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.

@sauceyorange fair enough then that one I got wrong. I still stick by my other points though.

The other thing I meant to say is that I agree that mental health care in the UK is absolutely dire, but I wouldn't blame GPs for that.

There are many adverts on TV again these days encouraging people to 'have a chat with their GP' is they have a whole range of 'symptoms'.

The NHS is actually running a campaign around possible cancer symptoms, and going to one's GP:

The NHS is encouraging people to contact their GP practice if they experience any of the following symptoms:
intestinal trouble, such as discomfort or diarrhoea for 3 weeks or more
blood in their urine
unexpected or unexplained bleeding
unexplained pain that lasts 3 weeks or more
an unexplained lump
a cough for 3 weeks or more (that isn’t COVID-19).
For guidance on the recognition and referral of suspected cancer in primary care patients, see our summary of NICE’s guidance

It seems harsh to criticise patients for going to their GP therefore with 'intestinal trouble such as discomfort'.

For most of my adult life I lived in a country - and with a job - that financed an old-fashioned family doctor for me and family. I could ring her/him (we changed over time; one of them sadly died) at any time, and see her later the same day. I could discuss my children's health and progress, get advice about specialists, consider prophylactic medications, physiotherapy, specialist massage for back pain ... everything.

Usual medical travails of family life - childhood ailments, broken bones, chronic diseases, dietary advice, appendicitis, etc., etc. - were dealt with without fuss. Hospitals superb, specialists immediately available ... all with the help of Dr Wonderful our family doctor.

Then a few years ago I retired back to UK, children grown and scattered. Registered with the local GP service. It soon became clear 'old-fashioned family doctor' was no longer on offer, following massive prolonged underfunding of NHS. Well, I thought, you get what you vote to pay for: the NHS worked on a hugely smaller per capita investment than where I had been living.

OK, the 'National' part of 'NHS' gave significant efficiency savings, and the good will of health service workers - clinicians and others - was likewise beyond compare, again making for good provision. But, overall, much less money spent, much less service offered. And, in particular, old-fashioned family doctors? Too expensive.

What to do? I wanted to live in UK (well, by this time, die in UK is more appropriate, really). So I swallowed hard, took on board that too many of my fellow citizens were prone to vote Tory for one reason or another, and tried to mitigate the loss of primary medical care.

Not too difficult, in many ways, albeit it can be time-consuming. I read relevant medical research papers, get copies of all notes from NHS clinicians, do some calculations of Bayesian risk ratios and differential diagnosis, all that stuff; very occasionally get in touch with GP re prescriptions for chronic conditions, keep up-to-date with vaccinations and annual checkups on offer. This works fine for me. I don't need an old-fashioned family doctor; I really don't take much of my GP's time at all. I'd prefer Dr Wonderful, but that's not on offer. So I make do.

But, I realise, not everyone wants to do this ... not everyone is capable of doing this. (My GP himself has no real idea of how Bayes' Theorem works for differential diagnosis ... but there you go, he's a nice chap, not unusual in that, first-year med school was a long time ago for him.)

So what can be done? Nothing much, other than politically. Don't vote Tory! Ever. Under any circumstances. No matter what Rupert Murdoch tells you. No matter what you think of woke and the culture wars. No matter what you think of Jeremy Corbyn, Dianne Abbott or Keir Starmer.

It'll take a while - probably longer than I have left to live - but really it's the only thing you can do. Don't vote Tory

YANBU! It’s not too dissimilar to the utterly outstanding number of parents who have suddenly lost the ability to read letters from the school (and fail to understand the importance of doing so).

A growing number of people seemingly don’t want to help themselves; the amount of hand-holding is staggering (and worrying, and tedious) and is affecting every echelon of society!

It's not the patients' fault. Most of the problems you see as a GP will be minor ailments. If there aren't enough GPs to meet the demand then that has to be addressed, perhaps by looking at the way they are financed.

Many health problems are ongoing and exacerbated by personal decisions. If you can no longer cope with that then I think you need a new job.

