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.

What's to blame is losing the family doctor. We don't know you, you don't know us, so there is no trust. And because we have no trust in you, we have no faith in you. So our health is in our hands and you are a service to ease our concerns.

I think the whole thing needs a revamp. You're not happy, but people aren't happy with it either.

I moved to Ireland some years back and was genuinely surprised and annoyed that I had to pay to see the GP. Having grown up with the NHS it was a shock to release this was not free to access, it costs €65 for an appointment here. I now feel that actually paying to see a GP naturally whittles out the ‘need to have’ versus time wasters/people that should see a pharmacist first or use self care. This way the system can allow for people with real medical needs to see a GP quicker. I’m obviously not suggesting €65 as it’s a hell of a lot for many families to find but surely it makes sense for a nominal charge to be applied and this may have the desired effect.

Yes. It's the system that needs rehauled. It's not the patients' fault; its not the doctors' fault.

We either save the NHS (it might be too late already) or we lose it.

I totally agree with the OP, reading these pages one can see that GPs are expected to get involved with the smallest thing, way beyond the scope of the NHS, as it was formulated. Someone was moaning because she couldn't get to see her GP face to face to discuss her diet, was that really necessary? A and E gets clogged up with parents who have a tiny concern, the sort of thing that common sense used to deal with. Someone referred to schools going back, great, then parents will have yet another over stretched place to take their parenting woes that have nothing to do woth the core business of educating children. Get your yellow viz jackets out teachers, there be parking wars again soon!

Re pp I agree a nominal fee changes behaviour but I’m not sure it’d ever get the votes if in a manifesto

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)

Thanks, will seek it out. McCartney is great.

DS has had a run of bad luck starting with an injury that was slow to heal and needed checking beyond self-care, and then a rarely troublesome chronic health issue flaring up to the point where 111 sent an ambulance for assessment one week, then a 999 call out the following week (based on the previous advice). At the point of picking up the phone on a weekend evening you know you're running the risk of an all nighter. DS was over the worst of that attack by the time he was triaged so was put on the Urgent Care GP pathway as he needed an urgent review of his medication, and thus we settled down for a long, uncomfortable night in the waiting room. The waiting room fills. Then the GP coming off shift comes in, announces one GP on duty, 32 patients also in the adult waiting room and a minimum wait of 6 hours and that people may want to evaluate their being there...
Within two minutes, there was an exodous and about 3 or 4 of us were left in the room for the next 6+ hours. The clear out was mainly of parents with grouchy toddlers, probably a high proportion that would have been better off sleeping off a mild virus in their own beds. If you're that concerned, you roll with the wait to be seen. Expecting to be seen in an hour or two on a weekend night is pure fantasy.

On my previous visit there for the injury, there were families wanting antibiotics for their toddler's virus and hoping that Urgent Care was going to cleverly swerve the difficulties in trying to see their GP 🤦‍♀️
can't think how I ended up testing positive for Covid 4 days later...

I've worked in the NHS and other public facing jobs and there is the mix of people who wait until they're near death's door before being seen in my DF's case literally 8 hours, and the GP was not astute enough to see the urgency of cardiac symptoms and patient history and missed a window of opportunity to attempt to save him and there are people who don't practice any self care and expect HCPs to wave magic wands and make everything better and aren't impressed when it doesn't. Then there's the middle ground that generally make sensible judgements most of the time.

If you could magically take away the percentage of people who could but don't self-care appropriately, that would make a significant difference in making the load on the NHS more sustainable. It wouldn't solve the major structural issues, but 5% less on an overstretched service does go a long way, especially for the HCPs treating patients.

After reading some of these replies OP, I’m not surprised that you have had enough. What horrible entitled people you must have to deal with.

I feel for you OP.

I have over the last year been part of the NHS cycle as a patient (stage 4 cancer and a few other bits and pieces). My treatment, care and speed of attention has been nothing short of amazing from my GP’s surgery ( which gets attacked regularly in our local social media) to my wonderful oncology team.

Having to spend time waiting in the GPs surgery, pharmacy and various hospital departments I am horrified sometimes by the behaviour, demands and expectations on medical personnel. Examples include ( but are definitely not limited to) abuse thrown at the GP’s receptionist because someone who had a cough for a day couldn’t get an emergency appointment, to the patient I heard swearing and physically threatening a GP ( so loudly I could hear it through the wall from next door), to the person at my local hospital pharmacy yelling at the pharmacist that they’d taken more than 10 minutes to prepare a prescription. Obviously not everyone behaves like that… but in reality nobody should be.

I have felt a level of frustration at times due to ‘admin’ but realise this is not the medical practioners fault, this is as a result of health and safety and increased levels of litigation.

I am incredibly sorry OP that you feel that you’re time as a GP is up, but in all honesty I am unfortunately not surprised.

I think this advice, generally assumes (naively) that necessary self care has been used and that the patient is following any medical advice already given, and that this has been tried and failed. Problem is this is not the case for many people.

I frequently attend patients complaining of prexisiting/chronic pain, who call with the demand that we sort their pain out who on questioning aren't taking the already prescribed pain relief at all, or per the instructions written in very simple terms on the pack. It is one of my absolute pet hates!!

Where I am from they started a pound per visit to stop people who don't need it. People can afford the pound (well equivalent there) but it does make them think before going there with every scratch.

