To think this is what happens when receptionists are the ones who decide whether or not you actually *see* a GP? (Ear infection)

[lCantHearYou]

Wednesday last week- woke up with an intense pain in my left ear, and assume I’ve just jammed my ear plug in a bit too far, but over an hour later the pain is still there and I can’t hear out of that ear, so I ring the GP surgery.

The receptionist, based on no medical expertise whatsoever, asks what the problem is and unilaterally decides that all I need is a telephone appointment. The GP she’s scheduled the call with is well known in our community for not doing face to face appointments if she can help it and generally having the attitude of just wanting to get you off the phone as quickly as possible.

Later that morning, GP call. I explain that I’ve been having this very intense pain for several hours now that paracetamol isn’t really touching, my ear is ringing very loudly and all external sound is very muffled and barely audible.

She decides over the course of the 3 minute call that since I’m recovering from a cold I’m probably just a bit congested, tells me to take some Sudafed/other decongestant and paracetamol and it should right itself in a few days.

I start alternating pseudoephedrine, paracetamol and ibuprofen, but the pain wakes me in the night every night.

Thursday evening DH, the DC and I travel up to PILs house.

Friday morning, DH and I leave for a long weekend abroad (on the Eurostar, thank god we didn’t fly or I’d probably have at least one ruptured ear drum).

By Friday evening the pain and hearing loss has now spread into the right ear as well. Spend the whole weekend in pain and practically deaf, which kind of spoils things somewhat.

Monday evening, we all get home. 3:00 am I wake up in so much pain I can’t keep still, DH wakes to the sight of me sitting upright, rocking back and forth with my hands clamped over the back of my head. He calls 111 who schedule a phonecall with a Dr… who rings back 3 and a half hours later and says, sounds like an infection, I can prescribe antibiotics or you can just wait and see your own GP. I opt to see my own GP, so 111 Dr puts in notes that I need a face to face appointment.

So we’re back on the phone to the surgery, to the receptionist who’s halfway through saying “I can schedule a phonecall…” when I tell her about 111 Dr’s advice to seek a face to face appointment. Then she relents and schedules one with a different GP to the one I spoke to the week before. At the actual appointment, this GP barely needs to glance in my ears before saying it’s a severe infection, inner ears are very sore and red, lots of pus and gunk and, in her words, “looks incredibly painful”.

I’ve now been on amoxicillin and cocodamol (which I’m alternating with ibuprofen) for 5 days now. I can still barely hear a thing beyond the very loud ringing and the sound of my own pulse throbbing in my ears. All external sound is very muffled and distorted. If I wait too long between taking pain meds I fucking know about it… I’ve taken to sleeping with the cocodamol under my pillow so that when (not if) the pain wakes me in the night I don’t have to grope around on my bedside table to find them. Part of my job involves being on the phone, sometimes for hours at a time, so I have to jam my earphones right into my ears and turn the volume up full, and by the end of my shift (I work very late at night) I’m doubly exhausted from the effort of straining to hear anything.

AIBU to think that if, on that first day, the receptionist or indeed the GP had paused for a moment and thought “hmmm, intense inner ear pain, badly affected hearing, maybe get her in so we can see if there’s an infection”, then I could have started on antibiotics that day and at the very least the infection would likely have been contained to one ear and might even be starting to get better? As it is the receptionist didn’t bother, the GP didn’t bother, and instead of getting better it got considerably worse, the antibiotics are making fuck all difference and I’ve now had almost two weeks of intense pain and hearing loss for no good reason? And AIBU to be pretty pissed off about it?

Sorry for the twilight rant… I’ve just woken up feeling like the back of my skull is being squeezed. Again.

Honestly, how anyone can actually support the NHS is beyond me. It's an utter disgrace. Not being able to see your GP face to face?!

I couldn't believe that I could only visit one doctors surgery, that I had to register with and get approved.

Honestly, the alternative isn't the US system.

