my experience.

dikkertjedap Thu 14-Mar-13 19:52:58

Of course it is not true that nothing can be done if it is a virus. There are anti virals available for people in at risk groups. Also, GPs could be much more pro-active in positively excluding bacterial infections rather than just having the default stance that everything is a virus unless proven otherwise.

FasterStronger Thu 14-Mar-13 19:55:44

but you dont go to A&E unless there is an Accident or an Emergency.

because otherwise you will cause delays for people who have had an accident or an emergency.

Sirzy Thu 14-Mar-13 20:00:13

Faster - if your child is having enough trouble with their chest you suspect pnumonia then of course your right to take them to A and E.

A child with chest problems is very much an emergency

banana87 Thu 14-Mar-13 20:03:32

*but you dont go to A&E unless there is an Accident or an Emergency.

because otherwise you will cause delays for people who have had an accident or an emergency.*

Very ignorant comment here. If a child has a high temp that is not coming down with medication, you DO go to A&E. High fevers are very dangerous, especially if they are not responding to treatment. Comments like this are careless.

FasterStronger Thu 14-Mar-13 20:09:47

Sirzy - I don't read what the poster is saying in the same way as you do.

on a different note: has your DC been tested for a propensity for pneumonia? i cannot remember the details but there is a test for it - i think it runs in families. i recall flu jab is recommended.

banana87 could you show me a medical reference for you assertion?

banana87 Thu 14-Mar-13 20:40:18

Read "when to call the dr".

banana87 Thu 14-Mar-13 20:40:30

http://www.cpnonline.org/CRS/CRS/pa_fever_hhg.htm

banana87 Thu 14-Mar-13 20:41:20

Forgot to add: in both instances that we went to a&e, it was out of hours and NHS direct told us to.

crashdoll Thu 14-Mar-13 20:49:11

Of course it is not true that nothing can be done if it is a virus. There are anti virals available for people in at risk groups. Also, GPs could be much more pro-active in positively excluding bacterial infections rather than just having the default stance that everything is a virus unless proven otherwise.

1.) But unless OP says otherwise, the child is not at risk. What else is there that a GP can prescribe?

2.) By the time the GP has swabbed and got results, it will be about a week. Will people like the OP be happy to wait? Anyway, the NHS cannot afford this.

Again, not excusing GPs fobbing patients off but there are a lot of people who cannot grasp that ABs will not help a virus. It will only leave them with side effects.

Anti virals aren't given very often though. DS1 has been given them once, but he was at risk of death without them.

Sirzy Thu 14-Mar-13 20:57:07

Faster DS has his flu jab anyway, from his x rays/blood tests they have identified the strain he gets and why.

silverstaresatnight Thu 14-Mar-13 20:58:47

I agree with you , a lot of GPs are way too laissez faire especially with kids, can be dangerous.

silverstaresatnight Thu 14-Mar-13 21:01:11

And I am a hospital dr

Zavi Thu 14-Mar-13 21:09:02

Can't believe the number of people on here - including OP - who have sick children and phone the GP for advice

GPs do not have crystal balls. They can ONLY make a diagnosis based on clinical history, to include past medical history, AND a clinical examination.

If you are concerned enough about your child to phone the GP then you should be taking them to the surgery where they can be examined properly.

Where are your priorities in this scenario?????

thebitchdoctor Thu 14-Mar-13 21:09:08

Well silverstaresatnight I'm a GP and I can tell you there are PLENTY of GPs who aren't laissez faire with kids at all.

silverstaresatnight Thu 14-Mar-13 21:19:30

I do think there is a prevailing attitude among some, obviously not all , GPs of feeling that either all illness is a virus or that parents / mothers are being over anxious.
It always strikes me there is a reluctance to think it could be a serious pathology or some difficulty in distinguishing the serious from the trivial, and not enough info given to parents about when to come back and what to actually do, ie a plan if things don't get better.

Then as soon as hey go to AE every single child with a fever is referred to paeds!

landrover Thu 14-Mar-13 21:25:41

Thankyou RoseandViolet xxxx Have a lovely daughter called Gabrielle now, she is a huge comfort x

Zavi - I didn't phone my GP I rang the eye A&E as that is what you have to do. I rang them because my ds1 is severely autistic, very hard to examine and because you only get a quick glimpse you need an expert. You are not allowed to just turn up at the eye A&E, - they won't see you - the procedure is to ring and they decide whether you will be seen.

