To think that people have become completely incapable....

[memorial]

Ok so I'm a GP (yes yes I know I could be anybody) and have been for over 20 years.
But bloody hell our society have become completely and utter incapable of any kind of self care or self responsibility. I have never known anything like the kind of demand we are facing. And I'm sorry most of it is just complete and utter nonsense. Over and over again.
Genuinely ill and needy people are being lost in the deluge. It's absolutely impossible to offer any kind of decent care. And we are losing doctors, nurses and staff rapidly. And we cannot recruit. It's not about pay It's about absolutely ridiculous workload and risk.
Yes the system is broken yes we need more of everything.
But every single thing does not need GP hand holding. It doesn't need 2 page complaints because you didn't get what you wanted when you wanted it.
Some days I just think people won't be happy until I go and wipe their arses for them.
I'm done. And it's not just me.

and I would like to add my agreement to this - the number of people I hear saying that they're going to see the doctor for self-limiting issues is astounding and then it clogs the system for people who really need to be seen. My GP practice is amazing and I really don't know how they manage to keep going but they do.

Anyone on the front line of the public sector will have experience of the ‘I know my rights but I don’t have to take personal responsibility’ school of thought. I’ve been retired years, but saw it almost daily, although I didn’t work in healthcare. There are people who go out of their way not to work, whose ailments are often brought on by lifestyle, laziness, and an unwillingness to take any meaningful steps to improve their own well being.

They take up services that are needed by the genuinely ill and vulnerable. There is 111, I’ve found to be very helpful, but their operators are often abused for not complying with callers’ requests. Social prescribing is a great initiative IMO, although not popular with everyone. After an illness it was suggested I needed gentle exercise, a cheap intro to our local leisure centre was on offer, some years on I’m a member, have lost weight and no longer take medication for HBP. Most of the people in the classes I go to are 60+, some in their 80s. As well as keeping us mobile, it provides company and friendships, and a reason to go out!

Enjoy your retirement OP.

Agree OP - I’m a nurse and work in a clinic. Some examples from this week …

The 40 year old man who cut himself at work and came to me to put a plaster on it (40 minute appointment given for that whilst elderly folk with actual need are told there are no appointments).

The woman in her 20s who dropped hot water on her foot … came in for me to put a plaster on the blister (30 minute appointment)

The 30 something man who got bitten by a spider on holiday, came in to ask me if the bite looked infected. 40 minute appointment.

To be fair though, half of my patients come to me in appropriately as they can’t get in to see their GP

Sending love, OP.

My closest friends are GPs and I understand what you are experiencing.

I think you sound very caring and fed up with an utterly broken, underfunded system.

@MinkyWinky your GP sounds wonderful, but hopefully you realise that calling at 9pm at night is not sustainable or acceptable in terms of work load for the GP? Not blaming you at all, just saying this is an example of the completely outrageous workload that we are under.

GPs don’t get paid for those extra hours, they work until their job is done. Where I used to work had an unlimited cap on patients per day, which means if you called and said it was urgent, you’d get a phone call/ appointment that day no matter how many others there were. Clearly patients lied and abused the system. Sometimes I would have to see 70 patients a day, plus deal with prescriptions, letters, admins, referrals etc. it’s unsafe and not achievable. But patients would shout at me if I told them they should have booked a routine appointment for their knee pain for 3 weeks. It took more time trying to rebook them than just trying to sort it, but then they never learn and just continue to abuse the system. I wasn’t a partner so couldn’t change the appointment system.

The public have lost respect for GPs, and no that’s not all our fault. Of course we can’t meet the average joe public expectations because they are unrealistic, so we disappoint people.

I am a lawyer married to a hospital doctor (consultant with PP) with a family member who is a GP registrar.

OP is correct that there are loads of patients unable to self-care for even a day or so or recognise a self-limiting illness, the demand and entitlement is ridiculous. An awful lot of consultation time is wasted on "shit life syndrome" (as my family member calls it) characterised by poverty, isolation, drug and alcohol dependency, poor living conditions or all of the above. We also read about rare occurrences of disease on SM and lose all sense of proportion - 99.9% of the time, your child will have a self-limiting infection that is not meningitis or septicaemia, but the coverage on SM makes many of us think that is a likely outcome. The same mentality makes otherwise healthy people call 999 when they "spike a fever" of 38.2 (real example).

