I'm a GP AMA

[DrBubble]

I'm a GP. Any questions about my job?
(Please refrain from asking for specific medical advice)

@NovemberR
Us GPs are cheap dates - even a verbal "thank you" message left for us at reception brightens our day so anything above that is a luxury :)
These messages are almost always passed onto the recipient as we are all desperately in need of morale boosts

Have you ever mistakenly sent someone home without a referral for something serious?

I often worry after visiting the GP for lumps, bumps, moles etc as I’ve noticed it’s not always easy to distinguish between benign and malignant.

I have a (telephone) appointment with my GP tomorrow to discuss what's left of my post childbirth bum. Feeling a bit embarrassed about it, but on average how many embarrassing bits (bums and stuff) do you see / speak about on a daily basis?

How common is it for a GP to call an ambulance there and then for a patient? (Pre covid)

@extentioncord
This can be frustrating for patients and I've heard many people complain about this. However receptionists are usually highly trained and are often enacting protocols made by the Doctors. Most surgeries have a system where if something is beyond the competence of the reception staff then they can ask GPs/nurses as needed. Well trained reception staff can be invaluable as they can stop much unnecessary queries reaching already snowed under GPs.

@BlowDryRat
I usually listen and then redirect them to 111 or their own GP. That way I'm not offending them by shutting them down before they ask and also not offering any medical advice

Do you think GP fund holding has had an effect on outcomes for patients, length of time before diagnosis etc?

Why are GPs so hopelessly ill informed and dismissive of peri-menopause and menopause?

What do you think the future holds for primary care? I'll be upfront and say that I don't actually see the point of GPs. I rarely go as I think most things are cured by painkillers and a good nights sleep and only go if I need steroids for asthma or want a referral.

But having worked for one - I know loads of people come along very regularly! Can you see England moving to a model where patients go directly to specialists?

@jewel1968
Very interesting point
I agree massively
As mentioned before I'm from a working class background, council estate, hugely deprived area.
The first time a man got up and offered me his seat was in my first year of uni. I nearly died of shock as growing up I was more likely to be pushed off a seat than offered one haha
Uni was full of well to do people with pools in their back garden. Many had parents who were doctors and they had work experiences etc all sorted with top consultant friends
I on the other hand never even got offered work experience. I ended up volunteering at the hospital shop. Never even made it onto a ward.
I think there are ways for those from deprived backgrounds to enter into Medicine. But requires much harder work. However there are initiatives to increase uptake so we are moving in the right direction

Hi op. I hope this doesn't count as specific medical advice.
I have a long long list of symptoms. Some are related. Some might be. Some I don't know. But the Dr will only deal with 2 symptoms at a time, how do I know which 2 to mention? As depending on which 2 I pick the possible diagnosis could change.

@Nsky You can absolutely ask to see a preferred doctor of your choice. Most surgeries are understanding of patient choice

@Wonderbrush my gp looks on google while I'm there 😀!

@Cuddling57 Mine did this.

In my area the decision has been made for triage via witheld calls first only; same for hospital and social services. Some, myself included, have them blocked for safeguarding reasons and they cannot be unblocked and buying a new phone doesn't help as all now must be registered, I can't afford a device that'll run e-consult.

I wonder if anyone, medical, has actually thought about the impact on these people?

Not asking you to comment on my situation. I've complained etc etc got the standard NHS reply (I was NHS I know how it goes).

We all google our symptoms and often self diagnose. How do you feel about patients who turn up with a self diagnosis?

What would you say to someone with a abcess the size of a grapefruit (hydredenitus surpritiva) who won't to go hospital because they think they will catch covid and die in hospital.

I'm saying gtf to hospital he's saying no. At times he's screaming or crying in pain.
If I called ambulance he would never forgive me.

What do you think of care in the community? Do you think as many people should be living in the general community as there are or do you think more people should live in specialised homes with support (I don’t know the correct terminology I’m afraid).

What are your thoughts on physician associates and would you work with one?

I have a two weekly appointment with my GP. He makes the next appointment with me whilst I am at the appointment, I don't have to ask for it. This has happened since 2015. So fortnightly appointments. Each lasts about 30-45 minutes. I have no idea why, but I have multiple medical issues. Why do GP's do this?

@Evenstar
Morning clinic 9-12ish. 15-20 phonecalls, of those 1-2 patients will need to be seen face to face
"Lunch" 12-2.30ish. lots of admin to do.20-30 prescriptions to sign (have to check each patient has had the right monitoring to safely continue meds eh bloods, bp etc, send tasks to reception if monitoring not done)
10-20 letters - from range of people, usually hospital / discharge letters / physio / OT. have to ensure instructions enacted eg give patients certain meds or blood test or follow them up in GP or please refer to a different specialist etc. All this has to be done by GP
Check results inbox - About 20 blood test results which have to be acted on or filed.
Complete report requests from patients / DWP / Insurance companies etc. Complete letter requests
Then home visits - usually have 2 to do. Takes about an hour including travel time.
I usually eat while doing my Admin
Afternoon clinic 2.30ish-5.30ish. another 15-20 phonecalls and then see face to face if needed.
Most clinics generate about 20-30 mins of paperwork in the form of requesting bloods and tests and writing referrals

@coffeerunner. Your reply is as patronising as the admin person who tried to deal with my problem without referal to a HCP. My problem was related to cancer treatment but she didn't understand the background.

Being a 'generalist' rather than a 'specialist' have you ever misdiagnosed an illness in a patient and if so how far did it get before the situation was resolved?

Can all medical/nursing staff at a practice view any patient’s medical records whenever they feel like it?

Unfortunately, fairly recently three people I know on a personal level have all started working at the GP Practice I’ve been a patient at all my adult life and I have a feeling two of them have accessed my records and told mutual acquaintances about it.

One is because the best friend of one of the nurses I know, knew I’d had my vaccine despite me not telling anyone (I didn’t want anyone to know I was invited as it was due to mental health problems I’ve kept secret).

Secondly, I was suicidal and the sister of two of my friends I haven’t heard from for years is a nurse at the practice. Within 24 hours of me having a conversation about my suicidal thoughts with the GP, one of the sisters randomly text me (after years of not hearing from her) to ask if I was dropping out of an event and seemed surprised when I said no. She had no reason to think I would have dropped out of the event and no reason to
get in touch after so long. Their mother also saw my mother in the street and she started asking lots of questions about my “health” with a sympathetic look on her face. She really had no reason to think there was anything wrong with my health unless her daughter had been passing on confidential information.

To clarify I don’t have a paranoid psychiatric
illness or anything like that. I’m just really worried that nothing is private anymore but people have told me that there’s a way of tracking when someone not directly involved with a patient accesses their notes and they can be dismissed if they are found to be viewing notes with no reason. I’m hoping this might be true?

@Turnedouttoes
Some practices do still have named GPs
Issue is significant lack of GPs hence difficult to see same person regularly