A lot of GP's now operate telephone triage as well - so you ring, and either talk to a doctor or nurse and they decide whether you get an appointment.

thebitchdoctor Thu 14-Mar-13 21:30:57

Utter codswallop. What kind of hospital dr are you?

I'm not denying there are many terrible GPs (just as there are terrible doctors in every speciality) but there are many, MANY good GPs who screen for red flags, who don't dismiss anxious parents out of hand and most importantly they SAFETY NET for if things don't improve, they follow up with appointments or phonecalls if they are worried about the patient but don't think they warrant admission. Its the basis on which our practice is built on. You probably don't know about these many good GPs because you don't see many of their patients as they are managed at home.

And yes, if a child is in A&E I would bloody hope they would be referred to paeds if necessary.

I find there is a tendency for some hospital doctors to forget that GPs have only 10 minutes in which to take a history, to do a competent examination and form a management plan without the comfort blanket of on-site bloods, ECGs, X rays and the like. We have to rely purely on our clinical skills and sometimes our intuition to decide the best form of action.

thebitchdoctor Thu 14-Mar-13 21:31:21

And land rover I'm so very sorry about your loss.

silverstaresatnight Thu 14-Mar-13 21:33:57

It's not, honestly.
Not suggesting you are not a good dr obviously wouldn't dream of being so rude but the ops experience does happen.

Sirzy Thu 14-Mar-13 21:38:26

I have to say my GP is awful with children at time simply because he doesn't listen to parents and is too "by the book" even refusing to do a repeat prescription for an inhaler because DS is too young even though it was prescribed by a respiratory consultant. Other times he has given antibiotics when I have said I felt it was his asthma not an infection so he needed steroids - he has done that 3 times and each time we ended up in A and E within 12 hours needing steroids, nebs and oxygen by that point.

I do agree there is only so much they can do with the time and resources they have but in my experience that isn't always used effectively (surely GPs should be able to check sats at least yet they have never checked DS)

There again, its better than OOH who now won't see DS and just send us straight to peads A and E even if its not serious enough to warrant A and E.

thebitchdoctor Thu 14-Mar-13 21:43:39

I know the OPs experience does happens and it's a disgrace that it does but don't generalise against GPs please, I'm astonished you would do that as a hospital doctor.

And yes I think I am a good dr. I'm not perfect though, no doctor is. I know my limitations and work on them daily. Having a child has made me a better doctor, I know the true terror of being a parent to an ill child. I lose all logic and reason when my DD is ill and understand that panic in my patients and their parents when they present to me.

banana87 Thu 14-Mar-13 21:47:03

Zavi- my surgery won't give you an emergency appointment until you've spoken to the GP. Also, I wasn't overly concerned at that stage, but mummy instinct told me to ring the dr in case.

Landrover- I am so sorry to hear your story.

silverstaresatnight Thu 14-Mar-13 21:53:19

Not generalising, just said a lot of GPs under treat children ime. Also the onus to come back lies mainly with the patient, or with the parent in the case of children, but I don't think it's often clear to them when they should worry / go back or whether they should at all if the GP hasn't asked them to.
With adults I find there is a lot more caution.
As I say I am sure a lot of GP practices are excellent but this is definitely something that happens.
Same as for eg hospital drs often don't tell patients their diagnosis and send them home too early with no information to the GP!

dikkertjedap Thu 14-Mar-13 22:05:09

Maybe there are many good GPs, who knows? I just didn't have the luck to come across them.

In the end, whilst still in the UK, I either took my dc if we had any (major) concerns to a private paediatrician or to A&E, thus bypassing GPs altogether. I know quite a few parents who do this after some near disastrous experiences with either incompetent or uncaring (or maybe both) GPs.

We have found the hospital doctors far more thorough (eg checking temperature - several GPs we saw over the years never bothered to do this, checking SATS (again our GPs didn't do this), checking heart rate, respiratory rate, eg things you would expect, but many GPs don't do whereas hospital doctors always seem to do them. That is maybe why hospital doctors are more able to identify the issues and address them.

The ten minute slot is a red herring, if a GP is not able to do his job as a result from sticking to the allocated time, then why should we patients take the risk bothering with GPs?

thebitchdoctor Thu 14-Mar-13 22:27:12

The ten minute slot isn't a red herring at all. Mind you that is the reason why most doctors tend to run late, because they take longer to deal with problems because they deserve longer than 10 mins.