Hope you feel better soon OP, that is just shit service 💐

cks.nice.org.uk/topics/otitis-media-acute/management/acute-otitis-media-initial-presentation/

I think there are two separate issues:

1. Ongoing insistence on phone appointments- I agree this is crap. There should be at least the option of in-person if not as routine by this stay.
2. The management of your complaint- This is the NICE guidance for otitis media, which from the sounds of it is what you have. It's not a given that you would have been prescribed abx anyway. You should have had good safety netting advising return if no improvement or worsening symptoms.

cks.nice.org.uk/topics/otitis-media-acute/management/acute-otitis-media-initial-presentation/

I'm sorry you feel shit and hope you are on the mend soon.

I'd always go and see the pharmacist first. Or at least read the relevant NHS advice to see whether you need a GP appointment at all.

www.nhs.uk/conditions/ear-infections/

It's not a case that a sore ear at the beginning needs a GP visit/antibiotics unless you are already very unwell with it. I've got rid of potential infections with things like warm olive oil to soften ear wax, and Swim Ear if the issue is trapped water or other ear drops from the pharmacy can help shift an infection in the early stages. I've also had a lot fewer issues now I take time to dry my ears properly after a shower rather than rushing.

GPs and receptionists can be a pain in the arse, and I agree that they do need to see people face to face, but for many conditions there are much more straightforward things people can do to sort themselves out. Also cleaning your ear plugs/ear phones and headphones might be an idea to prevent further issues.

Sounds like an awful experience and hope it clears up soon. As an aside, French health care is great. You can see a doctor wherever you are on holiday, mostly same day for €30 or less and get the antibiotics immediately.

Happened to me, only the infection was so severe the two week course of antibiotics did bugger all. The drops the G.P prescribed were not to be used with a ruptured ear drum. The bone at the back of my ear swelled (mastoid bone, I think) and I went to A&E. Ended up in hospital 5 nights on IV antibiotics and Oramorph.

Hospital consultant advised on antibiotic ear drops should be used. Oral ones take too long/won’t always work.

GPs are independent practitioners who provide services to the NHS, they are not NHS employees.

It's crazy that we have to be so well informed about NICE guidance before we even try to book, so that we can explain to them what stage we're at with the progression of our illness, an illness in which we have no formal training.

Yes I agree it’s crazy that someone with no medical training effectively ’triages’ you. I also find at my drs they are quite overzealous and treat you as though you are definitely a time waster stealing from the nhs.

but I do think your whole situation was made worse by you not dealing with it properly
you couldve been more insistent on the phone call
And its not the receptionists fault the gp is lazy
after being up all night wednesday I don’t know why you wouldn’t call back Thursday, knowing you are about to go away for the weekend
and why when a gp offered to prescribe you antibiotics you didn’t just take them, but instead opted to wait, allowing the infection to continue

and there’s no way if I wasn’t sleeping and the pain was as bad as you describe, I’d be going into the weekend without speaking to the gp again on the Friday

i know that all sounds harsh and genuinely ear ache is so bad so I’m really sorry to hear you’re having a lousy time! But in this case I don’t think it’s the receptionists fault at all.

I don't understand why on earth you didn't accept the antibiotics from the emergency doctor?!?! It was obvious that your GP would've tried the antibiotics themselves initially anyway so surely getting a head start on them would've been beneficial.

Sounds awful. I have epilepsy and have had seizures in the past due to ear infections as the body temperature rises and this is one of my triggers. Anyway, I called the surgery as I felt the pain of a perforated ear drum and the brown stuff was pouring out of my ear. I asked the receptionist if I could have an appointment and she said no. I explained that my neurologist had told me that if I got another ear infection I should get treatment straight away to hopefully prevent a seizure. I explained this all to the receptionist.

No prizes for guessing that I had a seizure within 24 hours. I was absolutely fuming although a part of me was a little smug when I called the receptionist to tell her and to re-ask for an appointment. She probably thought it was ‘rather convenient’ but I know it was true and that’s all that matters.

It’s the doctor that should have decided to see you face to face to examine you, not the receptionist- they are following instructions

I’ve had more than one telephone appointment that’s lead to a face to face appointment later the same day

YABU

Please write a letter of complaint to the GP practice manager mentioning that receptionist. Her gatekeeping caused this issue and the first GP sounds 8ncompetent. Together a very dangerous combination.

