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?

ahh screw it.. typos galore

The thing about the pharmacist here is that they always give the same advice " see your GP" always without exception.

I think the problem with Macdoodles post was that it sounded like we should all be understanding when a GP is blunt/rude with us because they may have seen our complaint 20 times that day already and he/she has had enough. Well, no. I understand that they are rushed off their feet and the working conditions sound awful but I won't accept a bad attitude from a gp and pass it off as them being stressed or bored of seeing my symptoms for the 20th time that day. Plenty of people in their jobs have enough... I am sure police officers have enough of dealing with certain people and surgeons get bored if they have to do the same operation all day long and supermarket workers get bored of being asked where the stuffing is.

The thing that stuck out to me most actually was the line about how complaining made the GP feel. This is emotional blackmail and discourages complaints and this wall of silence that has damaged medicine.

The truth is, when considering whether to complain how the nurse/doctor/other HCP might feel because of it is a total red herring and irrelevant. It should not be used as something that a patient should think of.

Not because the patient is being malicious or we shouldn't have sympathy with the doctor, but because it means people are less likely to complain and feel they can complain. It closes the door to communication and how to improve services. It lets things fester. Which is no good for anyone.

Someone can feel shit from an invalid complaint against them, but also feel shit because of a massively valid complaint and that's really the point.

This is why it is deeply unprofessional for a doctor to be saying this.

The complaint I recently made, I didn't want to. Precisely for this reason. My DH actually made me do it because of just how upset I was and how much small remarks had a massive impact on me. When it came to it, my complaint was taken very seriously and they acknowledged how important communication was and how handling things badly can have serious consequences. It was handled remarkably sensitively and well considered.

The person in question, was referred for retraining and they wanted to use it as a example for future training. I actually think by complaining, its improved things for the future not just because I had a beef with a certain person. I still feel guilty about it though and the impact on that HCP despite all that because of this culture that exists about looking down on complaints.

Do not underestimate the power of that single sentence and the damage it does.

The GP was not rude.
GPs should be helpful and explain things but its not cause for complaint. She hasn't done anything wrong, just a less than ideal style.

I agree RedToothBrush

I am not entirely sure if the OP should complain, I don't think it was a great visit but it probably wouldn't be enough to make me complain, but I completely agree with the rest of your post.

For me, what came across quite strongly was the contempt I felt that some of the posters ( in the medical profession) had for Some of their patients.
I found this really unsettling. The language used to describe some of them was appaling.

Why don't you direct your ire at the system which everybody knows is hugely underfunded, and struggling, to cope instead of patients who are for the most part pretty powerless, and just trying to access services which they are perfectly entitled to do.

What exactly is that instant test and why has no UK doctor ever heard of it? Did you by any chance read about it in the Daily Fail?

No Kundry. It's called a rapid antigen test and I've watched the doctor doing the test on my children several times. It has been very useful in diagnosing strep particularly for my daughter who has enlarged tonsils.

Next time you want to accuse someone of making stuff up perhaps engage your intelligence first?

Well said Wobbly A touch worrying that apparently according to some posters, no UK doctor has ever heard of it! so much defensiveness on here.

I took DS1 to the GP with viral wheezing earlier this year. I think he expected that I was going to ask for antibiotics, as he was initially quite dismissive and rather nastily said "Well what do you expect me to do?"

I asked for steroids to stop the wheezing and prevent him being admitted to hospital, and the GP was suddenly much nicer...

The last time I took him for the same issue, we saw a different GP, who put him on a nebuliser straight away and called an ambulance for him!

You posted the link wobbly. Interesting and no we don't have it here.
I can be nice all day to people. And have been 99% of the time over the last 23 years but, when I am duty doctor my guard can slip because you know that you have so much to do. I spent one Monday morning trying to see extras and get them to the surgery but the calls kept coming in and when a patient mentioned her son needed seeing too I must have sounded exasperated because she pulled me up on it when she was in the surgery. Her son was fine actually. I said that I was sorry and didn't mean to come across dismissive but the morning was incredibly busy. She was fine about it.
I think it is the unpredictability of the job that takes its toll on you plus the extra stuff we have to do now such as regular meetings about things and drawing up plans to keep people out of hospital. These all take us away from the patients.

I think the GP in the OP sounded as though she didn't have the best consultation but did do all the right things. (We all have consultations that are bad sometimes) If you want to complain that is your right but constructive criticism is better than "all out flogging". If she is a trainee it would be discussed with her trainers and they may do some more joint consultations or videoing to look at her consuktation style.