And yes there a good GPs. I'm sorry some people on here haven't found any yet.

GPs do those examinations definitely.

And silverstaresatnight you are generalising by saying that and that may be your experience but its not everyone's. Good GPs should be are cautious with every patient. I'm surprised at your attitude towards your medical colleagues, being a hospital dr and all. (Speciality?)

NightFallsFast Thu 14-Mar-13 22:27:28

The OP is expecting a private service on he NHS. The NHS has insufficient funding to provide appointments with a chosen GP at a time of your choosing. NHS appointments are 10mins long and GPs often see 40 patients a day while a private GP sees 10-15. Are the Great British public prepared to pay more for more doctor time?

A GP gets paid about £70 to look after one patient for a year, no matter how many appointments that person has. Private GPs can charge this for a single consultation.

And for those advocating x-rays before antibiotic prescribing - x-rays do not come without radiation risks and not all bacterial infections show on x-ray. There is no perfect solution.

banana87 Thu 14-Mar-13 22:41:51

Night: no, I'm not expecting private service. I'm expecting decent service. I pay for it, so I should get it!!

silverstaresatnight Thu 14-Mar-13 22:50:43

thebitchdoctor
Don't make it personal, I think this does happen . It's not about you personally you sound quite thorough.
I agree with the posters who just don't understand why not do more examining and basic obs like sats? I really don't get why this doesn't happen as routine.

I think some GPs don't recognise sick children or make it clear what should happen if the child does not improve.

landrover Thu 14-Mar-13 23:16:53

I think you are right silver, parents are often left not knowing how long to leave things. In my experience the doctors made it obvious they didnt believe me and that i was over reacting.
One thing i kept going on about was the fact that she had been on calpol 24 hours a day for five days, on the package i think it says treat child no longer than three (or something similar). The doctors seem to think she could stay on it as long as i wanted!
Truly heart breaking that we weren't listened to. The whole story actually is horrific, ending with us being sent to a major hospital by ambulance from our local hospital and then being sent home with the doctor saying he was perfectly happy with her, she died 24 hours later.
Thankyou for your thoughts you lot anyway!! dont know what id do without this site!!! I do a lot of laughing at "Am i unreasonable" xxx

lisad123everybodydancenow Thu 14-Mar-13 23:42:48

Message withdrawn at poster's request.

FasterStronger Fri 15-Mar-13 07:45:30

banana87 Thu 14-Mar-13 20:40:30

your reference does not say go to A&E - which is what you said - it advises, under specific conditions, to contact your health provider which is very different....

crashdoll Fri 15-Mar-13 07:53:12

lisa The trouble is that some people are naturally very intuitive and know when something is wrong but many people are not. That's not a criticism. I've had lots of health problems and I tend to know when something is not right.

dikkertjedap Fri 15-Mar-13 10:23:38

crash - I think that unfortunately for many of us with no medical training we are learning the hard way.

I now have a pretty good idea what to look out for. I have learned this the very hard way through watching paediatricians assessing very ill dc in A&E. I have watched nurses checking sick child during the many days and nights on the ward. All these little things together give me an idea what to check for.

However, I think that it is utterly unreasonable if doctors expect all parents to know these things, because this is why we are supposed to have doctors.

I think the way forward for the NHS is far fewer GPs and better local hospitals (basically the opposite of what the current NHS reform is doing). In a hospital setting there are more experts, I think we need more experts and fewer generalists. My experience with GPs is that they either don't care or just don't know enough (they may know lots of things superficially but we all know that a little knowledge is sometimes more dangerous than no knowledge). I also think that GP training needs to be massively improved. GPs need to learn their own limits.

