To think a good GP is a rare thing these days

[BackInTime]

Just based on experience but I feel that GP care in this country is seriously lacking. GP appointments at my local surgery seem to be filled by locums and it is virtually impossible to get an appointment with a GP. When you do get seen they barely pay attention - I took DD last week for a pretty bad infection and he was more concerned about his printer than DD.

I get that the NHS is stretched but it seems that they way they are failing to treat people in the first instance leads to people either having to come back or they end up in hospital which is not cost effective or good patient care. Why not just give patients their full attention for 10mins in the first place.

Threads like this make me want to leave mumsnet.

Sweeping generalisations by people who have no concept of how difficult and demanding General Practice is.

If it’s so easy to get away with being terrible at being a GP then why don’t you apply OP?

I’m assuming you already have a medical degree and your F1/2 and ST years (including all of those post grad exams which must of us do with little children) under your belt?

Seriously, go for it.

Show us how it’s done .

I think it's really difficult for them with the ten minute limit. I went to one with a mole/growth on my leg a few weeks ago and explained I had really bad anxiety about it, couldn't sleep etc and also I'm in third trimester of pregnancy. He told me to come back in two weeks if it didn't go away which it hasn't, and then of course it's four weeks before I can get another appt with him so will be 6 weeks in total. I know this is a product of my anxiety but if he'd just typed me a quick referral on BUPA I could have been seen by a dermatologist now at no extra time or cost to the nhs and before I get too pregnant if it does need to be removed etc. Sometimes the American system looks quite attractive - ie you phone your dermatologist directly and get seen the next day! Although it has its drawbacks too obviously.

I feel your pain. My old GP was amazing but my new one is not professional. The reception lady is polite however. Complain to the politicians.

I have never had a bad experience with a GP consultation. Maybe I’m lucky - but have seen loads (childhood surgery, surgery at university, back to home surgery and then different surgery for about the last 16 years. Yes - getting an appointment for me can be tricker, but with the dcs I don’t think they’ve ever not been seen relatively quickly.

A recent example was my ds had shingles, wanted advice on whether he should have flu jab later that week. Main point of the visit because having perused the NHS site was pretty certain that too late for antivirals. GP said yes, unless had a temp. Then rang me on my mobile about an hour later, having rethought, discussed with practice nurse and called the paediatric team at the hospital. Full of apologies, but I appreciated that she had had second thoughts, checked, and then contacted me. So despite getting it ‘wrong’ at first, the service was I thought pretty good actually.

I think someone, somewhere, is trying to run all services into the ground so it can all be privatised.

Two women in my department at work have developed bowel cancer in the last 3 years, they both had all the symptoms that indicate this problem and reported them immediately to their GP's (same practice) One was not referred for diagnostic tests for a very long time, and when she got there the cancer was quite extensive. The second was referred for counselling as she was told she was suffering from stress, despite having bleeding that was very dark and substantial pain. A few weeks ago my mother was discharged from hospital with an increased dose of one of her usual medications being told it was vital that this dose be maintained, a locum GP carried out a post discharge visit and took her off it, she was readmitted to hospital with very serious problems. I have no faith in GPs at all. Before anyone goes on about the stress and the hours just compare their lot with those of people who work willingly and to a high standard in care, GPs get very high pay, so high most of them can afford to work part time only.

Generally I've found the GPs I've seen good although on two or three occasions they've made mistakes on blood test paperwork. Luckily I've noticed whilst at the surgery in time for them to correct it. (Ordering the wrong tests etc.)

I had a GP who was well known for being an arse. A woman once stormed out of an appointment with him screaming thay she would never see him again. He always had free appointments when the other GPs were booked for weeks. He laughed in my face when I said that I wanted to be tested for diabetes. And I've had loads of amazing GPs and amazing care after infertility, miscarriages and finally birth. I always thank them for their time too which seems to suprise them.

I keep hearing this on mumsnet but all the GPs on our surgery are brilliant. I have heard really bad things about the very local one though (a very small surgery).

I've had a fairly good GP in my home area of London (very east, not at all affluent).

I had a bloody awful one when we moved to furthest essex (deprived area). Impossible to get a regular appointment within 3-4 weeks. Emergency appointments were a nightmare because you had to call at 8am and hope and if you didn't get an appointment you had to do it again the next day, what make it better is I had a long commute (1.5hours) so had to be on a train an hour before the calling starts. No flexibility in it to give my an appointment for the following day. Ended up with worse infection because I couldn't endlessly miss work. And I had cow of a locum who was very dismissive of my depression, there's a new doctor there who's the same according to my DM and theres only one other GP.

