To think I might just give up having a GP altogether?

[higgle]

I seldom need to visit my GP and when I do it is usually for some medication I could buy off the internet anyway.

I find the whole hassle of trying to get appointment, never being able to see "my" GP and the dark musty waiting room always staffed by a real dragon of a receptionist who has no idea of the concept of confidentiality a nightmare. The in house pharmacy never has either of the two things I've been prescribed in stock.

Now they have taken to pursuing me ( due to my advanced age) with patronising letters in large print about screening tests for things I know I haven't got or have made a conscious and informed decision I do not want. I can self refer for most things that might happen to me to the local BUPA hospital and if the need arises I suppose I could see another GP privately so I'm thinking of just asking to come off their list altogether and going without a GP - would that be a terrible thing to do?

As a one-time GP's Receptionist, I will try and answer your questions awsomer - although macdoodle may come back & answer them better!

1. They are Receptionists & there is training. Obviously not medical training - more just warnings signs to look out for (chest pain, shortness of breath etc.) However, the Receptionist is purely taking down information to pass on to the Nurse Practitioner or GP - they are not actually giving you a consultation & are not asking the questions to be nosey or to try & diagnose you. It just helps the Nurse Practitioner prioritise her list of call backs.

1. At some surgeries you can. However, quite some time ago (years I think) a new government thing came in saying that everyone had to be able to see a GP within 24 hours if they wanted to (may have been 48, but I think it was 24). This meant surgeries had to limit the amount of pre-bookable appointments in order to have enough availability for people needing to be seen on the day. In many surgeries, the pre-bookable appointments will be more or less exclusively taken up by returning patients (i.e. where the GP says "come back and see me in 2 weeks").

1. Most patients triaged by a Nurse Practitioner will not actually go on to require/have a GP's appointment. The Nurse Practitioners can usually prescribe nowadays & will only pass things they cannot deal with on to a GP. A Nurse Practitioner's time is cheaper than employing extra GPs.

I'm not saying it's a perfect system - but those are the reasons a triage system ran at the practices I worked for.

Salmo - I doubt very much whether macdoodle is rude or abrupt to her patients.

I always read her posts as a very overworked person fed up with constant criticism. She is just venting that frustration on here because it's an anonymous forum & she can't vent in real life (I think!).

onedream my best guess is that the other poster was not british and people took offence. Also they refused to disclose the exact reason why she didn't want to register with the NHS GP.

www.mumsnet.com/Talk/am_i_being_unreasonable/a2143051-AIBU-to-not-be-registered-with-a-GP

Thanks Santas that's really interesting. Although it still won't help me feel any better if I ever get a rash in an embarrassing place and have to tell the secretary, the nurse and then also go in and show a GP!

"Bun some people think that the risk associated with doing the tests are too high compare to the risks of the illness itself. Smear tests are a good example for that."

I thought that was more applicable to younger women.

I know someone who did the standard bowel cancer screening test and was diagnosed very early on, even before she had any symptoms. The treatment was not very invasive and she was soon given the all clear. I know this is anecdote and not scientific data, but IMO instances like that make for very valid reasons for doing this type of screening.

SantasLittleMonkeyButler my family and I wanted to actively deregister from our surgery as we wanted it known we were appalled with the service we had received on a number of occasions.
A surgery receives money for every patient registered, even if you never visit, and we did not want the surgery to receive the £240-£400 for our family. We are happy for another, competent, surgery to receive this money and will register with the surgery that runs the drop in we have used 5-10 times in the last 5 years with no problems whatsoever.

It's not the test itself that us an issue. It's the factorial a lot if people are treated for 'what could be a cancer' but would actually have never developed into a cancer.
Because it's impossible to say which will or won't everyone who 'might' have a cancer us treated and thousands of women undergo unnecessary treatments like chemo or radiotherapy that DO have a lot of side effects.

I wouldn't be able to give you the exact numbers but the % IS high. Then you compare it to the number of women actually dying of that cancer and you might find that actually numbers are quite low and you are happy to take the risks.

Or at least that's the best way I can explain their pov

That's fair enough blueemerald. Of course you will deregister if you have been treated terribly.

What I meant was that, in the OP's situation, there is no need to deregister just because you no longer intend to use the GP's services.

I hope you find a good practice to register with in the future.

Wow my post was deleted, seriously?? Gosh was it the "shit", or the fact I didnt actually give a "shit"

The impression that somehow GP's care if patients leave, or that it is somehow a punishment is wrong. Most GP's are massively oversubscribed, and would quite like to shut our books to new patients, but the health boards wont let us. The £40/year capitation fee we get doesnt cvome close to covering it.
And yes we do get paid for chronic disease management/screening/monitoring, but its really not a problem to "exempt" people, just say you dont want to and we tick a little box saying "informed dissent". Simple. You may have to do it once every 15 months or so though.
Trust me, spending 15 minutes explaining to someone the risks of not managing their BP, diabetes, etc etc, is not for MY benefit, I actually do care about my patients health, but if I give you all the info then you can choose not to participate. Just when you have your stroke or heart attack dont come back and blame me (yes this has happened and doctors have been sued).

