AIBU to request a medical appt NOT with 'dave the paramedic?

[IamtheDevilsAvocado]

Our local GP practice has a pretty efficient triage system... either a phone appts, refer onwards or see you face to face...

Rang in this morning as I've found a boob lump, I asked who was triaging... When I found 'Dave the paramedic' was also triaging said I'd be happy anyone other than him... (several m/f GPs and nurses), because the last time I spoke to him by phone he insisted thrush that I had, coudlbt possibly be thrush and was probably an STD, I did a swab and of course it was thrush (which I knew I did have as its exactly the same as the other dozen times I have had it over the last decade....)

Op, I suggest you request for a female gp or nurse as you clearly are not comfortable with Dave. Also when they ask to send pictures you can deny if it's an intimate area or if u r not comfortable. I have done it for my child and myself too. Gp's have always been quite understanding barring a few odd looks. Hope you get this sorted soon.

‘Dave’ won’t just be a paramedic but an advanced practitioner with considerable additional training. Suggesting that you need a swab before treating isn’t inappropriate, people do misdiagnose themselves or have multiple problems eg thrush and bacterial vaginosis which can get into a viscous cycle of reinfection.
I presume if you were sure of the diagnosis and it was a one off you’d have just bought your treatment at a pharmacy? The fact you were ringing the GP suggests it was more complex/ recurrent? What part of the treatment did you think was inappropriate?

@Mum233

I have requested this before. Mainly as usually when I deal with the paramedic he doesn’t know about MS or the complicated stuff that taking the medicine I do entails and then gets me to cal to make a gp call anyway!

My surgery doesn't have a paramedic but until recently used to always have a trainee doctor, fully qualified but in their final year of GP training. DS is very complicated, so if in doubt they'd ring through to their mentor - the senior partner - who would pop in and we would get two for one!

@mumwon

or sepsis after colonoscopy said with deep feeling (we have a dave & he OK with somethings but NOT that) Thankfully this occurred before covid so the patient who landed up in hospital for 6 weeks on 4 hourly double drugs IV didn't have the additional worry that many have at the moment. We are both grateful that this was the case. Trouble is -there is simply not enough GP's & they are trying to cover this lack of GP's by using Nurse Practitioners & Paramedics who are both very skilled but whose training will have gaps

Sounds similar to my experience too. I don't doubt that many non- doctor HCPs do a great job (and indeed doctors miss things too despite their training) but I worry that a lot of this is papering over the cracks. A non doctor at our GPs misdiagnosed my DH's incarcerated hernia as "a bit of an infection" and told me that my post operative wound that felt like it was about to explode "didn't look too bad" to her, whilst she was literally wiping up the pus that was pouring out of it onto the floor. Fortunately on both occasions we decided to ignore her and turned up to A&E where we were admited for emergency operations. She's probably brilliant at other stuff but clearly didn't have the level of experience/knowledge needed on these occasions and didn't seem to get a lot of supervision. Of course "not all paramedics/nurses/pharmacists etc...." but it is difficult not to lose faith when you have bad experiences (and nothing serms to change as a result.)

I would just request a female and that would solve that problem!

@AlbertBridge

of course it was thrush (which I knew I did have as its exactly the same as the other dozen times I have had it over the last decade....)

If you already knew it was thrush, why did you go to the doctor? Why didn't you just get some Canestan from Boots?

Boom!

Utterly ridiculous that GPs aren't seeing people face to face.
When everything else is more or less back to normal I fail to see why in person appointments seem to be so beyond the bounds of possibility.

He's only the phone triage; he will of course refer you to a Dr for physical exam and I really don't think he's going to argue about the need to do that.

ALL that matters is to get your lump examined soon. Good luck.

If you already knew it was thrush, why did you go to the doctor? Why didn't you just get some Canestan from Boots?

Maybe she’s entitled to free prescriptions and can’t afford £10 on canestan as she needs to eat and keep her electric on. Plenty of reasons people don’t have a spare tenner.

@TooWicked

Ah the old “be grateful, you’re lucky to even be getting an appointment at all”. For a breast lump.

No wonder the NHS is so shite, if these are the standards we are told to hold it to.

The NHS is currently so ‘shite’ as you put it is in part due to a massive reduction in the number of HCPs now working. Recent letters in the Times from GPs point out the difficulties faced by them in this pandemic. (not sure if the link works!)

www.thetimes.co.uk/article/all-religion-is-a-threat-to-democracy-rs8jddkln?shareToken=db41e79a30d34a8085063ffe2ed6c33f

Nope, sorry - wrong link!!!

Agree with doing an e consult if possible, but have a chat with Dave as it seems he's the gate keeper and in any case whoever is doing the triage should know that breast lumps deserve a face to face.

