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....)

@Cyw2018

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.

I was calling him Dave the Paramedic... Not to insult anyone... I've come acorss many fantastic paramedics who were truly brilliant.

I was insulting HIM as he had previously INSISTED that I didn't have thrush... And was generally a poor consultation. He was dismissive, patronising, mysogynistic, and generally not helpful. He couldn't seem to explain to me WHY he believed I had something different. I wasn't being diffocult, stroppy or in anyway 'difficult'. I have had at least 3 consultations with other HCPs about the same problem since Christmas with no issue.

I understand that patients self diagnosing often get it wrong... And I'm OK with this... But his attitude and example was not OK and far from acceptable.

He was triaging me then and doing diagnosis over the phone....

I don't generally insult whole professions...

No woman should have to be examined by a man if she's not comfortable with that. Not only that but is a paramedic qualified in that area? Id want a GP.

@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.

This.

How are patients supposed to know what qualifications a paramedic has these days? Genuine question.

I know one who has two GCSEs, one A level as a mature student from a night class, and no degree, no BTECs, no apprenticeship. Joined the ambulance service in the 1990s. Seriously, how do I distinguish that person from a Master's-qualified Advanced-trained paramedic, over the phone?

Related but actually separate, how do triage paramedics deal with breast lumps? Is there a set protocol to get women straight into a breast clinic referral?

I’m not defending a patient feeling patronised but judgement of ‘ineffectual’ and ‘shit care’ doesn’t always mean that it was. It’s not normal practice to do a physical exam as it’s not usually particularly helpful and it’s unpleasant for the patient. So a face to face doesn’t seem to be needed. It’s perfectly reasonable to suggest it might not be thrush. It’s perfectly reasonable to do a swab to confirm. The expectation from the patient might be that they should just receive a prescription but if it’s better to take a swab is that good care? Some STDs can actually be caught years and years before people start noticing symptoms.
OP it sounds like the problem was the way he communicated with you. Do you feel that you could feed that back to the surgery?

@SpindleWhorl

How are patients supposed to know what qualifications a paramedic has these days? Genuine question.

I know one who has two GCSEs, one A level as a mature student from a night class, and no degree, no BTECs, no apprenticeship. Joined the ambulance service in the 1990s. Seriously, how do I distinguish that person from a Master's-qualified Advanced-trained paramedic, over the phone?

Related but actually separate, how do triage paramedics deal with breast lumps? Is there a set protocol to get women straight into a breast clinic referral?

Your GP surgery are not going to have someone working on triage who is incompetent. Their qualifications will be verified by the employer. If you want to check whether they are a registered paramedic (rather than a technician, ambulance crew etc) you can do that on the HCPC website. Most practices also have a website with staff and qualifications listed. If you want to know on the phone you could ask what their role is. You could ask what qualifications they have but that may be difficult without sounding derogatory. You could ask directly whether they are an ACP. Paramedics are tricky as it’s a less well established career path than the majority of HCP that have required degrees for a long time. However older nurses don’t all have a degree either. Any symptom suggestive of cancer is a red flag and would be triaged as such. Triage is about assigning an urgency and red flag would be urgent. You would be invited in to see the GP to verify that there is a lump And they would refer as 2 week wait if appropriate.

@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.

Couldn’t have put it better myself

@Ozanj

Be grateful you can see someone. My GP surgery advised me to go through our Bupa cover for my boob lump as it would be quicker.

How’s than an issue?

@Lolojojonesi

I also have a boob lump, was seen the same day by the practice nurse who was reassuring but anyway referred for a mammogram which took about 3 weeks to come up. Photo wouldn't have done the trick, you can only feel it.

These threads are always full of 'NHS falling apart' doom but that's not been my experience, though I suppose it depends on area (I am in Scotland). Totally get why you don't want to see Dave, but I suppose it depends how urgently you want to get seen? No harm in requesting another person and seeing who's available.

I hope you are okay Lolo and OP.

I think the situation in Scotland (or at least in some parts of Scotland) is actually very different and much better than England. A same day appointment with a nurse or GP is very unusual in most areas of England; even for a breast lump.

My family member who lives in Scotland was shocked by how much longer people are waiting for ambulances, out of hours care etc. in my region of England compared to where she lives.

Dave the paramedic sounds like a bit of a knob if he doesn't know what Thrush is. I understand your concerns OP. But there are guidelines to follow regarding breast lumps which Dave couldn't have ignored - pretty much all of them get referred to the two week wait breast clinic. I know that having had several lumps myself. Most of them are just harmless cysts BTW try not to worry. But agree that GP surgeries are taking risks by employing paramedics not trained in these things, regardless of the extra qualifications eg prescriber courses, and minor injuries and illnesses, paramedics are not really experienced for day to day stuff like this and risks are being taken by turning paramedics into 'cheap GP assessors' and paying them as much

DH is one of these - advanced prescriber trained paramedic, working out of a GPs surgery. So Dave may be an arse, but that's his personality rather than his profession surely?! Also, no GP or nurse or anyone else come to that, is going to be able to diagnose breast cancer. They are all going to follow the protocol just like DH and Dave would do. And at least seeing Dave gets you on the right pathway today rather than next July or whenever the GP has an appointment

Glad to hear you're well on the way to getting sorted @IamtheDevilsAvocado.
Hope all goes well.