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.

Something that always strikes me as inefficient about the NHS - and I may have misunderstood how it works - is how prescriptions and investigations requested by a specialist can get sent to the GP to organise.

In Australia, if someone is seen by a specialist and they want investigations, they order them. They prescribe their own medications. They follow up their own investigations.

There’s a few caveats - there are efficient private labs and imaging providers. most will bulk bill (free to the patient) but for a while an MRI brain was “free” if ordered by the GP, but not the specialist, so that investigation was fobbed back to the GP to organise.

it seems like a huge time-waster to have prescriptions/investigations sent back through the GP when they are busy enough.

Similarly, I see posts on here about children having to get bloods done at the hospital, because they are children. Locally, there are 4 main private pathology providers, all with numerous clinics. All of them have experienced phlebotomists who are great with children, even toddlers and babies. AND - the bloods are back and reported within 1-2 days.

I know everyone on MN is averse to anything private but it seems nuts to me that everything has to go to the GP first.

I agree though about people valuing what they pay for. In Australia there’s a system called the NDIS; it funds therapy for children with physical/developmental challenges. Over 6 years there needs to be a “concrete” diagnosis, under 6 there just need to be two or more areas of developmental concern. The therapy is provided by private OT/physio/speech/psychology/any other therapy that is NDIS registered. I was talking to a speech pathologist the other day who provides a mobile service - she said the number of people who forget she’s coming and are out when she visits has risen considerably now that therapy is “free”:

I think you are very brave and dedicated to work the frontline as a GP. I am a medical epidemiologist and hide behind data crunching computers trying to draft guidelines etc. The GP always gets the brunt of 'everyday' problems. You must be under enormous pressure post-pandemic, and I agree this society engenders a sense of dependence on experts. I nearly died in lockdown as I had an accident leading to arterial thoracic outlet syndrome. It was very bad indeed, and I am four surgeries deep in this, with more to come for ulnar damage. My GP stopped me coming to the clinic for a physical exam and did a telephone review. He fobbed me off, but I went to A&E and they could see subclavian and jugular buckling. I still had to go private for assessment, and then wait months for surgery under the NHS. The surgery made me worse not better due to surgeon damaging ulnar nerve (left arm/ hand paralysis). But I am not blaming the GP, or the emergency staff at A&E, or the surgeon working under terrible pressure. People who moan about the NHS should go to America and wake up to the real cost of health care. Unfortunately the role of GP has become one of social care and social worker, sadly.

I also don't understand how so many "timewasters" are actually getting to see the GP given the difficulty of making appointments. 45 mins on hold here last time I tried.

A lot of practices are apparently triage-ing by "ability to make repeated phone calls and wait on hold" which is not going to lead to an efficient outcome.

I know Covid has made this harder. My university medical centre dealt with time wasters and minor complaints effectively by letting everyone show up, quick chat and you got a yellow letter if it was something infectious or serious. It worked well - yellow letter people were expedited.

I don't have any confidence that charging would help. For one thing the NHS would be incapable of running a charging system and no-one would want to staff it. People also expect polite and timely service when they are paying. You can't expect them to be grateful for a poor quality service AND charge them.

Oh wait. Considers water, electricity, gas, trains, planes, ferries. Maybe you can!!

That’s exactly it, even a pound may make people stop and think about booking an appointment. It can’t be a figure that prevents people struggling financially from accessing care when genuinely ill. Regarding a PPs reference to A&E charges, it’s €100 here to attend A&E…now that would make a time waster think twice!

It’s the same everywhere. I’m leaving my frontline ambulance role very soon after 22 years of being spat at, punched, kicked, sexually assaulted, verbally abused, threatened, objects thrown at me, bitten, urinated on etc and I cannot wait. I will NEVER go back to a frontline role. There is literally no personal responsibility or ability to apply common sense anymore and the sense of entitlement is absurd. I’m done with it all.

The amount of ambulance staff that die shortly after retiring or die by suicide is crazy. I personally know 6 staff members that have taken their lives in the last five years. I also know other HCPs who have done the same. They spend 40 years of their life helping and caring for others, then never get to enjoy any retirement because their body and mind has been broken beyond repair.

Get out now OP. Nobody will thank you for staying.

If you lived abroad in a well paying job for so many decades, surely you saved a lot of tax and national insurance payments that you can now spend on private healthcare?

It is a system that very few people want to pay more into and more people want more and more out of.

No wonder it is struggling.

@JaneJeffer

don’t get sick when you’ve encouraged all the doctors to resign, pet

This is horrific.

Nobody should have to deal with this for any reason.

Why are these people not prosecuted? It is a scandal.

I think part of thr problem is that if you're from a normal family and don't have that sort of job you can't conceive of anyone behaving in such a way.

Well it does. And it needs sorting.

This is ALL so sad & broken. :-(

@scoobydoo1971
I nearly died in lockdown as I had an accident leading to arterial thoracic outlet syndrome.

Do tell us more, how did you do that? I once went to a teenager having a massive stroke following an illegal karate move which partially dissected his carotid artery, very very sad.

Doesn’t sound like the job for you anymore OP. Triaging works in most places - You are assessed by a nurse and are referred to the GP for anything other than a minor ailment.
Some people spend half their lives going to the doctor for a scratch.
I’ve always found that GPs jump into action very quickly when they recognise a real problem. The problem is, investigations and referrals are needed to rule things out as much as to diagnose. Recognising a serious problem from a 5 min conversation is very tricky.
Your IBS example touches a nerve … My DM was told she was suffering with ‘IBS’ many times… finally persuaded GP to send her for tests & guess what, it wasn’t IBS.
I don’t know what the answer is. More minor injuries/minor symptoms walk in centres might be a start.

