To want to see a Dr at an appt

[Purplerayhan]

I can see a nurse, a care practitioner but a Dr? No. It's so frustrating. Without going into details, it's something that needs examining but because I called up with 2 non connected issues, I got told to lets see how the first one goes, they do a referral for a specialist, SALT oversubscribed team, to get in touch at some point in the future (no time frame given, understandable but frustrating) and they'll have a look at the hernia after that. Sorry, just frustrated. Why is ok for lower paid nurses and care practitioners to have to see patients face to face but not my Drs?*
*rhetorical

@TableFlowerss

**This is hilarious. How long do you think it would take before specialist services collapsed? Imagine every woman with heavy or painful periods sees a gynaecologist? Every person with acne sees a dermatologist? How many specialists do you think there are?

And if you have abdominal pain, which specialist do you want? Gynae? Gastroenterologist? Lower GI surgeon? Hepatologist? How will you know for sure?

GPs are gate keepers for specialists. We filter out the minor conditions, enabling them to manage the serious stuff. How’s a dermatologist going to treat skin cancer patients if all his/her clinics are filled with people with dry skin or mild acne**

This this and this

In France you can self refer and it works really well. I've just checked and can book an appointment this evening with a Gastro consultant (in a state hospital). No need to see a GP. Contributions are higher into the system, but it functions effectively, and cancer outcomes etc are better than the UK.

Most Advance Nurse Practitioners and Advanced Clinical Practitioners have done a three year masters on top of their three year registration training.

Many ACP’s in acute hospitals work on the middle grade doctor/registrar rota.

Do you think ANP’s and ACP’s can’t clinically examine someone?

@Onatinyboat France has more doctors because they pay more for their healthcare in France

Maybe we could have asystem of self referral if we paid the same for healthcare as countries with a system of self referral

In France you can self refer and it works really well. I've just checked and can book an appointment this evening with a Gastro consultant (in a state hospital). No need to see a GP
Actually that's much less the case unless you go private. France adopted the British system of referral before seeing a specialist many years ago.

GPs are gatekeepers for specialists
Nurse practitioners also refer to specialists. Mine has referred me to the breast clinic in the past and for a gastroscopy.

A nurse of health practitioner will know (better than you do) if you need to see a Dr. Its like triage. There is a lot they can actually deal with though including prescriptions.

Drs are are very much working. I have had a number of telephone appointments and f2f with both GPs and HP since the pandemic started. If anything in my area it has been easier to get seen initially though tests/referrals are taking longer and are offered less. For example my surgery used to send you off for a blood test at the droo of a hat but not since covid,

@dontdisturbmenow

In France you can self refer and it works really well. I've just checked and can book an appointment this evening with a Gastro consultant (in a state hospital). No need to see a GP Actually that's much less the case unless you go private. France adopted the British system of referral before seeing a specialist many years ago.

That's certainly not the case where we are. Your GP can of course refer you, but as I said, I could book an appointment online today to see a gastroenterologist without a referral.

If schools are back and pubs will be open soon, WHY NOT Drs. ni, still not any less annoyed now

What are you on about?

GP surgeries have been open throughout this pandemic!

They never 'shut their doors'- telephone & video consultations have continued throughout, patients have come in for face to face when deemed clinically necessary, prescriptions sent electronically...practices in general have functioned as before, just not offering any face to face unless a triage of some sort has taken place prior.

This was the only way to maximise the chance of keeping everyone safe- staff and patients alike.

Last Easter they were open during the bank holiday- Easter Friday & Monday

So, in summary, doctors have been 'open' all through this

I dont think anyone is saying that the issue is that nurses are less qualified but I genuinely wondered why they are able to see patients but gp's are hiding behind phone triage. It's disgusting imo and I think things will be missed because of it

GPs are not hiding behind telephone triage- that's what they do before deciding whether to bring a patient in for examination.

Wow just the first page of this thread is infuriating!

In case it's not abundantly clear already...YABVU!

It's not no. GPs are gatekeepers for specialists
Nurse practitioners also refer to specialists. Mine has referred me to the breast clinic in the past and for a gastroscopy
Why have GPs then if NPs can do their job just as well?
It's a moot point now anyway as I have seen a private Dr who has given me an oncologist referral. I really hope that there isn't anything wrong but I know that it certainly wouldn't be going away under the 'wait and see, let's sort out one unconnected issue first, then consider thinking about this but no f2f at all'.
For the PP, it would appear that I DID need an appt where I could be examined by a GP but I couldn't get one. I hope that no-one at my (STBX) surgery has a problem, but I'm not confident.

GPs are invaluable but expensive consultants and should be used as such, allowing them the time to focus on complex cases.

No, GPs are not 'consultants' who should be focussing on complex cases - they are general practitioners. They need to know how to diagnose and treat the everyday problems that cause people to visit a doctor, and to refer on to the specialists those things that they are not qualified to treat or do not understand.

Nurse practitioner here! I've been qualified 20 years, have a masters degree in Advanced practice, a bsc degree in Emergency care, 10 years as a prescriber and 15 years in ooh and community work. I find it insulting for you to insinuate I am unable to do my job.