My current GP in south east London (inner city, not affluent area but close to middle class bits) had 7 GPs when I signed up almost 2 years ago, now there are just 3 and the one I see regularly because of my MH is part time. The other GPs I've seen there are also good. Can usually get an appointment in about 2 weeks, sooner if I check the online bookings regularly. I've moved recently and made sure I moved where I could keep my GP.

Will get DP and baby registered at a closer practice for convenience though.

I understand why GPs are finding it very difficult but there is no excuse for rudeness. I have had GPs not even look at me when I have walked in right until the minute they have had to check something out. I don't like that and it doesn't hurt to make eye contact when you walk in.

I also had one on Friday who was very efficient but her people skills needed some work. She did what was needed so that's fine really, but she was a bit scary. She was running very late and I think she was just very stressed and wasn't really meaning to be rude. I would see her again because she is a GP who gets stuff done and her clinical skills are great.

Like every profession out there you will get good GPs and poor GPs. I have had a lot of great experiences as well though that do outweigh the bad ones.

I don't think good GPs are a rare thing.

Oh and as for getting a routine appointment, we can get seen in 7-10 days.

However, the other day DH rang and they suspected DVT and got him in within the hour.

They are great for emergencies but not so much for routine appointments but that is to be expected right now.

The majority of ones I've seen have been great, or at least good enough. The GP I usually see is one I chose based on what others with MH issues in my area recommended (after my previous one left the surgery). She relatively young, very matter of fact, but always helpful and always takes me seriously. I must be very lucky in my area, too, as it's not too hard to get an appointment.

If I'm in for something unrelated to any chronic issues, I see whoever I can see first. Occasionally it's a locum, but usually a NP or one of the other GPs in the surgery. I've not really had a problem with any of them, although luckily it's usually been a simple issue (ie. my ear hurts -> they look in my ears and see it's infected -> they give me a spray for the infection).

There's only one GP in my surgery who I would choose not to see, and that isn't really based on any experience of my own - rather I've had some MH professionals in my area comment to me that he's not the best person to see if you have MH issues, and I'll take their word. (He's the "main GP" in the surgery, which is why his name comes up as my GP often, which is how the comment arose. I've never actually had a consultation with him.)

Based on my and my family's experience in the past 10 years it's been awful.
Can't fault my GP for making time and prioritising babies and children but anything else has been pretty bad, not listening to symptoms, ignoring what patients say.
My DF would be in a wheelchair today if he relied on his GP and the NHS. My DM would have a serious long-term back ailment if she listened to hers and my neighbour would be seriously ill or dead as she was prescribed the wrong medication at the wrong dosage 3 times despite raising her concerns with the GP in person and in writing twice. They were adamant that that was the amount she needed. She went private and was told that was potentially fatal with worse side effects than the condition she was trying to combat.

From my experience It seems misdiagnosis is quite common and patients need to do their own research and constantly question and chase their doctors if they want to get anywhere.
Its concerning.

I think being a GP sounds incredibly tough and I certainly couldn’t and wouldn’t do it myself.

Most of them probably start with the best intentions but get worn down by the system.

That said, I also think general practice used to entice people who wanted to do it for the wrong reasons; it was seen as the cushy option with nicer hours so you could have a better work / life balance etc. It isn’t seen as cushy anymore, that’s for sure and I have a few GPs in my family, two of whom did so specifically so they could be a doctor but also have a family without the demands of hospital medicine. They now massively regret it, as it’s not what they expected. One is now in private practice.

I think the people who chose GP expecting it to be the nicer option are now feeling bitterly disappointed.

Other GPs, who have a calling for general practice maybe not so disappointed. Just a theory.

I have left the office if many a GP in tears because of their attitude and the way they speak to patients. I have been fobbed off, and been talked to in a condescending manner. On two occasions the lack of care could be considered negligent. I have had to seek and pay for numerous private tests in order to get a diagnosis. And regardless of the pressure you are under no I do not think that is acceptable.

There are now only two GPs I will see at my surgery because of the above.

I think there is a massive issue with many doctors thinking they are Gods and not treating patients with basic courtesy and respect, and sometimes not even doing the basics their job requires.

So yes I agree wholeheartedly with the OP.

Hmmmm bit on the fence here. Out of some 50 different GPs I have seen in my lifetime, some have been great, and some have been shit. Most have been OK.

What makes me a bit worried is I get some googling what they think is wrong with me! And sometimes prescribing the incorrect meds. In fact, I had a rash under my armpits last summer (and didn't know what it was,) and the GP said it was gave me steroid cream. It flared up even worse and I was in AGONY.

