Does anyone feel like when you see a GP their job is to disprove anything is wrong rather than investigate what is happening? I just wonder if this is the case in other health services?

[Whyjustwhy123]

I’ve not had to see a GP for years, but in the last couple of months has to see them twice. The first time for an injury and the second time for a reaction to medication that was given for the first visit.

Both times I’ve given my symptoms and rather than any tests to investigate what may be causing the issues or blood tests to check something I was just offered strong painkillers.

It very much feels like rather than my symptoms dictating what conversation we had but the GP very early on in the appointment haven decided what the issue is. Then followed up at both appointments, but if this changes go to A&E or call 999. And I’m thinking surely it would make sense to treat me properly at this point and avoid a trip to A&E.

Im not wanting to ‘bash’ GPs and I suspect my experience is the result of the pressures on them. But both times I came away feeling like I had been mistaken in having to see them. And despite this neither issue has been resolved!

@PatchworkDonkey is this what we’re excepting?

This is what I mean. How come we’re just accepting it? How come I can’t say you know what for this injury I know (easy to find out) that a X-ray would help in defining treatment.

Also a simple blood test would confirm the issue with the medication.

But I am unreasonable for suggesting that rather than do these things it’s ok to just go for the GP guess work.

Meanwhile I’ve been in pain for 6 weeks and felt shit all week.

But it’s ok because I’ve been offered cocodermol

You're not wrong. Gold standard would be to use whatever diagnostic tools were necessary to establish the exact nature and severity of the injury then provide the best treatment for the fullest and fastest recovery, but that costs so they go with "best guess" diagnosis and conservative "wait and see" treatment.

Are we accepting it? Yes because it's all that's on offer and most of us aren't upto a fight for anything else. Also you can't get blood out of a stone. The NHS is fucked

The majority of the clinical decision making is done during taking the history. Clinical exam helps support/rule out your differential diagnosis with investigations to support.
Non clinicians tend to devalue the history and increase value of investigations when the converse is true.

Yes. 5 years I got fobbed off. A sense of weary boredom about my symptoms.
Thankfully I then saw an optician who realised I had Myasthenia Gravis. The key "tell" being very visible ptosis (eyelid droop). Looking back through photos I had it throughout those 5 years. Yet they didn't really look at my face did they, just at their computer screen.

I am sure it is partly a lack of time. But I think it is also a tendency to leap to quick judgements that people (especially women) are just complaining with no real foundation.

I have two friends who both spent years going backwards and forwards to GPs before finally being diagnosed with coeliac.

And yet in my case an X-ray would allow me to go to the next stage of treatment, instead I’ve waited for 5 weeks for a physio appointment, and exercises that are not working.

In another country I would have had the X-ray and the treatment bu now. But somehow we’ve been sold a lie that this is good practice. I’m starting to believe that GPS in the NHS actually believe that this is correct when it is not the practice elsewhere!

I’m not saying what it is because it’s identifiable to people I know are on MN and I’ve moaned about this 🤣

Our surgery has the interesting new approach where the receptionist asks you your symptoms. They then decide whether you need to see a doctor. You are also asked to see a pharmacist first, which is even more interesting. Do pharmacists diagnose now? Sorry to say, not only do doctors seem reluctant to treat, they seem reluctant to see you in the first place!

But have you considered that you’ve been sold a lie that other countries which over investigate symptoms (which generates income) are better for patient care on a population basis, than those which focus on history taking, clinical examination and prudent and evidence based use of investigations?
This is a health care cultural question not one specifically about your symptoms/condition OP.

Are you seriously telling me that the NHS at this point in time has it ‘right’ compared to other countries???? I’m not buying that any GP today believes they are providing the best care to their patients.

Also @MyDecadent70sArmpits are you telling me it’s ok that I’m in pain and have been for the last 6 weeks and that to try to even see a GP is an impossible task?

