GP is forcing me to go for an appointment

[alwaysprepare]

Don't like going to dr's or hospitals, never have. Moved to a new town and was told I need to have a dr appointment if me and the kids are to be accepted.
What would they find to refuse us a place? If I have cancer or an infectious disease, does that mean they won't accept us? Why is this linked to my children who do not have an appointment?

I ask because I have had 4 GPs in London over 15+ Years and have been advised to do a check up with the nurse, but never once obliged to take this appointment or else...........

Also, we are just not sick people. We had the usual coughs, noro, etc, nothing you cannot treat with over the counter medicine. Been to the hospital for a broken arm, but do not go to dr unless it's an absolute emergency- I am talking post baby years here. Still all this was no problem with previous GPs, they only saw us when we made an appointment. It seems like a waste, when that time could have been given to someone who actually feels they need it.

Yes, QOF is still live in England.

It was killed, with fire, because it was crap no longer fit for purpose

Oh, and the GP Negotiators and the Government Negotiators work at the pace of glaciers, apparently.
We are currently in Year 2 of no contract and 'interim' solutions are in place to pay staff, rent, surgery bills, HCP etc etc.

We live in interesting times....

'This is why physicians associate jobs are being implemented, to try and cover the shortage of GPs but I'm aware some GPs are against this.'

I wonder why? Perhaps because other people will prove their sometimes very inflated salary is not justified. My gp is great. What she does though could be done by any of the hcps at the practice. Hospital consultants are completely different and highly specialised.

I sense you have an issue with GP's.. I think go to this appointment for the sake of getting your children registered

That certainly sound 'interesting'. Is the plan to try and make QOF look like a better option?

Myrtle, will respect, you have no idea what GPs do.
My DH is a hospital consultant and after 20+ years of living with a GP, he still doesn't really know what I do

GPs are Specialists in Primary Care, they are experts in assessing risks, they coordinate care, they (typically) know their patients better than any specialist.
It is a completely different role from a hospital one (I have done both). It is a brilliant job but behest with difficulties and when 'free at the point of access' Primary Care goes (and it well may) I know I will miss it (as I am also an NHS patient, as are my children).

I don't know much a Physician's Assistants, it is an Amercian Concept.
I personally have not truck with other HCP being trained to take over some of what traditionally GPs did (I have not syringed an ear in years! - nor do I wish to), as long as they are fully qualified, have the legal backup and are prepared to carry their own risk when things go wrong.

Oh, and the money GPs make...
That DM headline from a few years ago has a lot to answer for.
I make more than a teacher and far less than I would if I worked in hospital.
My income in not in 6 figures.
I earn well, I am not complaining about my income at all, I never have - but I am getting fed up with the profession being seen as lazy, incompetent, greedy and generally useless.
I don't mean that that is what your implied, Myrtle , just the prevailing wind is harsh at times.

For the record, I love my job.

It's normal. If my last two have been anything to go by, they take basic health details and medical history and ask to weigh you (you can say no). It's no big deal. If you don't want to register just yet, wait until you have a problem needing a GP appointment anyway and then do it then.

Myrtle I'm not saying hospital specialists are different my parents are consultants & im a med student. I do feel like some patients would be unhappy to see anyone other than a Dr when at their local practice but with the way it's going they're going to have to get used to it.

'GPs are Specialists in Primary Care, they are experts in assessing risks, they coordinate care, they (typically) know their patients better than any specialist.'

Yes but with respect any HCP could do that ^, As I said my gps are great but prescribing and referring patients isn't that highly specialised imo. I know the admin side of things is challenging but I don't believe the clinical side is.

Glad to hear your salary isn't in 6 figures, I think many full time gps will be though going be the flash cars outside the surgery and DC in private schools. Not jealous , it just really isn't that specialised and gps should most certainly not be doing NPMs.

Those GPs retiring now have been grossly overpaid and will be paid grossly inflated pensions.

As I understand it, things are changing rapidly for younger docs.

Screening of new patients is a very easy way for GPs to tackle problems before they present.

Most people go to the GP if they start having symptoms of problems, pre screening allows them to address issues with weight/smoking/drinking/anything else before they become big enough to warrant a proper GP appointment.

It helps prevent any gaps in care, allows for early support and lets to practice pre-empt population of patients who may need care later on.

Another thought - OP, can you afford to see a private GP and get them to send a report to the NHS GP so they know you are a real person? Private ones are a lot less scary.

Don't go the NHS is overworked. One family less on the books is a good thing. You are being pathetic

'As I understand it, things are changing rapidly for younger docs.'

Well that's reassuring.

I've seen oncology in the past, surgeons and neuro consultants. Every appointment I have had complete respect for their knowledge and skills. Gps though, I've always come out with the prescriptions, referral or sick note I went in for, just doesn't seem that hard really. Other than the admin.

Well at least we've cleared up the idea that Myrtle might have been implying something.

Her feelings are now quite clear.

80% of what a gp sees could be managed by a nurse practitioner, things could be much more efficient with more staff to do the referrals

Where did you get this statistic Myrtle. Just flicked through the 36 patients I saw today and I think 4 could have been seen by a nurse practitioner. All the things that we can send their way, already are being sent there. These 4 people probably thought they needed to see GP, unless you get the receptionist/someone to triage all calls (which lots of patients dont like - and it doesnt always help).