My friend who had suffered from thrush said it's THRUSH! You need canestan! I got some canestan, and within 12 hours of starting to use it, it was about 25% better. Within 3 days it was nearly gone!

Comes to something when your not-medically-qualified mate can diagnose what you have, and the bloody doctor can't!!!

That said, this was a fairly newly qualified GP - finished her medical training the year before. Then again, surely she should have been on top of things (maybe even moreso than a GP who qualified 30 years ago.)

IME the better ones are the one who qualified more than 6-7 years ago, but less than 25. The 'newer' ones still have a lot to learn, and some of the older ones (55+) don't seem to care about the job anymore, and often don't look me in the eye.

When I was a kid (1980's) the middle aged and older GPs (who qualified in the 1950's and 60's,) were actually horrible and spoke down to people like they thought they were God. They were all men too.

I also know a very senior person in the NHS who says that she thinks the time will come when lay people can do a specific general practice degree instead of recruiting doctors.

I mean, already nurses seem to be doing some of what GPs did, HCAs are doing some of what nurses did and receptionists are doing some of what HCAs did. It wouldn’t surprise me if they started recruiting “lay people” (with a degree other than medicine), to do more simple things in GP practices.

our surgery is such that I don't know who the doctors are, let alone always get the same one and have any kind of a relationship with them. It's at least a 3 week wait for a non-emergency appointment and the management of the practice is pretty incompetent (if the first appointment is 8am, you might want to open your doors before 8, no?).

I know of a few people socially who trained to be GPs and all but one has quit. The one who is still a GP does more management type work and only a couple of clinics per week.
As one of them said to me: for every 10 000* patients you see with a headache only one will have something significant going on. It's very difficult to find that one and you will ocassinally miss it unless you send every single one for a brain scan (extrapolate this to other conditions and the NHS will implode).
There is a lot of pressure on a GP - some handle it better than others but most quit.

Who will be hit the hardest? The patient.

*i can't remember the actual number but you get my drift.

At my doctors, you can see any one of about 10 doctors, I presume it's the same in all practices. Over the last 12 years of parenting I know exactly which doctors I need for which thing. One is an amazing all rounder and I aim for him all the time, the best thing about him is he is comfortable admitting he doesn't know the answer and will look something up or phone you later. He's great with the kids too. Doesn't over or under prescribe. Doesn't patronise. Doesn't dismiss.

However the head of practice is old school, i've learnt not to suggest a thing and okay dumb or he will completely dismiss you. But he is fine to see if you know there is an obvious bacterial infection and want quick antibiotics. There are others who are told for different things. I left there in tears many times before I learnt how each one ticks.

I switched GP a while ago, it’s as different as night and day to the last. If you can it’s worth trying different ones, I’ve moved a lot and I have seen some truest shocking places

I’m sure the majority will have a good experience but few times I’ve been, my problems have just been ‘normal’.

Dizziness and nausea? Normal
Itchy ear drums (I mean severe, like on fire)? Normal
Hairloss in clumps? Normal (tbf this one suggested a hairdresser atleast)

Different GPs each time.

I have been having MH problems for so long, I was on AD years ago and I’m really spiralling atm. But I’m dreading going to the GP about it.

I have only received good service from the numerous gps I have seen, and have had various different issues including more complex mental health ones.

Those complaining that they never see the same gp, I’m afraid this is a result of the various factors (decreased funding, fewer uni places in medicine, reputation for high stress etc) which have led to a shortage of gps and an increase in the scope of their role. It’s not just verrucas and ear infections, they are expected to be counsellors, keep an eye out for abuse, soothe the worried well, be kept on hold for 30 mins trying to get somebody into hospital etc etc All within a 10 min slot. It’s an impossible task and means that they simply aren’t able to work full time as they would burn out, so cannot guarantee continuity of care. Add to that the emotional burden of dealing with some of the things they encounter.

I would add that it’s important for people to be good patients!! Remember you have only 10 mins, don’t take more than 1 problem to a gp per appointment (book a double slot if you need), think about what you want to say and what you want from the doctor and put it across succinctly, do not drop additional issues in at minute 9, do not be pissed off if your appointment is 30 minutes late (as I said before, the doc could have been trying to get somebody into hospital in an emergency) and for the love of Pete remember that this person is doing their best and has studied for many years to get qualified. Fine, they are not infallible but for the most part if they politely tell you to go away it is because there is nothing wrong with you and you need to just wait it out.

And finally, privatisation is something to be at all costs - lobby your mp, vote for a party who is not trying to drive the nhs into the ground so that they can privatise, and remember that gps are the good guys in this situation.

*avoided at al costs