You are correct OP ime. I'm still waiting for blood tests ordered 15 months ago by a consultant. My severe rheumatoid arthritis is being left untreated with no care plan in place. I requested x-rays (which don't only show broken bones btw) which show dislocated toes and degenerative damage in every joint. Despite asking the GP outright what the plan is ,very politely, no answer has been forthcoming. It's taken years to even get an opioid based painkiller prescribed as I am allergic to anti inflammatories. I have also had the non appearing telephone consultation frustration, the ringing my number once then hanging up trick etc. Good luck with your recovery, I don't think it's fair that a person already feeling rough gets treated with disdain. We.just get dismissed as tedious menopausal women quite often, with nothing better to do than become hypochondriacs

I think they are doing this ( if they are doing it ) because middle aged people have usually a lot of general health issues, like hormonal changes, inner organ mild didsfunctions which produce aches but are not life threatening, joints aches, muscles and nerves aches which can present as heart ache also. But what they do not tell the general public is , that one need to be aware of this and not panick but go to Hollands and Barrett and buys herbal painkillers

When a higyenist made a mistake and left me with 24/7 pain and ache , everybody from the NHS laughed me off and left me without any help. The dental practice ignored me, the hospital doctor i visited laughed me off asking why i am there and we works with oral cancers, i kept asking what to do and how to medicate it. - to this day i dislike the NHS because of this.

went to the local Boots and the ladies showed me at least 5 options which immediately relieved the issue

I think anyone with a long term health condition might agree. I find you have to fight for every little thing. I've been asking for HRT for about 8 years. It's only because a consultant I see for something else has suggested it might help my symptoms that it's now being considered. I have osteoarthritis. I only know because I paid for a private scan as GP attitude was, well the treatment is the same regardless. It makes a difference to whether I can get help at work, with PIP, how I plan my future, what vitamins I take. If they dealt with a problem instead of fobbing off, they'd have loads more appointments, as you wouldn't have to keep coming back for the same thing.

@Blackbyrd what you’ve described is similar to my situation and I know that I could be in this position for months. And in that time I’ll go from an active 40 something to an unfit 40 something. It’s utter madness.

Nope, I’m not telling you that.
Reread my first post.

went to the local Boots and the ladies showed me at least 5 options which immediately relieved the issue

If OTC medicine was all that was needed, perhaps the GP felt you were wasting their time.

yes and like Stabee, this is why i moved all my and family healthcare into the private sector, exlcusively.

Your first posts suggests that when the GP took my history they then made the best plan?

Genuine question not being goody at all. Are you telling me the all GP clinical decisions are made purely on clinical decisions and the state of the NHS makes no difference? Are you telling me that in other health systems they would be making the exact same decisions?

Definitely not my experience recently, my GP and the rest of the NHS has been beyond amazing about breast changes.

GP said she couldn't feel anything, but trusted my judgement that I felt they'd changed. So referred me and also booked in some blood tests to make sure all basis were covered.

Seen by GP within 48 hour of e-consult form and then the breast clinic within a week. Weirdly seeing the nurse for a blood test was the thing I had to wait 3-4 weeks for!

I've not been to mine for several years now but when I did go I constantly got fobbed and told things would somehow magically resolve on their own (despite having symptoms for several years). He would also contradict himself from appointment to appointment and had a woeful knowledge of even quite common medications. All the time it was excuses not to treat me and not to do any investigations.

Now I can't get an appointment so am now going to a private GP. I'm fortunate to be able to afford it, but it really shouldn't be like this.

OP, if you thought you needed an xray, why did you see a GP and not go to A&E or a walk in / minor injuries clinic with xray capability?

What is the issue with the medication? Why would a blood test assist you with that?

@PinkFootstool it is not an accident or an emergency! It’s a chronic condition.

I have no idea if your GP, after they took your history, made the best plan, because a thread on mumsnet written in hindsight is never going to accurately represent what was asked, answered, observed, examined or discussed during that consultation.

Yes the current state of the NHS makes a difference. I know this because both my husband and I work for it. Does the state of the NHS change my opinion that (good) history taking, followed by a clinical examination is far more important to reaching an accurate diagnosis than than investigations do? No.

No, of course other health care systems won’t be making the same decisions. Health care is financially and politically driven just as with all other things. Good and bad aspects in all systems. It would be wrong to assume more investigations = better though.