"Well, what do you expect me to do?" - said sneerily - is increasingly what you get from a GP. They are very angry people.

I'm sure I should qualify that. Not all GPs are sneery, and I'm sure no MNers who are GPs are sneery. IME they tend to be nasty old guys.

Wobbly The NHS is not an infinite source. There are plenty of places that primary healthcare needs money pouring into but diagnosing throat infections is not a priority IMO.

I would be very uncomfortable about a GP googling some info to check if ABs were needed. Sorry but I would really expect them to know that wo having to check. And I would also be able to expect her to be able to explain why wo having to use google to prove her point (and then find out that that google actually says the child needs ABs)
The temperature part is worrying too. Surely she must have felt by the touch that the child has some temperature.

Fwiw I am a HCP too. I see patients and some if them can be aggressive and it's part if your job to deal with it.
And yes there are some good GP/HCP and some not so good ones. There are some patients who are hard work and some who aren't.

The one thing I would say though is that I don't agree with pacificdog on the fact that patients should state clearly what they want. Yes I am sure it helps. Yes I am sure it make the communication easier. And yes the GPs don't really have time to unpick things. But my experience, as a patient and as a HCP, is that it's extremely hard for patients to do that. Fir one you can't always verbalise what us going in your head. Then you might never have seen this GP before and to do that you need to feel comfortable/trustful enough. I know it can take a long time for people to tell me what us actually wrong/what they want. (And I have the time to do so unlike the GP)
What I'm trying to say is that I believe it's wrong to put that on the patient's shoulders.
Unfortunately the system doesn't allow that and we are now in a system where patient/practitioner relationship has been reduced to nothing. Which is a shame because studies have shown it is just as important to the outcome as the medication that us being given.

What sort of HCP are you friar ? Primary, secondary, elective? Just curious. I would work in secondary again at a heartbeat, primary just isn't worth it IMO, patients want everything and won't give anything. Secondary is much nicer.

Re explaining the difference between viral and bacterial, maybe too it would be nice to go further than 'oh 80% of site throat are viral so we don't give AB for that' which is the answer I was given when I went there with tonsils completely covered with pus.
I would love to see the test wobbly was talking about routinely used, esp with children.

On a slightly different but perhaps relevant note, I read Macdoodles first post and more or less agreed. I used to be a HCP and was complained about twice in my career, for things that were totally unreasonable and unsubstantiated. It made me feel like shit.

But, three years ago, I suffered irrepressible harm at the hand of a senior, and I mean senior, HCP. I was initially worried about complaining and considering legal action but was reminded that actually the threat of complain and litigation does keep standards high. I am engaged in litigation now.

I expect a total flaming for this but in response to the op, you were annoyed by her manner. She didn't do much wrong. Maybe she had toothache.

Complaints should be saved for serious concerns and issues. Investigating complaints actually takes a huge amount of time within the nhs.

We are hard on GPs be ause we are constantly being told they earn £100,000- 200,000 a year with no out of hours work and protected public service pensions yet we see them for just 10 minutes and at my surgery are told:
If you want to talk about more than one thing you need a double appointment.
If I ring up to see the GP who has asked me to make a follow up appointment with her in a month's time - her diary for then is not open yet, they can't tell me when it will be, I just have to keep ringing bak and see and then when it is it is booked for a month within a couple of hours and I have missed it.
When I do get an appointment the surgery runs at least 45 minutes late
They have been a Dr and at time 2 Drs down for the last 4 years ( out of 4). Locums come and go and you can see any of them because no one wants to see them.
I was told by Dr R (not a locum)that I needed skin tags removed round my neck in minor surgery. He would ask the nurse to make the appointment. 3 weeks later I rang up and spoke to the nurse who was 'just about to ring me'. She gave me an appointment for a month later. I turned up, it was with Dr D and it took 5 minutes. Why didn't he just do it in the first place- it would still have been within my 10 minutes

Don't always agree with mcdoidle but certainly do here.
I'v had tonsilitius repeatedly for a year till i had them out and i stopped having antibiotics as it just wasnt worth it. I had tperarures everytime.
I took painkillers and had cold wet flannels on myself. Best course is too let it run it's course.
I don't think it's odd for gp to look in books or net either!
My two doctors have looked in books loads ( i have a disability and few health problems) and they were always looking up medications to see what would help.
I think they are overworked.
Everytime i try to book in theres a two week wait or more. It's always busy and for one doctor i can wait sometimes over two hours for my booked appointment. With only 10 minutes slots though!
Iv had various things to go through when i see them yet they never rush me so i'm sure i'm over my 10 minute slot!

