Only 1 GP in a surgery

[amillionyears]

AIBU to think these are inherently and potentially dangerous.
I didnt think they were allowed to exist any more.
And I have been surprised that so many MNetters have said there is only 1 GP at their surgery.

[Milliways]

There are lots of single=handed practices around, covering small areas. Sometimes they share areas with large surgeries but people really like the personal relationship they get with 1 GP. He has to allow x pre bookable and x emergency appts per day - and these will be agreed with the local PCT. They employ locums for holiday cover and have a practice nurse seeing patients too.

Every person should have the choice of 2 GP surgeries though.

I work in a huge practice and am registered at a fairly large practice. Both of these try hard to get you to see the same GP wherever possible though, but at least you can see "Dr First Available" if you want!

[amillionyears]

I thought that after the scandal of Dr Shipman,that single handed practices were banned.
Also,every GP has to have personal medical strengths and weaknesses,which cant therefore suit each and every patient.

[amillionyears]

Im not GP bashing or NHS bashing.
If the GPs surgeries concerned had say 2 part time GPs so the patients had a choice of 2 GPs ,that would be better standard practice surely.

[Feckbox]

why dangerous? I don't get it at all

[amillionyears]

There are some GPs who will not necessarily have your best interests at heart.They may have the best interests of the practice or themselves at heart.
As I said all GPs are not the best in all areas of medicine and even diagnosis.
All the people are not going to like the GP so will be reluctant to go to that GP.This is probably my main reason for not liking a single GP in a practice.
If a patient delays going to a GP beacuse they dont much like them for whatever reason,then that patient is at risk of incurring more health problems.

[ginmakesitallok]

YANBU - In our area we only have 1 single handed GP practice and when it goes it won't be replaced by another. It is extremley difficult for a single handed GP to deliver the range of services expected.

[amillionyears]

Do you mind me asking how far you will have to travel to another surgery,and is that one a single handed one too?
The only good reason I can think of for a single GP in a surgery is if the surgery is in a very remote place in the British Isles,say an island,and even then,I still cant see why it cant be manned by 2 part timers.

[Feckbox]

why would a GP not have your best interests at heart?

[tribpot]

The Shipman report commented "It will be clear from the above that the main problems associated with single-handed practice are the absence of peer review, the risk of clinical isolation and the danger of abuse by the doctor of the trust implicit in the continuity of care."

That said, the inquiry then notes that Shipman killed many people whilst not in a single-handed practice as well.

Obviously, as the report makes clear, the risks are not that your GP is going to kill you. There are some risks for both patients and practitioners in a single-handed practice but the Inquiry did not recommend the banning of single-handed practices.

That said, OP, I tend to agree with you that patients would likely be better served in a practice with a choice of GP.

[amillionyears]

Feckbox,are you honestly saying that every GP in the land is honest,and has pure unselfish interests.
Are you a GP?

tribpot,thanks for the link

[InVeryveryBadTaste]

Live in remote and rural mainland north Scotland, not too far away from a singlehanded practice. Not ideal but not bad either. GPs should of course always have ur best interests at heart and I don't see why working alone would make this any less likely The Shipman case changed the regs surrounding death certificates and cremation forms but not sure about the organisation of GP practices.

[amillionyears]

True,InVeryveryBadTaste,Gps should have your best interests at heart,but if a GP didnt,he/she may be more likely to consider working in a single-handed practice,and it is one of the main reasons that I would try to avoid them.

I think I have read on MN twice this week and at least once last week, on the General Health board,Mental Health and Relationships where a MNetter is reluctant to go back to their single handed GP practice,to see the same GP who is likely to say the same thing medically again.And the MNetter still thinks they have something medically wrong with them.What are they then supposed to do?
My normal response when someone thinks that they have been misdiagnosed,is to advise them see a different GP in the same Medical Practice.

[tribpot]

Just to quote from the conclusion to that section of the report:

"It seems to me that single-handed practices vary in much the same way as do group practices. Some of each are good, bad or indifferent. Certainly, group practices do not have a monopoly on high quality patient care. Small and single-handed practices have their devotees, particularly among those who seek a personal relationship with their GP and who value the continuity of care which this provides. The number of small practices may be diminishing for a variety of reasons. However, there are still a significant number of them and this is likely to be the position for the foreseeable future.

