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.

Sounds really tough op and there are likely many incidences where GP use is adding to your stress

The pp suggestion of £60 or equivalent of 60 euro is too high though imo. People would try hard not to go and problems would increase

I think a minimal fee would help adjust behaviour - if you look at plastic bag use for example it doesn’t take much to shift behaviour even with a low cost

I agree with most of what you are saying OP, but things aren't always so simple.

My friend had a constant dripping nose for years, kept getting sinus infections but kept going to her GP only to be given 2 week prescriptions for steroids each time she went. This worked for the 2 weeks but then as soon as the treatment finished, her symptoms came straight back. Finally after 3 years of constantly going back to the GP, he referred her to the ENT clinic. Turns out she had a deviated septum which minor surgery sorted out, and she's had no problems since then.

So yes, some would say it was 'just' a runny nose and to not bother going to the GP, but in reality it was a genuine medical issue. That may be the case for quite a number of patients. It may not be 'just' a headache or 'just' a sore throat etc.

I have noticed a massive increase in drunk people or drug addicts at A&E every time I have visited.

I don’t know if this has any impact on gps but it must put a strain on A&E.

I'm not a medical professional but I do have ulcerative colitis.
Have you had a calprotectin test done? It's done on a poo sample?
Have you had the possibility of bile acid malabsorption explored?
Finally have you just asked for a referral to a gastroenterologist if you haven't already seen one?

I completely agree with @memorial . People seem to have become incapable of using simple first aid following an injury or minor boo boo, or basic home care for things like colds, flu, or a plethora of regular viral illnesses.

We have a great selection of resources that should be the first port of call for advice. Pharmacists & nurse practitioners are well trained & a good first step if the standard protocols for say, a cough, earache or cold, is persisting for over a week or there is a deterioration in condition/ear discharge/increase in temperature after several days which could indicate an opportunistic bacterial infection has snuck in.

Isn’t it next year when Pharmacists will be able to prescribe antibiotics to reduce pressure on Doctors?

Minor injury units for things you can’t clean & pop a couple of SteriStrips on or if an injury has left your arm looking decidedly wonky (as my daughter’s arm was after she fell from a tree & broke it) are vital to free up A&E units.

I was diagnosed with type 2 diabetes a couple of months ago on a routine blood test for one of my pain meds which can cause kidney & damage (on a 6 monthly meds check by our practice pharmacist), Referred straight to my practice diabetes specialist (a practice nurse), complete change of my diet & bought my own blood glucose monitor to keep me in check, along with metformin being prescribed. On my first appointment a month after diagnosis, my bloods were so improved (& my cholesterol had dropped dramatically) that I’ve gone straight onto 3 month surveillance. And that was with a shocking high HbA1C level at the start. Why? Because it is my responsibility to manage my illness!

My Dad, who died a month before my diagnosis, actually had Type 2 diabetes as one of his causes of death. He was one of life’s ‘it’s not my responsibility’ folk, didn’t change his lifestyle, spent months in hospital following gangrene & amputations (directly attributed to his diabetes, because he didn’t look after his feet & skin) & ended up in a wooden box because of it.

Health Visitors - another great resource. Why they’re seen as the devil’s anus on here is beyond me (my daughter’s was excellent & I had a good relationship with her).

We have a wealth of information at our fingertips. We need to learn to be self sufficient, so we can recognise what (& how) we can treat ourselves, and what needs the input from A&E or a GP. And how to recognise what we can’t handle at home.

I’ve always been an advocate of education, and including the teaching of first aid in school would be a good start. This could include simple illness & treatment education too. Add in first aid/illness advice for under 1s by antenatal sessions, and 1-5 year old advice by Health Visitors.

I know too many GP & NHS friends who have burnt out & left. Every one that leaves in this way is a massive loss to everyone.

One of my collegues, now retired, used to refer to "Boo shock" when we would get passed calls saying xy or z had happened and the patient was in "shock". It definetly wasn't clinical shock (Hypovoleamic, cardiac, obstructive or disruptive) but yet they would still dial 999 to be "checked over". Of course if something unexpected or scary happens you're going to feel out of sorts, but that does not automatically mean you need to see a HCP to give you some "there there".

Please explain "title you haven't earned".

I completely sympathise with op because you just have to spend 5 minutes on here to see how many people seem to try see a doctor for v little reason.

Having said that, I think its more complex. The nhs process is clunky and inefficient. I recently received a letter from a specialist to say some test results may need some treatment and please review with my gp. Its not clear to me why the specialist didn't just send me a prescription and save the gp the effort and time? Post emergency c section, I saw the same midwife who had given me painkillers on the ward but there was no way for her to give me a few extra- less than 5 days after ds' birth. (I fully appreciate painkillers are tricky but a woman who is 5 days post-partum after an emergency c section asking for an additional 2 days of pain relief surely is something that could be built into the system?) A friends child was transported by ambulance to another hospital to see a consultant when it turned out there was one in the hospital he was at.... these are just a few inefficiencies I have seen that have wasted nhs time ans resources.