I live abroad in a place where you pay for GP appointments and get a set amount back from the government. Some just charge the government amount so it is free. Some charge a bit above.

Consequently, I am treated like a customer by the receptionist and the GP and it is a much better experience as a patient. You don't get GPs with the attitudes expressed by the OP.

"By comparison primary care physicians GPs have it unbelievably easy. Nowadays they barely even cover face to face appointments and triage them all by phone first. Phone a GP's surgery for an appointment and 'you are number 25 in the queue'. They work limited hours on a very undemanding basis and no wonder so many of them are able to retire so early, as they're paid handsomely for doing so."

I don't understand why you think this when the entire profession is telling you otherwise. It is certainly not the experience of the GP I know in rl.

You are 25th in the queue and struggle to get a f2f appointment because they can't recruit or retain staff, in part because of the awful attitudes of those they come into contact with, and because they are overwhelmed by people with spurious need such as those outlined by op.

I can't help but think that things won't improve until we listen to what GPs are telling us, and act on it.

They work long hours and are under enormous pressure. Of course they triage, to weed out the time wasters so that there aren't even fewer appointments available for those that need them.

Do you mean 'letters', or do you mean one of the message on the ... hold on, let me count ... minimum SIX channels of communication the school(s) use?

That is one phone app, several email accounts, three facebook groups, Seesaw, Satchel, plus letters, occasional texts?

Because I have to admit, I do find it somewhat hard to keep track of the many messages I get over the course of a working day.

I completely agree op.
Society has lost its backbone, resilience and ability having slipped into a non stop whinging collective of negative ninnies pathetically bleating for everyone else to fix their problems.

The energy crisis is the latest example of this. They stupidly look blindly at government, the council, anyone at all to do something rather than use their own resources and wit to deal with their problems.

i admire your patience and professionalism. I have a similar job and am currently taking a break.

When DH’s patients complain to him about the state of the NHS he literally advises them not to vote Tory. He explains what the austerity years did. We live in a very middle class Tory area, his patients are often a bit taken aback! 😁

I was completely on board with you to start off with but the more you respond the more bitter, rude and condescending you appear. I'm glad you're not my doctor. You've made me think twice about my recent consultation, (first in about 2 years) - struggling with MH and early menopause after chemo and radiotherapy. Now wondering if I've been branded as a time waster after the "Davina" effect.
I'm also a HCP (not a doctor) and you brand us as the worst type for not understanding primary care despite navigating it for our own families and patients.

Please find another job, whilst I agree with the time wasters thoughts you've clearly lost empathy, compassion and manners.

The rise of the worried well and the instant life in the world of social media and amazon which has shifted expectations and destroyed patience.

I feel for the OP actually. Margaret McCartney wrote about it a good few years ago in the Patient Paradox and how it impacts particularly on chronic patients and vulnerable patients (especially mental health patients) who don't want to 'waste the doctors time'.

It isn't a coincidence that this is happening at a time when we are bombarded with media messaging saying things like 'do you have a cough? then you might have lung cancer.' 'If you have a cut, it can get infected and you might get sepsis and DIE'. The constant charity health campaigns to raise awareness might be having an unintended side effect - which might block access to healthcare for those who really do have worrying symptoms. There might well be a huge spike in unwarranted health anxiety in people who just have a bit of a headache not a brain tumor because we've created this society where we are scaring people that much with slick fundraising campaigns and PR campaigns.

Then there is a section of the population who really DO NOT WANT manage their own very basic healthcare needs because they think this is not their responsibility and this is what they pay the GP for. They need GP approval to put on a sticky plaster because they've somehow abdicated all social responsibility for themselves and think that the state should provide all solutions to problems. Again its part of the culture of instant gratification where you can order something from Amazon and have it delivered to your door. There is no notion of a social contract with our neighbours and how we have a collective responsibility to consider how our own actions might impact on others. There is a complete breakdown in community and there is only 'the self' if you will. Perhaps its a symptom of this feeling of total isolation and desiring social contact and care from the community in a world which doesn't give a shit otherwise. In the past people might have looked to the church for this type of lower level emotional and social care but are now instead going to the doctor and are pathologising it as a medical need.