So far, I am very impressed with the Dutch system. The few times we have used it, we were swiftly referred to local hospital for tests (literally send to hospital straight after seeing the GP). GPs here seem more the first point of entrance and then refer you to the appropriate place rather than trying to do it all themselves. Hospitals are geared up for this, so if you are send for an X-ray, you can literally go straight away and are seen quickly plus the dialogue between hospital and GP seems to be very swift. So a treatment plan is very quickly being put in place. Admittedly, it is easier in the Netherlands as distances are short, there are lots and lots of hospitals (where I live there are 5 of which 3 are very major in a 30 minute drive radius) and there is a lot more capacity in the system, so it is possible to see a GP/hospital doctor at short notice. Clearly this comes at a cost, it is one of the most expensive systems in the Western world. And mistakes are still being made as well, it is definitely not perfect.

dikkertjedap Fri 15-Mar-13 10:41:10

Silver I have always had the impression that when you arrive either by ambulance or own transport with a seriously ill child in hospital the A&E doctors follow a very strict protocol, like a check list to tick things off, because they all seem to be doing the same things. Sometimes they were done one after they others, sometimes there were around 8 doctors or other medical staff all doing things at the same time it seems.

That is what I think GPs need - some kind of check list of all the things they should basically always do. I don't know precisely what should be on the list as I am not medically trained, but expect things like temperature, sats, heart rate, ear check.

I am not to sure about listening to the chest. In my experience GPs don't seem to be able to diagnose pneumonia no matter how often they listen to the chest. They just seem to go through the motions so they can tell you that your child's chest is clear even if the child has life threatening double pneumonia.

I also found that many GPs cannot use ear thermometers. I have the same one as many doctors and nowadays take it with me, they take the temperature and it is fine, I take it or let my child take it and it indicated high fever, then GP tells me my thermometer is unreliable so ask to use theirs and get exactly the very same high reading - many GPs don't seem to insert the thermometer properly, I didn't have this problem with hospital doctors and nurses. Again this was not a one off but time and time again and it makes you totally loose all trust in GPs.

Also, I contracted whooping cough (positive swab), correctly identified by OOH GP. I was concerned about my dd, given her medical history and wanted antibiotics prophylactically for her. Regular GP refused and said that there was no whooping cough in the UK but only on the continent. I said 'actually there are several outbreaks at present and I have been positively diagnosed as visible in my records which you have on your computer'. She refused to treat dd prophylactically as she was fully vaccinated and there was no need as there was no whooping cough and she also said that she really doubted that I had whooping cough myself as I was much too well and didn't even whoop. Dd ended up hospitalised for weeks.

I don't have it in for GPs BTW, but I do think they need clearer guidelines, better back up/supervision/inspection (basically performance assessments like for hospitals) and much better training initially and ongoing.

Sirzy Fri 15-Mar-13 10:54:49

Apparently listening to a child's chest is actually quite hard and it's easy to miss things. DS has a patch of permenant damage on his right lung and it is always quite interesting watching doctors listen to his chest and fills me with confidence when they notice this without me having to tell them.

I think it would help if each GP practise had a peads specialist GP as I think that would greatly improve the treatment for children. To many GPs seem to ignore the fact that what is "just a cold" in an adult has the potential to kill a young child. Our local A and E is a peads A and E which I think is part of the reason why they are so good as it means not only do they have the medical knowledge needed for treating children but also they have the bedside manner needed to treat children!

dikkertjedap Fri 15-Mar-13 11:14:44

Sirzy - I fully accept that it may be very very difficult to diagnose pneumonia through listening to child's chest. However, then GPs should also not be so damned sure that a child's chest is clear and hence no risk of pneumonia and labelling parents as over anxious. You can't have your cake and eat it and that is what many GPs are trying IME.

thebitchdoctor Fri 15-Mar-13 11:20:41

Silver I'm not making it personal at all. And don't patronisingly tell me I seem 'quite thorough'. I'm starting to doubt you are a doctor actually.

I'm hiding this thread anyway, I'm sorry people have had bad experiences I really am but stop generalising about how bad all GPs are and dismiss our supposed 'lack of knowledge' because we are generalists. GP training is intense and tough. We spend a long time in hospital in different specialities (such as paeds) before we ever go to the community and we have to pass postgraduate exams just like hallowed hospital specialists have to do. It is very hard to be a good GP, it's a very difficult job but one that is much maligned which pisses me off when I and the majority of my colleagues work bloody hard for our patients.

If you all actually spoke to your GPs and practices instead of bitching about it on here that'd probably be more helpful. Like any job, feedback is important and good GPs do take notice of patient comments and complaints. For example we changed the wording of a letter we sent out to patients recently after one patient complained to me and I brought it up to the practice, a small thing but we took notice of that feedback and did something about it. Write to the practice managers and do something about it!!!!!