I do think we have lost the ability to self-help though. We are so lucky to have a free-at-point-of-use service that I think we do take it for granted at times and 'just get things checked out' when we don't need to. Case in point - last year I had a never ending virus - 3 weeks of a cold, that eventually turned into extremely painful sore throat, aches and high temp. I didn't look down my throat until late on a Friday evening and was horrified to see massive tonsils, covered in huge, white, pus-y lumps. I freaked out, not having had tonsillitis since I was a child; but I'm sure if I had gone on here I would have been told to go to out of hours because I definitely needed antibiotics as there was pus. Went on the NHS direct website - it said that most times tonsillitis will go by itself. The most important thing is rest, fluids and painkillers. Only need to see a doc if you can't swallow your own saliva, have problems breathing or you start puking. As was late on a Friday, I thought I'd leave it until the next day. It was still bad, but I stayed in bed and thought if it wasn't showing signs of improvement by Monday I'd go to the doc. By Monday it wasn't 100% better, and I was still feeling bad - BUT it was improving - the spots were smaller etc. So I got over tonsillitis, with pus-y tonsils, by myself. My immune system did it and the advice to rest, drink and take painkillers worked. I'm glad I didn't waste anyones time getting antibiotics I didn't need.

Antibiotics are not a quick fix. Apart from the problem of resistance, they can seriously screw up your digestion and make you have a whole load of other problems. They're there for when you really need them.

Doctors can be arsey - but so can a lot of patients. I think that the NHS must be one of the most difficult places to work in at the moment. There simply is not enough investment in it or resources to go around. The government needs to stop killing it, but they don't want to - they want a privatised system like in the US, so they won't stop breaking it until they get it. And I think we all need to take a step back and seek help elsewhere if we can - pharmacies, practice nurses, NHS website are all good starting places. I'm not saying don't see a doc - I am saying, sometimes we're ill and we can deal with it ourselves so we need to stop going to the doc for every single sore throat or cough we get and try other things first.

Because Dr R does not do minor surgery probably. Not all GPs do cryo/minor surgery.

Oh and we don't earn £100-£200k... I certainly don't. I'm sick of hearing about my supposed massive wage packet.

GPs do out of hours. It's run differently though. I don't do OOH but most GPs do duty doctor days. I do a 12 hour on call shift once a week. (My other days are often 12 hours but that's unpaid). I have to see my family at some point hence why I no longer do OOH sessions on top of my regular work.

We run late because 10 mins is not enough to sort out every problem the patient has. Try sorting out a potential cancer referral in 10 mins!!! Try to sort out suicidal thoughts and depression in 10 mins! We run late because we bloody well try our best to sort out these issues. Next time you bring your list of problems in your appt lulujakey and the GP does try to sort them out, running over the 10 mins remember the rest of the patients on that clinic are late because of that.

OR patients actually turn up late to appointments still expecting to be seen making the GP run late. Or what about the patients who constantly do not attend their appointments at all, wasting a slot that could be used. I firmly believe we should start charging people for not attending appts like my dentist does.

It's not GPs fault there aren't enough GPs to meet demand. Is not GPs fault we only have 10 mins to see patients (it used to be 5 mins and 7 mins at one point). We didn't put the 10 minute appointment rule in place.

It's the governments fault. Plain and simple. They are destroying the NHS and we are their target for redirecting the blame.

We see 90% of daily NHS contact yet have 8% of the NHS budget. Yet we're apparently the scum of the earth and the root cause of all the NHS' problems. No wonder there's a recruitment crisis in GP.

By 'LuluJakey1":

We are hard on GPs be ause we are constantly being told they earn £100,000- 200,000 a year with no out of hours work and protected public service pensions yet we see them for just 10 minutes and at my surgery are told:
If you want to talk about more than one thing you need a double appointment.
If I ring up to see the GP who has asked me to make a follow up appointment with her in a month's time - her diary for then is not open yet, they can't tell me when it will be, I just have to keep ringing bak and see and then when it is it is booked for a month within a couple of hours and I have missed it.
When I do get an appointment the surgery runs at least 45 minutes late
They have been a Dr and at time 2 Drs down for the last 4 years ( out of 4). Locums come and go and you can see any of them because no one wants to see them.
I was told by Dr R (not a locum)that I needed skin tags removed round my neck in minor surgery. He would ask the nurse to make the appointment. 3 weeks later I rang up and spoke to the nurse who was 'just about to ring me'. She gave me an appointment for a month later. I turned up, it was with Dr D and it took 5 minutes. Why didn't he just do it in the first place- it would still have been within my 10 minutes'

As a GP, I find this post so depressing. I'm not even sure where to start.

