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?
MNHQ have commented on this thread
AIBU?
To complain about this GP? Long, don't want to drip feed.
OriginalGreenGiant · 12/12/2014 15:31
As is usual the case with complaints the issue is much more with communication rather than competence - there's nothing wrong (and is infact encouraged) to use standardised assessment forms, thermometers regularly give different readings, and the whole consultation could have ended happier if communication had been less dysfunctional.
Problem is doctors are people and they don't always manage to do/say/perform everything perfectly, but it is expected that they do.
Like I said, I don't have the answer.
A bit of mutual respect I suppose helps.
And I agree, unless you've worked on the shop floor in primary care or A+E it is very hard to convey what the stresses are and how close to total collapse the system is. The government is doing a great job of pitching A+E against GPs and both of them against secondary care - divide and conquer.
The NHS will come to an end and we will all only miss what we had when it's gone.
Sorry, I degress - you have every right to complain, so why not sleep on it and make a decision in the morning?
Ya think?? And therein lies the problem 
Feel free to come and work my on call day on tues ocelot. I have google, gpnotebook, BNF and a number of medical sites saved on my favourites, feel free to use them all.
I will also expect you to be able to -
(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
(4) when you're done there, you can do my up to 10 tel call backs including results, make sure you know whether the reduced Hb is significant, what is causing the deranged LFT's. Reassure the worried well after "advice".
(5) you might have time to quickly do some urgent admin, the urgent letters/referrals that must go off today, the suspected breast cancer one, dont forget to ring the CMHT about the young lad with psychosis and distress you saw this morning, make sure they will see him soon
(6) nope not done yet, you need to read all the patient letters in docman, there might be 20 or so, about 25% will be asking/telling you to do/check/chase something, make sure you dont forget to do it, you can get sued and held culpable if you do. ooops almost forgot you havent done your results yet, maybe 30-40, I am the diabetic doc, so I need to make sure all their risk factors are controlled
(7) whew, done, no not quite. You have 2 house calls to do, one to the lovely gent you have known for years who is slowly dying from his incurable lung disease, he is short of breath and anxious, can you help, no not really, but you can chat and reassure, maybe hold his hand, talk to his wife, they will really appreciate it, shame you had to miss lunch but this is more important.
(8) on your way back for the afternoon surgery, just pop in and see the housebound elderly lady with exruciating back pain, you cant quite get her meds right without causing constipation, confusion, falls, but you will keep trying until you get it right. She really appreciates it to,
(9) right back in time for afternoon surgery - whew, nope no lunch or wee yet, but dont worry your lovely recptionists have taken pity and left a coffee and biscuit on your desk.
(10) off you go, afternoon surgery, a bit less now, only 15 or so, mostly prebooked so chrnic follow up and new problems. maybe some extra emergencies thrown in for good measure, maybe another sore throat or 2. Lucky you have google handy eh?
(11) right afternoon call backs done as well, are we done now, can we go home??
(12) dont be bloody daft, you have to finish your letters, you havent signed and checked the 150 scripts yet, keep going
(13) getting there, but wait, the PM has been trying to talk to you all day, about the QOF money, the building repairs, the trying to recruit a new dr, the underperfoming nurse. Too much now, you promise him some time on your half day tomorrow.
(14) Well just about done now, you didnt get round to any of the blue badge forms, or private insurance forms waiting to be done, and boy they are complaining now, theyve been waiting weeks.
You can go home to your kids now, youve done well, only 13hours straight, you did really well, thank goodness you had google, you would never have managed without it, after all, anyone can do my job as long as they have google cant they??
I hope you didnt make any mistakes, miss anything, kill anyone, and I must certainly hope you didnt annoy any one with your attitude. But never mind, you pay handsomely to your medical protection society in case of complaints, its only about £600/month for a part time GP. If its so easy to be a GP then I wonder why there arent more of us, we could certainly do with some more!
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