How do you reply to this question?

[ormirian]

I rang the GP yesterday to make an appointment. Was asked if it was an emergency - as i was not in danger on imminent death I said no. So the receptionist arranged for a doctor to ring me back. Doctor rang me back, asked a few question and then said;

"What exactly were you hoping to get from us today?"

Not sarcastically, not rudely, not whilst (I don't think) rolling her eyes, jsut in a matter of fact sort of way. I didn't know what to say apart from 'I am in a lot of pain. I would like some help finding out what is wrong and stopping it'.

What answer was she expecting? Am I unreasonable to be a bit confused by this question? Is it a new sort of NHS corporate speak ? Or was she genuinely unsure of her purpose?

I was asked this by my gp when I took ds with a recurring condition. I replied that I'd like a referral back to the paediatrician that we saw a couple of months previously. Gp obliged. We were all happy (and ds is fine now).

This is shared decision making. it's good practice. There are always options in treatment- OK maybe not if you are having an MI, but for everything else.

Eg " doc I've god a cold and a fever"
doc "what are you hoping I can do for you today" (given that you know and I know it's all viral)
You "well I can't miss a day of work I need as many drugs and as strong as you have to keep me going" OR "well it's really busy at work, I think it's making it worse and I risk infecting my work mates, can't I have a sick note for a couple of days to rest up and get better"

Both equally valid choices- well as long as you aren't always wanting a couple of days off work...but it's your choice the doc can't mind read!

I think my gp might need retraining then.

Last time I went with a pain issue (and it's not like it's been investigated or I'm in there every week. I got kicked off the register because I hadn't been for so long) he said, quite sarkily imo, well what do you want me to do about it?

Proper put my back up and I've not been back since because I feel like a time waster. I'm moving soon and plan to try with a new surgery to get to the bottom of it, but it's shit if that's down to someone with crap social skills interpreting some sort of policy.

I think it's a good thing. If (for ex) you go in with an ear infection for which you want anti-b's, then they can just give you a scrip and send you on your way ASAP.

As a doctor, I want to know your (apologies for the buzzword but this is what it is called!) ICE.

Ideas: "I think I have cancer" - either I can reassure you or agree that we need some tests to exclude it

Concerns: Lots of men in my diabetes clinic are concerned about erectlle dysfunction but don't want to mention it

Expectations: Nice example from tiredtomybones. She wanted referred to a paediatrician.

Now I am not going to laboriously ask you, "What are your ideas, concerns and expectations today?" but I might ask something like, "What are you hoping to get out of today's appointment?", "What's your biggest worry about this?" or something like that. It flows better in an actual conversation!

My GP practice has started asking this sort of question. I saw a new doctor the other day . I explained my problem and he said "what do you want from me then?" . I replied "I want to stop feeling this way" to which he replied " how can I make that happen?" I felt like a nuisance to him, his tone was awful, almost robotic . I came out feeling worse than when I went in.

I've also found my dr has started to ask this type of question. I see my dr once a month about an on going illness and she always asks me if there's anything else she can do to help, if I'm happy with medication, what i think about what shes advising etc.

it's so much better than how it used to be.

Thanks all

Yes I got an appointment. I am wondering though if someone was a little lacking in confidence and not at all sure they really needed help, or didn't think their condition was important enough to bother anyone, they might have been put off at that point. It did sound a bit like ' what on earth did you expect us to do about it?' But I am sure it wasn't.

I did wonder if it was a cut to the chase question - ie 'look, do you want time off work ?'. She did ask me about my job and how my injury would affect it.

Not sure if this is quite what I'd want to be asked by someone who is supposed to be better qualified in medicine than I am.

Okay, if I go to my GP with my right leg in my hand I've got a pretty good idea that I'm there because my leg has dropped off, which would be obvious to anyone. However, if I'm there because I have an unidentified pain being asked by the doctor what I think it is or what I want to happen is pointless. I've got a pain, I've described my symptoms, it's up to the doctor to diagnose what is causing the pain and then take the appropriate action. And asking if the doctors take on it ties in with what you've self diagnosed from the internet, as someone said up thread, is pretty patronising imo.

What I think most of us would like when dealing with our GPs is an appointment as quickly as possible and, if necessary, a referral to a specialist within a reasonable period of time.

They ask these pointless questions as a way of making us think we are being listened to when in fact the NHS is falling apart and nobody gives a damn what we think.

I believe it is quite a common question, since most people now attend appointment with a specific expectation, i.e. wanting antibiotics, a specific medication or procedure, or a referral.
It's just a way to work out the best way to help the patient.

