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?

If I wanted advice from Dr Google I can do that myself, ffs a GP having to use an online checklist to know whether a bairn needs an antibiotic is a joke.

It's so tough, I don't have the stresses of a GP but I work a lot of my time in an emergency dental setting and people come in and put on a huge act about their aymptoms, not listening to the questions I'm asking, telling me all sorts of things I don't need to know- I still have to write down a list of detailed symptoms and I'm not getting it from their over dramatic history so it takes extra time to dig through their story to get to the crux of the matter.

Then what when someone says "I want antibiotics" and you spend 5 min explaining to them why you're not going to prescribe them and they say "I want your name and registration number so I can sue you". From these details they can get my address off the GDC website, hmm, makes one slightly defensive.
Repeat 12 times in 3 hours on a Sunday for very little pay and I can hugely see where this GP is coming from. Patients are hard work.

The patient who comes in and concisely describes their aymptoms, listens to your plan and doesn't tell you they hate you is worthy of note.

Ho hum. We have no appreciation of healthcare in this country.

Sorry Idefix - I meant that the GP checked that Abx were indicated in this case, op didnt attend asking for them, but the decision was that they were appropriate.

Ffs Fanny if only you knew the bloody truth

Antibiotics have been routinely prescribed for a long, long time. Why do you think we're in the mess we're in with regards to "super bugs"?

It is prudent for a GP to check current, standardised guidance to absolutely ensure that antibiotics are the best form of treatment.

Try working at they front line THEN come back and tell us what is and what isn't a joke.

I very much doubt the GP did a general Google search that we would all do. I expect there was a specific site aimed at helping doctors follow ever changing antibiotic guidelines.

Would you prefer they consulted a huge leather bound tome instead? Would that look more "professional"? Because really, there's no difference at all.

Last time I took my son to the doctor, both the newly qualified GP we saw AND a senior partner that she called in for advice ended up looking on some website.

(DS had very severe stretch marks across his back, neither had seen them quite so pronounced before - but all was fine, as the site indicated).

Everyone is online now....even doctors.

Can I deviate slightly from the original post to ask a question?

I might be wrong but aren't there some conditions including tonsillitis where there's very little a gp can do but to be referred onto a specialist a patient has to present so many times?

Is that not a fantastical waste of resources? Neither gp or patient are in the wrong but how can that be managed? Do gp's go off the patients say so or could it be seen once let me know of any other episodes/duration and then refer...

I'm just musing really as I've definitely felt fobbed off in the past because I had no knowledge of how the system works and ended up leaving a condition to develop for ages taking on trust that 'it's just one of those things' as the be all and end all of what could be done medically.

As far as tonsillitis is concerned, you can't just refer to a specialist and have them removed any more. There are certain criteria (eg must have missed x amount of school, has a certain number of episodes in a set time) before they can be removed.

If they are infected then all you can do is manage with antibiotics (if appropriate).

I have a lot of respect for GP's, have actually just written a letter of praise to my previous practice and copied to CQC. I also do a job that people constantly criticise, and requires me to be professional towards a lot of people constantly.

However following my recent C section my midwife wanted my stitches checked by a doctor prior to removal, doctor begrudgingly saw me, and made me feel like I was fussing when another HCP had advised to see a doctor. He dismissed a huge lump in my stomach which 3 days later the nurse who checked me instantly asked a doctor to check and I was given medication for.

I didn't complain but I will request not to see that doctor again.

The only complaint I have made about a GP is the locus who took 3 non work related mobile calls during an appointment which was running 45 mins late!

Just to add - clinical opinion accounts for nada any more. It is all policy and target based - managers and policy makers are the ones making all the decisions, not the doctors.

And they don't have professional registration so when it all goes tots up, the Drs lose their livelihood and the managers just get a different job. Hopefully post Stafford, managers will be held more responsible.

Hopefully MrsMorton

The trouble is, RTB, if all the GPs who are burnt out leave before they do "serious harm to a patient", you're not going to have many left. In fact, loads are leaving and that's why we have a GP recruitment crisis in this country.

Also, your attitude is part of the pressure heaped on GPs. Not only does she have to be perfect 13 hours a day, every day, she also has to be perfect on an anonymous internet forum.

Yes, I was going to say the same as cornetto, to get a referral for certain conditions you need to see a gp a certain number of times. This usually means an emergency appointment each time the condition is in full swing.

My DS had a run of burst ear drums that would have been enough for a referral to ENT, but I stopped taking him after the first time as there wasn't anything they could really do. Turned out two years later that he had severe hearing loss from glue ear, so if we'd taken him in each time he might have got the grommets in earlier (and he's a changed boy now he can hear properly, his confidence has sky rocketed).

It seems a big waste of resources really. Our practice has nurse run minor illnesses clinics, so you feel less like you're bothering the doctor, but I'd imagine a lot don't.

broccoliear, does that mean patients should tolerate it?

No.

And that's what it comes down to. Tolerate it and it becomes acceptable and normal.

Bad attitudes from doctors breed more bad attitudes from patient and in turn more stress regardless of finances.

broccoliear, she shouldn't vent on an internet forum like this, as its a way of trying to silence whistleblowers. Its deeply unprofessional and actually brings the profession into dispute. I think if you look up what is acceptable from professional bodies for doctors and nurses, I suspect its in breech of their codes of conduct.

Just to demonstrate the utter insanity of it all, I wonder how many people know about new to follow up ratios in hospitals? These dictate the number of specialist appointments you can have before you have to be discharged back to your GP so that you can be managed in primary care? I.e. You can have 1 new appointment and X number of follow up appointments.

If the ratio is breached, the hospital is fined.

There can be no more than 12 months between follow up appointments, so patients with long term conditions that need specialist intervention need to be re referred by GPs to hospital specialists.

Now, this doesn't mean that all doctors should be excused all the time due to stress of the job; it is often better to address problems swiftly and appropriately so that a) things don't escalate into a bigger problem, and b) service improvements can be identified.

But quit it with the whole GP bashing thing. It's abhorrent and misguided.

On a tangent, but how can a gp tell if something is viral or bacterial without taking a swab??

So a GP isn't allowed to complain about their job in private or anonymously? Do you ever bitch about your job? The day she describes sounds phenomenally stressful and busy tbh. From her description of visiting the elderly man with cancer just for a chat and reassurance, I really doubt that she is letting patients see how fed up she is, she is venting here.

OP I would probably choose to see a different GP if I had a choice in future as she wasn't a good communicator with you, but I wouldn't complain in the absence of harm tbh.

In private yes milkpudding. However this is a PUBLIC forum...

can you clarify who is allowed to rant about work on an anonymous public forum please.

My GP always always checks my medication dosages either in a book or online. A lot of them are specialist so I have no problem with this, even if they were routine meds and the GP wanted to double check the dosage, wouldn't you prefer this to be checked rather than relying on memory, with the amount of medication and different prescribing routines available? Genuinely don't see why this is a problem.

What really annoys me though, why are you posting here OP, instead of mentioning it to the GP at the appointment? Presumably you're an adult who can communicate - you weren't happy with the GP's manner, why didn't you say instead of saying nothing, moaning on here and wanting to make a formal complaint? Why do people do this, I genuinely don't understand. As my mother would say, you have a tongue in your head, use it

FWIW, I think the GP was busy and harassed and of course we only have your side, maybe hers would be different. I wouldn't have taken my DC to the GP with those symptoms tbh.