I'm a GP AMA

[DrBubble]

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

What is your honest opinion of patients who don’t want to have medical students present at their consultation?
I’ve got an “extremely rare” condition and every time I go to the GP, if there’s a medical student in the building, they ask if the student can be present at the consultation. I’ve even had phone calls from the GP asking me to go in (when there’s nothing wrong!}, as they have medical students that week and want to know if they’d be able to diagnose me. Is this common practice?
I have a good relationship with my GP and don’t really mind, but it does get a bit tedious.

Many thanks

Hi Dr Bubble

Regarding F2F appointments, the GPs I’ve seen usually tried to usher me in and out in less than five minutes. Are GPs happy with this system, or do they wish they could spend more time with patients?

Also, (in pre-Covid days), did your schedule rely on some patients being no shows?

What happens in your practice when a patient is diagnosed with a serious illness, say cancer, yet there were missed symptoms and their gp could have picked it up sooner? Do they get a telling off? Are they allowed to apologise to the patient or is there a policy against this?

@DrBubble

why bother to take responsibility for your health when the NHS is there to fix it for free?

I'm sorry, this is a great thread, but I couldn't let this remark of yours go by without comment! I'm all for taking as much responsibility as we can for our own health, but really? The NHS is not free. It is not a charity. We all pay for it. I'm very thankful for the health system we have, whilst being very conscious of the huge inefficiencies and vast room for improvement, but the sooner we stop thinking about the NHS as philanthropic set-up which is providing health care to us for free, the better. Yes, it needs to be more efficient, and yes, we need to be more mindful of what we can do to help ourselves, but that's because it's our money that's often being wasted. I would fight to the last for the principle of health care which is free at the point of delivery, but it never has been 'free'.

How do you feel about large American companies taking over (buying) GP services?
Thank you, this a great thread.

Why do you all take “lunch” at the same time and therefore have to effectively close the surgery at a time when most people would be available for appointments?

Why don’t you stagger the couple of hours you all need for the tasks you describe, so the surgery can stay open and always have cover?

Sorry, I've got some more: What do you think of the advice "Just take some paracetamol and come back if it's not better in three weeks"?
As someone who only goes to the GP if I have to and only if I have exploited all other options, I find that really patronising.

What can I do so my GP doesn't always "makes up" time with my appointments? I seem to be in and out in five minutes tops. The worst experience was when I went in because I was concerned I had osteo-arthritis. Dr. took one look at my hands, said "Yes, you have it, nothing we can do" and I was out the door again.

Do you think access to specialists would work a little better if they had their own practices rather than working in hospitals?

@NoMackerelInSwindon

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.

Are you serious? It's a piece of fruit, not a magic wand. Vitamin C is good for you. Apples contain some, but not the most. They don't contain woo health.

Be honest - are there conditions in the NHS that you have to just say " oh it's your age " or "there isn't much we can do for that " when that decision is financially driven ? To give you two examples - lower back pain which was cleared up by a chiropractor privately and an anal condition which was rectified privately .

Do you have a favourite type of patient?

Do people with health anxiety annoy you? Do you think they waste your time?

@GreenWillow

Why do you all take “lunch” at the same time and therefore have to effectively close the surgery at a time when most people would be available for appointments?

Why don’t you stagger the couple of hours you all need for the tasks you describe, so the surgery can stay open and always have cover?

Not the OP but - where I work they all take their lunch at the same time as this is when they do the home visits and process blood test results and so on ready for patients to phone in for them from 2pm onwards. They do it at the same time so they can deal with any business involving talking to other GPs, sharing opinions, having meetings, dealing with any queries that have been left that need attention the same day.

@rabbitholes

Literally no company in the private sector does this though, and we all manage.

The absence of any form of competition has led to this, and it is pretty poor when you consider how much we pay to have an NHS. Regular use of letters/faxes just don’t happen when you operate in a competitive market.

I do kind of agree with a pp that GPS don’t afford patients the same courtesies that they expect from us.

That said, my (named) GP is ace, and is as frustrated by this system as I am.

I'm not going to pull any punches here. Why are GPs so bad at diagnosing and treating chronic illness? I know so many people with thyroid problems who are clearly underactive, yet they are constantly being fobbed off by GPs who tell them they are 'fine' and their labs are 'normal' - when the labs are NOT normal because the ranges that have been set cover 95% of the population and aren't narrow enough. Why do GPs insist 'there must be something else wrong with you' and are only too happy to hand out anti-depressants instead of actually digging further to find out what's really wrong? There are so many of us fuming about this, very angry indeed. Lives are being ruined by inadequate treatment. I won't even get on to chronic fatigue.

I love the telephone consultation system and hope it continues. I am immunosuppressed and hate having to go and hang around in the waiting room. The last time I got an opportunistic infection I had to make an appointment, sit in the waiting room for 40 minutes, just to get the antibiotics I needed (written clearly on the laboratory results paperwork).

Whilst there I picked up another bug and 48 hours later I was so ill I was really scared.

Being able to have telephone consultations with my GP and my consultant has been brilliant and my health has actually improved.

I have also felt that the doctor has had more time to talk and listen with the telephone appointments.

Do you anticipate using this system going forward?

[quote GreenWillow]@rabbitholes

Literally no company in the private sector does this though, and we all manage.

