I'm a GP AMA

[DrBubble]

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

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Why do receptionists think they have the right to act like the gestapo and make it so difficult to speak to a GP??

My in-laws and dad seem to go to the GP every week and get every test under the sun. I don't begrudge them this (honest) but it seems as if GP's have a lot of time and budget to address the needs of this generation. On the other hand, it is impossible to get a dental appointment on the NHS for your DC, and whenever I have tried to get something addressed for my DC I've been told the NHS won't pay for it. For example, my DC had a wart so bad that he couldn't bend his finger on his writing hand. The GP told me that they used to do freezing, but stopped due to cost. I ended up paying over £1K to get it sorted privately. One of my retired relatives on the other hand gets paracetamol posted to them from a pharmacy completely free when they are 50p in Aldi.

In your opinion as a GP, do you think our DC do not get the same level of services as other generations? Is this fair?

@PinkGlitteryTiggs thank you for your comment. My last two practices have had notices all over reception, often in capital letters, telling patients the Dr's are very busy and not to waste their time. Yet there seems no mutuality of respect as far as the patient is concerned and no cognizance that the patient may be every bit as busy as the GP - in fact none of the GPs at my last two practices worked full time. Yet the patient who had to get two children to school in opposite directions for 8.45 could not feasibly go the surgery for 8.15 to queue to book an appointment f2f when it was not possible to get through on the phone, advance appointments were scrapped and only book on the day were available!

My other question was around 28/56 day prescribing. My thyroxine dose has not changed in 30 years and I only get a blood test when I remember to ask every 18 months or so. In 1990 I got 365 pills per year and an annual blood test. Now I have to faff every two months and there must also be increased administration for the GP - I am glad my GP has time to faff about but if that's the case it ill behoves the practice to have so many notices up about how busy the Drs are and apts must not be wasted. It is just plain rude.

There never seems to be an appreciation that the NHS is free at the point of delivery but is funded by the people for the people. We have a home in France and the system there is sonmuch more efficient and ime one is never made to feel one has to be grateful. It is so much more mutual and I don't find that to be the case in the UK.

From your experience can you explain why men in particular specialise in women's gynae? Is it because they relish having power over what happens to women's bodies.

I'm sure that doesn't apply to all male consultants who specialise in that area but I'm interested in what motivates them to choose this as their main practice.

Do you get fed up by the "ping-pong-ing" between GPs and specialists? GP referred me to gyn, told me so and said I'd get an appointment by post. Then was told I'd need a scan first that needed to be reviewed by GP before I could get the gyn referral.
Also, do you find it frustrating that in 2021 so much is still done by letter? I get not everyone is online, especially older people, but there must be a more efficient way to deal with things.

And lastly, do you think patients are sometimes forgotten or not informed about changes? I ask, because I was recently asked by the nurse why I hadn't taken up my flu jab. I didn't even know I was eligible, no one bothered to tell me that my heart condition puts me in that group.

From your experience can you explain why men in particular specialise in women's gynae? Is it because they relish having power over what happens to women's bodies

Huh? Seriously? That is some twisted way of thinking! Does that logic not apply to a doctor do any speciality then...?

How do you see the role of the GP in opioid addiction.

Why are GP are so dismissive and hostile? I dealt with quite a few and the conversation always goes in the same pattern.. Nothing to worry about, take Paracetamol, wait for a couple of weeks... Right until you mention a private medical insurance.. Then suddenly they are eager, polite and urge you to go and see a specialist

@DrBubble could you answer this question for me? Would a rectal prolapse be picked up by a flexible sigmoidoscopy?

What's your thoughts on pregnant women and the covid vaccine? I know some have had it, but it's generally advised against right now.

To the PP who mentioned access to medical records, the general rule is that you don't look at a record unless there is genuine reason to do so. Each time you access an electronic medical record it is recorded, so your name appears as the person who has accessed it and the date and time you accessed it. The record is confidential, so you don't discuss it with people not involved in the patients care. Anyone who does can find themselves in serious trouble.

Hi! What is you opinion on GP’s who refuse to prescribe birth control or refer for terminations because it’s against their religious beliefs?

Would they not be better practicing in another area of medicine?

Well, I'd just like to say thank you for what you do. And to the other GPs who'll be lurking on here.

One of our kids was chronically ill while younger, and one is having mental health challenges now. My practice has been outstanding, very practical and sensible and I am so grateful.

There have been blips and there have been times where I had to advocate for myself, but, really those were because the appointment is 10 minutes long and it must be really hard to figure out the next steps for a complex situation in 10 mins.

