To wonder how many times GPs get it wrong, and risk someones life? for the sake of funds??

[lisad123]

Had a call from friend earlier today to say another friend of ours has a tumor on her spine. GP has fobbed her off for ages :(
Same happened with dh, and my gp misdiagonised gallstones and sadly i ended up very unwell.
DD2 we were told had a virus but instead she had pnemonia, and so spent a week in hospital.

Cancer seems to be the thing they miss most often, especially if you dont fit target age ect.
I always feel GPs dont refer or do tests because of funding and people are dying, getting very unwell because of it.

Reading through this thread makes me very grateful for my GP, he's kind and considerate and has helped me through gynae problems and spotted signs of a post miscarriage infection before I did so that I was left with no after effects.

Similarly DP has diagnosed with diabetes after going to see GP with an ear infection and has received great care levels from his GP practise for managing that.

It's awful reading of the problems people have had with getting diagnosis and referrals.

If there's a shortage of GPs, then it's not just understandable but heroic that they cover the hours.

But if there's not, then having the doors open for a long time or doing a lot of paperwork is a red herring. The open doors can be covered by staggered shifts, the paperwork and indeed reading time can be part of the scheduled hours, just as for other jobs.

I suspect that in London, for example, there is real pressure on total numbers of GPs. But where I live I don't think that's true ? unless there's a national shortage.

It's not heroic, they get very well compensated! Most GP's are earning more than 100 grand a year plus. I don't doubt they work very hard, many of them, but in all professions the demands of paperwork have massively increased our hours (lecturers, social workers, teachers). Most GP's do not do night-work at all now, and regular days in surgery even if they are long.

I am not saying they don't deserve it, just that their heroism is really just good work for very good pay and shouldn't be characterised as anything else (IMO).

It doesn't really work out at that high an hourly rate though when you take into account the amount of training and amount of responsibility they have.

Am I unreasonable ? to wonder how often GPs get it right? and save lives? inspite of funding issues?

Sometimes I'm sure it is heroic ? someone forcing themselves to do a heavy workload because if they don't do it, it won't get done. And being paid a lot is not a straight swap for not getting enough sleep or downtime.

But I wonder if that's always the case, or if sometimes it's structural ? the job has just been set up in such a way that long hours are the norm, as a hangover from hospital habits, or the image of the heroic lone doctor going out in the night.

If there's any of the latter going on, it's really not to the benefit of either the doctor or patient.

And BTW I will happily man the barricades to defend the NHS (or be built into one, which seems a better use of my proneness to proneness).

Our family GP is excellent very thorough and gives you time to talk. He also is not patronizing and explains things (and even admits he doesn't know everything!).
My late DMiL however had a TERRIBLE GP who missed all the signs of ovarian cancer and it was sadly too late when she was referred. He even then told her (despite her having chemotherapy etc) that in HIS opinion they'd got it wrong and it wasnt cancer. She sadly died within 6 months.
There are bad practitioners in every profession but not many are playing god with people's lives- if it isn't incompetence and purely a drive to save money then - well words fail me.
Maybe we should do as they do in France and refer for everything starting with the worst case scenario and work back.

GPs are self-employed.
We are independent contractors; we have a contract with the government to provide General Medical Services (well, most of us do; there are some exceptions).

Tianc, I think you are right, some of the long hours are 'traditional'. Were I work and live, people still talk about a local GP who was available all hours, sometimes falling asleep in people's lounges on her way out, only to be found by them in the morning!
She clearly was an exeptional individual who dedicated her entire life to her profession.
However - she also worked in a time when if you had a stroke or heartattack, you either lived or died: there was not much anybody could do to actually change the outcome.
People remembered a time when they had to pay to see a dr and were conscious of the resource they had with free healthcare. People would NOT call the dr in the middle of the night to, say, certify a death as they were aware of long hours etc.
I stopped doing OOH work because I got to the point were I thought I would struggle to remain professional with the next person needing their pill prescribed at 3 am, or get abusive ("I know where you live, you fucking cunt"), or look to have complex problems sorted out for which multiple agencies and normal hours were required. I could go on at tedious length.
OTOH, you got people who apologised to 'waste your time, dr' who had perfectly genuine reasons for attending.

My practice is open 8am to 6pm, practice manager usually arrives after 7am to get the computer system fired up and check for OOH faxes.
Of course long days could be covered by some kind of shift system, however that would required MORE doctors, would involve LESS continuity. We are contracted to be open the above hours.
Having OOH done as a seperate service (for which we pay approx 35000£/year) was a desperate carrot offered to GPs before 2004 (when the New Contract started) to avoid even more of a recruiting problem there is anyway.

By earn good money, I am not looking for more, but would you please, please stop with the 'most GPs earn more than 100000£' - there is a minority that might, I certainly don't, nowhere near and am fed up hearing about how greedy we all are

I have a mixture of experiences too.

My most recent was upsetting, unfortunately, as they wouldn't refer DD even though I knew something was wrong. I kept taking her back and they kept fobbing me off with different, minor reasons (say 'they' as there were 4 different doctors seen 5 times). In the end, I was that worried that I took her to A&E and started a hospital process myself. But even they kept sending me away and put me on a waiting list for tests. It wasn't until 3 months later that her symptoms became more complicated and she was admitted by children's medicine that they finally found out she has leukaemia.

That was a fluke as they weren't looking for it!