And its those who do think about that social contract and perhaps do have worrying symptoms who are worst affected.

I don't know how you fix the problem. Its not through merely saying 'we need more doctors' because a huge part of the problem is nothing to do with GPs or the attitude of GPs or the finances of GPs. Its much bigger and wide ranging than that. Part of this problem really does lie firmly with attitudes to society and personal responsibility. Perhaps what we need is to be looking at more social support centres to fulfil that void left by the absence of the church - where can isolated people go to ask dumb questions and make contact with a human. Even places like citizens advice are a dying breed. The decline in these type of services needs to be looked at even more than recruiting thousands more GPs because a) its cheaper b) its more appropriate c) the training is in social issues not healthcare.

YES we DO need more doctors but we have multiple problems here which we do need to identify and tackle. There are parallel problems.

The other big one is the commericialisation and exploitation of insecurities and fears about health - Margaret McCartney wrote years ago about the 'Rise of the Worried Well' as a concept in the Patient Paradox. (This is a book EVERYONE should read). This isn't just about doctors but also about the charity sector and big pharma. The book is ten years old now and the problem has really exploded.

Children’s a&e is exactly the same. Full of patients who have a five minute history of a temperature ‘we didn’t give calpol’! Or vomited twice. It genuinely feels as if no one knows how to look after their child at home now, the anxiety is huge. Everyone wants their child fixing now. They haven’t got time for their child to be sick.

We can’t cope with it. Staff are burnt out and leaving. The biggest worry is that with the numbers we are seeing the sick child is going to get missed or not get the care they’d should.

It must be a very tough job as a general practitioner and I feel for you in many aspects but…
I haven’t yet read the whole thread. However, as someone who has suffered for 24 years with IBS I find your remark regarding sufferers so very typical of health professionals. You obviously have absolutely zero idea how this condition completely ruins lives.
I totally understand the frustrations of GP’s when it comes to seeing the same patients who present with the same conditions time after time but what else are we supposed to do when there is so little help for us yet our lives are shaped (and not for the better) by these conditions? Where do we turn if you are not interested? Throw ££££’s of pounds out to all of the private ‘experts’ because the NHS has wiped their hands on you? Yes, I have done this, money I can’t afford but am desperate to live a normal life.
It must be a very tough and demanding job as a GP but I do believe so many are becoming complacent and have lost their empathy.
And it’s not helped that so many GP’s are so very dismissive about symptoms. My 73 year old mother in law presented with digestive issues (had never suffered any issues in her whole life), her GP completely dismissed her symptoms as being IBS. This continued for a whole year. MIL did not have IBS, she had a neuro-endocrine small bowel tumour. She died a very painful death.
Her consultant was fuming that she had been shelved by her GP for so long.
And whilst it must be beyond frustrating when people waste appointments asking for antibiotics for a simple sore throat etc and other conditions which can be treated with rest or a trip to the pharmacist PLEASE have a little thought for those with chronic, life changing conditions, including mental health ones too.
I don’t know what the answer for you is but many of us patients are worried, scared and have very little quality of life and this will only get worse with such an inadequate health symptom like we have now and will have in the future.

I'm glad you're not my doctor.

How do you know they’re not? I doubt OP goes saying this to his/her patients.

How much money do people want to pay in extra tax to sort out the "underfunding" and do you actually think given some of the attitudes shown on here, that more money would genuinely sort it out?

The NHS staff I know are massively critical of the bureaucracy and how that burns money faster than anything. How about being grown ups, looking at the NHS from top to bottom and removing the inefficiencies and in some cases, because we have to caveat everything posted on here, take some responsibility for yourself.

