This man should not have been seen before us

[Teenagecrisisagain]

Dd2 felt unwell after school. Suspected UTI and very high blood sugar (she has type 1 diabetes). I called for an emergency appt and was told yes but we may have a long wait. That was ok as she needed to be seen and often there is a wait

We got there and waited. And waited. After 45 mins dd was quite fed up and obviously feeling rubbish so o have her water and tried to distract her etc. after an hour she was more unhappy and tired.

Our surgery is not a walk in. In our borough there are three big walk in surgeries /ooh for anyone and also both hospitals have urgent care centres

A man walked in and said he had an appt. after a while two receptionists were speaking to him saying it was impossible he had an appt as he wasn't registered with the surgery. He kept arguing saying he wanted to see a Dr. They kept saying no. They asked where he lived and he named somewhere approx 30 mins away so not even in the surgery catchment. He sat down and refused to go saying he wanted a prescription.

They kept reiterating he wasn't a patient and they didn't have his medical notes but he insisted.

They then let him see a doctor! Dd had to wait another 20 minutes so I complained and they said "oh we had to see him he had been waiting" to which I replied "so have we and dd is six years old and feeling very unwell and had to wait longer than someone unregistered who just walked in and demanded an appt???!" They just said "sorry"

AIBU to put a proper complaint in tomorrow to the practice manager? There's no way I could walk In to a random non walkin surgery and just demand to be seen! It's not fair at all when other people have to register and wait

Clarence the surgery wouldn't be able to explain why they allowed the other patient to go first because of confidentiality issues but there could be a real risk by not allowing him to.
Lougle has explained why the twenty minutes didn't make a difference to OP's dd but twenty minute might have made a very big difference to the man who was seen before them.
At the benefits office twenty minutes for some clients could have been the difference between them being loud and aggressive to them physically assaulting members of staff or others waiting.

I would put a complaint into the practice manager.

No wonder so many people act like total arseholes when the whole world bends over backwards for them when they kick off, as illustrated by this incident and the benefits office incidents described by insan1ty.

GreenFish I don't think any of us thought it was fair but when you were faced with people (this was before the protective screens and the security guards that they have now) who were unstable, on license, had form for serious assaults on staff previously then everybody's safety overruled what was fair.

I don't see why you shouldn't complain. Just seems if you make a fuss now people get attention. Same in A+ E. I've had numerous visits both by ambulance and when taken in by myself with my children with asthma attacks and breathing problems and I've seen it all too often. My dad did too. (A&E Dr) He was always complaining about it.

I really doubt that it was a methadone script, even our out of hours gp wont write a methadone script, they get referred to the drug and alcohol team.
The prescribing of controlled drugs is highly regulated after the whole Harold shipman affair

Yanbu but they probably didnt want a scene in the doctors

It could have been diazepam or anything else that you can violently fit and die from stopping cold.

He wasn't registered when he turned up at the desk but could have been registered as a temporary whilst waiting for /seeing the Dr. (I have done this at a random surgery, didn't get to skip a queue though)

A 6 year old type 1 insulin dependent diabetic child who has high blood sugars and infections needs to be seen promptly. They are at just as much risk of a bad health outcome as the random man.

No wonder so many people act like total arseholes when the whole world bends over backwards for them when they kick off, as illustrated by this incident and the benefits office incidents described by insan1ty.

But those 'total arseholes' have the potential to cause very real damage to a staff member. In a previous job I had a knife held to my throat by a man who didn't think he was getting seen quickly enough. I could have let him hurt me, or I could serve him (whilst keeping him busy while we were waiting for the police to arrive). If someone in the waiting area had complained about waiting longer because I didn't want a knife in me, then they are the ones who would be the total arseholes.

madamginger is right. GPs can't just print off a methadone script for any random patient who walks in. Our patients are registered for prescribing with our drug and alcohol team or with shared care GPS, and before prescribing for any new start the doctor has to contact a pharmacy to arrange dispensing.