I find, even now, that doctors are quick to dismiss parental concern. But I've also seen, through my countless hours in A&E, many families who do make giant fusses about nothing and take up everybody's time. It must be difficult to call and I appreciate that.

I still feel - nearly 10 months down the line into chemotherapy - that I am having a continual fight to be heard. Other parents of cancer patients I speak to feel the same. And I'm writing this from the teenage cancer unit as DD has been admitted again today with symptoms they can't explain.

I just wish we weren't here. But I certainly agree, and think YANBU to think some GPs are reluctant to refer. And reluctance to listen, in my experience, goes beyond the GP surgery.

I've just seen it's you lisad who is the op; am I right that your DH has had a similar experience to DD? I think we've spoken before.

In fairness though, I was told many GPs work their entire career without seeing a case of leukaemia in a child. The symptoms are symptoms of many things. I just didn't feel like they were listening to me when I said I knew it was serious. But that isn't just GPs, and some of the doctors and GPs I've met have been rather amazing.

Continuity would be a good argument for long hours even where there is no staff shortage.

But it's clear that continuity is not considered an issue by the many, many surgeries with the "any doctor, never the same one twice" appointments system.

More doctors is precisely what I'm suggesting. I may be very wrong, but I'd assumed the contract to the govt was as a practice, not as an individual doctor ? otherwise how do partnerships work and receptionists and locums get paid? So the practice needs to decide its staffing levels for GPs just as it does for admin staff.

If the practice is then choosing to employ essentially too few GPs, it's entirely valid to ask why, and what impact this has both on the patients and staff.

(Obviously in a genuine shortage situation, the practice isn't making an active choice to under-recruit.)

PacificDogwood, I'm sorry btw. You engage on here, so get the brunt of what people are saying about general issues.

When this government with your help has destroyed the NHS and dismantled GP you will realise what a wonderful thing you had that you will never get back. And you will truly deserve the shit they replace it with.

It must be lovely, macdoodle, to have never been treated with disdain or apathy by the people in charge of your medical care and to believe that all GPs should be placed on a pedestal as a 'wonderful thing'. I apologise if I'm mistaken and you still hold them in high regard after your GP repeatedly turned you away when your daughter had cancer and you were begging them to do something... oh wait, that was me.

I do think the NHS is a wonderful thing; I have said that in my previous post. I have had some amazing doctors. But in every profession you get people who are good at their jobs and who give a shit, and people who don't. That would be the same whether NHS or private.

I don't think people should be expected to live with a system which isn't working properly - possibly because of the issues Tianc raises - just because they're told that anything different will be much, much worse. There is too much at stake. And it's not responsible citizenship.

In other sectors of society, problems are analysed and some improvement is usually possible.

I think Tianc's questions are interesting. Schools are certainly churning out countless wannabe doctors; tons must be qualifying as we speak. There's no shortage of demand for med school places, quite the reverse.

The system works, the alternatives will undoubtedly be worse. I wonder if a single person in this thread has any experience of another primary care service.
I do. I have been an NHS GP for 10 years. I trained in a 3rd world country and have worked with systems all over the world including the USA and Europe.
You will sow what you reap and be truly sorry sadly. I am saddened to be witness to the death of GP in the NHS.

I think the most serious point of the - let's be charitable and call it 'variability' - in the abilities of GPs is that there is no clear mechanism for complaint. Like others here, my family has had a series of bad experiences with bad GPs. One was almost killed. And yet they have all been either reluctant to complain, in the case of the older members who would never question a doctor, or they don't know how to complain. The 'Harold Shipman Syndrome' If the NHS reforms mean that GPs will have more power than they do then we can't afford to have shoddy doctors running the show. And I don't even think funding is the problem.

I'd like to see league tables of GP performance, star rating systems Amazon or TripAdvisor-style from patients & feedback actively encouraged. Above all, it is essential that we have clear & simple methods (not law-suits), for patients to register complaints if they've had bad service and that those complaints are seriously followed up.

It's clear that atm it's a terrible idea to make any kind of complaint to your GP surgery.

The defensiveness on this thread is a good illustration of precisely that.

There are very clear protocols and pathways to complain. To say otherwise is pure ignorance. Unfortunately doctors are not computers and the good ones are leaving the country in droves.
Doctors are also not books or hotels

One member of my family that has had particularly bad experiences with serious misdiagnoses, wrong medication and so forth will not say anything because she fears being struck off the GP's list. That's just not right.

So how do you complain about your doctor? Where do you start?

I thought this thread was about Grandparents risking their Grandchidren's lives...

I don't know, I think GP's are as their names suggest - GENERAL practioners. They don't know all the ins and out of every type of illness.

My Dad's illness was diagnosed by a GP after about 2 years of him complaining about his back and shoulder ache.

My GP diagnosed my illness after the second visit with a simple blood test.

I am sure for every person who doesn't get the correct treatment from a GP, there are many others who do. The GP's I have had in the past, have been brilliant, and do exceptional jobs.

It's not a terrible idea to complain to your surgery if something has gone wrong. In fact it is the best way to ensure that any incident is investigated and any remedial action is taken to avoid a recurrence.

If people are being defensive on this thread it is because of the sweeping generalisations and the blaming all for the actions of the few. It is certainly what has made me uncomfortable.

In the first instance you would conplain to the practice manager and they are obliged to acknowledge your conplaint then follow up with a full reply once investigated.

If you are not happy with the outcome you can escalate your complaint. In Scotland I think you would go through the local Health Board. Then there is obviously the GMC.