I'm a GP AMA

[DrBubble]

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

Great thread @DrBubble. I have 2 questions for you.

1. What did your sister end up studying and does she enjoy her non medical profession?

1. What makes a great GP?

Do you think less of your patients if they ask for a private referral? (you would be referring them via NHS anyway)

Are GPs told to ask what the patient thinks the symptoms might be caused by as part of the consultation?
If so what is the reasoning behind this - is it a double check in case the GP had missed something? is it a test to see how on the ball the patient is ? Is it to put the patient's mind at rest if they were worrying it was something more serious ? I am curious!

@Devlesko

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.

As a fellow sufferer in remission I’d say encourage him to read up on elimination diets - there’s a fantastic support groups on Facebook The HS Diet Connection. And be careful who he allows near it. It took 10 years before I got a diagnosis, not one GP I saw had a clue - an inexperienced doctor opening a HS abscess can do a lot of damage...read up on the right way to do it, so you can be sure the doctor who’s treating you follows the latest technique otherwise his wound will remain open for months to years.

@BobVance
I don't consider it time wasted if a worried patient comes to see me and the condition is a minor illness. Patients don't have the medical knowledge and training to be able to differentiate serious and minor illness. If something can be managed at home or the pharmacy then I'll educate the patient.
If you are worried about wasting the doctors time then you can always pop to your pharmacist first and if you need to see a Dr then they will let you know.

@whatmakesmesad
There is a huge drive for social prescribing
I think it's needed. Loneliness / unemployment and other social issues do impact health services so I can see the potential for good of social prescribing

How much do you prepare for each appointment? What would preparing look like?

Do you ever wonder about the outcomes of patients that you send down to A&E with potentially life threatening conditions?

I'm British currently living in the US and one thing I've noticed is the emphasis on preventive medicine here. It's commonplace for children and adults to have annual physicals, for example, including blood tests, and helps detect conditions before they become serious.

Of course, you need health insurance to cover them, but do you think the NHS should adopt that approach as well? I know health checks are available from 40 onwards, but do you think it should be more widely available?

@chipsandgin
I don't think people intentionally waste my time. But I do struggle with those who are disrespectful. I however have a low threshold for such behaviour so if a patient is rude or disrespectful then I will warn them and if they don't desist then I will terminate the consultation.
In terms of enjoyment, I s'pose it's like any other job. Good days and bad days. Mostly it's just a job and I do my best while I'm at work and I try and leave it at the door at hometime.

I have heard it said that pharmacists are a massively underused resource for patients, do you think this is true? One example is checking medication interreactions.

Gosh where to start:

1. 56 day prescribing. What is the logic for someone like me who has been hypothyroid for 30 years and 100mcg has worked well for 30 years. When we have to respect the GP's precious time, what of mine? I don't have 30 to 40 mins every two months to waste. If GPs have time to muck about with this nonsense do you mind much when patients find it hard to accept you all have too much to do.

1. As a GP do you comprehend that some of your patients also have full on professional jobs and their time is as valuable as yours?

1. When your staff screw up over repeats, referrals etc., and waste my time attending the practice to collect things that haven't been dealt with as promised, why is the response "if you want it posted, you'll have to give us an envelope and a stamp". Is there no respect for the time of your patients?

1. My GPS usually greet me with "hello Roses" and introduce themselves as Dr Bloggs. Pray why do GPS think they may assume to use my first name when they introduce themselves with a title? Do you agree this is excruciatingly rude and no Dr should use a patient's first name without asking if they may?

@DeeplyMovingExperience
I haven't read invisible women but I am aware of it.
Thankfully I haven't personally seen this phenomenon of women being overlooked by the Drs I trained and work with
The men's health check drive is to destigmatise the concept of men attending the GP
When I am in my GP chair, my behaviour doesn't change depending on gender. Id like to think I don't overlook women, infact I try to do the opposite and have a good nose around to make sure they're not hiding things from me - I have noticed that many perimenopausal women don't seek help for those symptoms so I'm on a bit of a crusade whenever the opportunity arises to ask.

