Aibu but 2 mornings per week isn’t cutting it

[Bythemillpond]

Bit of background
Ds had a telephone appointment with a GP (not his own GP as tbh we try to avoid this dr as we have had some bad experiences with them) and was told he was going to be referred for an ADHD assessment.

About 2 weeks later his own GP sent a form to fill in before he could be referred. Including an alcohol assessment. Ds doesn’t drink as he hates the taste. No idea why the alcohol assessment was included.

Filled it in and sent it back immediately by email. Got a reply the following day to say they had received it and would it take 3 days to process.
We left it 1 week and rang the surgery to check he had been referred

Nothing was picked up on the screen by the receptionist who said they would ask the dr to see what was happening
Left it till middle of the following week to see if he had been referred yet.
Receptionist said that ds had not sent the form back. I said yes he had and found the email and quoted her the time and date it had been sent and also the email in reply to say that the email had been received.

Asked to send it again which I did from ds’s email address and the receptionist said she had received it whilst I was on the phone
I was told that they would talk to the doctor the following day to bump Ds up the line as he had sent it weeks ago.

We rang back a couple of days later only to talk to another receptionist who again said Ds had not sent the form back as there was no email from Ds
Sent it again and was received by the surgery.
Receptionist said they would bring it to the drs attention when they were next in.
I obviously asked when and was told the GP only works 2 mornings per week.

Aibu that 2 mornings per week for what was a full time role (they were supposed to replace a retiring gp who is now back working at the surgery presumably to pickup the slack) is too little and if that is all they work then they shouldn’t be getting involved with sending out forms that they have no time to process.

Normal fees and living expenses for the initial degree are borne by the student as per every other student in the country. The rest of the £220K is paid by the taxpayer. I don't know if the post graduate training is subsidised at all.

IMO there needs to be a tie-in like other countries who send med students here to train or indeed the army has if you want to leave early. If you leave before 5 years of full service (spread over more years if PT), you pay it back.

There are two areas of NHS provision that are private businesses being paid to deliver public services- GP practices and dental care. Both are the ones that are shit.

There should be no GP practices run as businesses. All GPS should be employed directly by the NHS. The buildings they work out of owned by the NHS. Sadly we missed the chance to fix this with the last Labour gov. Tories won't.

SamVimes6

Just because your GP is only working 2 days a week at your surgery, that doesn’t mean that’s all the work he does! He may well be working 5 other days a week at various other hospitals, clinics or surgery. He could well be doing evening clinics on top of his daytimes too

So he may well be “horribly overworked” and I think you are being very entitled in judging the doctor without knowing what he/she works. You’re not his only patient and as much as I understand your frustration, you’ve accused him of deleting emails to avoid work and you’re arguing with everyone who gives you advice that you don’t like

The real issue is with the surgery losing the emails, I don’t think anybody gets a say in other peoples work patterns

There are 2 doctors.
Dr A was the person Ds had the phone consultation with. They were quite happy to refer him and probably would have done if left to themselves.
When he came off the phone we were left with the impression was going to refer him.

Dr B then emails Ds out of the blue a week later and says he needs to fill out a form so they can look at whether he actually does have ADHD.
The tone of the email was that he would have to score a certain amount before they will even consider referring him (snd he probably won’t so go away)

Ds filled out the form and even leaving out a section about work which was about people who went to work and had a manager/supervisor and about time keeping he managed to score well above the score needed.

The form had similar questions to what Ds answered when he spoke with Dr A.

Dr B now doesn’t have time to look at the form because they only work 2 mornings per week

Firstly why did Dr B get involved with Dr A’s work and create more work for themselves especially if they only work 2 mornings (not days) per week at the surgery.
Dr B has form for not referring people to the clinics they require.

I would change surgeries but it is a mammoth practice and has taken over every small surgery in the area.

As for the practice manager, it wouldn’t be worth my time as nothing gets done.
Not just me saying this. I have a few friends in the area who say they have complained about various things and you get a standard email reply that they will look into it. But then nothing

@Bythemillpond - can you not get another appointment with Dr A again?

My df was a GP and of the general opinion that the GP model in this country does not work well on a part-time work model

He's probably right.

One of the elephant's in the room is that, when my father qualified, 98% of the cohort was male. Almost all of them worked full time til they retired.

Now (and for the past two or three decades) the cohort is over 50% female, who tend to take extended breaks from the workforce and return part time.

We either need to restrict entry to men, in the expectation most will work full time, or train more doctors to allow for this. Either route has consequences.

Well, atrocious admin aside, Dr TwoMornings was unreasonable in getting involved at all, then. Sorry, but I get really narked when things like this happen.

Can you try to get another telephone consultation with Dr SemiRetired and explain the situation? I know it's awful and you shouldn't have to do this, but persistence is everything. They are relying on making in difficult for you so that you will give up and they don't have to fund diagnosis and treatment. It shouldn't be set up to make you fail like this, but sadly it is.

Maybe Dr A messaged Dr B to chase up the form to get the referral done.. Dr B may have to approve the form before it can get signed off...

Drs use their professional judgement regarding referrals. The patient may like to be referred to xyz clinic, but it’s up to the dr to decide if it’s relevant and appropriate,

Why would Dr A have asked for a form for Ds to fill out as he had already said he was referring Ds. He had asked Ds similar questions that were on the form and decided to refer him.

Dd and myself have been through all this within the last few months so we know you don’t have to have a form.

It is Dr B who sent the form out and got involved and made up work that didn’t need doing and now it looks like it isn’t going to happen anytime soon.

Dh thinks they delay and delay and hope you either move, go private, give up, or die.