That being so, it seems to me that the policy of the DoH and of PCTs should be to focus on the resolution of the problems inherent in single-handed or small practices rather than to try to reduce the numbers of them in existence. I know that the DoH says that it has no such policy but I have the clear impression that such a policy exists in the regions, if not in Whitehall."

[InVeryveryBadTaste]

I think that in that case the patient in question should be asking for 2nd opinion. I'm afraid I don't agree though about that type of GP seeking out a singlehanded practice - would prob be far too much hard work as would usually have to cover own ooh cover etc

[InVeryveryBadTaste]

On and I think (certainly where we live) u would be exceedingly unlikely to be able to avoid such practices as the distance involved getting to another one are so great. In my situation I would be either 72 miles north, 75 miles south or around 30 going east ( with Tesco at the end of it to make it worthwhile) if not registered at current GP. Not sure of situation in England but neighbouring practices can refuse to have u as a patient too as outwith practice boundary.

[amillionyears]

In,do you mean travel to the next practice to ask for a 2nd opinion?Or get a 2nd opinion from a specialist?

I still dont see why each isolated practice cant have 2 part time GPs.Wont get rid of all problems,but would help with some.

[Feckbox]

No I'm not a GP, and what has that got to do with anything?
No I am not saying every GP in the land is...etc...but to generalise they are a pretty honourable bunch and I think it is weird that anyone would worry that a single handed GP might be a bit dodgy

[amillionyears]

Feckbox,if you were a GP you would know stuff behind the scenes.
Also people can be biased,so if for instance you are the wife of a GP you may be biased.
And no, it is not weird,it is a matter of being aware of potential problems.
Have you read the link that tribpot posted?

[Feckbox]

oh, I see what you mean.
Yes, I read the link.
Lots of GPs in my family and I think they are a much maligned profession and I really can't get my head round anyone being wary of a single handed practitioner , other than if you live in a rural area you don't have much choice, but that's the choice you make if you live in a rural area. You don't have much choice over most stuff.

You said single handed GPs are inherently dangerous. I think that is worse than weird - it's ridiculous, and insulting to those who choose to work single handed.
My sister's village school has one teacher. Is that inherently dangerous?

[amillionyears]

Have looked up the definition of inherent.
Yes,you are right,inherent is the wrong word to use,so please ignore that word and I apologise for that word.

A village school with only 1 teacher could be potentially dangerous.

[Aquelven]

You can have problems with a one man practice GP.
It would be lovely to think that they are all wonderful but I'm afraid we've found that not to be the case.
We now have a new GP, who is fine, but the one we had before left much to be desired. He's retired now. Although he was the only GP for miles, his surgery hours were 10am to 11 am & 4.30 till 5.30, three days a week. He had no other practice where he attended. If you happened to have a 10 am appointment he never turned up till at least quarter past. My neighbour, elderly, had a bad fall. He came & when she complained that she couldn't walk his response was, "What do you expect at your age?" We later called an ambulance for her, turned out she had a broken hip.

My DH eventually after 5 years of appointments got a referral for surgery on his hand. The surgeon went ballistic saying there was now only so much that he could do to repair the hand. If he'd been referred sooner he could have given him back almost complete use of his fingers.
On top of this, I twice ended up in A&E, and bring admitted, as a result of wrong medication that the same GP had prescribed for a congenital heart problem I have. So yes, one man practices can be a problem.
Unfortunately we have no choice in this location. Eventually the GP was " encouraged" to take early retirement following all the complaints from many of his patients & now we have a much better one who makes you realise just what terrible service we were getting for all those years.

[amillionyears]

This is the sort of thing I mean Aquelven.
Would it be practical to have 2 part timers at the surgery?
And are you in the UK?

[Aquelven]

Don't know about part timers, it would be a good idea, though the new GP we have is a vast improvement.
Yes, we are in the UK, a fairly remote part in the north of England.

[DeWe]

Ours used to be basically single handed. He was and is a lovely chap, who now owns a practice with himself (full time ) 2 part time, and 2 registrars. If there is something a bit complicated I would always choose to go and see him rather than the others as he seems to have a instinct when something isn't right.

Of course problems might come in situations like the one where my friend went to him with meningitis and when he told her to go in immediately she said she couldn't because she had 2 small children. So he phoned an ambulance, and shut the surgery to look after them until his wife appeared and took them.

[amillionyears]

Yes,I hadnt thought that there would be of course some benefits.
Also,a single GP is likely to have fewer patients and might well know family histories better,
Still dont think they should be allowed though,for reasons already posted.