To wonder why it takes a GP 7 years to train?

[Swedes2Turnips1]

When all they seem to do is say 'I will write you a letter of referral' or 'You will have to make an appointment with the practice nurse for that'. What do they actually do these days?

I'll just add these two more as they are both very good.

www.drrant.net/2007/02/why-dr-findlay-doesnt-do-out-of-hours.html

www.drrant.net/2007/02/please-dont-admit-anyonethe-hospital.html

Swedes2Turnips1 - describing symptomolgy and diagnosis are not the same thing. so yes whilst one can describe a headache, it is not so easy to ascribe those symptoms to a specific conditions. that is why GP's and doctors are trained in taking history, medical and social to try globally undertand patients holistically

thanks for the reminder.

i really do need to see about my fecking blood pressure.

i've been in denial too long now. thanks, Dad, for the crap family history of hypertension and heart disease!

fecking anaesthetist had to give me all kinds of dope to bring it down before putting me out.

Anne - politicians may not be interested in good care for patients - managers are.
As I've said below - I am one. I talk to patients all the time and my constant focus at work is to get a good service for them. Yes - I meet targets - but not at the expense of patient care. I don't diagnose people - but I do take care of them - before and after they see the clinician.

I look forward to reading your links - I love blogging doctors!

I don't work for the NHS either, and I've had brilliant treatment from GPs, and have never (touch wood) been seriously ill. I don't know what job you do, Swedes, but I bet you'd leap to the defence of your profession, and expect your colleagues to do the same, if you felt it had been unjustly defamed. I don't think it's laughable. It's human.

As for self-diagnosis - I'd be interested if you could reference those studies. People may pin point what they feel to be wrong, but understanding the physiology and pathology of disease (apologies medics if I've misused those terms) is a different matter. There is most probably room for improvement in doctor-patient communication, but I think you're extrapolating too widely from a limited and unfortunate personal experience.

AnneM - I particularly liked : 'Fuck off you useless ignorant fuck. Fucking fuck faced lying cunt twat fucks. Bastard, fuck, twated cunting cunts.' LOL Thank you for those.

Well if you can look past the swearing he is really informative.

Hmmm. Maybe I should have posted Dr. Crippen stuff instead..he is a bit more mild.

habbibu - I would be the last person to jump to the defence of my fellow professionals. There are some excellent ones and there are some truly hopeless ones. True of every other profession, except GPs, apparently.

Brits really do have the market cornered on creative use of the word 'fuck'.

Swedes, I don't work in the NHS and I do think you were being unreasonable, sorry. You do have to be referred for a blood test - the health system would grind to a halt if every patient could rock up at hospital and demand any test they wanted.

Our system since 1948 has been that the GP is the gatekeeper; they assess patients and decide whether Mr X's headache or Mrs Y's breathlessness needs further investigation. Or treat them themselves. Or advise the patient it's OK and you can take paracetamol/try a bit of exercise or give up smoking.

Other countries have different systems, where you can often rock up directly to a specialist. Costs a great deal of money -think US is now spending 9 per cent of GDP on health. AND is not necessarily a good thing for the patient.

Over-investigation can delay things and put patients through unnecessary procedures and distress. Add to that the fact that, e.g., a gynae willl always look at a potential problem from their own perspective, knowledge and experience and maybe miss the fact that pelvic pain could be something not gynaecological at all...

Of course, there are crap GPs just as there are crap journalists or crap footballers... my poor Grandmother suffered from a terrible GP who ran his practice single-handedly part-time. He spent the rest of the time as a second-hand car salesman. And I hope he treated his customers better than my Grandmother - she might have lasted a bit longer, and certainly been healthier, if he hadn't been so appalling.

hear hear edam. but swedes doesn't need a gatekeeper. she diagnoses herself. or pays through the nose. (except when it involves parking at her gatekeeper's)

such commonsense just doesn't do it for her, tbh.

Swedes who else on this thread has been executed? tbh I think you have got off pretty lightly considering that you keep on making fatuous comments like "I think doctors should listen to their patients more."

Dear oh dear.

Any interaction with a health care professional (I am speaking personally now as a previous employee of the 'beast', an outpatient and orthopaedic physio) is a two way conversation.
Patient (or client ) comes in and says "I think I have got A"
Then follows a series of questions and answers, and then possibly an examination (if it is indicated) that will either confirm that patient does indeed have A, or that patient has B, or that the diagnosis is unkown and further tests/referral are needed.

I used to have 40mins to assess a patient, a good 20-25mins of this was listening to them and asking questions. For complicated cases 40 mins is a push. When I worked as private physio I got an hour.

GPs get 10mins.

Why do they get 10mins? Because of patient demand. Would my DH like to spend longer listening and talking with his patients? Yes. In fact he often does. A new diagnosis of cancer you are not going to shuffle out the door in 10mins are you? And then his surgery is running late, and people sitting in the waiting room are getting irate with him.

I am not quite sure that you understand that working in the health service is a massive juggling and compromising act. There is just no way, regardless of how much money is poured in it, that it can keep up with demand and the expectations that are put upon it.

fwiw I think most Health Care professionals are aware and accepting that some of their patients will able to correctly self diagnose. However, there are plenty that will not. The skill (and that is what all those years of training are about) is picking out salient details from what a patient is telling you, asking further appropriate questions and then concurring with the patient, or advising them that whatever they thought was the problem, actually isn't, and then discussing possible treatment options, and outcomes.

Except if you look at my last (or last but one post) I do say that there are some good GPs and some crap ones.

loving itscoldtoday's list too

self diagnosising patients - spiffing idea
so remind me WHY did i train]

if itscoldtoday's list doesn't convince that GPs need an incredible knowledge (and therefore 7 years training, and ongoing training) then I don't know what would.

Yes, DrScottishMummy, as your patient, I think you need to give me lots of drugs!

I have, erm, um, eh, hyperboredom.

go have a gin and a fag PRN

yeah, f*ck the blood test!

Swedes, I don't think anyone is saying there aren't crap GPs. What people are saying is that you are unjustly tarring all with the same brush, that your complaint is pretty trivial in the grand scheme of things, and you keep digging yourself back in by saying things like "True of every other profession, except GPs, apparently." I have nothing to do with the medical profession other than being an occasional patient, so have no professional axe to grind, but if I was a GP I think it would be perfectly reasonable of me to respond, especially give the way you worded your OP.

Only someone with a very skewed idea of what is reasonable could find the statement "I think doctors should listen to their patients more" fatuous.

Because you are (again) tarring us all with the same brush. And not listening to what anyone else is saying yourself.

And I feel that I do listen to patients.

They often don't listen to me however..."oh so I was meant to take the full course?"

What you are talking about Swede when you discuss 'convenience' is a classic case of 'patient's wants'-ie would be good in an ideal world but isn't necessary
VERSUS 'patients needs' ie is necessary
These two things have to be balanced otherwise we will have an NHS meeting the wants of a highly educated, young, vocal, well population who are eloquent at expressing their wants, rather than meeting the needs of the poorer, less educated , chronically sick population who tend to put up rather than vocalise their needs