I'd never do the job, too hard for me. So, thank you.

Do you mind when patients offer their own opinions on what the condition may be and treatment? Or consider them to be well informed and being responsible for their own health?

I often go well armed with my own ideas about what the issue could be.

What do you think about the fact that AT Medics, who operated 49 GP practices including some large London ones, has now been acquired by the Missouri-based Centene Corporation through its Operose Health offshoot?

Does this pave the way for GPs simply being target driven employees, with patient centred care coming second to profit?

Can you please use the quote function to answer questions? It will make it much easier to follow. Thank you for the interesting thread!

Do you think the NHS would have discovered covid?

In December 2019, we all had an awful virus, very similar to covid but stayed away from Dr as per the advice. Covid wasn't known to us then.

However at xmas dd, then 2, became so ill that we saw a hospital GP.

She checked DD and laughed and said " it's just the virus this everyone has, don't know what it is, if dd becomes unresponsive call 999". She also said she had been so busy because everyone was presenting with it.

I got ill November last year (2020) I think it was covid but tested negative but nhs 111 sent me to see a gp. He said that lots of viruses have the same symptoms and seemed not to care what this was, as long as it wasn't covid.

Which made me think, does the nhs ever try to find out what the other viruses are?

Do you think covid could have been around earlier but no one was looking for it?

I’m going to pretend you’re my GP as you come across in the way she does. Thank you for being so amazing over the years, especially the last few when you had to pretty much treat my family as one due to a parent’s poor and declining health. You alway sounded interested, didn’t fob us off and you gave us the time we needed. You reception staff are also pretty awesome, I know in their position I’d have rolled my eyes when I heard my parent’s name, but if they did, it certainly didn’t show.

@NotPrude that is horrendous, your GP has behaved incredibly unprofessionally. What else might he be doing? He deserves to be reported.

Do you have any funny stories you can tell us? My cousins a nurse in a Gp surgery, once a patient brought in a stool sample wrapped in tin foil 😂 and somebody took a urine sample in a jam jar they hadn't washed properly and the sugars were obviously through the roof.

[quote DrBubble]@AlwaysMoreCoffee
Us GPs are nosy. We want to know you're problems! If she's worried about overburdening the GP in one appointment then booking a double appointment means she can talk about more issues[/quote]
DrBubble I am very grateful for your answers on here, and you seem fabulous - but what it's underlined for me is the difference between having a woman GP and a male GP.

My male GP is uninterested to the point of dismissal. He "doesn't believe", for example, in Long Covid. The other GP at the surgery is even worse, and treats all middle-aged women like they are automatically wasting his valuable time (I know friends registered there). The idea of either of them being "nosy" about my health or wellbeing is laughable.

(When I joined the surgery there was a fantastic woman doctor who, sadly, retired.)

wrt your reply to DeeplyMovingExperience

Thankfully I haven't personally seen this phenomenon of women being overlooked by the Drs I trained and work with

Do you audit to check? How long endometriosis, an inflammatory/auto-immune arthritis or auto-immune illness takes to be identified? Or the various CVD?

Backfired a lil by creating a dependent society - why bother to take responsibility for your health when the NHS is there to fix it for free?

Do you honestly think people willing develop painful or debilitating illnesses because the can get treatment for free?

You said you haven't noticed women being treated differently from men by doctors. Have you seen fat people treated differently?

I’m not sure how to frame this, but I’ll try!
My experience of both NHS and private is the attitude and even language used by private health care towards clients is so much more polite and professional. I understand thats partly because it’s a bought service. What I don’t understand is why (some) NHS staff feel they can be so rude to patients and other staff at times, and it’s so culturally unacceptable to challenge this. I’ve got up and left a consultants appointment before because of the way he spoke to me, being very clear I’d not be spoken to in that way, and the nurse in the room followed me out and said well done, she wished more people stood up to him. (It was after a MC and he was awful). Many more examples over years of using various services. (Tons of examples of amazing care too, obviously).
I wouldn’t put up with bad service in other areas of my life, but because the NHS is nationalised somehow the standards shift, and patients are seen as owing or something, rather than receiving a service that should be professional and polite, and is after all also paid for by taxes.
I’m not NHS bashing, not at all, I just don’t understand why internally this sort of practice or culture is allowed. It’s obviously endemic throughout the NHS, more so in hospitals than GPs I’d guess. I don’t know if it’s also reflected in the way levels of the organisation treat each other?
I have trained in organisational dynamics as a therapist, and the nhs fascinates me in this way. Such entangled historic dynamics and hierarchies. I think it must be a confusing organisation to be part of.