I knew someone who nicked her baby's skin when cutting baby's nails. She rushed her baby to the GP who said ' what do you expect me to do?'

However, on the other side OP, there are many patients with tales of their genuine health concerns being brushed aside, you see the stories here all the time, and from RL. And all the research showing that women's health concerns in particular are dismissed. So, it works both ways.

My Dad's bowel cancer was stage 4 by the time he was diagnosed as his GP kept telling him that he was confident it was nothing serious and refused to refer him to hospital. He died. His neighbour (whose partner died of cancer) told me after his death, and in tones of considerable distress and frustration, that she kept telling my Dad he had to keep going back to the GP, and back and back, and insist on a referral as she was absolutely sure he was seriously ill. She was right.

"It's not the patients' fault. Most of the problems you see as a GP will be minor ailments. If there aren't enough GPs to meet the demand then that has to be addressed, perhaps by looking at the way they are financed."

It's the patient's fault if they are not showing up for appointments, not acting on advice given, returning again and again to worry about conditions that have already been ruled out, seeing the gp for things they could have sorted with an over-the-counter remedy. There is a lot wrong with the NHS and it is not all down to the patients but some of it is, and the attitude of 'nothing is ever my fault', and the fact that we can't even voice that opinion anymore, is part of the problem.

I feel sorry for GPs. It must be hard to be the gatekeeper, the only person an angry or upset or frustrated person can gain access to. I am sure at least part of the solution would be to say no more often, tell people they're being ridiculous, tell people you won't run the same test for a fourth time, tell people you can't help them unless they do the exercises/lose weight/whatever but I don't suppose it would go down well and they'd have to deal with the complaints and fallout, and those people would just go to A&E instead.

@Badger1970 a diet that poor is actually a key risk factor for bowel cancer as is altered bowel habits over a lengthy period. It sounds as though you just don't like her much. The GP was absolutely correct to refer.

Sometimes GP's are damned if they do, damned if they don't!

Same but they are probably the twats that waste GPs time, let's face it.

'oh doctor, I have a sore toe, what do I do? I have just knocked it into a wall accidentally, but it could be something very bad'

'doctor I have had a sore throat for a few hours, think it might be cancer, help!'

I think they should actually bring in fines for people who waste time at the gp. People will say that others will be put off going but they already are thanks to the current time wasters. Least the NHS can do is make some money off the morons.

I get it.
I’m due a medication review and was given an appointment for three weeks from now! Just as well I was expecting that and jumped in early as I wouldn’t be allowed a repeat prescription before I need it.
but then - I’ve booked 3 weeks in advance when Little Old Lady gets herself in very regularly. I know of her purely from doddering in or out of the surgery several times a week (we live in sight). Yes she may have a good reason to be in so much. Or she may be making an excuse to natter. But guaranteed there are many others like her who don’t “need” to be in.
But then you have folk who finally get around/pick up the courage to have something checked, they can’t get an appointment and it’s left for weeks more, serious issues getting worse.

Lost all respect for @memorial after the comment about Davina.

Op, I totally see where you are coming from and it is a real issue.

I see it in our own local practice. Doctors retiring are not being replaced - we have went from 3 full time doctors (relatively rural practice) to one permanent doctor and a stream of locums. Am sure burnout has sometime to do with that.

People seem to go to the doctors at the drop of a hat. First sign of a sniffle - phone the doctors. Certainly seems true among my work colleagues.

Nhs is struggling and we are using it even more than ever before.

Can you explain this test (normal for the 100th time)/ hospital letter/medication

There is nothing wrong with patients asking you to explain a letter/ test result they are not trained to be able to interpret themselves. The problem is with the NHS sending out information patients, unless they are medically trained, cannot possibly understand. Who else are they meant to ask if not their GP?

So many people saying that a GP appointment takes weeks to get, makes me wonder how timewasters manage to get so many appointments. I don't mean, why aren't they screened out, but physically how do they do it? Do they do nothing but wait on the phone to the surgery? Or are they waiting at the door at opening time every day?