Sirzy Fri 15-Mar-13 11:32:43

I fully agree dikker, if they are in any doubt they should seek a second opinion

dikkertjedap Fri 15-Mar-13 11:40:37

Bitchdoctor I have tried to speak to GPs about my concerns, I have discussed them with the practice manager, but I have found that it is all an utter waste of time and that it is best to bypass GPs altogether. If there is sufficient time and if you can afford it, my advice is to go private, if urgent go to A&E.

And this is based on my (and my dc and my dh) experiences with a number of GPs who happy blunder their way through life with patients having to deal with the consequences sad. Not saying that there are no good GPs, I am sure there are, unfortunately I haven't come across them whilst in the UK.

quickdowntonson Fri 15-Mar-13 17:22:10

Silver - How dare you be so unprofessional as to criticise GP's? It is because of secondary care doctors like you (who have no idea what we do every day, seeing 50 + patients at times) that we get get so many unfounded and unnecessary complaints. Get your facts right before making some casual throwaway remark to patients. So unprofessional.

quickdowntonson Fri 15-Mar-13 17:24:11

I obviously agree with Thebitchdoctors comments above.
Don't criticise people who are doing a very demanding and high risk job.

quickdowntonson Fri 15-Mar-13 17:25:30

I obviously agree with Thebitchdoctors comments above.
Don't criticise people who are doing a very demanding and high risk job.

Sirzy Fri 15-Mar-13 18:17:35

So we can't criticise people when they make mistakes just because they do a demanding job?

So I should just accept a GP refusing to prescribe medication for my 3 year old because he is too young dispite this having been done by a pediatrician? I should just accept that it took me, the consultant and his secretary 3 days to finally get the medication issued?

Sorry if someone is doing something wrong then people should speak up about it. That should certainly be done if you feel colleagues are doing things wrong aswell.

firesidechat Fri 15-Mar-13 18:44:06

I must be very fortunate with my GPs (we have moved around quite a bit) because I have never had these substandard experiences. I've always had the level of service that I would expect. Perhaps my expectations aren't as high as some.

Our GP diagnosed my husbands cancer very quickly, for which I am very thankful. I had a possible infection just before Christmas and the doctor gave me a prescription for antibiotics "just in case". I never had to get them because I waited and waited and it got better all by itself. I've had to take antibiotics in the past for serious infections ie dangerous chest infection and kidney infection, so only have them if I absolutely have to.

Personally I hate going to the surgery, but just felt the need to stand up for doctors who do a job that must be very difficult and stressful sometimes.

quickdowntonson Fri 15-Mar-13 18:53:51

Sirzy - where did you go to medical school?

rollmopses Fri 15-Mar-13 19:31:24

quickdown..., only the GPs who don't do their jobs properly are critisised here. I hope you are not so naive as to believe that such specimens do not exist? hmm

Sirzy Fri 15-Mar-13 19:42:54

Quickdown - you need to go to medical school to know a gp should prescribe medication as requested by a pediatric respiritory specialist? Really? Surely the letter from the specialist detailing why that decision was made (which I saw) should be enough?

banana87 Fri 15-Mar-13 20:00:50

It is a complete waste of time complaining. I agree that there are some really good GP's out there but this thread isn't about them, especially as they are so few and far between. At my local practice I trust 2 out of 8 but both are impossible to get an appointment with (now I know why!).

By the way, my SIL has a serious chest infection. She's been given steroids, antibiotics, and told to take double the amount of the inhaler her regular NHS GP prescribed (the GP said she would prescribe that amount for a baby, not an adult). Also she does do NHS work and said she would have done the same on the NHS. She was also much more thorough than the other GP. Also she saw my niece today and did NOT prescribe anything because there was no clinical need. Kind of backfires the whole "needless prescribing" theory of private GP's now doesn't it?

alarkthatcouldpray Fri 15-Mar-13 20:33:56

Sirzy - when you print and sign a script as a doctor you have to stand by what you have prescribed 100%. So if a specialist advises you to prescribe a medication with which you are unfamiliar it makes sense to check it out a bit. Most/many medications given to children are unlicensed since understandably few parents would enter their child into a clinical trial. So we go by experience, and while the specialist may have built up a considerable body of experience using that drug, it may be the GPs first time. It makes sense that they may want to speak to the consultant or do their own research. The GMC advises against prescribing outwith your area of expertise and would not stand by you if you wordlessly followed another doctor's instructions and the worst happened.

