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?

And yes you are being unreasonable about the work and training that GPs do

i suspect swedes means she wishes doctors would listen more to her. but given her own take on the NHS I'd be very surprised if they took her seriously

I have posted before on this thread and I don't work for the NHS either. Hell, I've even had a useless GP at one point, but he was the exception rather than the rule.

i think my blood test is essential but the gp face to face isn't. i think he should have sent me for the blood test first as it is so bleedin obviously a candidate for elimination given my classic symptoms and familial link plus the fact that i am 5 months post natal. some of a gps' duties may well be highly technical but this isn't one of those instances. of course if it is eliminated then i need his help.

swedes believe it or not i think the face-to-face element of the gp service in this country is invaluable. on seeing you a gp might have an inkling of another cause for your problems and ask for another test to be done on the same blood sample you'd be already be having done. so saving time/money. a cursory glance at your hands or face (which you might not realise was going on) might be all a gp would need to ask for say liver function tests etc.

Once again - you are actually complaining that your GP is trying to be more thorough and think beyond "thyroid problem" and consider other things too. It sounds like you actually have a very conscientious and good GP who wants to take the time to engage you and find out about your symptoms etc.

Point is swedes your blood test may well be necessary but the systems are in place to gatekeep the many, many other requests which aren't. eg if there is a storyline on a soap about some disease you will not believe the numbers of people wanting tests which are not justified at all.
Apart from the resource implications all tests have a false positive rate and if you just do tests on an unselected population you will get loads of these and cause a lot of unnecessary treatment.
The US system works by people just going to a specialist and paying for whatever tests they want and it is the most inefficient in the world. They have a concept of a CT -ve headache there ie just for a simple headache people are getting v. expensive CT scans with huge radiation exposure.
I'll take the NHS any day.
My name will give away that I too have a vested interest I'm afraid.

I don't think that most doctors object to you coming up with ideas about your illnesses either, as long as they are rational ideas, and you are prepared to be flexible about them, and not dogmatic.

I always feel that I have a working relationship with my doctors. I'm expert about how I'm feeling, and they have a better grasp of medicine than I do! And consequnly we have a relationship of equals. I never make the mistake of treating them as anything less than a highly trained professions, and so far they have all repayed the compliment.

Post M/C I developed a rare condition called Asherman's Syndrome. I saw my GP and told him that my periods hadn't started. He told me that it could be stress. I disagreed (politly), as I'd been stressed in the past and had never missed a period. I also told him that I was getting ovulation pain, and period pains once a moth, but no bleeding. Could I have adhesions in the uterus, I asked him. Yes you could, he said, and refered me.

We both worked towards the dx in an attitude of mutual respect.

Had I gone in demanding a blood test and a hysterosalpingiogram (sp??? not a doc) he might have been thrown on the back foot a little, and being human, might have been somewhat defensive.

making negative comments are seldom that productive.

do folks really go in self-diagnosing like that?

feck i have to be dragged in there half-dead before i'll even see a doctor, i hate going so much.

and DH! omg!

he really does need to be at the non-functioning state before he'll consider it.

i went with a pain just below my ribs, some nausea/vomiting, convinced it was a gallstone, told gp what i thought and he agreed i should have blood test/scan, and that's exactly what it was. but I suggested it to save time, not undermine him and working as partners you can definitely both benefit

The reason I went in was that every month I was in so much pain I could hardly stand up. It was like period pain but much worse.

Given that I'd had periods and he hadn't I felt I was at an advantage! I put a few things together, and asked him if it could be the case, and it was.

As Bundle said, it just sped things along

mamadoc - agree, I too will take the NHS any day. I just think that strict adherence to passing through the gatekeeper does not always result in the most effective outcome for patient or the health service purse. If someone fairly sensible is fairly certain of a certain outcome and the cost of that test is relatively minor then surely it is sensible to eliminate that possiblity. Then pursue further examination with the GP or whoever (and all the associated cost and time to the patient as well) route is explored. CT scanners are clearly an expensive bit of kit and I wouldn't dream of presuming any medical knowledge to set myself off on some expensive or time consuming (for other medics and me) path. But a blood test?

then why not go private for this, Swede?

sounds like it would save you some time and hassle.

Re the blood test thing.

I'm not sure what they cost, I would assume that it depends on what the blood test is for.

I do know that there is one hell of a queue ion the haematology department every time that dh goes to get his blood tested.

If patients could just self refer, there would be even bigger waits. And that would be for people who already have a doctor diagnosed need for a blood test.

Dh needs his test. If he doesn't have it, he will miss his chemo and will die sooner. the same is true for all the other people in the oncology unit.

Resources being scarce, they have to be rationed.

Or you have the option of paying

blood tests so suck, too.

i hate having them.

Not much fun, are they?

Poor old dh has to have one the day before his chemo.

at one point that was one a week, three weeks out of 4, for 9 months

Swedes even for just a blood test you still have the false positive problem. It is to do with Bayes theorem if you test in a population with a low likelihood of disease you will get a lot of false +ves and then you will be off down an expensive and time consuming path in any case.

I can sympathise with you to some extent. I wasted a couple of afternoons in an obstetric clinic in my pregnancy because I have a kidney problem. The only outcome of the 1st afternoon was for the consultant to say she hadn't heard of my rare condition and would speak to my renal consultant and of the 2nd for her to say she spoke to him and it was all OK! Same result could surely have been achieved without the need for me to show up on either occasion. I didn't mind (I had a sleep on the examination couch) but felt I was wasting their time.

Swedes, how can he possible know you're sensible without speaking to you though? You'd need some kind of computer system on which people were graded for common sense with others being told they were too daft to decide for themselves.

ah but tamum, they can't do that cos of data protection

Yes, that and the problem that you would be regularly insulting 90% of the population!

'I'm sorry Mrs Winterbottom, but we have you listed as a bit of a flake, so I need to see you in person before I order a full bodyscan for your ingrowing toenail'

...

This really happened with my Aunt.

She has a prolaped uterus and her dd eventually persuaded her to go to the GP.

Aunty came home, black afronted, that the GP had examined her 'down below'.

Her dd asked what she expected the GP would do.

Aunty replied 'I expected him to take me at my word!'

She honestly thought she would be refered to surgery just on her say so!

And what did she think the GYN surgeon was going to do, MB, examine her with her knickers on? Operate on her whilst someone held her pants out the road?

I mean, dang, she did realise what position a patient is put in for GYN surgery, no?