@MNWorldisCrazy
No prescriptions for people I know I'm afraid. It's frowned upon
And haha pretty much. The way a medic describes symptoms often gives them away. Tho if the GP disagrees or thinks plan B is better then they will usually say

What positive advice would you give to an a level student wanting to become a doctor please ?

What is your salary? Do you think its fair for the work you do?

What's your view of online triage systems, e.g. 111 website or Doctor Link?

@rockinaftermidnite
If I had my time again, I don't think I would chose medicine. But I think I am happy enough for the time being.
I don't feel burdened with responsibility. I do my best for the patient sitting before me and then I try and leave it at work and not take it home with me.
Ideal patient is anyone and everyone who is not abusive haha

How important would you say keeping records is?

If a patient attends a hospital appointment or a visit to A&E, Minor Injuries or Out of Orders does their GP geta report/ information on such a visit and how much informationis in the report?
Thanks for taking the time to answer our questions

Do you believe that "An apple a day keeps the doctor away"?

I only ask this because the USA is one of the biggest apple producers yet also the world's biggest spender on healthcare with a mind-blowing annual $12,000 per capita. Not only that but New York - known also as The Big Apple - is by far the largest city in the US and has the largest incidences per capita of cancer, heart disease and gunshot murders. Personally, I think there is some truth in the saying, but sadly until 'big pharma' can find a way of extracting apple into tablet form that could be sold to the NHS at $600 for a daily dose I think mankind are a very long way from benefitting from this wonderful natural product.

@Covidwedding123
If I had my time over I don't think I'd pick medicine. But if I did then yes I'd be a GP again. Best of the bunch imo
I think locums get a bad rep. But I think they are invaluable to primary care. I did solely locuming for a number of months and it allowed me to still work and offer something whilst I wasn't in a position to dedicate regular hours to a salaried role.

Great AMA DrBubble. What’s your opinion on the appointment systems?

At my GP surgery, you cannot book online. You need to phone at 08.00. Phone is always engaged, so I phone repeatedly.

After maybe 15 or 20 attempts, I’ll be connected and join a phone queue, listening to music, waiting for my turn to speak to the receptionist.

The wait to reach the top of the phone queue is really long - thirty minutes is normal. Recently I waited over an hour.

If the receptionist approves of your reason, she will get the GP to phone you back at an unspecified time during the day.

The system is pretty rubbish and just doesn’t work for anyone who is trying to hold down a job.

Thanks for your hard work. Any thoughts on how appointments can be improved?

Why is it that families trying to access help when a relative is showing signs of dementia have more hoops to jump through than help. Should there be a standard procedure involving families? Do you feel data protection is used to buy you time from diagnosis to cut costs when help could be offered sooner and to greater effect? Is it generally accepted that while there is no cure it is ok to delay treatment by sending letters in the post to the patient that will be ignored or lost, as well as emails and texts that there is no chance they will ever engage with? It took me turning up in the foyer of my mums GP in tears after she falsely accused me of stealing from her yet again before her GP would engage with me despite having written permission from her that I could discuss her health. Are we just getting fobbed off on one of the countries largest killers because no one knows what to do about it?

@Boph
It's practice dependant but rarely do GPs deal with everything. Many of the e consults can be admin related and don't need GP input so doesn't make sense for a GP to be to be initial recipient. Most are filtered and redirected to the appropriate person

@DrBubble what's your salary? Do you get bonus? How long have you been a GP for? :)

Thank you for your honest answers, I like this thread!

Stay safe x

I miss having a named GP. I'm reluctant to phone surgery now, as I have to explain everything to random duty doctor. I loved that my now retired GP knew me so well, both lived in same town, and he knew my history/family set up/job etc. My question is, is the 'family GP' a thing of the past?