It may also interest you to know that the specialist could have written a prescription for you - but they didn't want it coming out of their dept budget.

Banana - most GPs who work privately do some NHS work too, or will have done in the past. I do both. I do exactly the same in whichever setting I find myself. Measuring pulse, resp rate, sats, blood pressure in the ten minute slot plus whatever else needs done. And my approach is pretty similar if I cover a shift in A&E. It isn't a completely different cohort of doctors in each of these settings.

crashdoll Fri 15-Mar-13 20:34:11

I get the impression that some people will never be happy with their GPs.

Sirzy Fri 15-Mar-13 20:57:06

The specialist wrote a prescrption at the appointment he then wrote to the GP 6 weeks later he needed a repeat - I put in for a repeat as normal with the details of when it was prescribe as per the letter (I had a copy to)

4 days later I went to pick up (they ask for 48 hours) Then i found they weren't going to do it. The GP had made no effort to contact the consultant it took me phoning the consultants secretary to sort it out.

Are people seriously going to try to defend that? The Gp wanted to leave a child with severe asthma with no preventer inhaler!

crashdoll Fri 15-Mar-13 21:03:50

No one is defending obvious bad practice but there are still some people who will never be happy with their GP.

alarkthatcouldpray Fri 15-Mar-13 21:12:51

I would certainly prescribe a repeat medication. It wasn't clear that's what it was. However it is all too easy to see private GPs, A&E staff and specialists as faultless while the NHS GPs are the dregs. I don't actually know any GPs I wouldn't trust to treat my family. The standard here is high though, it is competitive to get into and morale is reasonably good. Maybe it is different in other parts of the country.

Sirzy Fri 15-Mar-13 21:15:25

Sorry if I wasn't clear.

I don't think anyone is faultless and our gp is fantastic for something's I am just rapidly loosing faith in him when it comes to looking after my son

banana87 Fri 15-Mar-13 21:19:10

I think as a parent, you need to trust your GP. As I said, I have a couple I trust, however they are rarely available.

I do realize that some NHS GP's do private work and that they don't vary their practice. The private GP we saw said the same thing. I was just making my point as other posters had indicated that private GPs probably prescribe needlessly and I disagree with that.

Re: a&e. in every instance I have gone (its a pead a&e) NHS direct have told me to. So obviously a high fever that isn't coming down is a cause for medical concern or else NHS direct just tell everyone to go to a&e (that's a whole other threadwink)

silverstaresatnight Fri 15-Mar-13 22:11:23

hang on, don't start telling me off and criticising me and calling me not a doctor!!
I am entitled to my opinion as a parent. I am a hospital dr.. you can't just pretend everything is perfect when its not, you have to be open to criticism . Some hospital drs are rubbish. it happens .

It is definitely true that some GPs patronise parents / mothers minimising symptoms or not believing them. Listen to the people on the thread! The best service I have had is from the OOH GP . I may have been unlucky,
I may have been too trusting being a dr myself but they massively under treated my children.

I would never have believed it before having my own children but as your childs advocate I don't see why you have to convince them something is wrong... it should be their job to find out and investigate. I have been absolutely shocked.
Truly bad lack of awareness of what was going on .... while the GP was planning nothingor maybe a blood test in a week for my daughter [ after me politely requesting a test asap] I just took her in to the hospital and her hb was less than 5. Afterwards when he was more than a little embarrassed after her lengthy hospital stay he said " she was a bit pale ". No shit Sherlock !

Like I said you could be an amazing GP. I could be a rubbish Hospital Dr but I am just as entitled to my opinion and to relate experiences as the next person so stop being so defensive, some GPs either don't know what they are doing or just get used to most illnesses being trivial.

