GP Bashing

[Arealmanithink]

To think this was really unnecessary and politically driven? Why? Just why?

Daily fail link. Sorry

www.dailymail.co.uk/debate/article-2840252/Why-fear-GPs-NHS-s-problem-not-solution-surgeon-J-MEIRION-THOMAS.html

Yes, the patch is much more expensive than alternatives with no real benefit and at a time when NHS costs are rising and funding I'd frozen decisions like that have to be made. I would prefer money was saved on things like that so that it is available for e.g. renal dialysis or chemo drugs. These are the choices we are faced with.

lampygirl type 2 in my case although they aren't sure now if I really am! I work similar times to you but I'm an hour away from home plus I travel internationally a fair bit. But the appt system can't cater for anything more than a week ahead so got no chance.

It looks like GPs are starting to get the bashing teachers have had for decades. That bashing is always a precursor to some little bit of 'reform' or other. Which ends up being disastrous because MPs - who make the reforms - are not professional educators. And neither are they doctors. If I was a GP, I'd be very worried.

So rather than my GP being honest and telling me actually the patch is expensive, I have to recommend other cheaper forms of contraception, it's acceptable to make up nonsense about it falling off in the shower? (which I've been told doesn't happen!). How unpleasantly patronising, as though mere patients are too stupid to be told the (fairly obvious) truth.

I too live in Moniker's parallel universe; our GP practice is wonderful, the police do a good job, and the schools are excellent. Again, it's a tiny rural town, so perhaps that's the key.

The constant GP bashing by the media and government is what made me leave the UK 2 years ago. I now work abroad and love my job again and can treat and get to know patients to a much greater degree than I ever could in the last few years in the UK.

GPs are gatekeeping hospital resources. They are keeping hospital services from being over run by those pesky 'worried well' people. Who can in fact be quite hard to tell from actually ill people!

This is the problem Mamadoc, they are not always terribly good at this and can become very fixed in their mindset that someone is neurotic or hypochodrial rather than ill. This means that they don't refer for further testing.

Three people in my family (including me) have had cancer missed by a GP, in 3 different practices, in 3 differents parts of the country. We asked to meet with the GP who misdiagnosed my uncle's brain tumour as high blood pressure - we didn't want to sue, just to understand how it all happened, and were basically told to leave and "never darken his door again". My own misdiagnosis was horrific - despite the fact that I had every bowel cancer symptom going, the GP decided I was hypochondrial and said that the only referral I would get from him was to the mental health team. I only got treatment when the tumour ruptured the wall of my bowel and I collapsed with the pain. Result - I had a much more major operation than would have been necessary had my GP not been a twat and yes I did sue in the end

Obviously 3 cases is statistically insignificant, but this seems to be happening all over the UK. Having since married an oncologist, I know that he sees many, many similar cases. I have no idea whether it is resources, poor training, overwork, or what, but it seems to be a shit way to run primary care.

The mail article is written by a dinosaur who most likely does most of his work in the private sector and has no idea of what GPs do and how much pressure they are under. Anybody can walk into a GP surgery and demand an emergency appointment for practically any reason (from trivial to life threatening emergency).

We have had population increase without enough increase in trained GPs and primary care funding to match. So services are stretched and everyone is getting a "just about good enough" service, rather than the 5* service desired.

It is very easy to say the GP "missed X obvious diagnosis", but I wonder how many patients they see each day with symptoms that could be serious but 99.9% of the time are not........ if they referred everyone the hospital consultants would be complaining of unnecessary referrals and huge workload. Part of the GP role is risk management and sometimes even the best will get it wrong.

That's fine eyebags - until its your child/mother/friend who dies as a result of the GP not referring despite obvious symptoms. My understanding was that the reason GP's are so well paid is that they are trained to spot the 0.01% of people who will have something more serious, but they don't seem to be doing that very well in view of how long it takes to get a cancer diagnosis in the UK.

I no longer live in the UK and here we have private (largely employer-funded) healthcare for non-nationals. The difference in quality is phenomenal - x-rays and blood tests are all done immediately after an appointment to see a GP and I have never, ever waited more than a day for a non-urgent appointment. I am more than happy to pay for that level of service. I imagine there are many people in the UK who feel the same - particularly given the high level of dissatisfaction with GP's.

'anyone can walk into a GP surgery and demand an emergency appointment'

Bollocks. If you tell my surgery it's urgent on Tues, you might at best get an appt on Thurs or Fri. Certainly NEVER same day, not even for children.

