AIBU to wonder why it has become so impossible to get a Doctor's appointment?

[Bluebananas01]

I remember when I was a child in the 80's, if you were ill you could always get to see the Doctor the same day. I even remember the Doctor doing a home visit when I had the measles. I called up this week to try and get a Doctor appointment and it is a three-week wait (South East).
Everybody seems to talk about there being no Doctors appointments but what is the real reason? Is it just down to underfunding? Are people not turning up for appointments? A sicker population?

Even when I get to see a Doctor it is as if they are trying to get me out of the surgery asap and heaven forbid if you need a referral. Two years ago I went to the Doctors with joint pain, shooting pains, weight gain etc. I told him that autoimmune disease runs in my family and it felt AI as it came in waves (like flare-ups). He pretty much told me I was a hypochondriac. Asked if I exercise (because of the weight gain) and when I told him 6 days a week he told me to take up yoga and sent me packing.

Fast forward to this year when I was going overseas with my husband to his place of birth where it is super cheap to see consultants and have blood tests done. My symptoms had been progressing so I have blood tests etc and saw a Doctor there and discovered that it wasn't all my mind as suggested by the Doctor and that I actually had:-

Hashimoto's Thyroiditis (Autoimmune underactive thyroid)
Pernicious Anaemia
Severe Vitamin D deficiency.

How the hell did my Doctor miss so many warning flags about my health? I only ever go to the Doctors for smears and pregnancy so hardly one to visit the Doctor for the slightest sniffle.

It makes me wonder how many other people are being fobbed off and are living with a poor quality of life because their Doctor just can't be bothered to give a proper consultation.

[OhTheRoses]

It's no different to the GP being informed after a private consultation in the UK medschoolrat.

[Bluebananas01]

Actually MedSchoolRat, that is what triggered my post. I've been trying to get an appointment to take all my blood test results and just get my treatment put on my records but was told that the waiting time is three weeks. To be honest, I didn't go overseas specificallyto have treatment, we were visiting families and there was a nearby blood lab and as I've not had a blood test in 7 years I thought I should get a routine test and just get my Thyroid checked as my brother had been diagnosed with Graves.......and then it all unravelled.
The Endo spent a lot of time with me and I saw a nurse first who took my medical history. I certainly felt confident that I was dealt with professionally. I've also been in touch with the Pernicious Anaemia Society and Thyroid UK and indicated that I had received good treatment and probably more thorough that I might have received in the UK. Just glad to finally have the mystery solved and get my health back.

[MsChicken]

I've all but given up trying to get a doctor's appointment. The last two times I've needed to go I've just sat at at a Central London NHS walk in for two hours and been seen that way. Annoying but the Walk-In is open really late as well so could go after work. In 12 years I've never seen the same doctor twice at my surgery so don't feel there's any loss of continuity. I recently ordered a private prescription for next day delivery online as well rather than either go to the Walk In or pay for a Medicentre type appointment - I'd go this again if I needed something urgently and knew exactly what I needed.

[LeSquigh]

It definitely seems to depend where you are. I am in Home Counties and I can ALWAYS get a same day appointment and if my kids need to see a doctor they are generally seen within an hour, maybe two.

[OhTheRoses]

My GP comprises 4 surgeries and 32000 patients. Until recently it had no practice manager. It is administratively a fiasco but swalliws up every practice that clises or is classed inadequate by the CQC. It is a bizarre situation and it is not healthy in the context of competition.

[BingandFlop2019]

@Bluebananas01 PLEASE tell me you went back to the GP who fobbed you off and told him/her???

[ASauvignonADay]

I have no difficulty getting an appointment.

[thinkingaboutfostering]

The whole system is on its knees. I work for 111 and see it all first hand.
The trouble is we have a top heavy population. Far far too few gps and insufficient funding. A&E, 999 ect are taking a huge hit as a result.
We need a huge shift in how gp practices operate. We need a lot more gps more practice nurses and longer opening hours. Perhaps surgeries dedicated to seeing over 65s so freeing up appointments in family practices.
Patients need to take greater responsibility for their own health. More emphasis on other more appropriate services for certain things coughs,colds, rashes to be seen by pharmacists rather than doctors. As well as routine stuff like meds' reviews. More triage nurses and nurse practitioners.
I also wonder if being able to pay for an appointment would be a good idea. In a similar way to we do for dental treatment. We are used to paying prescription fees so why not instead of paying for the prescription you pay a nominal amount of money upfront for a gp appointment- say £10 ish - same criteria as currently in place as for prescriptions. So over 60s, pregnant ladies, under 16s, those on benefits all get free appointments. It would encourage people to only book appointments they need and keep to them. It would also put more money into the system.

