A question for GPs

[username38474371]

This is not in anyway to have a go at any GPs. I am very respectful of your profession and I can only imagine what a hard job it is sometimes. I do however have a question that has concerned me afew times recently. A few family members/ friends have had illness some very serious some not. In every single case the GP had sent them away assuming it was something else. The most serious case being told it was vertigo for months to finally find out it was stomach cancer.
I am not blaming the GPs i know they just go off the facts of what is in front of them and in a lot of cases they are right. My question is, however, why does it seem that everyone has to be misdiagnosed first. Why are test not carried out sooner. I think what concerns me the most is how long and often some people had to keep going to doctors before any proper tests were done. Is it down to NHS cuts? I have heard that doctors are encourage to reduce their referral rate this to me is alarming. Any opinions from the medical profession welcome.

This happened to a friend of mine. Given a medication for reflux. (Had refulx and diarrhea). Second time, more medication but also booked in for tests... Stomach cancer.

I assume its because the first diagnosis is the most likely given what he presented with, age etc. Chances are, theyd be right and they cant refer everyone for every possible eventuality. Thats why not improving on medication, further symptoms, or specific symptoms like losing weight for no good reason need follow up.

I believe there are rules on when you get referred. I had this last year, GP referred me, hospital turned me down based on not meeting "nice guidelines", but GP argued back as theyd made some error on the data and I did meet those guidelines.

Well speaking for myself, apparently it would have cost the NHS too much money to diagnose my now-confirmed condition before the age of 40. The irony is that prevention is better than cure with some of my symptoms so it’s now actually costing more.

Also because they are General practitioners I suppose, as opposed to specialists?

Process of elimination. Rule out the common / most likely / cheapest things to test for first

Using the stomach cancer example:

Reflux is incredibly common. Most people attending the GP with reflux symptoms will have reflux not stomach cancer.

The GP will have a list of red flag symptoms to look for that indicate it might be stomach cancer but on the first attendance, even a lot of people with stomach cancer won't have those.

So treating for reflux and saying come back if it isn't resolved is the correct treatment.

Only the people who aren't resolved will come back - they then merit a closer look. These will include the people with stomach cancer, who might also have developed some red flag symptoms as well, making it clear that they should have stomach cancer investigations.

Do that help?

Their diagnosis wasn't missed on the first appointment, they weren't misdiagnosed, they had a treatment and safety-netting and then went into a diagnostic pathway.

I've lost a grandfather and an aunt to this - by the time their symptoms were taken seriously their respective cancers were too far advanced to be halted.

I think the system in which GPs are responsible for thinking about funding is totally wrong. They should be referring anyone who needs it and someone else should be the funding gatekeeper. And someone needs to come out and admit they aren't interested in saving the lives of people of retirement age, if that's going to be the policy. It's appalling but better than lying surely.

Only the people who aren't resolved will come back

This would be kind of acceptable if it were true.

But many people don't return to the GP after being told their symptoms were indicative of an insignificant passing health issue.

GPs have become gatekeepers for the rest of the NHS. They give a strong impression that sticking to time restraints and budgets is their main priority rather than patient care. If that isn't the case then perhaps they should ask themselves why their are so many people suffering in silence after being fobbed off by a GP.

I don't think it's at all true that Only the people who aren't resolved will come back there's only so many times a person suffering can be told it's nothing before they give up asking.

*there are

Only the people who aren't resolved will come back - they then merit a closer look.

Not the ones who trust what their doctor tells them and believe that they must be imagining it, there isn't really a serious problem and they are wasting their GP's time.

My late aunt went to her GP multiple times and wasn't told "try this and come back if it doesn't work" - she was just told it was fine, and her symptoms were just one of those things. It was only when her usual GP was away and she saw a locum that she was referred, too late, for tests.

If I get a hint a doctor is bullshitting me, I won't go back to waste more of my time