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?

[OneWaySystemBlues]

Actually antibiotics are not ALWAYS the correct treatment for tonsillitis. From the link that PacificDogwood posted - which I was about to post too - it says:

"Do I need an antibiotic medicine?
Usually not. Most throat and tonsil infections are caused by germs called viruses, although some are caused by germs called bacteria. Without tests, it is usually not possible to tell if it is a viral or bacterial infection. Antibiotics kill bacteria, but do not kill viruses.

Even if a bacterium is the cause of a tonsil or throat infection, an antibiotic does not make much difference in most cases. Your body defences (immune system) usually clear these infections within a few days whether caused by a virus or a bacterium. Also, antibiotics can sometimes cause side-effects such as diarrhoea, rash, and stomach upsets.

So, most doctors do not prescribe antibiotics for most cases of tonsillitis or sore throat.

An antibiotic may be advised in certain situations. For example:

If the infection is severe.
If it is not easing after a few days.
If your immune system is not working properly (for example, if you have had your spleen removed, if you are taking chemotherapy, etc)."

[mumbanator]

"I also feel there seems to be a lot of misunderstanding between the medical profession and the people they serve about what constitutes a minor ailment that does not need GP attention. I may be obvious to the doctor but it is not always obvious to an anxious parent."
Exactly. The taxpayer has trained me to be able to assess patients and that's why they come. A car mechanic might think I am an idiot for not knowing what to do with my car but how am I supposed to know? This is why I do not get too upset when people want their coughs and colds checking out to make sure it's not a chest infection, especially young children. I have seen an awful lot of minor ailments this week, I don't mind seeing them, it's more that it can be at the expense of those who actually are unwell.
TheHorse - I always discuss antibiotics use with patients and parents, discussion is welcome. "I was wondering, how do you decide whether antibiotics are needed or not" ie just ask politely, any way should be fine. If you're polite I don't see that it matters how you ask.

[Theoretician]

Since apparently the majority of appointments are patients who doctors think they don't need to see, I do think we need to bring in charging for GP appointments.

TBH I don't think a GP appointment is something that should be covered by insurance, social or private. It is a routine part of the cost of living. To use an analogy, it is more like a plumber's bill than the cost of rebuilding a house that has burnt down. (The latter is something that should be insured against.) People on benefits can have some or all of the cost refunded by the taxpayer, though I'd prefer not all, I think even they should be left with some incentive not to waste resources.

[Alpacacino]

Theoratician, may I make you aware of macdoodle's post on p.2 of the thread, where she describes her daily tasks (amongst others) thus:

(1) see anything up to 30 patients every 10minutes in the morning, work out which ones are self limiting minor illnesses (the majority), and explain to them why, how, that there is no treatment, and how they can self manage - all the time make sure you remain calm, polite, considerate and perfect (after all someone might complain about your attitude)
(2) in between those, make quite sure you do NOT miss those with serious pathology, the weight loss that might be lung cancer, the tears that might be a serious depression, the bloated lady who might have ovarian cancer, the anxious man who might be thyrotoxic
(3) make sure you spend enough time with the complex, elderly, multi co-morbids, you need to make sure their meds dont interact or cause side effects, or falls. You dont want to miss an early dementia because the government says we are crap at that too

How then can you possibly make a round statement that most GP visits are unnecessary?

How on earth can you expect patients to know whether their condition is in fact serious or not?

It would just be a case of "Oh no, I'm sure I'm fine, I don't want to pay for a GP to tell me that, I'll just carry on", and then being diagnosed with a condition that would have been manageable if it had only been picked up earlier, and possibly dying as a consequence.

Detecting nasty illnesses such as cancer early, and hopefully being able to clear people of their cancer through just an operation - would that not be important, worthwhile and also economical in your book?

And why on earth would you describe people going to see the doctor as a "waste of resources"? Which resources?!? This is taxpayer's money if I'm not entirely mistaken?
and you don't want people on benefits to see the doctor, possibly so they can get better and find a job again?

This is such a corrosive and misanthropic post, I couldn't let this be the last word on the thread.

[Springheeled]

Hats off to the GPs on the thread. Generally nicer attitudes to most public servants would be nice. Everyone is just trying their best!

[Sirzy]

You start charging for gp appointments then you will cause two things to happens - a and e departments will be even busier than they already are and too many people will put off going to the gp when they really need to leading to a delay In diagnosing serious conditions

[Coyoacan]

Well said Alpacacino

This idea that money can be used as a filter to avoid time-wasters is totally daft, especially in a society where ten pounds could be a week's food shopping for one person or an hour at Starbuck's for another.