Nobody insinuated that you can't do your job. What has been pointed out is that you can't do a doctor's job, because you are not a doctor. You're a nurse, albeit a highly qualified nurse.

spuds GPs have to do specialist exams, just as consultants do. There is a move being considered to rename GPs eg Consultant in Family Medicine or Expert Generalists as the term GP is so often preceded by ‘just a’. Certainly the lack of respect the media and general public display to GPs would seem testament to that.
I don’t really care what we are called but I know the NHS would collapse without us. Secondary care colleagues often have not ever worked in GP and don’t really understand all the stuff we deal with without referring. Ditto the general public doesn’t really get it either. We’ve been dealing with a huge covid outbreak at my practice recently. In a nursing home with a huge number of very ill people, many of whom sadly died. 5 weeks in we are probably over the worst. It’s been the worst period of my working life in over 20 years as a GP. Guess what, we didn’t tend to see these patients face to face because the staff nurses working in nursing home we able to do the necessary checks and we worked together to look after these patients as best we could. Often spending 4 or 5 hours each day just dealing with this one nursing home. As GPs this is our bread and butter, care of the elderly, communication with colleagues and family members and if required palliative care and all that entails.
The point is we can be working bloody hard, and doing work that other specialists would not be able to do, yet not having people sitting around in our waiting room.
I’d much rather go back to the previous system of seeing everyone face to face (phone triage is really, really hard and often takes longer than a face to face appointment)
But I suspect the current model is here to stay, due to the ever increasing GP workload, and the requirement to have other HCPs working with us to take redirect the work to the most appropriate person first time round.

Hi @Ghislainedefeligonde,

I don't lack respect for GPs - my interventions on this thread have generally been to point out that alternative HCPs (e.g. nurses) are not the equivalent of doctors, who are highly qualified diagnosticians and undergo a completely different training.

But whilst I understand that GPs do sometimes have specialisms within the context of working in general practice, in the post of mine to which you've replied I was in turn replying to somebody who was wrongly suggesting that GPs are precious specialist consultants, and that it's basically unreasonable for the public to expect to see them. That's not true, and it's not what GPs have chosen to train to do.

I agree that it's looking increasingly likely that our existing system of access to medically qualified professionals is likely to change, because we don't have enough GPs, but I'd like to think that those of us who value GPs, and the service they offer, wouldn't wish to just roll over and accept it as inevitable. Browsing through here I increasingly see people in a frenzy of anxiety at the prospect of bothering their GP with symptoms that could potentially be signs of something serious, or proposing to take their potential skin cancers to the pharmacist to ask for advice. This seems to me to be bizarre, and very worrying.

I went to an appt with a HCP ex paramedic as the Dr couldnt/wouldn't see me. The pharmacist called to say that he wouldn't dispense the dose as - at 50 times the recommended dosage and with contraindications with another medication i am taking - he was convinced it would be fatal. The HCP ex paramedic had suggested that dose, the Dr had just signed it off and if it hadn't been for an on the ball pharmacist I could be dead. But hey, don't let's hurt any non Drs feelings reet?

You do know that doctors sometimes make prescribing errors just like that too don't you? A close relative is a hospital pharmacist and much of their job is doctors asking him what the correct dose of a medication is to prescribe/calling doctors to correct dangerous prescribing errors. Doctors are human beings who make mistakes sometimes too and they're not medication specialists either given they aren't pharmacists.

If I got offered to see a NP (or any other appropriate AHP) I would happily accept, they can often be more experienced in various ailments that more junior GP trainees after all. If they have any concern they would refer to a GP for advice anyway.

Yes I do know Drs make prescribing errors. I also know they have more training. In my case, my breathing is still an issue with long Covid but one of the contraindications of the medication suggested by the HCP was severe breathing difficulties. I shouldn't even have been prescribed it in the first place not to mention at a dosage that would have been fatal. Thank God for the pharmacist.

@KevinBaconsMoustache

Yes I do know Drs make prescribing errors. I also know they have more training. In my case, my breathing is still an issue with long Covid but one of the contraindications of the medication suggested by the HCP was severe breathing difficulties. I shouldn't even have been prescribed it in the first place not to mention at a dosage that would have been fatal. Thank God for the pharmacist.

that mistake could have easily been made by anyone. that’s a bit part of a pharmacist’s job, catching errors like that

that mistake could have easily been made by anyone. that’s a bit part of a pharmacist’s job, catching errors like that

If that's true (that such an enormous and potentially fatal mistake could easily have been made by anybody) then that's pretty terrifying!

@SpudsandGravy

that mistake could have easily been made by anyone. that’s a bit part of a pharmacist’s job, catching errors like that

If that's true (that such an enormous and potentially fatal mistake could easily have been made by anybody) then that's pretty terrifying!

HCPs are human, prone to making mistakes like all humans

I don't care about hypothetical possibilities. I care about the fact that I could be dead by a fucked up system that meant someone without a drs training gave me something that could have fucking killed me. The regular dosage is between 1mg and 5mg. I had a prescription for 50mg.

I have to say I've found my GPs to work well throughout the pandemic and a lot of the changes I hope stay

1. with my son I rang up he had an infected spot near his eye (known acne and he's on medication for it) - had swollen so he couldn't see. GP rang back about an hour later, asked if he was happy to do a video chat so she could see it, she text me the link to the chat room - took one look, agreed he needed antibiotics and arranged for the prescription to go to the chemist to be picked up in about an hours time (and I think that delay was because it was lunch time) - this was near the start of the pandemic

2. I filled in an e-consultant form, GP rang back later that day, arranged for the blood tests then got results over the phone

3. filled in an e-consult form, GP rang back about 3 hours later 'I need to see you in person' can you come at X time

The only issue I had was n when trying to get the results of the swab - was text to say results back and needed to make a phone appointment - only to be told on the phone there were no appointments that day and to ring back the next day - she couldn't put me on the list for a phone call the day after which I thought was silly, I was happy to wait for the results

@KevinBaconsMoustache

I don't care about hypothetical possibilities. I care about the fact that I could be dead by a fucked up system that meant someone without a drs training gave me something that could have fucking killed me. The regular dosage is between 1mg and 5mg. I had a prescription for 50mg.

again, that’s got nothing to do with a doctor vs another type of HCP. both can make mistakes so I’m not sure what point you’re trying to make