I think your DH is right, OP. I'm sorry to say.

I hope he survived and recovered from the cancer treatment.

They are relying on making in difficult for you so that you will give up and they don't have to fund diagnosis and treatment. It shouldn't be set up to make you fail like this, but sadly it is

Yet in not funding treatment the condition doesn’t go away and it costs more money to fix if it can be fixed in the long run.

@Tibtab

I think you are working on an unrealistic timeline for a non-urgent referral. I would assume it would be processed within a month rather than a week.

Eh? Waiting times are long as it is and you think it's right that a referral should take up to a month to get sent off?! Talk about low expectations

@Bythemillpond

They are relying on making in difficult for you so that you will give up and they don't have to fund diagnosis and treatment. It shouldn't be set up to make you fail like this, but sadly it is

Yet in not funding treatment the condition doesn’t go away and it costs more money to fix if it can be fixed in the long run.

I know, but short term money saving solutions seem to take precedence over spending money in the short term to save in the long term.

I agree, it's wrong. But it's the way the system is rigged.

AutistGoth

I think your DH is right, OP. I'm sorry to say

I hope he survived and recovered from the cancer treatment

Only because we personally funded the operation and his treatment by decimating our savings and his pension which means they might have saved the NHS a couple of thousand on what would have been a simple operation. In the long run because they refused to refer him, during the operation we paid for, his spleen was removed and now he is on medication for life and they have to pay for his medication and because he has had stage 4 cancer he doesn’t pay for his prescriptions.
It has probably cost them more than the operation he should have had if they had referred him in when he first went to the GPs.

Tibtab
I think you are working on an unrealistic timeline for a non-urgent referral. I would assume it would be processed within a month rather than a week

Just looked and from ds’s phone appointment it has already been over a month

It is the fact that I know once he gets the referral it will only be a few weeks till he gets his assessment and starts medication. It is very quick around here.

I wonder if Dr A did refer DS, however because the referral wasn't done 'correctly' they contacted the surgery and Dr A was off, for whatever reason, so Dr B picked it up and is trying to get the referral filled in in a way that it can be processed

I'm sorry you've had to deal with this frustration.

But I agree with others - how many days someone works isn't your business.

I work in medicine, part time. I have a disability which causes severe pain. My patients don't know about this. I'm just about coping with work but I do my best for my patients. Would you judge me for that?

You really don't know why this doctor only works 2 days.

iolaus
I don’t see how it could have been done wrong as it is just about sending him for an ADHD assessment.

Neither dd or myself filled out a form and if Dr B is so short of time then I presume the referral could have waited for Dr A to get back to sort it out rather than have someone who doesn’t have time, sit it on their desk and forget about it for months (if Ds is lucky)

I work in medicine, part time. I have a disability which causes severe pain. My patients don't know about this. I'm just about coping with work but I do my best for my patients. Would you judge me for that

I would judge you if you started taking other patients from other doctors and then making them wait till you got round to them when the other doctors were quite happy to treat them immediately.

Fair enough. I don't.

In this case I'd speak to the practice manager and get them to sort it out

I hope your ds gets what he needs.

Can you try and ring up and speak to Dr A again? I agree the surgery have been crap - not dealing with 3 emails is completely unacceptable.

And I also think that primary care needs to be reviewed. It doesn't work in its present form. I also disagree with GPs. being private businesses. I used to work for a GP practice and a lot of it was massively inefficient.

Referrals are made and usually certain criteria has to be met for the referral to be approved. Maybe Dr A failed to ask a vital question when he spoke to DS on the phone. Often online forms are filled in and submitted electronically. It’s not as common now for doctors to write actual letters asking for ‘Dr Hospital’ to assess patient x’. Possibly Dr A did submit the referral but it got rejected (missing question, needing more information etc) and Dr B followed it up.

Standrewsschool

No referral was made as the receptionist said that Dr B has taken over and needed for him to fill out the form because Dr B hadn’t spoken to ds

It later transpired that ds’s email with the form filled out form attached was never received back from ds.

Checked as I knew it had been sent.
Found not only the date and time the email had been sent back to the surgery but also an email saying that they had received it.

Sent again whilst we were in the phone to the receptionist and she said this email had been received.

Following day with another receptionist I was checking if the form had reached Dr B only to be told the form had not been sent back.

@Bythemillpond

Standrewsschool

No referral was made as the receptionist said that Dr B has taken over and needed for him to fill out the form because Dr B hadn’t spoken to ds

It later transpired that ds’s email with the form filled out form attached was never received back from ds.

Checked as I knew it had been sent.
Found not only the date and time the email had been sent back to the surgery but also an email saying that they had received it.

Sent again whilst we were in the phone to the receptionist and she said this email had been received.

Following day with another receptionist I was checking if the form had reached Dr B only to be told the form had not been sent back.

sounds like complete incompetence ...

3 emails confirmed as received.. suddenly disappear..

yeah right ...

@NOTANUM

Normal fees and living expenses for the initial degree are borne by the student as per every other student in the country. The rest of the £220K is paid by the taxpayer. I don't know if the post graduate training is subsidised at all.

IMO there needs to be a tie-in like other countries who send med students here to train or indeed the army has if you want to leave early. If you leave before 5 years of full service (spread over more years if PT), you pay it back.

Like I said, Medicine is not the only degree subsided by the government. Basically any science degrees and especially degrees where the graduates don’t typically go on to earn about 21k. Unless it also applies to them that is unfair. Your suggestion is ludicrous and I’m glad it will never happen!

Post graduate training isn’t subsided.