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.

This is true in theory

Yes it is. Thank you for agreeing with me.

I don’t think you know what gaslighting is.

a pretty crumby wage actually compared to other countries half decent wage means that they owe you their blood.

Which countries?

Nobody is asking for blood. Patients are entitled to expect good care from their health service that an enormous amount of our money goes into. It’s not ‘free’, we actually pay for it. Wanting face to face appointments isn’t unreasonable. It’s basic. My GP surgery has 3 doctors all part time and the average salary is £55,000. That is an excellent wage and it’s ridiculous to suggest otherwise. GPs are paid well here. My GP started face to face months ago and gives great care. Everyone else should get the same excellent service we do here.

Pneumonia wants A&E surely?

nah. Had it twice. In those days they gave antibiotics but I don't think they do now.

other posters - do not take medical advice from me!

Agree that receptionist is not to blame here, doctor should have seen you from what you described here

@cc1997 thank you.

@WahineToa so if someone rings the surgery and doesn't tell the Receptionist they have chest pain and has to wait for a call back from the GP, in the first instance a telephone call, and they have a heart attack, whose fault is it then?

Or the patient who doesn't want to continue with a pregnancy and they can self refer to a clinic which is what the GP will tell them to do.

Or the patient who needs the morning after pill and they can't see a GP for a few days and it will be too late to get the Morning After Pill from the Pharmacy?

Or the person who's elderly relative has fallen and now in pain with an injured arm?

Fine, don't tell the lowly Receptionist who honestly is so busy your ailment doesn't register as they are taking the next call and who hasn't time to care if you have a chest infection, urine infection, worms or athletes foot but does care that you are signposted to the correct place whether that's GP, Minor Injuries, Dentist, A&E or Pharmacy.

"Or the patient who needs the morning after pill and they can't see a GP for a few days and it will be too late to get the Morning After Pill from the Pharmacy?"

you can get this without seeing a GP. Very important to know this.

tell your kids to study medicine as after the next 2 years of tory government they’ll only be able to see a doctor if they are one

No. they’re not your doctor. This puts people off making appointments

so you want to discuss menopause and HRT.

you refuse to tell the receptionist this. They book you in with the first available GP who’s specialty is elderly care or diabetes.

you attend the appt, to be told that this GP doesn’t know much about HRT, and you need to book in with Dr smith, who has had specialised training and is much better placed to help.

so now you’ve taken up two appointments, when the receptionist could have booked you in with dr smith straight away.

if everyone does this then the GP’s workload immediately doubles.

I’ve not seen a GP face to face since the start of Covid. In that time, I’ve had a referral to dermatology, one to a consultant about a knee issue, 1 lot of antibiotics for a urine infection, an urgent ultrasound scan and a referral to a muscular skeletal therapist.
IME, phone consultations work very well most of the time.

Just in case you need it in the future:
www.nhs.uk/conditions/contraception/where-can-i-get-emergency-contraception/

“Hi, I need an appointment to see the GP. I’m not sure if a phone appointment will do”
”Can I ask what it’s for?”
”I’ve previously had a mole removed and have another similar one that I’d like the GP to have a look at.”
”I’ll book you in for a phone appointment and send you a link to send the GP a photo before your appointment”
”thanks, that’s great”

GP checks the photo, phones me back and refers me to dermatology. Job done.

If people feel comfortable ringing up and discussing their medical issue with a receptionist and do it that way, great. But a 78 year old woman doesn’t want to ring up and discuss vaginal pain with a receptionist. So she should be able to just ask for an appointment with her regular doctor.

Triaging is a wonderful thing. When it's done by someone with actual medical training.

If I think there's something simple wrong with me, or I need a new prescription for a pre-existing condition, I can book an appointment with a nurse practitioner or prescribing pharmacist. If it turns out what's going on with me is more complex than I thought, they know enough to recognise that and refer me to a GP or even a specialist. They're not reading from a script - they've seen things.

(The thing that I love about speaking to nurses and pharmacists is their advice is always more practical - they know all the tips for how to administer treatment in a more effective/easy way.)

I don't understand how anyone ever thought it was acceptable to farm out this service to receptionists. It actually feels pretty damn disrespectful to me to anyone who isn't a GP. There are plenty of medical professionals who aren't doctors who are very well equipped to talk to you about your health and know if it's urgent, not urgent, simple to sort out, or needs further investigation. They don't need to read from a script because they've been medically trained.