However, ime GP's are not as skilled at sorting out the trivial from the serious as they think they are (perhaps as a consequence of the number of timewasters?) I sued my own GP about 15 years ago over a delayed diagnosis of cancer that caused, and continues to cause, significant pain and disability. It also went on to cost the NHS about £50k in IVF costs alone. I was presenting with red flag symptoms for bowel cancer and when my solicitor requested my notes, I had been seen >30 times in 6 months with no referral to secondary care (other than an offer of counselling for anxiety) when I begged for help.

Some of the delightful comments from more than one GP included "you can worry as much as you like, but I'm not going to do anything about it" and "you are using appointments that are needed for other patients" (my tumour was the size of a grapefruit by this point) and the classic "people who are really in pain don't cry about it". When my solicitor contacted them, the partners lied and obfuscated - happily unsuccessfully - to avoid paying. I have known scores of people with similar experiences through my voluntary work with a bowel cancer charity - Deborah James, for example, was refused a colonoscopy referral by her GP! I dread to think how long it would take to get diagnosed because now I would not physically be able to get that many appointments.

Yes GP's are overworked and it is a thankless job. But there are significant pockets of mediocrity, some appalling attitudes and a pretty punchy attitude to negligence. This can only exacerbate the behaviours of which the OP complains, because the trust and respect from the patient's side has completely eroded and some of this can only be laid at the door of GP's themselves.

Tony Blair hasn't been in Government for fifteen years!

I would equally blame the Thatcher Government for encouraging people to 'know their rights' and have a sense of entitlement in which society doesn't matter, only their own interests, which has continued to be propagated in the TWELVE years of Tory government we've just suffered. Meanwhile they've systematically run down public services. So people demand more, do less for themselves AND there's no one left to supply these services.

This is really interesting, and also like a PP said, people are anxious in case anything goes wrong. Thanks for the insight

It appears I'm not the only one, and for your info, I'm also a 'professional person'.

Just the other day I saw (IIRC on another forum) someone advised to go to her GP about nits. To be fair others did say FGS, no need for GP, just go to Boots, but the OP maintained that she’d go to her GP for a prescription. I dare say the initial phone call would put her straight, though.

IMO as long as we don’t charge for GP visits, there will always be people wanting the GP for every very minor thing. Even in Sweden - popularly supposed to be a socialist Utopia - everyone pays a small amount for visits to GP and A&E. That is according to a Swedish friend.

Can’t ever see any U.K. govt. ever having the guts to introduce it, though - free at the point of use is such a sacred cow.

I think you are getting me confused with the ex-Aldi person I was quoting - you and I are saying the same thing!

@speakingofart

that wasn't the GP's doing.

I think the Internet has made people panic more. They Google 'pain in little finger' and there will always be some site that will tell them this could be the first sign of cancer/ms/kidney failure and so they rush to make a doctor's appointment.

GPs don’t get paid for those extra hours, they work until their job is done

Sorry @Cinnabomb - I agree with some of your post, but the above is standard for all professionals on GP-level salaries. As a lawyer I have had that in my contract since I was a trainee on £15k a year - I am old, but it was crap money even then!

It really isn't the norm to get paid overtime when you are in the £100k pa zone.

There’s a huge difference between reading between the lines and interpreting something through your own agenda.

There is no indication that the OP is referring to mental health issues.

I think it's far more a sense of entitlement than an erosion of trust that people clog up public services. I wouldn't conflate the two, they are two separate issues, time wasting patients and GPs that are incompetent.

It was never, and I addressed your comments.
You have a real bee in your bonnet about this 🤔

I think that's the problem with most doctors, they lack empathy. If somebody comes to you with a sore elbow that's up to you as a doctor to treat them, yes it may seem minor in comparison to other things but some things can seem minor at first and turn out to be serious. Always better to be safe than sorry.

*me

The thing is OP, I am sorry for GPs and I think the system is terrible, and I really try not to bother my GP unnecessarily, but we get mixed messages. GPs and A&E are overwhelmed with timewasters. At the same time, we’re constantly told, don’t be embarrassed to see your GP! Spot cancer/diabetes/etc early - see your GP if you have any of these symptoms! Know the signs of meningitis! The actual GP’s waiting room is full of posters saying exactly this and there are millions of minor symptoms that could be something or nothing. You feel bad if you do go in, you feel bad if you don’t.