I think some of this is fuelled by Dr Google. There's a lot of self-diagnosis and then when patients present themselves to the GP complain of being 'fobbed off' when the Dr doesn't agree with them. There is a lot of helpful info online, especially once a diagnosis has been reached, for example on type 2 diabetes But it seems to be a double edged sword.

People seem very demanding and angry a lot of the time, demanding instant gratification. I see this in all walks of life.

A colleague of mine had a complaint when she’s dropped her scalpel into a branch of the femoral artery and bled all over the floor, the dr had to stop her bleeding to death while the ambulance was called.

Pateint saw the blood but complained they had to come back to complete treatment.

Yes me too. The sneery attitude is awful!
I’ve no idea how all these time wasters are getting to see the GP. I rarely visit the doctor, but on the few occasions I need them, it’s a battle to even get through on the phone. When you do, you then get grilled by the (non clinical receptionist) as to what the nature of your problem is, before a consultation, which is never face to face😣

The NHS is not fit for purpose and hasn’t been for a long time, but the OP directing her ire at patients is completely misplaced!

I see where you're coming from OP. I have had a few minor illnesses recently (coughs, colds, sore throats - not covid) and each time at least 2 members of my family have told me to see my GP.

I think it's OK to argue that people who can pay, should pay, get insurance etc, but we all pay into the NHS (the more you earn, the more you pay) and yet we have a supposedly national system that has so much variation in what's covered, which diseases and conditions are considered "worthy", what services are available, what wait time, what quality...

I do feel for HCP but they are trying to defend the indefensible mostly.

Would it? Really? Definitely? For sure?

'Misunderstanding' is a very polite way of putting it. MN is full of foul, nasty individuals whose mission is to destroy and upset other posters.They are sick in the head. It sort of reflects the UK.. fucked up and sick. This thread is a perfect example.

OP - the Wanless review predicted this scenario in 2002 (his health care report, not the social care report of 2006). He predicted the staffing shortages, and also counselled that people needed to be fully engaged with managing their own health care, as well as seeking support from professionals. He had 3 scenarios - slow uptake, solid progress and fully engaged. I haven't looked at it recently but would suggest that the UK progress is scenario 1 (slow uptake). I empathise with everyone - this is an untenable situation for both professionals and patients.

Do people want more out of the NHS? Or do they want approximately similar service levels to about 20 years ago?

OP thanks for all your hard work, I don't think I could do it! That said my Mum who was a GP said that you don't know what hard work it compared to their generation of female GP's - no idea if that is justified or not! She used to be on call regularly, out lots of times overnight, on Christmas Day...etc etc. I guess that is what she means. She wouldn't have much truck with the deluge of time wasters you have to see I am sure.

OP, it sounds like you are experience.

I think most Healthcare services are under pressures and there are staff issues.
I think is fair to say people do contact their Gp needlessly but at the same there are occasions where GP do misdiagnosis people. I have experience this myself.
I went to the GP multiple times and was very dismissed numerous times. I eventually received the correct diagnosis and had surgery. It amazing how differently doctors treat you when you have an official diagnosis. I have never forgotten how I was treated.

In terms of the the current trends, I think the younger generation are less healthy due to diet and lack of exercise.

It sounds like you only want to be a GP for the meek, mild ‘truly deserving’ patients who make you feel like you are going above and beyond for just doing your job.

Those who can advocate for themselves and ask for what they are entitled to seem to make you feel inadequate and don’t give you the same ego boost..

Maybe a little self reflection is in order.

As someone who is approaching the end of a second pregnancy I've learnt this.
Pharmacy won't give advice because you're pregnant you need to ask a Dr, Dr says ask the Midwife, Midwife says ask your Dr or phone maternity Triage, Triage say drink more water and call your Dr.
In the end I just ask my mum 😅
Thankfully so far anything has turned out to be pregnancy rubbish which has sorted itself out but the anxiety is pretty intense!

I was bullied into accepting a letter of apology when I got punched in the face by a drunk man rather than the ‘hassle’ of having to put him through the courts and I was awarded £50 by the court after being kicked in the shin by another man, though never actually received any of that money.

The rest, well, it’s ‘part of the job’ apparently and ‘we knew what we signed up for’ and ‘if you can’t handle it then you’re not cut out for the job’.

Most staff don’t even bother reporting it after a while because nothing ever gets done about it. Putting up with having ‘you’re a fucking c*&t’ yelled in your face or having your arse or breasts groped repeatedly, or being threatened with physical violence or a complaint because you’ve dared to ask questions they’ve already been asked or suggest they probably don’t need to go to ED is ‘all part of the job’ now. Same as being told to take your boots off before entering someone’s house, or being told to drive someone home instead of to hospital, or someone demanding a drug you don’t even carry then getting aggressive about it, or demanding you take them to that specific hospital for no other reason than it’s nearer their house, or demanding you organise how they’re going to get home from the hospital you take them to.

We get training in how to get out of dangerous situations, how to get yourself out of grips and holds. If someone grabs your hair do this, if you’re pinned against a wall being battered do this, if you’re being threatened do this etc etc.

When I first started I was so proud and happy to be doing a job I’d always wanted to do. Now I wish I’d never bothered. I can’t wait to leave.