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?

Obviously the NHS is failing, but not because it is free, but because the government is not supporting it. Obviously GPs are stretched to the limits. But unfortunately, from what I read here, GPs have taken to blaming the patients for not self-diagnosing.

But from what I've read on here, GP's have taken to blaming the patients for not self- diagnosing

This is exactly what I have taken from this thread.

Interesting that none of the GP's on here have answered my question, or indeed Dazzle's about schools requiring sick notes., and whether they will write them for ill children who will otherwise be marked as having unauthorised absence.
Perhaps this is just another inconvenience for them..

They don't have to and they shouldn't, they aren't to blame for schools having daft policies!

Right, Sirzy, so this is what would happen then. My DD is off ill for more than a week. The school requires some official note/ letter from herGP, certifying this is the case.
The GP, has seen my Dd has has diagnosed whatever. The GP knows she is not fit to be in school, and has reccomended that she take say two weeks off to recover.
Are you seriously telling me that you would refuse to write a note to this end?
My DD has luckily never been off for more than a couple of days tops since she stared secondary, so thankfully this is all in theory.
However, just to be clear, are you telling me that GP's should refuse to write a couple of lines to the school to confirm that a pupil is indeed genuinely ill, and will not be at school for this reason?

Providing sick notes for school is not NHS work. You can self certify for less than 1 week - for a child that should be the parents. If a child has been off more than a week then they should have seen the GP anyway.

The school may choose to have a different policy - that is not the fault of the GP who is entitled to charge for writing what is a private note.

Exam boards have their own policy which again, rarely requires a GP to write a note.

I am not a GP but another doctor who finds that demand has gone up exponentially. I have a huge amount of sympathy for GPs who are seeing endless amounts of new work - school sicknotes are just one example - being dumped on their doorstep, with no thought as to the impact it has on them.

Some GPs will write notes, while silently drowning in a corner, some will refuse or charge and some will say they will do it privately if the school requests it in writing - I understand that they never do which largely proves that the request is pointless.

I'm not a GP but I wouldn't be wasting time getting a GP to write to school no. It's my job as a parent to keep school informed and if school have an issue with that they can take it up with me not expect a GP to waste their valuable time saying a child is ill. If school are that bothered then they can send a member of their staff to waste time see if the child is ill.

DS has a lot of time off school and at no point have we been asked to prove he is ill.

OK Sirzy, here's what I will do if this event does arise at sometime in the future.
If my GP refused to confirm with the school that my Dd was ill and was absent for that reason, then I will tell the school that they will have to contact the GP directly as she is refusing to write them a note.( as she doesn't do notes)
It's then completely out of my hands, but I would imagne that it would be much less hassle for the GP to do it in the first place rather than trying to field phone calls from someone that they will probably have to speak to in the end.

I bet the school wouldn't even bother chasing it up. Why should the GP waste their time because of a pointless school system?

celticlass I'm not sure of you are deliberately not reading my post but I've already answered your question and will bold it so you can't miss it.

IT IS NOT AN NHS SERVICE TO WRITE SICKNESS NOTES FOR SCHOOL CHILDREN EXAM OR NO EXAM. HOWEVER WE WILL DO IF IT IS NEEDED BECAUSE THE SCHOOL ARE DEMANDING ONE BUT FOR A SMALL FEE

So there.

Oh and nowhere on this thread has ANY GP said we are angry that people don't self diagnose. We are irritated by people using appointments when they don't need to. Come on do you really think going to the GP with a cold is appropriate?!

And no Dalzell there was no contradiction in my post. Another case of deliberately misreading I think.

I've said it clear. We don't do sick notes on the NHS. We will do one for a fee. If your school is demanding one, we will write one but will charge you. I don't know how clearer I can be.

I've just explained planned why to you why Sirzy. You obviously don't understand plain English.
And you don't know my DD's school. They would indeed chase it up. Parents are sent texts if their children are late for lessons more than twice a week.
You're obviously the flag waver for some of the doctors on here who treat their patients as an inconvenience.

Ah, just seen that some of you will write notes it for a small fee. Ok then..

