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?

Blaming individual patients doesn't help anyone. It would be better to put a stop to all the articles in mags, radio, TV, saying "If you have x symptom, go to your GP".

There should be articles which state clearly: "Only go to your GP if you have these symptoms, not if you have these symptoms". There are vast offices full of health PR people who could put out that message, instead of the usual "if in doubt, see your GP".

Actually what we need is a website where you can input symptoms and be advised whether to see a GP or not. If told by a website to go to a GP, we couldn't then be given grief for going. It's very offputting!

Total derailment now but I want to stand up and say my GP is awesome. I have a chronic pain condition and all that goes with it. She sees me personally, very regularly, phones me and pretty much runs to time which is amazing considering how long I'm in with her sometimes. 45 minutes on Thursday. She constantly reassures me I am not a drain on the system and I am infinitely grateful.

I appreciate not everyone is perfect, not every surgery has an appointment system that suits everyone and god forbid, sometimes everyone has a bad day.

The original question was 'should I complain?'. No, thank your lucky stars you live in a country with free, accessible health care. As I said up thread, complaints should be reserved for cases of serious professional misconduct. Your son is ok. Get a grip.

I would never ever tell a patient off for wasting my time. GPs shouldn't be doing that. But there is nothing wrong with EDUCATING patients about what constitutes an appropriate attendance. And it's a fine art getting that right with a patient who feels ill, or has terrified themselves completely when there isn't anything wronged. I struggle to get that right and I'm a reasonably experienced GP now.

idioth as you have probably noticed I am a HCP... I have an issue with it but because they might have used a perfectly valid website, the same way that they use to refer to reference books.
I have an issue because of the problem the OP came with. It was nothing complex that required check up IMO. Actually it was so 'simple' that a lot if posters are saying that the OP should have made the diagnosis herself, known it was a virus and not bother to go and see the GP!! You can't have it both ways.
I also have an issue about how she used it ie to prove her point to just realised actually it didn't

In any other cases where the diagnosis isn't clear enough, she wants to check on something or whatever, then if course it's appropriate.
Maybe though entering the details on google isn't the best because it gives the patient the wrong impression, ie that the go doesn't know what he/she us doing or that the patient can just diagnosed themselves from google. Neither of them are true or suitable.

Beside I hope that you would react this way at a similar comment from a patient. But everyone is supposed to know what sort of professional apps or website professionals are using, including the GPs. Expecting that from patients is going miles to far.

Dazzle, that would not work. And in fact is not working - there's plenty of symptom checker websites out there and they usually arrive at 'cancer' whatever the symptom

The problem is not individual patients or even individual doctors, it is a mutual distrust and fantastic number the powers that be have done at pitching us against each other.

I also think that there is a wider problem of the society we live in being a fearful one: our health is better than ever (in general), but we fear ill health more. I am quite frightened how common sense has gone out the window, particularly wrt minor illness and minor accidents.

Oh, and of course I understand that it can be very difficult to open up about a difficult problem to a HCP one does not have an established relationship with (I've been there…) and taking ones time is fine of course. Maybe it will take several appointments to get to the root cause of things? Further tests? Trust that only develops with time? etc etc.

I feel very strongly that the Daily Mail and similar rags should be sued for all their worth for the damage they have done and are doing. The twisting of the truth, biased reporting, downright lies - I hope they will have their comeuppance once.

I wish more people voiced their unhappiness about what they encounter in the NHS towards those in power - by all means, make complaints: as I've said before they are a valuable means to address issues in individual practices and with individual drs. But the systematic failure of various bits of the NHS goes far wider and deeper than that and is NOT individual doctors fault or responsibility.

Wrt to antibiotics: the vast majority of upper respiratory infections, whether viral (when they are totally useless) or bacterial do NOT require antibiotics. Sometimes they do and that is where an assessment comes into it. And sometimes illnesses develop and the plan needs to be changed. Medicine is not an exact science, but an art - using Google or the BNF or any number of other tools is just like an architect using a calculator/computer rather than doing everything in their head. I'd much rather look something up (and frequently do) than make it up as I go along - would you not rather I did? I've been in this job for over 20 years and have come to accept that children's doses will forever defeat me. So shoot me.

At the end, the OP criticised the GP for looking up the antibiotic dose. But that was an example of GOOD practice. The dose varies according to age and size, often with two different regimes depending upon severity of infection, and the dosage recommended for one of the most common abs changed within the last year. Every time we get new trainees (6 times a year, twice being GP trainees) we hammer into them that the only safe way to prescribe for kids is to look it up every time.

