To complain about this GP? Long, don't want to drip feed.

[OriginalGreenGiant]

Ds1 (6) has had a minor sore throat for a few days but yesterday had woken up crying in pain, couldn't swallow, yawn or talk. I had a look and his tonsils were huge, felt his glands in his neck and they were like hard round marbles and he went 'ow' when I touched them. Felt a bit warm but no actual temperature at that point. So I managed to get a morning appointment in open surgery time and took him to see GP.

We waited over an hour for an appointment, in which time I could feel and see ds's temperature going up. He was tired and a bit lethargic and you could feel the heat radiating off him. So I stripped his top off and put him next to the window.

Anyway...in we went. The GP didn't look at ds at all when we entered, just maintained eye contact with me and asked his symptoms, then picked up the thing (light...magnifier?) and looked in ds's ears and throat. It's hard to explain how 'off' this seemed in words, but IMO you can tell quite a bit from how a child looks, so it seemed very odd that she didn't even look at him, let alone ask him anything.

So, she pronounced his throat red and ears fine. She then ran her hands lightly over his neck and said 'glands are normal' and took his temperature (in the ear) and declared it 36.8 and fine. Then asked me what treatment i was hoping for from then on .

At this point I could feel the warmth still radiating from ds so asked if she could test his temperature again. She gave me an indulgent smile and did...looked surprised and a bit shamefaced and went 'Oh it's actually 39! Sorry!'

I asked her about his glands and said to me they seemed very pronounced and painful. She felt them again a bit more firmly, ds1 visibly winced but she again said they were completely normal.

She then said that she understood I was probably hoping for antibiotics, but...and gave me a two minute lecture about the differences between viral and bacterial. I tried to politely interrupt (I'm not an idiot, I know the difference and had given no indication I was 'looking for' anti b's) but she was on a roll with her speech so on she went.

She then turned to her computer and brought up google, saying she would check if antibiotics were needed. She googled 'fever pain score', clicked on the first result and filled in a form. She said to me 'You can actually do this from home, to see if anti b's are necessary but obviously I don't mind completing it for you'. Well gee, thanks

She turned to ds (and just to point out, this was the first time in over 5 minutes in the room that she had looked ds in the face or spoken to him) and asked him 'So, would you say your throat pain is moderate or severe?'. Ds is a bright 6 year old but fgs, he's 6. He stared at her, obviously not understanding so she repeated it to him word for word. So I answered that it had seemed severe.

Anyway, this form came up with the result that antib's were recommended. So she completed a prescription after poring through some text book for a full two minutes to check dosage. And out we went.

It all just seemed so wrong. Other than the moderate/severe question, she didn't actually look at ds or speak to him/question him at ALL. I'm not a Doctor, but considering the painful marbles that are protruding from ds1's neck, I'm pretty certain they wouldn't be described as 'normal'. Plus add in the temperature mistake, and google telling her whether to prescribe or not.

I said to dh I feel like complaining. I know that Doctors are probably sick of people traipsing in kids with a sniffle at the moment, but ds clearly had more than that and I don't feel that she really examined or diagnosed him at all.

Dh thinks I'm overreacting. He is of the 'Aw come on, she's probably newly qualified or having a bad day' opinion...tbh I couldn't give a fuck and neither of those warrant not doing your job properly IMO.

AIBU?

I have lived in Cyprus for nearly 11 years, one of the things I miss from UK is the NHS. We do have a form of free healthcare here but it is very poor, extremely long waits for appointments, poor care and dirty facilities. If you can afford it you have medical insurance and even then there is excess to pay.
I have not seen a dentist for 10 years since I broke a front tooth, cost me over 300 Cyprus pounds to have that fixed.
Not seen a doctor for about 4 years and a gynie for about 5. It's too expensive, for a decent private doctor it can cost upwards of 70 euros just for the consultation and then through the nose for any drugs needed or further treatment.

Lucky for me that I am in good health generally but at 45 I really should have more regular smear tests but can't afford it.
I am 5 months into a new job which comes with subsidised medical insurance after 12 months service so only 7 months to go till I can get a smear done and hopefully some help with the prolapse I have been suffering with for a year.

I don't like how some people on this thread are trying to excuse a GP being rude or not listening due to their workload.

I had to take my son to a and e last night, it was packed the staff where working exceptionally hard and yet they all managed to treat the patients respectfully and listen to them.

Being busy in work and feeling rushed and whatever else is horrible but it's no excuse to take it out on those who you are supposed to be helping.

The thing is,getting back to the op,what is the worst that could happen?I suspect just a return visit.We've had dire sore throats and tonsillitis to the extent dtwin2 has had his tonsils out. Personally I prefer to ride out anything without the use of antibiotics as they don't seem to suit us as a family. Calpol to keep the temp down,bed and fluids got us through most severe bouts.In some cases we may have had to return and then use antibs as a last resort but I prefer that to be frank.