I think you have to speak up more. I would have called again the next day and in the GP phone call
insisted on an examination or a prescription. I do worry for lots of people though as I'm not shy of asking what I want and have a fair bit of medical knowledge. I know others are far less willing or able to advocate for themselves.

What @Thatskindafun said.
I am sorry you are so unwell OP and my GP surgery is similar. Since covid they will avoid any face to face consultations it's only phone service which you get after hours of calling them for an appointment. But ideally you should have got better before going on holiday.. you could have called back if it didn't get better over time.
Anyways please take time off and rest you are unable to work properly in this stage. I hope you feel better soon.

Have you seen anyone since the antibiotics were prescribed, it sounds as though it’s not improving?

I'm sorry you are unwell but why are you blaming the receptionist and not the doctor in your title?

I do agree somewhat, but I do think you need to hold some responsibility as you clearly knew it wasn't get better yet carried on with the sudofed. You knew the level of pain you were in.

We went to pharmacy for ear infection, they wouldn’t look, said they don’t.
Personally haven’t seen a doctor in over 4 or 5 years, only ever a Nurse Practitioner.
Got overflow Appt for childs ear infection, it was bad and given antibiotics.
Suspect, I’d have been fobbed off for an appointment for myself, I always get a call back tomorrow

^^ this.

Have you seen any improvement since you started the antibiotics? I'm not a medic, but abx usually work really fast so if you haven't improved at all it might be that you need different ones.

It's the doctor's fault, not the receptionist's.

In my GP the receptionist always schedules a phone appointment, then the GP decides whether you need an appointment and how urgently. It works well; every time I've called about poorly children I've gotten same day appointments, and the one time I called about myself with a non urgent issue (athlete's foot), suitable medicine was prescribed over the phone.

Sorry you had such a terrible experience OP. I know the triage service was introduced during covid and nearly all appointments were telephone calls but I don't understand why it hasn't gone back to normal. I live in Switzerland and its so easy to get a same day face to face appointment. They never did telephone appointments during covid. Presumably because its a service that let's people down. I don't see how you can fully assess someone if you don't see them face to face.
UK healthcare system is a complete mess. I know of family friends who have paid the price and passed away over the last few years because of they were not seen face to face by their GP and their symptoms not picked up. I think they were made to feel like a nuisance so they reached a point where they didn't want to "bother" their GP.
I just find the whole UK healthcare system both public and private to be absolute shambles, a broken system not fit for purpose.
They can't seem to retain staff either and alot of nursing staff I encounter in the UK seem to be completely devoid of any compassion these days.

Don't you think it's quite a waste of the doctors time to be doubling up like that???

If they'd seen all the patients f2f first time rather than over the phone they wouldn't have needed to repeat half the appointments again with those who need seeing f2f.

How do people not see that this telephone triage is just doubling up the work?! No wonder people can't get an appointment.

I think YABU as you left it for 5 days

You could have called the GP again on Friday morning?

I’m going to go against the grain a bit here. A bacterial infection cannot spread from one ear to the other (because your ears are not physically connected to one another) so both infections are likely to have been secondary to your viral infection. A conscientious and competent GP probably wouldn’t have given you antibiotics for the symptoms you were showing at the beginning, even if they’d looked in your ear. Antibiotics are massively overused in the UK and most ear infections do clear up on their own, so painful as it was, waiting to see how it progressed was probably the appropriate course of action.

It is poor that some doctors now seem so reluctant to see patients face to face, but that’s a seperate matter. Receptionists have been triaging for years. It’s not perfect, but it hasn’t changed recently.

If it’s something properly urgent, can you still just present yourself in the UK? Years ago, if you did that and looked significantly unwell, they’d usually get you seen, or a nurse would do the triage.

When you'd had ear pain for a few hours, you probably didn't need antibiotics, and seeing the GP in person that day wouldn't have changed that. Most ear infections will get better in days without antibiotics, most will be viral.

You got worse, at that point seeing a doctor in person was worthwhile. You phoned up and this happened.