I can forgive ignorance.. we all have that after all but its much harder to forgive arrogance.

silverstaresatnight Fri 15-Mar-13 22:48:03

Another example. Son develops sore throat and fever. looks like tonsillitis and as an adult off he goes to the GP on his own. I mentioned to him I hoped he wouldn't be given amoxicclin as there was a chance of him having glandular fever. He goes to GP who diagnoses tonsillitis and prescribes amoxicillin. Son says could this be risky if it is GF? GP says why would you think that and son says you know my parents are drs and mentioned it to me. GP oh certainly not GF off you go. Day 2 of amoxicillin out comes horrific coalesced rash he is totally erythematous. Goes back to GP who does GF test which of course is positive... does the GP say sorry silvers son, my bad, does he heck he just says it is not connected.
No connection between GF and florid rash with amoxil? Perhaps he had never heard of it? Or perhaps he was just very arrogant ?
Son[18] was ok about the rash but felt he hadn't been listened to. Or that the GP was being awkward.

silverstaresatnight Fri 15-Mar-13 23:23:43

Third example.
baby ds has second set of jabs. Up in the night crying and in morning I see red area around vaccination site about 3 cm diameter or so. I give him calpol,it settled over 24 hrs or so and I remember my other ds had the same and it was the pertussis ... so anyway, I go along to third set of jabs and ,mention this and the GP says " I doubt it was a reaction but if it was why didn:t you bring him in and show us?* What, well most drs visit drs as little as possible anyway and are fairly confident about health issues and a visit to the GP really wasn:t necessary... so he was basically saying I don't believe you ! The health visitor who knew me well looked at him as if he was mad!
So anyway ds was under the paed consultant for basically being very atopic and eczematous and I remembered about the jab... he instantly said if the area of swelling was bigger than a fifty pence piece it was a severe local reaction and he should omit the third jab and have some other preparation for the pre school one! Sorted.
So basically in this instance the GP didn't really have the knowledge and tried to fob me off by disbelieving me...why?

nannyof3 Fri 15-Mar-13 23:35:44

Change ur doctors

silverstaresatnight Fri 15-Mar-13 23:40:19

yes one is ok the rest not.

dikkertjedap Sat 16-Mar-13 11:28:34

Change your doctors - I agree, but no guarantee the next one is any better. Good ones are like finding a needle in a haystack. Especially in more rural areas. I think places like London attract the best doctors, resulting in higher standards in London compared with other parts of the country. At least that is my impression.

The fact that some GPs in this thread get all defensive and in denial makes it so hard to improve the NHS. If people don't admit that there is a problem then there is no hope of the problem being addressed. The fact that one GP mentioned he studied so long is neither here nor there, you can study for seven years and still be a crap doctor. Also, to try to shush a fellow doctor because he was critical is outrageous, shows the 'you rub my back, I rub your back' culture in medical practice which totally undermines all credibility and explains to patients why it is a waste of time to complain as doctors are likely to support their own rather than the patient.

banana87 Sat 16-Mar-13 15:23:32

Also I don't think it's as hard here to become a GP as it is in other countries, I.e. America.

Case and point: friends bil studied in US at medical school, failed his boards and therefore couldn't be a dr. Moved here and is a A&e dr. Not sure if he's consultant (don't think he is), but point is that he shouldn't really be practicing at all, yet others lives are in his hands. Scary stuff.

silverstaresatnight Sat 16-Mar-13 19:21:05

Thank you for the support , I don't think it is fair or right to rubbish me on a personal level because a Dr is on the defensive. I don't see how that is " unprofessional".. Are they suggesting I must never criticise anything because that is wrong.

We none of us are perfect and the system isn't perfect at the moment for sure.. At the moment, managers are telling drs what to do and all drs care about is getting the patient better ( not freeing up a hospital bed) and the sooner these things are aired and improved the better.

2rebecca Sat 16-Mar-13 20:10:51

It is unusual for a GP to put a medication on repeat when you have only had it once. usually you need an appointment with the GP to check the medication suits you, no side effects, that it's done what it's supposed to etc. Only then does it get put on a repeat prescription. If a hospital doc only just started a medication it's unusual for it to go straight on as a repeat without a doctor somewhere reviewing it. In my surgery the only medications I get on repeat are those on my prescription form list, if it's a new med and not on that list then it's not a repeat.
In the case mentioned the GP hadn't even had the letter from the hospital saying the med had been started (it isn't a GP's job to chase up hospital letters) so it's not surprising it hadn't been added to the repeat med list.
Why is seeing the GP when the med runs out to ask for it to be put on repeat and feed back how helpful the new med is so bad anyway?