I do think GPs can be hit and miss within a practice at times and you need to find one that fits you.We have always had the most utterly amazing GP who has now left(young but fed up).Can't tell you how many people in the community were gutted.Asked around to get a feel of the others and now request the one that seems to really suit us and seems fab.There was one I had for a few visits I really struggled with(as did several others in the community). He left but I simply requested the alternative that really suited us.Have to say my parents,kids and dh are all at our practice and overall it is superb,absolutely gold rate and constantly evolving.They do exist.

Going in informed,brief as possible( I except not poss for everybody)and to the point and only when necessary I suspect has helped us get what we want every time.

I've found since my asthma has got difficult (with many hospital admissions) that GPs are fantastic! Ours are more than happy to slot you in, phone you back etc. When you are really ill the NHS is fantastic. The NHS in general and particularly general practice are so stretched at the moment, it must be hard when people don't self treat or visit a community pharmacy. Some people could make a lot more use of their community pharmacist.

To be honest I agree with the sentiments of Macdoodle et al.

I am long serving nurse - I am very compassionate - but yes the amount of people that do not take responsibility for their health is amazing. As is the amount of people who won't self treat or "watch and wait". The body is designed to degenerate ! Very few people are in a state of "perfect" health .
If people want an nhs they have to start to use it responsibly.

Blessed This is said so easily.

How do you know whether the blood in your stool is due to piles or colon cancer? Check on a website?
Whether the lump in your breast is a cyst or cancer?
Whether your child is having a particularly bad cold or scarlet fever?

The body is designed to degenerate - of what relevance is that to healthcare professionals? It's like saying, well, you've got arthritis there, yes, but that's age, nothing we can do. Take a painkiller.

The GP wasn't rude. She sounds a but rushed .No need for a big vendetta against her...she did everything and more required.

The OP is criticising the GP for not spending long enough on lymph nodes... ! That's a bit ott and really, what does OP think the GP may have missed in the nodes, a big abscess? A gaping wound? A huge mass? No. If lymph nodes are up from the sore throat then that means nothing. She probably meant normal in the context of big but in keeping with infection/sore throat. Ie not malignant/mass.

I'd say - let everyone above a certain income threshold pay £10 a month to the NHS. That would rake in a lovely amount each year.

To be perfectly honest it sounds as if the GP was a bit stroppy/ dismissive , but at least she was prepared to back down( temp) . It may not be ideal but she doesnt have to be super nice, that's not part of the job description.
Maybe she was rushing as running late, maybe the person prior to you was unpleasant. Maybe she was having a bad day or was unwell and tired.
Let it go, book in with a different GP next time. Complaining is misguided and vindictive.

Ika that's great I have found the opposite with my son that the worse his asthma gets the worse the GP is with it, to the extent the consultant told us last year to stop going to the gp for anything vaguely chest related as the gps in our practise simply weren't taking it seriously enough. Unfortunately no option to change locally other than to a worse practise.

In their defence our gp is fab with many things but has made life dealing with my sons chest much harder than it needs to be

Ok I have one last thing to say then I may hide this thread, as it just going in circles as all GP/NHS bashing threads go, with folk rubbishing the whole system because of their bad experiences ignoring the millions of patient contacts which go well, of all the good the NHS does. And those are ones with very big chips and for some odd reason dr envy/resentment/hate (well done government spin and daily mail rubbish).
They either dont care or cantwont see the big issues the NHS face, its easier to blame the frontline doctors and nurses on a personal basis. They jump on and abuse those HCP that even dare to speak out, they cannot understand it is not "winging", that it is not a matter of just getting on with serving the public with our huge wage packets and pensions and just shut up .
Those of us speaking out care very deeply about our patients and the NHS, we are desperately trying to fix the bigger issues.

So and yes I am shouting!

YOU CAN HAVE A GOOD SERVICE, A CONVENIENT SERVICE, OR A CHEAP SERVICE. YOU CANNOT HAVE ALL 3.

And the funding it not sufficient at all. 10 years ago, GP got >11% of funding to the NHS, now we get 8%, thats a massive cut in funding with increased elderly, comborbid patients, worried well, the cant be too careful, the entitled ones etc etc. The service either needs a massive influx of money, sadly though there are no GP's available to fill the gaps.
Or it needs redesigning, and the government plans for this are not great, they really arent. It will result in a horrible 2 tiered US type system, with those most in need falling through the holes. It wont be like Germany or Holland, because that costs too much. And some GP have suggested and designed very good plans (the Jersey model etc), but these have been roundly ignored by the government, they want rid of universal health care.