[Crazycrazylady]

I wonder is part of the issue the free bit. In ireland only those on benefits get to attend their gp for free while everyone else pays. A few years ago they brought in a system where all under 5s were free and a gp friend told me that it made the situation way way worse as people who previously would have gone to a pharmacy or simply had a cold now made an appointment where as before they would have had to pay for it. She said waiting times went way up and at she said they number of patients that were not prescribed anything went though the roof. Do people value something more if they have to pay for it?

[DianaPrincessOfThemyscira]

I never have a problem with my surgery either. It’s so annoying there isn’t a standardised way of dealing with appointments because some work well and others ... don’t!

[Mistigri]

It comes down to an ageing population, too few GPs and too many temporary GPs (because surgeries can't get permanent replacements) meaning no continuity of care.

Depends on where you live too. My ILs in a north midlands town have an excellent GP service and have been seeing the same GP for 15-20 years. My mum OTOH has not seen the same GP twice in the last 5 years. Needs knee injections/ surgery but keeps getting fobbed off. I've told her I'll pay for her to see our GP in France and get something done before her knee problems start to impact on her wider health (she's an otherwise fit 80 something).

[SinkGirl]

But the problem with introducing a paid for system is that it immediately disproportionately impacts those with existing medical conditions who need to see a doctor more frequently. My son spent two months in hospital when he was born and needs so many appointments with so many different specialists. It’s not his fault, it’s not my fault, it’s just how it is. Those with chronic illness would be completely screwed over by a system like that, and not everyone with a debilitating chronic illness gets disability benefits.

I don’t qualify for free prescriptions but I do pay for a pre-payment certificate because I’m on multiple medications. There’d need to be a scheme like that if the cost was moved to the appointment itself, and you’d still have the issue that people would wait longer before seeking medical help, which would make them more expensive and difficult to treat.

[EggysMom]

In defence of GPs .... I went to mine just over two years ago when, after three weeks, I still hadn't shifted a 'normal' cold/virus. GP thought that wasn't normal for me, and ordered blood tests. Diagnosis - hypothyroidism, I've been on Levo since then. GP didn't know that AI/thyroid issues run in my family, and I hadn't thought of the possibility as I showed no noticeable symptoms.

[OhTheRoses]

Another system statistic ass fact. Our household income is very high. Because of my hypothyroidism I get ALL prescriptions free. OTH it's small recompense for the £6k I had to spend on dd's MH care because the NHS refused. But it does make one wonder about the real reason for 28/56 day prescribing. If I just needed my calcium and vit D that would be an extra £54 pa.

[MontStMichel]

IMO, there would be more GP appointments if hospitals didn't only prescribe for a week or two! I am well aware, its because the hospital does not want to pay for the drugs out of their budget; but its ludicrous that patients then have to go to their GP to get any more of the drug, when its still the NHS paying for it, whoever prescribes it!

[thinkingaboutfostering]

Yes it would be more potentially for people with chronic conditions. But it is anyway if they are on medication. Currently there is the prepayment card for those who need multiple prescriptions which could easily be implemented for those with chronic conditions. I'm talking about a system which would effectively replace prescription fees and instead you pay upfront for the cost of the appointment

[MsChicken]

One area that does seem to work, at least in part, is the self referral system for counselling/talking therapies. I don't know if it's available country wide now. I needed counselling a few years ago and the GP wouldn't refer me, rude, not interested, said in their opinion it was better to get a really good solicitor for a lot of 'these types of things' (! - seriously, won't go into detail but it was such an inappropriate response, it had taken so much courage to actually get through the door and ask for counselling in the first place). Fortunately discovered IAPT (which the GP could have told me about but didn't). There was a wait and an initial consultation with someone who looked about 12 but otherwise a brilliant service and good solid counselling and at the time anyway the system ran pretty smoothly.

[nolongersurprised]

My son spent two months in hospital when he was born and needs so many appointments with so many different specialists. It’s not his fault, it’s not my fault, it’s just how it is. Those with chronic illness would be completely screwed over by a system like that, and not everyone with a debilitating chronic illness gets disability benefits.

Hybrid systems such as in Australia work pretty well. You could see the hospital specialists in public, or pay privately to ensure you saw the same specialist every time. A private paed would have you about 60-70 Australian dollars out of pocket each follow up (the rest paid by the govt) with communication between private and public specialists generally very good. It’s cheaper if your child has a chronic illness or you’re of lower income. Private doctors can refer to the public system and hospital results are shared with private practitioners. Almost all standard lab tests are free when done in private (exceptions being the fancy genetic tests and the like) with results sent electronically back to the referring doctor. Xrays done privately are reported and available the same day.