There are huge disparities between the levels of service provided by GPs. Clearly that can't be right. Why should I have had better access to a GP 20 years ago than I do now? I can go shopping 24 hours a day yet I can't see a GP outside 9-6 (and would have to wait 2 weeks or more for an appt before 10 or after 5). Yet 20 years ago I'd be seen same day, at 830am, or 7pm or whenever I could get there...

Increased demand + falling budgets = system under pressure and poorer service. It's fairly obvious? The people of the UK voted in a party dedicated to destroying the NHS and so it's not surprising we are where we are with general practice.

As a hypochondriac I have experienced my fair share of GPs.

Some are wonderful and kind, others not so much. It is getting easier to get appointments again. I had to book an appointment at my GPs request and got an appointment for three days time. I tend to go to the pharmacist more now and have found that they can deal with many things or point me in the right direction. With health anxiety this is invaluable to me because I have been known to rush to the GPs with a mole that is perfectly normal and never needed checking, for example.

I am always conscious of being a time waster. I probably went to the GP about once a year at the most before I became ill with anxiety. The vast majority of them have been very understanding but I ask for advice from the pharmacist so I am not rushing to the GP for something that doesn't need an appointment. Obviously they can't always help but plenty of times they have.

They definitely try to rush you through the door as quick as possible and it often takes up to 45 minutes past the appointment time to be seen, but that isn't the fault of the GP. An appointment is meant to be 10 minutes long but I am pretty sure they jam at least two patients into a 10 minute slot. Too many patients, not enough GPs.

OldFarticus
I'm not sure I would measure quality be how many tests are ordered and GPs do not have direct control over how long it takes to get an X-ray or blood test anyway. My experience is I have always been seen in an emergency and I don't think it is unreasonable to have to wait for a "non urgent" appointment.

You seem to agree a major part of the GPs role is screening the worried well from the actually sick. If a GP sees 40 patients a day, 5 days a week for X years on end, do you seriously expect they are never going to miss a diagnosis? Get real, they are humans not robots.

What system do you propose - scanning and testing everybody who goes near a GP for every possible serious illness under the sun? Private insurance driven systems that cost more and leave some without any healthcare at all? no thanks.

greygeese
Increasing demands, falling budgets, more targets and political interference, etc, etc.

My understanding is GP surgeries get about £100 per year per patient and have to provide all services for that. So that is £100 for the patient that never visits and £100 for the complex patient that visits twice per week. I believe the average number of consultations is around 6 or 7 per year, so £15 a go.

You couldn't even get dog insurance for £100, or a nice haircut for £15. Do you seriously expect to be able to see your GP of choice, next day, 24/7 for the tiny amount of money they have to provide the services for all?

I had a private consultation with a consultant a few years back and it cost £250 for 30 mins. Getting the plumber out on a Sunday to fix a leak cost nearly £200 for less than an hours work. Getting a solicitor to write a simple letter costs a fortune.

Everything other professional service costs money, why do you think that a GP can provide access for all on pennies?

Where have I suggested that I expect GP's to "never miss a diagnosis"?

We are all human and make mistakes, yes, but the consequence of a GP making a wrong call is far more serious than most occupations. There is clear blue water between "scanning and testing everybody who goes near a GP for every possible serious illness under the sun" and an appropriate level of referrral that takes into account the potential for serious escalation of disease that occurs when GP's fiddle about for months.

For example, I suffer from the same genetic condition as Stephen Sutton. My GP had never heard of it, which you might say is not surprising because they mot specialists. However, when a person takes a leaflet to his GP explaining what the condition was and why he was at increased risk, and how many of his relatives had died of bowel cancer, and the GP still refuses to refer to a specialist, then yes, I think it is indicative of a very serious problem in primary care.

I see absolutely no reason not to roll out more private GP surgeries in the UK, leaving more resources free for people who really need them. That way, if a person needs a routine appointment at a specific time, they can have it. But as ever there are howls of rage from the healthcare unions who really just want to keep riding that NHS gravy train.

GPs do not have direct control over how long it takes to get an X-ray or blood test anyway.

They do here btw. It really works. No waiting whatsover and those who cannot afford insurance are subsidised by those who can, so nobody goes without.

It is only the Brits' cloying sentimentality over the NHS - and their ignorance of other health systems - that stops us from putting the health service out of its misery and adopting a system that can cope with demand.

My GP surgery (urban) offers all the following:

Walk in clinic, twice a day
Regular appointments
Telephone appointments
Online appointment booking and prescription requests
Nurse clinics for just about everything
Blood tests
Pleasant receptionists
On site pharmacy

They still organise home visits in exceptional circumstances, too.