FWIW today 2 people who booked into the nurse, ended up with me having to advice/intervene.

I don't usually do the new patient appointments in my surgery, but I have done 2 when my colleague was off. One was extremely complicated medical history so needed about 30 mins to go through everything with him. The other was injecting her self with an epi-pen (the adrenaline pens for allergy) every 6 months or so - after insect bites, to "avoid" a serious reaction - epi-pens that she was getting from her previous GP on prescription, but hadn't been going to hospital, or mentioned it to GP, who must have thought she was requesting prescriptions to replace ones that had gone out of date.

I am sure that she was never advised to do this, she believed she was taking pro-active steps to avoid anaphylaxis. A nurse practitioner would have recognised this too in a new patient check, but would they be aware of whether there were blood tests needed, referral needed or just training on epi-pen/anaphylaxis?

I imagine our nurse would have sensibly told her not to use pen unless anaphylaxis symptoms, and to call 999 if it occurs. The nurse would have advised her to make an appointment with GP to discuss - and so I would have seen her anyway.

I really dislike going to the Drs and have to be at death's door very unwell before I drag myself to the surgery. I don't know if you could class it as a phobia or just a strong aversion. If the OP feels like this she has my sympathy. I manage to keep my aversion mostly under control and, as I say, can drag myself there once in a blue moon.

Our surgery has to have proof of identity/address for new patients, plus a questionnaire detailing any conditions you have, meds you take, smoking, drinking, number of children you've had etc. The subsequent appointment is usually with a nurse which is just a tick-box exercise.
So about this and any further appointments You do NOT have to be weighed if you don't want to be. (I am phobic about this and they have accepted it).
Some people are also worried about blood pressure checks, I have 'white coat syndrome' where mine shoots up if it's going to be tested. If this is you, you can have your BP checked at a chemists, or some surgeries now have BP machines you can use yourself.
And yes, they do want to tell you all about the services they offer and clinics they hold. BUT YOU DON'T HAVE TO SIGN UP FOR ANYTHING. Likewise a cervical smear test is optional.
OP, I really get that it may feel intrusive and unnecessary and just plain nosy sometimes (depending on the sensitivity of the person conducting the appointment) -- my only advice would be to shop around for a practice you find more sympathetic, even if it's less convenient.
I didn't know that children could not be registered at a surgery unless a parent was too -- what would happen if a person had a private GP, perhaps provided by their employer, but this cover did not extend to their family? Would an NHS practice still refuse to register children in this instance ?

Oh God, do the practice a favour and don't register with them - trust me they already have enough nightmare patients, they don't need another one!

When I joined my GP practice, they took a urine sample and then there was the whole rigmarole of why there was a trace of blood in my urine (there always is) etc etc.

And that right there is an example of why it is a good thing - for you having traces of blood in your urine is normal ... for other people it is very unusual and therefore would be the sign there was a problem or a symptom of a bigger and/or potentially more serious issue.

So if you came in without having had the initial assessment and were presenting with other symptoms, the fact your dip test showed blood could affect the doctor's diagnosis ... but because they will now have it in your notes that it is normal for you then they can take that into account when making a judgement of treatment.

Surely that can only be a good thing?

I've always had to have one

You don't have to have one.

OP, if you are having problems, just email PALS and tell them the doctor is refusing to register you as you are not consenting to a check-up. They'll liase with the doctor and tell them not to be so daft.

Myrtle, I am glad your health needs are such that they could be med by an ANP.

However, when making sweeping statements, please accept that your experience is not necessarily that of every patient.

Yesterday, I saw 40 patients in person, had 4 telephone consultations, spoke to 3 hospital consultants and 2 social workers, had 25 emails (a quiet day), about 30 blood test results and approx 40 clinical letters to deal with.
After my first 3 patients are was running 45 minutes late - I don't typically run late (I hate running late, it's stressful and I am aware that I am more likely to rush/make errors when I feel under pressure). I was running late because the luck of the draw meant that the first 3 patients presented with complex, not easy to solve, issues and they needed the time they got.

I repeat, with respect, you do not know what you speak of.

With our 2 salaries none of our children are in fee-paying schools, we have a big mortgage and go on holiday abroad once a year. We have a good life, but nowhere near what some media outlets would have you believe is 'normal' for doctors.

and children can only be registered at a surgery that their parent or guardian is registered at

That's not true. But if it is the case that parents are registered at a different doctor than their children, child protection flags are raised at the circumstances will be looked into.

well trained NP's or other professionals can alleviate some of the pressures on GP's, and yes statistics in a report a few years ago stated this to be around 70%. But I find it quite disrepectful to suggest GP's are administrators basically (Im an NP). Their generalist knowledge is wide and far ranging, they need to know huge amounts regarding symptoms clusters and diagnosis so that when you go for an appointment you get the right tests etc to rule out anything serious. Myrtle, be grateful your experiences have been straightforward, I'm not sure you would have the same opinion if you tried to do the job.

It was at one of these booking-in appointments that my high blood pressure was picked up, with the result that I have remained in good health through medication for 25 years now. I felt perfectly fine and had no idea I needed treatment.

A close relative who also felt perfectly fine and never needed a doctor is just recovering from a stroke - aged 50 and with teenage sons who were alone with their dad when the stroke happened. Not nice for a 14yo to have to deal with. The cause turned out to be unsuspected high blood pressure.