Alternatively, all of your medical specialists can be just private or just public but you do get to choose. You can not have private cover but still see one or more of your doctors privately with that doctor able to organise your public admissions.

If you live in a biggish centre there are a number of private therapists to choose from - zillions of speech pathologists, paeds psychologists and a fair few paeds OTs and physios. An autism diagnosis or a diagnosis of a specific disability as a preschooler offers 12 thousand dollars worth of funding until 7 - it’s now been replaced by the NDIS which is supposed to be less diagnosis based and more needs based.

It’s not a perfect system but it’s better than other places I’ve worked. The access to paeds psychologists is very good and this is seem to free up Child Youth Mental Health Services for children who are in dire need.

[nolongersurprised]

I should add that paeds OT, physio, speech etc can also be done publicly as well. Most people with disability-based funding go to the private community therapists though.

[BrazenHusky74]

I wouldn't mind paying a nominal amount to see my GP (£10) but I can't see it making much difference. Currently less than 10% of prescriptions are paid for and I would assume that the medical exemptions that apply to prescriptions would also apply to appointments.

[justasking111]

The government cut back the places for med. students years ago, it is expensive to train them. Add to that the bad press the NHS has I know two med. students, both intend to go to Australia as soon as possible. Add to that as my GP says the elderly with conditions that are untreatable that does not stop them making appointments a couple of times a week.

IMO there should be a red flag system for the worried well elderly who are plain lonely as well as in pain. If the GP has already seen a patient that week they should be asked if their symptoms have improved worsened. This will not happen by the way.

There should also be a private doctor system for those that cannot get an .because they are working hard.

Add to that the surgeries allowed to open are strictly regulated by the government.

It really is a mess.....

[mondaylisasmile]

A lot of the problems have already been highlighted in this thread.

However, a few of these are ones I've seen first hand - I rarely, extremely rarely, visit my GP (i think once every 10 years on average when i look back, aside from smears with the practice nurse!). i'm fortunate.

however, i have more than 1 family member who are constantly at the same GP practice - in many cases these visits can be lumped into two categories:

1. stuff that could be dealt with by a nurse / prescriber or possibly even pharmacist at non-critical surgery times. i'm not medically trained but i'm 99% positive they don't need a GP slot for some of the stuff i hear about - what's worse, when i've been biting my tongue unsuccessfully and tried to suggest if they could see a non-GP, I get told that they've "paid their taxes" and "need to see a GP", they aren't even interested in double-checking with the GP at their next appointment about whether it would be something to have a check in with the nurse about next time. or if they could use the pharmacy etc. instead of taking up pre-work morning slots "because they like to get to the shops before it gets busy at lunchtime" (!?!) - meaning people like me that work fulltime have NO hope of getting at pre-9am appointment if it's needed....!

1. gross misuse of "free" services and drugs. one elderly family member has a medication that needs to go in a fridge, and isn't safe to use if it's out of the storage temp after a certain amount of time. last time they visited i was in a panic because they'd left it out in the kitchen on the window ledge for the morning, and when i was in a panic, they said not to bother, because they had a dr apt the next day where they could get more. i couldn't believe the attitude of "oh well i ruined my medication but it's free so who cares" in an otherwise fairly responsible, civic minded person - i was really shocked at the idea that because it's "free" we shouldn't care about storing it properly!!!!

it can be summed up with an attitude of "i expect/demand this, so i'll cause a stink if i don't get it" - really, really selfish, entitled behaviour, and this is just a couple of people in my own immediate family/in-laws.

I've no idea how the NHS can cope if this is a common thing that GPs face.

[dreamalittlebiggerdarling]

I don’t know what the solution is. I went to the GP five times in 2 months last year, as I had a cough that wouldn’t shift, was putting on weight like nobody’s business, my periods had stopped, and I had constant abdominal pain. Was prescribed antibiotics on every occasion and told that it’d stop if I exercised more. The 5th appointment I was basically told that there was nothing more they could do for me and that repeat appointments weren’t the answer. Eventually couldn’t bear it and went to A&E where they discovered I’d had a pulmonary embolism caused by a humongous uterine cyst, which left another week would’ve caused a bowel rupture. As it was a total hysterectomy was unavoidable as it’d grown so big. I still get angry thinking about the GPs now!

[dreamalittlebiggerdarling]

Fibroid sorry not cust

[scaevola]

'The government cut back the places for med. students years ago'

But in the last few years the number has been rising

Still not keeping up with demand though.

First wave fundhilders are retiring about now, those who came after never had quite the same resources. Those who benefited from the Blair new contract can afford to take early retirement.

What's left isn't looking a terribly attractive choice of specialty right now.