Too often there are too many steps in a process, wasting time and resources.

Without reading it all i think the OP and others does have a point in terms of the streams of snowflakes visiting GP’s and Emergency heath services when they just don’t need to. Minor cuts and grazes, I’ve had a cough for 2 days, my daughter has been sick all day yesterday and doesn’t want to eat this morning. This used to be sorted out by common sense steps and only if symptoms persisted was a GP or hospital trip needed. People are fast enough to get in line to book an Uber but won’t go to NHS site to check the advice for said minor ailments. Sometimes worse, even if they have they ignore it and go because they want a magic want fix and then complain because after seeing said medical professionals, they don’t get a magic wand they get the advice they should have followed in the first place.

there is only so much doctors and governments can do. People have to start taking responsibility for themselves, there actions and actually thinking to resolve issues themselves before asking.

It’s so frustrating that public services have been cut to this extent, we haven’t saved money we have just built up more and more problems. I can’t help but think loneliness is such a huge part of it. It makes mental health deteriorate. The police are responding more and more to mental health issues and ambulances are forever going to elderly people who have fallen because they have no family around to help them. I’m not sure what the solution even is but what we are doing now just isn’t working.

Our population isn't too large to be supported by a state service

It can grow with the population and its needs or have its growth restricted by the small state ideology

If you choose through voting or through not bothering to vote , the later , you get what you voted for

OP isn’t wrong. I used to work for a GP and everyday people would demand emergency appointments for things like cold sores, runny noses, mild headache for a day, grazed knee. And then there were the ones calling daily for nothing, possibly due to mental health or loneliness but when there’s six month plus waits for referrals they are still coming to the GP daily. This may not be the case everywhere but the doctors I worked were working a minimum of 8am-8pm to fit in as many appointments as possible alongside visits, paperwork, follow ups, meetings etc.
There is definitely a significant number of people who will not attempt to self treat for minor illnessses before going to the doctors

They've proved the same issue at A/E in the past - the same 10% (or something) turning up all the time

I don't see how you fix this.

We don't see our GPs - just a phonecall first. Only seen if necessary.
They still seem busy.

@Sarahcoggles Doctor is actually a title for those who hold a doctorate (ie have submitted new academic knowledge into the public realm)

Doctor is an honorary title for a medical person. But unless they separately hold a phd then they are just undergraduare degree holders with some years work experience (like most of us)

OP, what are you honest opinions on social prescribing? Does it happen in your surgery and does it take off any pressure at all?

I agree with you OP and sympathise. My mother is constantly at her GP for minor ailments and everything is self inflicted due to lifestyle. Equally it's almost impossible to get an appointment at my GP.

I do think GPs need to be firmer with time wasters but also the enormous number of people who apparently now have 'healyh anxiety'. Why has that become a thing? Why do we accept it as normal now? It's not normal, and I don't remember hearing about it until the last few years. What about clinics for people with self professed health anxiety to find out why and help them overcome it?

I have to say as well that I feel like GP surgeries need to be run better. Getting an appointment, when you do really need one, has become such a mission that is suspect many people are already pissed off by the time they get to see the GP and that can't help.

These days we all expect to get what we want when we want it. We have the internet so we can shop or look things up 24-7, we have multiple ways of contacting each other instantly, we have shops open all hours, we have instant access to so many things that we used to have to wait for.
So when we have a symptom we want it fixed straight away.
When I started as a GP people would ring if they'd had a sort throat for a week. Now they will regularly ring if they wake that morning with a sore throat. Seriously. I've seen patients who have had a cough for half an hour. And it's the luck of the draw who gets through on phone first.

Yeah, that's comparable.

Yes, I agree this is totally out of normal working practice and not sustainable and was a reflection of how busy they are. My friend is also a GP and I know how close to burn out she came a year ago. As I said it’s a tough job involving too much work and I lack of appreciation. What I was trying to say in my previous post, was that I fully appreciate my GP practice and am aware that they go above and beyond.

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.

Absolutely this, however this attitude will get lots of people on mumsnet telling you you "aren't fit to do your job", "just leave", "why did you ever choose to be a HCP" ect.

I have the attitude that I don't hold any kind of personal responsibilty for any one who dies in my region on my days off or annual leave, therefore the same applies in my unpaid meal breaks. Management, the public and media seem to feel differently about the later however.

I appreciate things are very hard for you in your profession and I’m sorry you’re feeling stressed.

I am sure this has got much worse over covid but I wonder if this attitude and over stretching of GPS has been to blame for the absolute shit support I’ve had.