Well as I say it is appropriate and doctors do use it and are expected to.

There are score systems for certain things..I don't deal with sore throats v often but no doubt it was a guide to ABX use for distinguishing between viral and bacterial throat infection.

I often go into medcalc , even in front of patients and say' I'm not on my phone , just inputting your score into the protocol app.' Works for me. Everyone can have their opinion but it doesn't make them right. Maybe those reading the thread will now realise googling is ok.

friar you just have missed it before, I asked if you worked in primary, secondary or opt in health care. Just curious. It does change things slightly.

Friar has not said she is a doctor, she has said she is a HCP and clearly reluctant to say where/what she does, funny that. Like everyone else, so quick to judge a job you dont actually do.

Hotbuttered- You are missing my point- i was answering the question that was asked. 'Why are we so hard on GPs?' That is why we are hard on GPs. I know for a fact the salary and pension bit isn't true. But that is what the public are told. You don't have to explain to me about public sector pensions, I am a teacher and pay £100 a month more for a reduced pension that I cannot access until I am 67 instead of 60. My point is that the public is told repeatedly that Drs have gold-plated pensions, earn a lot ofmoney and never work over time. I didn't say it was true.

I have no idea why my practice can't appoint GPs. They never communicate with us about it. Much as I suppose parents of children at my school know we employ weak Maths and Physics teachers and wonder why. We can't get decent ones- why would they want to work 70-80 hr weeks for 21,000 starting salary. We don't explain that to parents. It is not there business. It is ours to make sure we try to get the best teachers and develop weaker ones into stronger ones. There is a crisis in teaching too at all levels. No one wants to be Heateachers either. In my local authority 3 secondary schools have advertised headteacher posts in the last year and been unable to appoint.

I never said I wanted to see my GP for longer than 10 minutes. I said if I go and want to talk about two things I am told I should have made a double appointment. My point is it does not need a double appointment. I go 6 times a year because I can't have my medication unless I am seen every two months for a check- up which takes 3 minutes. I have no idea why it has to be done every two months. I have asked and been told it is the protocol. If I mention something else at the end of those 3 minutes, I am told I should have made a double appointment which just seems stupid to me.

I did not ask for skin tags to be removed. I didnot mention them to the Dr. I had gone formy two monthly check- up and he mentioned them, because he noticed one was inflamed and had been bleeding. My post should have said it was Dr R I saw when I went to have them removed - the same Dr who suggested they were removed. Typo said Dr D. My point was about the time wasted in the system by him then referring me to a nurse, who eventually booked an appointment that was with him.

I do wait 45. minutes at least for every appointment. Why should I feel that is unreasonable?

I am sure GPs work really hard- no reaon to doubt that. I teach between 25-31 students for an hour 25 times a week, mark all their work, write reports, am held to account for their GCSE and A level progress every 6 weeks. My marking is scrutinised, surveys are done with classes about what they think of my teaching, my teaching is observed, I train other teachers, I deal with parents, students teachers, social services, CAMHS, the school nurse service. I am responsible for the quality of the work of 8 other teachers and 800 students results in my department- on which their future college courses, university places and careers depend. The government change the rules every fortnight or so and it's quite appalling really. I either get on with it and do may best and ignore the people who moan that teachers work short hours and have long holidays or I can quit. I stay because I believe in public service and free high quality education as a life- changer- as I believe in the NHS.

Nothing I said was unreasonable- you chose to read it like that, take offence and get on your high horse. Get off it and have a bit of humility and stop being patronising.

Honestly, all public sector workers are over- worked. We all do important jobs that affect people's lives and futures. You are better paid than most people. Stop being so defensive. You are a Dr to serve patients- public sector, public servant. It is an absolute privilage to be a Dr or a teacher and have people trust something so precious to you. I have a right to an opinion without you accusing me of being a Daily Mail reader- how patronising and sneery you are. By the way, I read The Guardian and The Independent.

No one expects patients to understand about the apps but don't criticise too readily what you don't understand..there has to be some respect for Drs too. I wouldn't be rude about my Bank if they used an app or calculator ..they presumably know what they are doing.

I didn't say she said she was a Dr macd I just wondered... y'know, sometime homeopathists call themselves HCPs...

One of these was even called to give "evidence" to the GDC. Quite how someone can do that when their entire practice is based on bullshit is beyond me. Still, at least the investigation didn't cost almost £80k... oh wait...