quickdowntonson Sat 16-Mar-13 21:51:10

Banana - What actual evidence do you have for that, apart from hearsay? It's all private medicine in the US so everyone with insurance gets over investigated - no need for clinical judgement there! Massive conflict of interest too - more investigations equals more money.
I think this debate is getting a little silly. Sure everyone makes mistakes, yet no other profession (apart from teachers perhaps) is slagged off so much. How many of you work 12 hour days at such intensity? It's easy to be critical of others.
And yes, I do think it is unprofessional for anyone in any profession to point out colleagues' 'mistakes' to others. Shows a lack of judgement and a lot of arrogance. Silver - yes, you should care about the patient, not scaremonger about how others Dr's can't possibly be as diligent as yourself.

digerd Sat 16-Mar-13 21:52:35

I have been prescribed something new as a permanent medication and immediately the chemist attached gave me a repeat prescription form < to go with the others.> I assume mine are not expected to cause me any problems, but looking at the leaflet about side effects, they all have lists of possible ones.

silverstaresatnight Sat 16-Mar-13 23:06:40

Quick.. Don't be so arrogant.

banana87 Sat 16-Mar-13 23:29:40

Quick-what evidence do you want? And sorry, but seeing as how GP's are our first point of call in a medical situation, their duty is to save lives. So when they are caring more about budgets than patients, it's a pretty valid concern to have. Really no different to your example of dr's in America over prescribing and over referring....it's all money money money.

Sirzy Sun 17-Mar-13 00:42:20

n the case mentioned the GP hadn't even had the letter from the hospital saying the med had been started (it isn't a GP's job to chase up hospital letters

Yes they had. 6 weeks before asking for a repeat.

And they didn't ask me to make an appointment with the gp before it would be done. They said no. He was going to leave him with no preventor inhaler and it was only when I did the ringing around to talk to the consultants secretary that it was sorted. Thankfully the consultant and his secretary where fantastic.

2rebecca Sun 17-Mar-13 12:37:16

I presumed they hadn't got the letter because you were talking about the GP having to make an effort to contact the consultant which implied for some reason this was necessary. You said you had received a letter but that didn't mean the GP's copy had arrived.
I think in general if you have never had a medicine from your GP then it's sensible to make an appointment to discuss the medicine and get it put on a repeat file.
GPs are more likely to get valid complaints about prescribing medicines without having reviewed the patient than having insisted a patient makes an appointment before putting a medication on repeat.

quickdowntonson Sun 17-Mar-13 16:22:16

Banana- you obviously have no idea how it works here. GP's do not earn more money from over prescribing or referring. Quite the opposite.

banana87 Sun 17-Mar-13 19:47:58

2rebecca: I never said they did. I said they do in the US but here they are more concerned about budgets than patients so don't prescribe or refer!

FasterStronger Sun 17-Mar-13 19:49:58

a GP obviously has to be concerned about their budget. like the rest of us, they cannot spend money they don't have.

they have lots of competing demands to juggle.

banana87 Sun 17-Mar-13 22:27:15

Then clearly if budgets are at the forefront of everyone's mind and not patient health or well being, the current system isn't working?

crashdoll Sun 17-Mar-13 22:32:44

banana you're slating a whole system based on your very high expectations of a free (at the point of delivery) service. IME, I've been referred and prescribed. I have had run ins with "this medication is expensive" and there have been some compromises such as; "we'll try X, Y and Z before referral" but overall, very few complaints. I've been at 2 different surgeries and seen about 15 GPs within both of them and while some are hard work, overall I have no complaints (nor do my family) of obviously bad practice. Now, far be it for me to generalise and say the system is ok based on my experience but, as I said, I think you expect a lot.

FasterStronger Sun 17-Mar-13 22:35:19

if you want better more treatment, go private. the NHS does not have bottomless resources and they need to be managed.

then your budgeting will enable you to access the healthcare you want and will only be limited by your finances.

problem solved!

Isitme1 Sun 17-Mar-13 22:52:54

Op I understand what you mean in the op.

However its the other way around for us.
Gp gives antibiotics out like sweets then complains. He won't refer due to 'pct tying his hands' and he is reluctant to give the meds ds really needs (ds has long term health issues so a lot of meds).
He did however help when ds jad meningitis. He prescribed course of abs and sent him to hosp to be sent home 'its just a virus' to 24 hours later being transferred by ambulance.
Im seeing him tomorrow. He sees me and starts.

MrsKeithRichards Sun 17-Mar-13 23:04:35

My Gp laughs and tells us he wanted to be a vet but failed the exams.

He's fantastic.

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