Since I was a teenager I have had chronic pain in my hips and knees and barely any GP has given a shit about it. I’ve seen a good number over the years in three or four different practices. One did a hypermobility test and a blood test for rheumatoid arthritis. I was told repeatedly it was “just muscle pain” and to “take ibuprofen” when it really impacts my daily life when it’s bad, even with painkillers. One GP didn’t even look up from typing as I explained and then said “it’s just muscle pain”. I had an appointment made where I wanted to discuss physio and then covid happened so I’ll chase that and hopefully get a good result but it has been disheartening, and has left me feeling like GPs think I’m wasting their time. I guess some people will consider this something that doesn’t need to be seen by a GP and that I should just be taking painkillers for chronic pain every day in my 20s and get on with it, but it is really hard to be in pain all day every day when it flares up.

I imagine those GPS considered me to be someone who “needed a GP to hold my hand”. They obviously didn’t think it was anything worth their time. Maybe this is exacerbated by people really wasting their time - I can’t imagine how hard and frustrating that is for you. I also think it’s a much wider issue and it’s important that we fix the things that are hard for GPs because that would make experiences like mine less likely.

Thanks for what you do, OP. I can imagine it's a thankless job.

I couldn't agree with you more. Most people using GP services don't need to be using them. Most people who are suffering from chronic ill health have self inflicted disease. Before she retired, my mum was a GP Practice Manager, so I've heard all this for years. Her frustration at seeing the same patients coming back in week in week out for the same issues while doing absolutely nothing to help themselves was considerable.

The majority of adults in this country are now overweight due to poor diets and lack of exercise.

People continue to smoke and drink alcohol to excess even though they know it destroys their bodies.

We've now got an epidemic of diabetes - which is the highest cost to the NHS of all illnesses, which causes a whole host of secondary health issues that take up so much time of GPs and practice nurses.

More self care throughout adult life would prevent a lot of people experiencing the kind of chronic underlying ill health that sees them clogging up primary healthcare services.

We also need more community services to support the elderly - many come and see their GP just for a chat, because they're lonely.

I operate on a leave it for a couple of weeks and then if it's still an issue, go to the doctor policy, and if everyone did that, things would be much easier. The problem we have now is that everyone's on Google, goes straight to the worst case scenario, and wants to be seen straight away for something that will most probably go away on its own with some self care at home. As others have said, it doesn't help that there's constant 'don't miss the signs of this!' and 'go to your doctor straight away if you have this symptom' posters/advertising campaigns everywhere, so you do have worried people turning up at GP surgeries with these symptoms, that 99% of the time aren't cancer and something much more common and innocuous. Unfortunately what that does mean is that the 1% of times it IS cancer, it often gets missed as the GP has seen so many people with similar symptoms that have turned out to be nothing serious. Particularly in younger people, and women, who are consistently fobbed off with 'stress' and 'anxiety' as a diagnosis. My aunt got told she had IBS for months. It's her funeral next week. She did have cancer. By the time the GP actually did something about it, it was too late. There are too many stories like this. But at the same time, I can see why it happens. The system is broken.

Growing up we had a family GP who knew us from babies and we always saw the same one, so he knew our medical histories and could work from that as a basis when diagnosing, meaning we had really thorough and intuitive care. Now when I go to the GP I see a different person each time, who's operating off the notes someone else made last time they saw me - which are usually inaccurate - and so each time you're starting again with explaining what's wrong, and links and connections don't get made, so that's where people fall through the gaps and you end up with people going misdiagnosed with severe and life threatening illness after being fobbed off by a succession of different GPs over months.

I don't know what the answer is. It's a complicated interconnected web of solutions, I suppose. People really do need to start taking care of themselves, and using their common sense when dealing with health issues. I also think charging a small amount to see a doctor would be an excellent way forward. If everyone had to pay £25 to see a GP, we'd see a huge improvement in waiting times - once people have to pay for something, they really think about whether they need it or not. Unfortunately when something is 'free' it's really not valued. We need to recruit more GPs and pay them better. Everybody should see the same GP every time they visit the doctor. And pharmacists need to be empowered to do more - when you know you've got tonsillitis or a UTI or whatever you should be able to go and get antibiotics straight away from a pharmacy like you can in Europe. Why you still need a GP to sign off basic antibiotic usage, I don't know.

Thanks again, OP. Sadly a lot of people have had negative GP experiences, but that's not your fault. It's the system.

Sounds like slightly petty hair-splitting to me!

Each to their own I suppose....

I think loneliness and mh impacts are a factor for some too. Anything that breaks down social connections exacerbates it. The last few years will have been tough on many for those reasons

I used to work for NHSDirect and am certain we deflected a lot of people away from doctors and into self help. Service ditched because it was too expensive. 111 is simply a sorting station and doesn't do genuine assessments by well qualified nurses with access to pharmacists, doctors, and the poisons centre.

Not surprised you're done because people are just ridiculous in their expectations.

Personally I see my practice nurse once a year for my thyroid check. Haven't seen my GP for over 5 years and it was necessary then.

I do understand the anxiety faced by mothers of young children though, when they child is unwell.