There are HCPs and there are HCPs, that's why I ask friar what sort of HCP you are.

Actually no I'm not a doctor and never said I was.
And the reason I'm not saying is two folds 1- I value my anonymity so I'm not going to say On here what I am doing work wise, regardless of my job and 2- I am very used to having people such as 'doctors' dismissing other HCP because 'they are not doctors so they can't possibly know'. Which is exactly what you are saying now

My point was actually much more about supporting some the pov if 'doctors' on here. I do have other experiences about being with patients though and they are neither better not worse than yours. Just different and interesting because I would hope they can shed light on other ways to do things, which I'm sure you would be interested in as a way to improve things.
I'm also not British which is bringing again a different outlook (eg on my country GP would ALWAYS treat a sore throat with pus on tonsils with ABs and they would ALWAYS do a check on what sort of infection/bacteria of things haven't improved within a couple of days. As you know ways of doing things vary a lot from country to country even though we are all supposed to look at the same evidence)

Fwiw I agree with your last post pacific that it is an issue with the system rather than the people. And that some people such as the pitied and the DM have a lot up say about it.

Not an homeopath btw...

I too am not British.

In many countries antibiotics are freely available over the country - which is a (small) part of the world-wide crisis of antibiotic multi-resistence.

IME many people from my home country have an abhorrent fear of antibiotics and treat them like poison and both over and underuse of them can be dangerous.

After teachers GPs must be the subject of more negativity on this forum than any other profession.

I'll explain again my point about google.
There is NOTHING WRONG about using professional apps and websites.
However what the patient SEES is the GP entering a search on google just as what they would do at home. So they will assume that the GP us doing the same than what they do at home. I've had countless people telling me exactly that. And no these people aren't convinced at all by it.

I'm not judging the fact GP etc use reference websites. I'm saying that it is not what the patients are seeing because they are NOT told about it (unlike what you are doing idiot)

Wrt rapid antigen testing:

"Targeted use of antibiotics for acute sore throat with a clinical score improves reported symptoms and reduces antibiotic use. Antigen tests used according to a clinical score provide similar benefits but with no clear advantages over a clinical score alone."

from here

The test is not available in the UK as a matter of routine, nor does it need to be IMO as there are 'no clear advantages over a clinical score alone'.

Can we all bear in mind that we are trying to provide the best healthcare possible with a limited pot of money? In the face of ever rising costs of more and more complex treatments and investigations.

Commonwealth Fund analysis of different healthcare systems around the world.
I can very happily live with what it shows.

I do not want to live or work in a country where health care is provided according to wealth.

Yes it's probably better to quickly say.

Lulujakey- with respect, it is quite easy to miss your point as you did not preface your remark with that question nor explain it afterwards.
The poster just after my post responded in exactly the same way and mentioned The Daily Mail in addition.

I have re read your post and it still reads like a whole catalogue of (mostly unreasonable) complaints. Clearly, whatever I may think, you feel that you are entirely reasonable and I doubt that anything I say will shake that belief.

I appreciate that many teachers , work hard although I don't see why it is relevant to this thread. At least the government don't seem to 'have it in' for teachers in the same way that they do for GPs. For more than 10 years, there have been constant headlines about how much GPs earn and how little work they do. Frankly, it gets one down after a while, particularly when it is very far from the truth.
As I said before that is not an excuse for rudeness or unprofessional behaviour.

But that brings me back to the job of the vast armies of PR professionals who work, at great expense, for the NHS. They need to get the message out that GPs may Google, they no longer syringe ears, they will be iffy about anti-biotics, etc etc etc. GPs expect us to know all this. How?

Whoever was going on about the Daily Mail - you can be sure they are well in with the NHS PR people. So sort that out - ie, make sure the PRs are giving out the right messages - and let us, the public, know what we are supposed to expect. And what we actually pay for, in our taxes.

The PR professionals work for the government and they are doing exactly what they are told, and that is to ensure that the NHS is brought down, but by blaming the front line staff, and ensuring that the public believe their "private cronies" will provide a much better service.
Roomsdoom, with the utmost respect, piss off with telling me about reflecting and other careers, just really piss off. It is GP's like me who have the balls to say it like it is, and stand up for our career, instead of pulling on the cardigans and giving in to everything, because of their over riding desire to be liked and needed, who are trying to save the service. I want to protect patients now and in the future from a health service based on wealth and want, not on need. Perhaps it is you who needs to rethink your career choice, perhaps social worker would suit you better!