I was asked this when I took DS1 with viral wheezing. The Dr said "What do you expect me to do?" - I felt he was laying a trap for me to ask for anti-bs so he could tell me off. I asked for something to stop the wheezing.

its about finding out what your agenda-/expectations are.
for example, when i spoke tothe doctor on the phone, i had a broken bone in a cast etc etc but my main problem at tohat moment in time was the horrendous bloating and gas i had post general anesthetic that wouldnt let me sleep. had she just gone by what was on her screen, instead of asking the patient, then she wouldnt be giving good care.

I would just have said 'an appointment'.

I was quite impressed by how quickly everything moved when I went to the doctor and said 'I think I have DVT'.

Saw the doctor the following day (a Saturday!), into hospital for tests and scans on the Tuesday with treatment started immediately.

The system worked! I am amazed and grateful.

I think "Is it an emergency?" is the wrong question. "Is it something you need to see a doctor today about, or can we make an appointment next week...?" is the sort of question they should ask.

If it was an emergency, you'd be going to A and E.

People aren't always/often that sensible, Katnip. Also, an 'emergency' GP appt isn't the same as a life-threatening emergency situation, so if asked by a GP if the situation was an 'emergency', it would cover different situations from what a 999 operator would consider an emergency.

I'm a GP - sometimes use that question to find out what a patient's expectations are - if they are keen for a scan or something then I can address it - not always clear on the phone if someone wants to be seen or would be happy for phone advice and you can waste a lot of time trying to advise on the phone if they definitely want to be seen.

But then aren't you favouring the pushy patient? I wouldn't ask for a scan - I'd expect the GP to have the expertise to decide whether it was necessary. I didn't realise that in order to get a scan, antibiotics, consultant appointment etc - one has to be upfront and ask for it

I think you do have to be pushy I'm afraid. It's the same with everything in life- if you don't ask you often don't get. I do think its important people speak their minds- it's their health after all.

I've always taught my DDs- who have just gone to uni, to say what they are concerned about, what they've already done to help it, then what they'd like the dr to do.(tests, medication, just listen to chest etc)

Unfortunately people who are ill are less likely to have the ability to be pushy.

I think this is good practice.

I have a kidney condition and have had surgeries for it which most GP don't seem to have heard of (which is fair enough as they are not urologists!).

Last time I went to my GP with pain he asked me what I thought was causing it. This is an important question because I tend to present atypically when I have a UTI so I was fairly sure it wasn't that, but there are some other factors which often lead to me being in pain. I also know what scans I am due to have soon, and when I will next be seeing the surgeon etc.

So my GP could have sent me for a blood test but didn't because I told him I was going to see the surgeon next week and normally sends me to phlebotomy on the way out, so it would have been pointless, but I did want some painkillers as I haven't been sleeping.

Bit involved, that, but does give a sense of why it is useful for a GP to ask.

Also if you don't know what you want, surely just say, I am in pain and don't know why and I want it fixed. Then the dr can give a recommendation. Not hard!

hun - that is particularly true when the problem is mental rather than physical. I have been depressed before now and if I was faced with 'what exactly do you expect' I'd have apologised, put the phone down and gone to find a nice quite corner to curl up in.

I just don't think it's a helpful approach. Even if the doctor had simply said 'would you feel better having someone examine your knee' would have been better than that open-ended phraseology. Once I had been seen, and a diagnosis was made and treatment given or offered it might be the time to say 'are you happy with that?' or 'do you want me to do anything else'.

I'm not convinced by encouraging people to dictate what they want/expect.

My pain is abdominal - could be gynae, bowel, bladder. Do I need a scan or blood tests as a starting point????

Point is, I'm not the dr, and in my scenario above I felt overwhelmed and defensive of my need to have even walked through the door.

Though I see the logic of being able to say I've had a cough for three weeks and national campaign advice is to see you to check my chest.

I suppose that's the difference between a talented gp and a bad one - the ability to know which situation requires which approach.

Ahh revolting, I agree with that. I am an athsmatic and my condition eases and worsens as times goes by. if the GP had asked me what I felt might have caused it to get worse I would have been able to contribute. Ditto with my depression - I more or less manage my own meds now with annual reviews from the doc. In that case it would be perfectly reasonable to ask for my input.

From my recent experience I would have to say that if you think you may have something serious then you do need to say what you think it is. I am fairly sure that if I had gone to my doctor saying I had an aching knee then I wouldnt have been diagnosed with DVT.