All since the new senior partner took over a couple of years ago. I would put him in charge of the NHS, especially as he is against privatisation.

Yes, the patch is much more expensive than alternatives with no real benefit and at a time when NHS costs are rising and funding I'd frozen decisions like that have to be made. I would prefer money was saved on things like that so that it is available for e.g. renal dialysis or chemo drugs. These are the choices we are faced with.

So it's easier to stick a foreign object inside a body for up to 5 years, even if it doesn't agree with that person, and the progesterone gives her terrible mood swings and bloating.
At least with a patch or a pill, you can change to another patch or a pill.
With a Mirena Coil you are stuck with it for a couple of years.

I would prefer money was saved on things like that so that it is available for e.g. renal dialysis or chemo drugs. These are the choices we are faced with.

I agree, money should be spent on renal dialysis or chemo drugs. But if that is the case, why are you so quick to refer people for expensive bariatric surgery? Why are men given Viagra on the NHS?

Why is a woman's wellbeing and health and choice in these matters (eg mirena debate) deemed less worthy than, say - an overweight person's well-being ....... (only using overweight as an example)?

No, I'm constantly amazed at the lack of professionalism and attention to detail shown by the vast majority of GPs. Perhaps I've been unfortunate enough to suffer from less common illnesses. I've had to privately pay to see consultants more than once, only to hear those consultants express their frustration that GPs are not careful enough about diagnosing and making referrals. It may be a fault in their training/funding or NHS structure but the result is certainly underwhelming in my experience - unlike the salary they're taking home. Yes, there is a problem.

I suspect the ratio of good/poor GPs is pretty much the same as in any other profession. But health is a sensitive subject and medical care impacts our lives in a way that other services don't. So I'm not surprised that people expect more from GPs. Lack of choice is another issue, some people can change surgeries if they are not happy with their GP but for many others there is no option. I'm very happy with my current GP, but I have seen a few in the past who frankly had no business being a doctor (conversations along the lines of "I'm suffering from such and such" "So what do you want from me, a sick note?")

The vast majority of GPs show lack of professionalism and inattention to detail? The vast majority?!!

www.dailymail.co.uk/health/article-2847776/GPs-aren-t-perfect-people-hospital.html

I have experience of excellent GP care and also extreme. rudeness and dismissiveness.
After having a hysterectomy I was given a sick note at the hospital for 4 weeks and told to see my GP at the end of 4 weeks.
Very young locum refused to give a note for a further 2 weeks as "Four weeks is long enough for anybody".

DH claims never to have experienced rudeness-leads me to wonder if a degree of sexism is involved.
I rarely go to the GP unless I think I need to rule out something serious, so it isn't as if they see me often.
Two of the GPs in our practice are brilliant-but its difficult to get an appointment as everyone prefers to see them.
I do think GPs work very hard but some can be quite arrogant and rude-this could lead to someone with a potentially serious condition putting off making an appointment.

I agree there is an element of sexism re treatment, my XP was always able to get earlier appts for our DC than I ever could (still not same day). I've also found linguistic difficulties with some GPs at our practice. And the whole sorry saga of contraception I've endured over the last 6 months and the dismissive way I've been treated particularly by the last idiot I saw, leads me to suspect a cultural element at play as well (being an unmarried woman, mother etc. I may be wrong but it's hard not to draw that inference).

As to the suggestion being a GP is so much harder now, when did this change happen? Because my old GP was consistently great until he retired 12/13 years ago. My current surgery have been rubbish since I joined them shortly thereafter...as for underinvestment, I thought the Labour Govt spent the Noughties pumping millions into the NHS - so that's still not enough?

My parents grew up pre NHS and were always staunch advocates of it. I was, but am no longer, because I can't see it ever improving however much public money is used. Sadly.

But to those not supporting the NHS what should take its place?

Like it or not international comparisons show that for the amount of money spent the ÑHS produces great results.

Private insurance systems usually spend more money ( in total counting private and public money) for the same or perhaps slightly better results. In the case of the US they spend much much more AND have worse outcomes.

What usually happens in insurance based systems is that there is an incentive to do more procedures, prescribe more drugs etc I order for the provider to get paid. More is not always better. There is a risk of cancer from radiation exposure from unnecessary scans, side effects of unnecessary drugs, not to mention anxiety whilst waiting for results.

Those who can pay get too much medicine and those who are uninsured get nothing. To me that is fundamentally unacceptable.

The NHS is in no way perfect but alternatives are worse not better.