I got grouched at and sent packing for taking my baby in with an ear infection. Wouldn’t even examine her, refused antibiotics. It was mastoiditis and she ended up as an emergency hospital admission, surgery and IV ABs for a week. What was I meant to do?

it’s a genuine question because I’d like to know how to get this right.

Are you a GP?

I haven't read the whole thread but even in my dead end job, the entitlement of the general public is unbelievable. They can't deal with being told "no, you can't have what you want on this occasion." It's fucking draining so I can imagine it's much worse as a GP.

The problems with the NHS, and primary care in particular, and fairly straightforward, but very difficult to fix.

1. Too many people. Our population is too large to be supported by a state service. It was never intended to cater for so many people. We are all living too long and having too many complex medical problems for the allocated funding to cope with.
2. Health and Safety - a lot of GP time is spent rubber stamping and authorising things eg if you want to join a gym, go diving, do a parachute jump, get a job working with children, reduce your working hours for medical reasons, apply for a council house for medical reasons, move away from troublesome neighbours, get a mortgage, get life insurance, drive a racing car, become a taxi driver, drive an HGV etc - all these things can require GP authorisation. It takes up a huge amount of our time. I'm not saying these things aren't necessary, but people have to acknowledge that there are only a finite number of hours in a day, and whilst we're doing these sort of things, we can't be seeing patients who are feeling unwell.
3. Any free service will be misused by some people. We have patients who get appointments 3-4 times per week with a never ending stream of problems. Of course sometimes the physical problems are real, but mostly these are sad lonely people who have never learned to cope with life's adversities. We try and refer them to counselling, other support services etc, but all they want is to see the doctor. Nothing else will do. You would be surprised at how many people come to see the GP because the service is free and it makes them feel better to have 10 minutes with a medical professional.

Sadly it is unsustainable and the concept of the GP will ultimately die out I think.

At the same time, we’re constantly told, don’t be embarrassed to see your GP! Spot cancer/diabetes/etc early - see your GP if you have any of these symptoms! Know the signs of meningitis! The actual GP’s waiting room is full of posters saying exactly this and there are millions of minor symptoms that could be something or nothing. You feel bad if you do go in, you feel bad if you don’t.

This is true though. Especially when it comes to children.

My DH is a GP.

Honestly OP, you care too much. It's admirable but you have to change your thinking imo. I also work in the NHS in MH and a manager of mine gave me an incredible pearl of wisdom once. My job isn't to 'cure' everyone. That's not possible. My job is to do the thing I'm trained to do, to the best of my ability, with compassion, and let the chips fall where they may. Some will get better, some won't, but you absolutely cannot take it upon you to feel as though it's somehow in your control whether people will improve. They have to do the work themselves. It changed my whole approach, I adore my job to pieces and like to think I'm good at it, I always go above and beyond for clients and find time in my day to do the bits and bobs that will supplement their sessions and help them get the most out of it. But I can only do my 50%!

Is it possible to try step back a bit mentally? If you're not in control of who you do and don't see just take each appointment as it comes, do what needs to be done, and try not to worry/think about the people who haven't seen you yet? I don't worry about the wait list because that's not my problem. Just like when I worked at ASDA we were taught to only worry about the customer you're currently serving, don't worry about the queue, they're the store's problem. Work to rule, do your hours, do what you can in those hours, but don't break your back.

I've seen public health campaigns trying to educate people on when to see a GP and when to see a pharmacist and so forth, doesn't seem to make much difference though sadly. We need a whole change of mentality. A lot of the time the people who present again and again for extremely minor issues should be assessed for health anxiety and signposted for treatment for that. The person who's in every week with an imaginary bump or a tummy pain that's been checked out as being fine or who felt their heart beat a bit hard one night in bed has got an actual problem, it's just psychological. But there are also an awful lot of people unable or unwilling to do very straightforward things that would make a big difference such as lose weight, exercise a bit more, cut down on caffeine, stop smoking. The help is all there to achieve those things but people have the mentality that someone else external to them should be able to fix them. I'm not sure where that's come from but it's a huge problem. The people who are most successful in therapy are the ones who recognise early doors that they're the only ones who can 'fix' them, nobody else can do it for them. We can provide the tools and guidance and support but we literally cannot do it for them.

Bit of a ramble and I'm sure you've tried the above but I feel for you. GP is a pretty much impossible job. Then you get people complaining they're paid too much!