YANBU.

Maybe the Dr just fobbed him off with some paracetemol? :)

t1mum I understand about diabetes. I really do. But the OP hasn't said that her daughter was sent to hospital for sliding scale insulin. The doctor would not have been able to do anything other than prescribe antibiotics. Antibiotics take time to kick in. The UTI wasn't so severe as to need IV antibiotics. Even if the DD had been sent straight to hospital, it would take far longer than 20 minutes to travel there, be triaged, be admitted and start treatment. Therefore, I stand by my assertion that 20 minutes made no difference and that the DD wasn't harmed by a 20 minute wait. Furthermore, GPs aren't emergency medicine providers and if 20 minutes would make a crucial difference, then the OP should have gone to A&E, as her DD would be in an emergency situation.

As a recent-ish (Nov 2015) T1 mother I have rapidly realised that only a teeny proportion of the medical profession and allied workers know anything about type 1 diabetes and how very rapidly high blood sugar can turn into a medical emergency. OP you were very patient and I probably wouldn't have been. I would probably call the diabetic team at the hospital but I guess you can't do that for everything.
lougle not picking a fight but sliding scale insulin therapy is no longer recommended as treatment for diabetic ketoacidosis. As I said, there is a lot of ignorance.

Interesting. We use it in ICU all the time!

oh well lougle it's only the opinion of the bmj so what do I know?

bestpractice.bmj.com/best-practice/monograph/162/treatment/step-by-step.html

Do you know what, I really don't want to come across as an arse - I'm in awe of all doctors especially with the nhs as it is but when you do have a child with a chronic condition you research everything and question everyone. It just piqued my interest because I had read about it recently (my child was admitted for DKA). Anyway this is off topic and I'm quite tired (3am hypo) so

As a t1, I can't believe your poor dd had to wait so long, irrespective of this man and his antics!
Hope she's ok today.

BillSykesDog Have you a source for that? It is inexcusable. Travellers are entitled to equal but not to preferential treatment.

Oh god.

Writing a letter is not going to do any favours is it? Your Daughter had a temperature.

How do you know he hadn't ran out of emergency tablets, anti psychotics etc?

Maybe they realised that a child with a temperature wasn't that much of an emergency?

I've been on the other side of this - I'm a type 1 diabetic, had an infection with high blood sugars, and a woman with a six year old came in and demanded to be seen first because her daughter was thirsty and they wanted to go to the shop to get a drink. I was even more when the receptionist sent her in first.

I think YANBU but complaints never get me anywhere at the GP. I've tried twice (not for the above incident) and got a load of excuses both times. I just put up and shut up now.

As a mother or T1 child I would have been pretty cross and also would have complained.

However, I wouldn't go to my GP in this type of situation - I'd phone our PDSN and get advice from them and if necessary go straight to the hospital. No offence meant to GPs at all but I do find you are better dealing with specialists in paediatric diabetes.

I hope your DD is feeling better soon. And just checking you do have all the stuff to check her ketones at home don't you?

A few years ago a man kicked off in a waiting room at a local doc's. He proceeded to set himself on fire in the surgery.
At a guess, that's the kind of incident your receptionist wanted to avoid, OP, but they should have at least had a quiet word with you about why he got to jump the queue.
Hope your daughter is feeling better now.

Notgonnaanswerthephone - do you know anything at all about type one diabetes? It wasn't just a generally well child with a temperature. Lordy, I despair.

BillSykesDog Have you a source for that? It is inexcusable. Travellers are entitled to equal but not to preferential treatment.

I'll try and find one. I actually worked for the NHS doing the admin side of putting a gypsy and travellers policy in place at the time (2010) and part of that involved going over the policies of a lot of other trusts. They certainly weren't equal to others and there was special treatment, eg they would be seen on demand (with as many relatives as they wished) because the potential they could be moved on meant they should be seen immediately. I'll have a look later (bit short on time now), but not sure if I will have full access just as a member of the public because I no longer work in the NHS.