I am sad, but yes also angry and burnt out, I am sadly too young to retire and too old to emigrate, I lobe being a GP partner, running my practice, knowing my patients, having some little power to change things for the better. But if it gets worse, then I (along with many others) will resign. We will locum and sell ourselves to the highest bidder. I will almost definitely be happier, better paid, work less hard with less stress. Sadly my practice and my patients would not be. And that is the future, if you ignore it or pretend it is the fault of single GP's like in the OP, then you will also be complicit in whatever comes next.

Sirzy - I should have said there are only 2 GPs in our practice we see! They are both great and we know them. I feel for the GPs as they can't be an expert in anything, and don't get involved in your day to day care but are expected to managed you just out of hospital on high dose steroids and nebs! We used to be able to do direct admissions to the chest ward but can't any more, hence more need for the GP. I hope your son isn't suffering with all the stinking colds going around at the moment.

Unfortunalty he is. Was in a and e last night narrowly missed out on being admitted so home and dosed up on pred and pen v hoping it clears it quickly so he doesn't miss all the last week of term fun!

I do think it's hard when the doctor makes you feel awkward about wanting an appointment. But I can see why, some people blatantly do take the piss. Unfortunately some people just make a wrong judgement call at the moment and don't really deserve tarring with the same brush.
I went to my docs this week with my 3yo. Both her and I had had a particularly nasty cold, I'd coped with it as you do, but hers had turned into a rather alarming constant cough and was quite wheezy. Still wouldnt be so much as issue but we have a bad family history of asthma. My older dd has been hospitalised more times than I can count and is on a raft of medication, and I strongly suspect this dd is asthmatic too, although not as seriously. I wasn't to get her seen mostly as I was becoming concerned and wanted to check I was right in not taking her to A&E.
When I took her in the doctor was very dismissive and cross with me, told me her wheezing was just congestion from the cold, told me I shouldn't even be considering A&E for a cold, gave her an inhaler and sent me off. I feel quite bad now that I wasted her time and I know I'm in the wrong and made the wrong call in being concerned, but I do wish she could have been a little less abrupt with me. I've been in a position with a blue child on a drip in hospital with doctors rushing around and hdu being rang. It was scary. When you have no medical training sometimes you feel you have no choice but to check with the professionals, even if you feel bad for wasting their time.
I guess without the miracle of more docs and money I don't see the solution. In an ideal world the docs would be free to deal with everything requested of them, but it's not ideal, and the poor beggers need cutting a little slack.

Dalzell your most recent posts are offensive to hard working dedicated GPs (and I count myself as one of them yes).

You say GPs don't want to be and are refusing to be the gateway to health care? What utter rubbish. We are and we want to be the gateway to health care. We want to do our jobs. Most of us love our jobs and are very good at it.

And how dare you even imply Doctors are punishing children by not giving sick notes and not telling you where to get the right advice. Utter codswallop. We're not punishing sick children at all. IT IS NOT PART OF OUR JOB DESCRIPTION TO GIVE OUT SICK NOTES FOR CHILDREN. However we will do it for a small fee, probably smaller than the fee from a private GP. I don't get the issue there at all.

I've just recently seen a link on Facebook from a Canadian doctor who has a standard letter for employers who ask for medical certificates for self-limiting illness such as sore throats etc. I'm seriously suggesting to my practice we start with one of these.

www.cbc.ca/m/news/canada/nova-scotia/nova-scotia-doctor-to-charge-employers-for-sick-notes-1.2814139

I had a highly intelligent professional come in on the first day of a cold to ask for a sick note. They knew it was a simple cold but wanted a note and were most offended when I told them that legally they should self cert for the first 7 days as per official Government policy. What a waste of an appointment. Employers and schools have a lot to answer for, they should tell their staff/parents about the sick note thing. ITS IS NOT THE DOCTORS FAULT.

Sirzy if the doctor was surly and rude, then I would say yes complain if you wish.

But complaining because of a dodgy thermometer, checking the BNF for dosage guidelines (which all doctors on the thread say they always do because it is BEST PRACTICE) and inputting his score into an online calculator (and I would put money that she was a trainee looking for the Centor criteria) is silly because none of that is wrong or incompetent or complain-able (although I would suggest the practice get better thermometers).

There have to be boundaries in everything...the boundaries are wide open at present. That's because we don't want sick patients to be missed. However, it doesn't mean GPs , already available for all physical and mental health issues, should be available for minor admin tasks and responding to excess patient demands which will then get in the way of sorting out sick patients and checkpoint test results and acting on them.

If this continues, as well as AEs breaking, GP Practices will break.

divegirl, what a great post.

The amount of anti GP rhetoric, passive aggressive abuse and entitlement on this thread is indeed astounding. I think the doctors on here have given us very valuable and telling insights into the difficulties of their professional lives.