I think it's completely the opposite and loads of people who do need help don't ask or don't get it and self-medicate with food, alcohol, vaping etc which makes them more unhealthy and in need of more medical treatment by the time they do get seen.

GPs have always had frequent flyers and moaned about it too. The difference is now that there are not enough GPs and the NHS is on its knees.

Also we've had 12 years of Tory cuts to public service which means that GPs see a lot more people who might have been helped elsewhere first in other times. And poverty is on the rise so this will only get worse.

I think we need more public training on how to use our doctor surgery, and what self care actually looks like.

I read in the times that 30% of ambulance call outs were to 1% of the population. Now a bunch of these people may be in poor shape so who knows on that one. The UK’s most frequent callers to the ambulance service made 8300 calls for ambulances in 1 year.

So yeah I totally do believe there are people clogging up appointments. Some of those people need mental health services some will have issues with loneliness etc. I think my mum used to go to get sympathy and attention. She once went because she felt there was a bit of a lump on her hand (there wasn’t).

Dh and I don’t really bother for ourselves but for Dd we give it a few days unless it’s genuinely serious before we go. Each time it has been something that needs to be treated (sinus infection etc). I do think menopause should be taken seriously though, haven’t been there yet but sounds horrible. And there are some shit doctors out there to be frank. A lot of women seemingly end up being told they are just depressed when they are actually sick. My GP was really good by the way, loved her but sadly I move.

OP sounds like she’s been a great doctor over the years and is more than entitled to feel thoroughly fed up with the ridiculous mentality they have to face more and more these days

Off topic but my old GP who has now retired was a very straight talking Irish man who had the respect of many and if the shit hit the fan health wise he was brilliant. He didn’t do time wasters very well though.

I visited him once at aged 19 after I had suffered my first migraine. During the migraine my left arm went numb. He asked me if it was one or two arms I said one he replied with “oh that’s good then if it was two arms you’de be fucked” 😂😂😂.

Can you imagine that level of straight talking now? And I’m 33 so I’m hardly a dinosaur.

I’m keen for a GP and A&E access charge. I’ve lived in a country which has had both and it would certainly make some people think twice. But people would be saying that it’s against the principle of the NHS etc

@hewouldwouldnthe

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.

Incorrect. When someone first calls 111 they are dealt with by a Health Advisor, if they can't refer the person to the appropriate service they are then referred to the clinicians were their needs are assessed and the appropriate treatment determined. We have access to Drs, Toxbase etc.

I think we need more public training on how to use our doctor surgery

I could do with training on how to navigate the phone system for ours.

Sorry 5 most frequent callers

I feel for you OP I really do. And you only get such short 5 minute apts, I don’t know how you do it when I’m sure people must come with multiple problems! It must be such a stressful job.

GP’s wife here: I completely agree with everything you’re saying. You want examples Mumsnet? How about:

I want to lose weight but I refuse to diet and exercise - can’t you just give me a pill?

People who ‘must’ have a home visit because they can’t get to the doctor… but when the doctor arrives they’ve gone shopping.

Emergency appointment for an ingrowing toenail.

Appointment for hay fever - complains when he suggests pharmacist.

Child has has a temperature for a few hours - complains when antibiotics aren’t forthcoming.

Appointment to complain about housing situation - which a doctor can do nothing about.

Appointment for shoulder pain, threatens violence because they won’t be ‘fobbed off’ with physio referral.

I could go on.

I blame the Covid clapping culture - this eulogising of the NHS means everyone now sees it as almost a religious vocation. It’s not, it’s a job, and no-one wants to do it anymore.

Think it's about time the time wasters are charged. Also people who miss appointments. I do understand the frustration of some patients though. My daughter has an underlying health condition which cannot be managed by our GP. She is ment to have a consultant appointment every 6 months but with only one consultant in our are that's not happening.

The only way she gets the appropriate treatment is if she is taken to hospital as an emergency. Even then she doesn't see the consultant. They go through the duty doctors. At her last admission it was discovered she has a vitamin D defisionsy. After months of her health condition getting worse. It's not always poorly managed my daughter eats really healthy gets plenty of sleep and has her meds at the same time every morning and evening. No wonder A and E is always chocca. Oh and they also stopped the open access to the ward to cut back on admissions. So anyone with a health condition has to wait in line with all the time wasters.

I had a friend who was always going to the doctors for some kind of mild ailment, think cold sore, rash, dandruff tummy ache, headache etc. She demanded bloodwork, medication, referrals and scans. She still complained, when they all said that there was nothing wrong with her. Some people like to be ill, as they like the attention it generates.

I get OPs pain, I get so mad with the GP bashing (my parents do it all the time). How are we going to keep doctor numbers up when they are treated like shite all the time. We need them!

I am on the other end of the scale - I do my own anticoagulant monitoring and its on a need to know basis with the path department. I do especially like it when I email in my INR to them and then they send me a letter telling me the INR I emailed up.

The problem in the NHS is not the medics.

I think we could to be a "HCP only rant" thread with a trigger warning on non HCPs reading it. Where HCPs can say what we are really think at the moment, use the language and black humour that helps us talk about it and offload our stress. People will be able to see the percentage of us on the brink of leaving, without any need for virtuos mumsnetter telling us to get a different job.

OP I hope your day is going okay. Do your best, think of the money, and remember it would all be a lot worse without you, even if your patients and the wider public don't appreciate that fact.