Perhaps you should pause to think before taking everything that you see in The Daily Mail as fact. Most GPs do not earn anything like the figures you have quoted there. The pensions contributions have gone up and the amount that we will have has reduced (in the same way as teachers, firefighters, etc) but you haven't heard anything about that have you?

Perhaps instead of complaining you might pause to think why things are not running as smoothly as you would like at your surgery. You complain that you would like to see the GP for longer than 10 minutes and that you find it unreasonable that you are asked to book a double appointment to deal with more than one problem. You also complain about the GP not having removed your skin tags during the first consultation because 'it took 5 minutes'. Incidentally, removal of skin tags for cosmetic reasons is not funded on the NHS and the GP was under no obligation do remove them for you at all.

You then also have the cheek to complain that the GP always runs 45 minutes late. You don't seem to have considered that patients like yourself who have unreasonable expectations of what can be managed in a 10 minute appointment might be contributing to this? In addition, there are patients who genuinely need more time because they are very ill, severely depressed, etc.

Most GPs have 10 minutes to scan the patient's notes, speak to them, examine them and write clear notes of what has taken place (this is v important nowadays as patient complaints are much higher than they were say 20 years ago when GPs could get away with a couple of words).

Perhaps you might consider why your GP practice is two doctors down and has so many locums. Does it not cross your mind that they might be having trouble recruiting more GPs?
If General Practice is so well paid and straightforward with no out of hours care then surely there would be qualified GPs desperate for the jobs. This is clearly not the case as you can surely see within your own surgery.

There is currently a crisis in General Practice as other GP posters have alluded. Older GPs are retiring early or cutting their hours, moving to rural and quieter surgeries, younger GPs are not interested in partnerships (yes, despite the supposedly huge pay), junior doctors are choosing other specialties. The workload has been increasing and increasing to unsustainable levels and yes, it is starting to show and things will get worse.
I would urge patients to disbelieve whatever the latest anti GP headlines that the government has fed The Daily Mail, etc and try to understand what is going on. (I am not trying to excuse any rudeness on the part of a medical professional with this last remark but I am fed up of ill informed people talking nonsense).

Why do people believe everything they read in the Daily Mail media? Do intelligent people seriously believe that the average GP earns between £100 and 200k?! Not a GP btw or even a HCP but I am a front line public sector worker who is struggling with the expectations of people who use the service.

The thing about Macdoodle's post is this: I can understand that GPs are overworked, and I fully sympathise but - it's not my fault. There are no doubt people who go to their GP for the most trivial thing, and then there are people like me (plenty of people like me, actually) who worry about "bothering" the doctor. There was a news story the other day that half of people with cancer symptoms don't go to their GP about it - things like a persistent cough. And those are people who think, I won't bother the doctor, because they know their GP was already overworked. And they worry that the GP is going to snap at them for wasting their time.

There was another story a little while back - I'm sure people will remember it - where a baby died because the locum GP misdiagnosed the baby over the phone, and told the parents to keep it cool because it probably had a bad cold (I think it had meningitis - can't remember the details.) But when the parents were interviewed at the inquest, they said they deliberately hadn't taken the baby to A&E because they were always reading about how A&E departments were overburdened with people going in with minor complaints.

In the OP's case, her DS's symptoms were severe enough that she needed the GP to look at him properly. And maybe the GP was overworked and had spent hours seeing people with trivial self-limiting illnesses - but why blame the OP for that? It's not her fault.

Thefriar
You can feel worried about the GO accessing Google if you like but there is no need to do so...Drs have to use Apps either via I phone ( or google if out of signal ) to access medcalc...a scoring app that scores individual patient scores fr certain things and that drives a decision usually about further investigations etc.
It's a bit ridiculous to comment about the competence of the Dr when you don't really know enough about how some of their protocols are accessed.
If an accountant got a calculator out would you tell him off for not doing mental arithmetic ? Would you make an official complaint?

This thread is an example of how many people feel they know better than the Dr and are only too happy to say so. That's a free right but misguided as the don't have the medical training and subsequent training experience to know anything about it.