The absence of any form of competition has led to this, and it is pretty poor when you consider how much we pay to have an NHS. Regular use of letters/faxes just don’t happen when you operate in a competitive market.

I do kind of agree with a pp that GPS don’t afford patients the same courtesies that they expect from us.

That said, my (named) GP is ace, and is as frustrated by this system as I am.[/quote]
Companies in the private sector aren't GPs though are they? They have all day to make their phone calls and deal with admin whereas people like GPs, medics, teachers have to fit this in in between sessions - when else are they supposed to do it?

@AntoinetteCoswayLives

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

I'd like to know this as well. I find it shocking that something that 50% of the population goes through and that causes so many to suffer to the extent of considering giving up their careers is treated so dismissively and that knowledge is often completely out of date.

How do so many people with a lack of common courtesy, interpersonal skills, or ethics, manage to:

1. Qualify as doctors / pass medical school?
2. Manage to stay in the profession without being struck off or held accountable?

The 1st, I can understand, as its difficult to weed out the bad apples upon entry to medical school.

But the number of doctors who are still practising that shouldn't in a customer facing role, let alone near an actual patient is ridiculous.

I can say this both as a patient, who as an adult has only needed consultation with doctors on 2 occasions, and had bad experiences both times. And also as someone who used to know 2 doctors that are nasty individuals.

On both occasions I was treated horribly / with no common courtesy. I have no doubt that both doctors were technically very intelligent...but they were bad human beings.

I dont mean any offence with this, as I also know 3 doctors that are my friends who are great and really want to help others. (I went to medical school).

But it seems to me that doctors are not holding colleagues to account for treating patients with dignity or respect.

Hi.
Healrhwise - Are older women given a rougher deal than older men?

Women have to jump through various hoops to get HRT
A woman then has to jump through even more hoops to remain on it, despite hrt's proven protective qualities such as good mental health, strinf heart and bones and now even some protection against covid.
Men in the other hand have no problem being prescribed Viagra. There is no age limit and they can even buy it over the counter Despite there also being a list of warnings and dangers as long as your arm!
Do you think this is fair?
Also on the subject of hrt, do Gp's keep upptodate with the current thinking on HRT.
Which is that. .....unless there is a history of breast cancer, the pros outweigh the cons

@rabbitholes

Nobody’s suggesting they don’t take those hours, just that they are staggered during the day, so that patients can be seen all day long.

This idea of 2 x fixed hours clinics, one morning, one afternoon clearly isn’t delivering patient value, so needs to be changed.

This is how we all work in the real world, but in the absence of any competitive pressure, GPs get away with it and the taxpayer gets short changed.

Interesting thread. Can you tell me how you get noticed by your surgery? Mine seems to have a secret list that fast tracks you an appointment- dh and dc can always be ‘fitted in’ within 48 hrs whereas I struggle to get one within 3 weeks (no- one has a serious underlying health condition). And what are the magic words I need to say to be taken seriously- my doctors appears to think that I am willing to wait 30mins on the phone to book an appointment, wait 3 weeks, take time off work just to waste his time with a minor complaint -last time I got sympathetic tutting and told me they were sure it was nothing and out the door within 5 mins - no tests, no diagnosis, no recommendations, no follow up. Whereas dh gets a whole pharmacy of medications, referrals, and invites to check ups. I’ve basically given up hope with my doctors and haven’t been in over 2 years and don’t intend to even bother them again as they clearly can’t be bothered with me. I literally have no trust in them at all (and I know how ridiculous that sounds).

I love the econsult service, I've a few things this year that I've not needed to see a doctor but needed advice on how to treat / refer. Things I'd have probably left to build up (and potentially make it worse) but a quick form and away it goes. Each time the doctor has come back with advice, meds, referral etc without me 'wasting' time.

Why do womens health issues not get taken seriously.
At 42 I went to my GP with heavy periods. I,m talking soaking through an ultra plus tampon and an always night pad in an hour and this continuing for the first 2 to 3 days of my period. I,m literally house bound for those 2 to 3 days. I couldnt see this being acceptable for men.
My GP's answer was "well some women get heavy periods and you will be getting your menopause soon anyway".
I,m 54 now and still haven't menopaused. This has affected my life and job for the last 12 years . Why wasn't ablation offered or even a gynae referral? After going back 4 to 5 times and getting no help I gave up.

I honestly think GP's need a women's health nurse specialist like they have with asthma and diabetes. There are so many issues around periods, contraception, endometriosis, thyroid and polycystic ovary disease which are poorly diagnosed, managed and treated that would have a huge impact on women's health and wellbeing but are totally overlooked.

@reesewithoutaspoon A specialist women's health nurse at the GP would be great, it took me 10 years and 4 GPs to finally get diagnosed with PCOS, another 8 for endo dx, and all I've ever been offered for either is hormonal contraception!

@reesewithoutaspoon - agree re a women’s health nurse; I was fifteen years for PCOS, ten for a bladder disorder and seventeen for probable endometriosis and confirmed adhesions with bladder and bowel involvement .

I have to take dihydrocodeine for period pain and get through a pack of pads a day at times; practice nurse told me to get a grip and get on with it .

No medication, no treatment, no support, no advice .