I've lived outside the UK for many years, and still remember my shock when I was asked (in Japan) if I had insurance when I had a serious facial wound that was bleeding profusely and eventually required more than 20 stitches. My American husband, on the other hand, was surprised that they didn't insist on the details. There you have the difference.

My mother died this year, but her treatment from the NHS was phenomenal. OK, the ward wasn't gleaming and modern as it would be in a Swiss hospital (which is where I live now); on the other hand, it wasn't costing hundreds of pounds a month in compulsory health insurance. Our family health insurance is over a thousand pounds a month. However, the doctors and nurses were kind and compassionate, and the medical treatment was exemplary.

The NHS is being wound down, for the benefit of the private companies and individuals who will step in and make a fortune. We are losing something invaluable - a service where you can have a head wound, or a heart attack, or a tumour, and nobody is going to ask for your insurance details (and God help you if you don't have insurance).

It's not just about the money. In a private system there is a lack of fluidity between different hospitals so getting old notes faxed over, getting repatriated closer to home, getting a colleague to take over care in another area will be a problem as will training. There will be a lack of coordination between hospitals and lack of commitment to training.think privatisation of train services ..but healthcare needs to be a bit more joined up to work.

Basically think what has happened since dentists had their nhs work largely taken away... But much worse when it involves hospitals. Healthcare will be unrecognisable and not in a good way.

Pishedoff, you must see the contradiction in this:

"And how dare you even imply Doctors are punishing children by not giving sick notes and not telling you where to get the right advice. Utter codswallop. We're not punishing sick children at all. IT IS NOT PART OF OUR JOB DESCRIPTION TO GIVE OUT SICK NOTES FOR CHILDREN. However we will do it for a small fee, probably smaller than the fee from a private GP. I don't get the issue there at all."

So we should go to GPs for sick notes for children. Or should we?

What I said about GPs not wanting to be the gateway for healthcare relates to this question: who else is going to decide whether a child is sick or not? The state says it's their GP!

Children who can't take important GCSE and A level exams because they are sick on the day get very anxious about the effect on their future. Doctors should also have some concern about that; it can have longlasting effects on the child's health. Just being cross with the child for turning up at the GP surgery on exam day - in the middle of a long exam period - makes things a whole lot worse.

Dazell, late to this. You asked:

JassyRadlett, if the armies of PR people are not talking to the Daily Mail on a daily basis, what on earth are they doing?

There is a huge difference between 'talking to' and 'in with', per your post earlier. And very different outcomes.

Where are you getting 'armies', by the way? The Mail?

I don't think anyone would argue with the fact that vast and disproportionate numbers of very highly paid PR professionals are employed by the Department of Health.

Dazzle I would also appreciate a straight answer from the GP's on this thread regarding sick notes for children.

I've just asked my 14 year old daughter, if she knows what the policy of her school is. She says that if you are off for more than a week, the school requires a note from the GP/ hospital, otherwise the absence is recorded as unauthorised.
So can the GP's on here please tell me in that instance whether they would provide a sick note or not?

The number of PR staff might be completely justified if patients understood what they can and cannot expect from a GP.

Well, you need to decide what you're talking about -DH or the NHS (which will also have communications staff). And then you might want to define 'highly-paid PR people' a bit too, along with 'vast and disproportionate'. disproportionate to what? What would be proportionate?

I've got no skin in this game - I don't work in the health sector at all. But you're making sweeping statements without backing them up, and that kind of rhetoric is really irritating.

From the OP itself, the thing that would worry me is a GP presented with a poorly, hot six year old who didn't click that the thermometer was off based on just how the child felt to the touch, and therefore give the temp another go to see if she or the thermometer has got it wrong the first time.

One of the most wonderful things about the NHS is that many once common childhood killers like measles, mumps, whooping cough, meningitis etc are now rare. If I go back to my great grandmother's generation I soon find many children on my family tree who never grew up.

Many of us don't actually know what serious childhood illness looks like (my heart goes out to those who do) but the fear is still there. In fact the media stories about antibiotic resistance, the scandals and the financial struggles of the NHS may actually be increasing the fear because we are worried that we might not be able to protect our loved ones much longer.

When our children start feeling pain and looking feverish it scares the life out of us and we don't necessarily know if it is serious or not and we just want the doctors to give some advice because we trust them. They are victims of their own success at a time when things are really difficult for all of us.

I am not surprised that doctors are exasperated by patients' reluctance to self treat but the confidence to do so is only acquired through experience. The OP's original post showed a doctor doing the right things (especially once nudged by the OP) but not doing them with particularly good communication skills. A little patience and empathy from both sides is required. It's a partnership.