Hope you're OK

I’d quite happily speak to any appropriate healthcare profession in order to protect GP time for those who need it most.
In this case I think you need it most and I’d be asking for a GP consultation- YANBU.
Good luck, I hope everything is fine.

YANBU OP
Primary care is in a terrible state at the moment - recruitment of GPs being one of the biggest issues. Our practice has a paramedic who’s hopeless. I sent a photo of DS ear which had a big lump inside it and sent her the normal ear photo for comparison. You’d have to have been visually impaired not to see the difference in the two photos…. or been that paramedic
It’s ridiculous that patients are being fobbed off with phone or online appointments and I really resent reception staff interrogating me on what the problem is when I phone - funnily enough as an intelligent adult I can assess who I need to see for myself thanks

Our paramedic goes on house visits to the housebound to take obs sometimes bloods and urine samples for the GP. Maybe look at sore genitals and report back for antibiotics or creams. He sometimes just gets them admitted to hospital if there is a clinical need. Knowing our paramedic he wouldn't be happy having to do intimate stuff intended for a GP or Nurse in the surgery as that is not his role.

@StoneofDestiny

Paramedics are very highly trained - you are lucky to get one

I know that they're highly trained to degree level... But presumably in critical life support /injuries etc... I'm unsure they'll have training in run of thr mill gynae type things? I also don't think they'd have expertise in breast type issues?

Cna any paramedics clarify?

I presume if you were sure of the diagnosis and it was a one off you’d have just bought your treatment at a pharmacy? The fact you were ringing the GP suggests it was more complex/ recurrent? What part of the treatment did you think was inappropriate?

I can't tell how old OP is, but I believe that pharmacies won't sell over the counter remedies for thrush to women over 60, as it's rarer in that age group, and a doctor should check it's not cancer.

@BungleandGeorge

‘Dave’ won’t just be a paramedic but an advanced practitioner with considerable additional training. Suggesting that you need a swab before treating isn’t inappropriate, people do misdiagnose themselves or have multiple problems eg thrush and bacterial vaginosis which can get into a viscous cycle of reinfection. I presume if you were sure of the diagnosis and it was a one off you’d have just bought your treatment at a pharmacy? The fact you were ringing the GP suggests it was more complex/ recurrent? What part of the treatment did you think was inappropriate?

The part when 'Dave' hadn't seen me in person, and was arguing vehemently it wasn't thrush over the phone...... He was quite unpleasant... Apart from the misdiagnosis... And the general mysogony.

I have a couple of chronic issues which mean I often have thrush and it needs to be GP monitored...

Which I told Dave at the beginning of the consult....

Thanks for those who sent good wishes...

In the end, had excellent service today ... Was triaged by female GP at 1140 am, was seen at 3pm by same GP... She can't be sure not worrying, so is referring me for the 2 week breast clinic.

Pleased it will be sorted soon.

Paramedics working in a GP practice will generally be Advanced practitioners- they have considerable post graduate level training and are prescribers. Yes they are trained in minor ailments. It’s a higher level than a general practice nurse. Personally I think triage is best done by the most qualified person but plenty of practices use nurses. He’s only doing the triage, if he didn’t make you a GP appointment then absolutely yes complain at that point. I think you’re unfairly criticising at this point unless he’s done something inappropriate?

If he was unpleasant then yes cause for complaint.
But suggesting it might not be thrush and wanting a swab is very normal. And could have been thrush brought on by another infection. You wouldn’t generally expect to have an internal so I’m not sure how having a face to face appointment would change things?

@marioduck

I disagree that people should be grateful for receiving so-called care from someone ineffectual and patronising who fails to listen to or respect their patient.

If we want a decent NHS then that begins by holding it to the standard everybody deserves, not telling people to shut up and be grateful for shit care.

I agree. Why should be eternally grateful that anyone will see you for potential nasty breast lump?

Maybe we all need to humbly curl up and die quietly unless we can be 100% sure we are extremely close to death.

Paramedics are great at Emergency triage, not so sure they all have the skills to assess a breast lump- and this is not a dig at paramedics at all, obviously they would be great at triaging and assessing other things. They just don't have the same level of experience as a doctor or a specialist nurse who works in a breast clinic.
I hope you can get sorted, OP. I wouldn't normally advise it, but if you can afford to go private, it might be worth it for your peace of mind.

Oh I think I misread the post- he's just doing phone triage, not physically assessing? I think thats fine, as I assume he will say you need to see a GP anyway.

Most paramedics working in GP surgeries will have a master's in advanced clinical practice. This will be in non-Acute care/general practice. Advanced clinical practice (critical care) is a separate course, with only a few modules overlapping.

If you feel that 'Dave' was inappropriate then asked to see someone different, but your thread title 'Dave the paramedic' is insulting to an entire profession.

Have I gone through the looking glass? Why are U.K. citizens being told to think themselves lucky to see anyone? Is this what this country has come to?