I also don't understand why so many GP practices are run like it's the stone age. Most patients can book their own appointments to suit their own schedule when you open up the booking system electronically, freeing up the phone lines for the patients who can only book over the phone. Plenty of practices still don't allow electronic booking.

I used to have a terrible doctor at a terrible practice, so I believe all of the horror stories on this thread. But I also have a wonderful practice now, so I believe most practices can be better. I feel very well looked after - and it's all on the NHS. It shouldn't be such a postcode lottery - everyone should be able to access medical care this easily.

With my current practice, I can book a video appointment by myself to see the right type of medical professional (I don't always need a doctor) at a time that suits me. I can check whether they're female (if you're feeling vulnerable, sometimes you don't want to talk to a male doctor). I can check what their background is (depending on what's wrong, sometimes it's beneficial to speak to a doctor with a clinical interest in a niche area). If I need to come in, a face-to-face appointment is then set up. All practices should be like this. Sadly, the vast majority aren't.

They do though and can give more information to the Receptionist without being prompted. You could just say a gynae problem and elaborate to the GP.

When I went to the local walk in centre I was expected to give details of my Bartholins cyst to the receptionist in front of all the other patients. Because I know that's how they work I typed it in my phone and just handed it to her which she was fine with. However, the nurse who was triaging everyone in the waiting area wasn't and kept asking questions that I wasn't happy about answering so that everyone could hear. She also had the cheek to say my heart rate was very fast and to calm down! Er that would be because I'm in a lot of pain and you're asking me personal questions in a room full of people!

There needs to be more thought about patients confidentiality and dignity.

We had to restrict online booking at our practice due to the admin time lost each day phoning patients to rearrange appointments.

Think along the lines of booking a smear appointment because the time & date suited, but then clearly stating in the booking notes you want to discuss your back pain. Totally different clinicians, which would result in a wasted smear appointment. Likewise booking a GP appointment for a depo injection - our GPs don't do these, only practice sisters.

We are a huge practice & resorting appointments inappropriately booked was taking far too long. Obviously this will be seen as disadvantaging people who used the service successfully.

I don't understand how anyone ever thought it was acceptable to farm out this service to receptionists. It actually feels pretty damn disrespectful to me to anyone who isn't a GP

So what’s your solution for those who can’t or don’t want to use an online booking system?

receptionists aren’t medical triage, they signpost the most appropriate service. This can be to a nurse practitioner, pharmacy, or GP with a particular specialty, phone or irl consultation. They are trained to ask a set of questions and direct appropriately, which is no different to the service 111 provide.

or are you expecting a GP or NP to man the phone lines? That feels pretty disrespectful to the years of training these HCP have done.

I had pretty much this exact experience with my 2 year old. It ended in a ruptured ear drum and trip to A&E.

This was despite her having a history of ear injections that require antibiotics. And calling the GP or 111 for 3 days in a row.

Eardrums 'rupture' all the time after middle ear infections (viral and bacterial). It's really nothing that dramatic or harmful as they usually heal themselves. Say whatever you need to make those naughty GPs look horrible and neglectful though...

So what’s your solution for those who can’t or don’t want to use an online booking system?

I'd love to book online like I used to but my GP surgery doesn't have that any more. They're also stopping their partnership with Livi. They seem to want to make it harder than ever to see a doctor!

you prob need micro suction to clear the ear out

privately

thwre are private ear clinics, specsavers or ent consultants

clearearclinic.com/

I will warn you not to go back to your gp for this and to pay to get it sorted asap. Oral antibiotics are not really targeted enough. You need the ear cleared and it looked at my someone who is not a lazy moron.

@Hangingoninthere88

Firstly, there are different levels of ruptured ear drum. Hers was pretty bad, hence ending up in A&E in the middle of the night, her completely unconsolable with blood coming out her ear. Either way if a GP had looked at her history or seen her in person it could have been avoided.

Secondly, at what point did I blame the GP. We didn't manage to actually speak to or see a doctor until A&E. We were always passed off to a call with the practice nurse or paramedic practitioner.

I don't understand why you are blaming the receptionist?
Why didn't you follow it up sooner by going back to GP?

OK - I'm evil; haven't read the whole thread. I just want to say that not all surgeries are the same. I rang my doctor's, asked for an appointment and was simply asked whether I wanted face-to-face. I said I did and was given an appointment a couple of weeks away. In a more urgent case I could phone on the day first thing morning or first thing afternoon and get an appointment the same day.