But writing sick notes when they aren't needed IS an inconvenience. I actually have many issues with our local GP service but I am still able to understand why GPs don't want to get mixed up in schools pointless bureaucracy when they have more than enough of their own to deal with!

sistersofmercy yes that is a good post thankyou.

And yes writing private sick notes is an unnecessary inconvenience. I would much rather my time be spent on seeing sick people and (hopefully) helping them. That was the whole point of my wanting to be a doctor - to help the sick. Not to write constant sick notes.

Another rude response celt my patients are not an inconvienience. Don't you dare imply I see my patients as an inconvienience. So offensive.

However some of their requests are an inconvenience and I have to draw the line somewhere surely it's common sense to understand this?

Do you really think going to the GP with a cold is appropriate
No, I don't think it's appropriate. However my self diagnosed ' bad cold' last Christmas turned out to be Broncitis (sp]
I absoloutely hate going to the Doctor's and will put it off as long as possible. That taught me a lesson.

I completely agree that GPs' time should not be taken up with writing pointless sick notes to satisfy school bureaucracy. But this is largely a product of Gove's DfE taking away the element of school discretion with regard to attendance.

What really needs to happen is for the Department for Education and Department of Health to get their act together so that GPs and parents aren't caught in the middle of this nonsense. Either the DfE tells schools that they shouldn't demand endless sick notes; or gives them the funding so that schools can pay GPs' fees for providing them; or the DoH tells the DfE that it is going to tell GPs to stop giving out sick notes for anything less than a week's absence and they'll have to think up something else.

Until that happens, I think parents who are faced with a school demand for a sick note should tell the school that they will get a note when the school pays for it.

I'm a GP. I don't get many parents asking for sick notes. What I do see a lot of though is kids with obviously mild self limiting cough cold type illnesses being brought to the doctors so that it is "on the record" that they were ill. This is usually because the child has had a few days off here and there across the school year and the school have become twitched about it. The parents themselves have told me it's because of school policy, not because of a genuine concern for the child's health.

If asked for a sick note I usually advise parents to simply tell the teacher what the illness was and how long they were unwell for. I also tell them that if the school want proof they are welcome to write to me and I will provide a brief letter with parental consent. Funnily the schools never do write because they realise it's as much a waste of their time as mine.

If it's a child who has missed an important exam because of ill health for which I have seen them, I have done a brief letter in the past, free of charge although I don't think we are under obligation to provide this for free.

There is a huge workload for this type of administrative stuff. It requires dictation of the letter, secretaries to type it print it, put it in envelopes. Reception staff time when patients call up to see if the letter's ready. None of it contributes to patient care - it's unnecessary arse covering brought about by bizarre school policies (not exam letters but these are rare tbh) and detracts from other more important clinical work.

And that's my twopenneth!

If a parent asks me for a si

Ignore the last line mobile phone failure!

Pishedoff Get over yourself. you're hardly averse to being rude. I'm challenging what you are saying that is all. The fact that you don't like it is not my problem.
By the way, I would not get paid if I didn't have a doctor's sick note after the self certifying period( which I think is still three days)

I haven't had any time off work for a long time, so I can't remember.
Good to know that Doctor's would refuse to write me a sick note, and compromise my absence record at work, not to mention my suffering a loss financially

celtic should the sick note be provided free of charge? If not then who should pay for it?

Plummyjam Your post is very much appreciated, and you have explained your position very well. Thank you.

I've followed this thread but kept out of it till now.

I trained as a GP but then retrained in a hospital specialty - everything on this thread makes me so glad I did that. I absolutely recognise the unpalatable truths that macdoodle and others report of GP workload.

Like a previous poster, I also left the country and have no wish to return to work in the NHS. There are good and bad things about the healthcare system I work in now but frankly I think overall the NHS does a good job for patients and people should be careful what they wish for when they talk about changes. I see people here who don't get treatments they would in the UK, lots of patients can't find a GP as their lists are closed - and yes, no GP home visits either. Also prescriptions and lots of other things have to be paid for. No, I'm not in the States either.

Regarding the OP. It sounds to me that an appropriately targetted exam was done, appropriate resources consulted - as with the other doctors on the thread I agree checking doses, especially for children, is fine. I hope the child is better now.