As for screening, well thats a whole other thread, much like vaccines, stupid not to participate IMO, but fine if thats what you want, just another little button to push to say so.
Believe me we dislike the beaurocracy just as much if not more than you do.

Mac doodle, many many (most!?) people really appreciate the NHS and it's staff GP's included.

The ones that don't don't have the imagination to understand how different their lives might be without it

For someone who seldom has to visit their GP you seem to have a lot of experience of problem receptionists, problems getting an appointment etc etc. For that reason yabu as i expect you are just nhs bashing.

"Mac doodle, many many (most!?) people really appreciate the NHS and it's staff GP's included."

I for one am extremely grateful to the NHS for being spot on with DD's medical issues.

to all medical professionals

It's the summer holidays. Teacher bashing has probably given way to alternative bashing and the NHS seems to be a regular target.

I don't see the point of deregistering. You never know when you'll be glad it's there. And if I were macdoodle or any other GP posting I'd be highly irritated by people saying that Dr Google and buying drugs online were equally good alternatives to GP care.

My stepdad is friends with a GP, apparently GP's have less and less power to diagnose and refer nowadays, the GP in question says he can only refer for bloodtests and x rays.

You see, some people just don't 'get' it do they.

Maybe all the NHS bashes should try their luck over in the USA for example, where an average straightforward vaginal birth will cost a private individual about $30,000. A Csection is a bargain price of $ 50,000

Even if you can afford Devon medical insurance you will still have to pay a percentage of this, or chance you luck with the very scarce government "maternity' services which are basically there just to literally save people from only the most dire and life threatening ailment.

Devon= decent!!

There is absolutely no excuse for the lack of quality of service and availability of GP appointments in many surgeries. My husband very nearly died last October of advanced cellulitis (CRP 380), having been refused a GP appointment, then fobbed off by a locus with totally inadequate antibiotics, finally admitted to the (excellent but overworked) A&E of our local hospital. Many GPs seem to derive a very comfortable living from the current setup. I visit the GP when we visit France three times a year, pay €23 for a far superior service & have much more confidence in their integrity, walk in with no need to make an appointment & receive branded medication if needed, not generic substitutes. If the Government is not prepared to assure a decent level of service in the UK through the taxpayer-funded NHS, we need to seriously consider alternatives. Our cancer statistics etc compared to other countries speak for themselves.

This is something I have been considering. My GP has said things before about me getting 'all my treatment from the NHS, or none of it.' I was becoming very ill on levothyroxine for a hypothyroidism (or possibly hashimotos, one of the things I was never tested for.) I now take T3 sent from Mexico and I actually feel like a functional human being again. My GP eventually agreed to give me 1 T3 tablet for every weekday and levo for the weekend, but I take 2-3 T3 tablets a day, depending on how I feel.

I have an appointment with him next month and I feel I should be honest. But I also suspect he will just take me off his books. I'm trying to work out whether that will be a big deal when I get all my tests done privately now anyway. I don't actually need the inadequate 'help' the NHS offers.

I went to my surgery today to drop off a prescription and I saw a notice up concerning patients who are over 75.

Both my parents are so I went to ask at reception and apparently patients over 75 are all receiving letters simply stating who their GPs are. Its a Gov. initiative apparently.

I said to the receptionist "Is that all that's in these letters. She said yes.
But the reason I asked her is because ive seen a couple of news items in recent weeks about elderly people being deregistered. So I got a bit worried.

albertcamus - if GPs are deriving a "very comfortable living" then why are they struggling to get newly qualified medics to train as GPs?

And why are they struggling to recruit locums to cover holiday work?

They are very overworked and spend an awful lot of time doing admin staring at a computer.

I doubt that's what they thought the profession was going to end up like.

I really would not buy medication on the internet, for all you know you'll end up taking a mixture of talcum powder and amphetamines, no matter how 'reputable' the seller.

The surgery won't care if you de-register. It is only about how it will affect you. I would have thought the possible benefits of staying registered far outweigh the benefits of cutting loose. Many private doctors you might see like to write to a GP and feel that someone has your full records. You never know when you might need to be registered; some major or emergency things are better dealt with by the NHS even if you have very comprehensive insurance. The last thing you will want if you are ill is any complications or delays from being out of the system.

God forbid anything bad will happen, but saying you seldom need to visit does not tell you anything about the future.

I am sorry you've had bad experiences though. If you were able to register with an alternative surgery that would be different. But being unregistered isn't worth it IMO.

Temporaryusername - I was thinking of eczema ointment and the odd packet of trimothoprim from Lloyds on line, not an exotic collection of phamaceticals from a dodgy source!

In view of the pressure on the GP system this thread has made me wonder if it might be a good idea for people like me ( I have not had a day off work sick for 10 years) in generally good health it might be less expensive and better in some ways to offer a designated dropin centre in lieu of a full GP service?

I don't have any particular grip with my GP apart from the fact that when I just need 5 minutes of their time once every couple of years I have to struggle to get anappointment, wait ages, sit in the dingy waiting room and get barked at by the receptionist - perhaps another option would be for GPs to offer an on line service too.

the local surgery who refused to attend my home birth

GPs are neither trained nor funded to attend home births. I rather suspect that there is more of a back story than you are giving and that your surgery won't miss you......