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.

@Tanfastic

But it is not the receptionist's fault if the doctors are encouraging phone consultations.

It sounds like a horrible experience and it does sound like you've suffered in pain for longer than you needed to.

Telephone appointments for issues where you clearly need to be assessed face to face are simply a further waste of NHS resources, so a really poor economy from the GP surgeries perspective.

That said, the majority of people who have earache, sore throats etc for a couple of hours don't need antibiotics and the conditions are self-limiting; if a GP gave everyone antibiotics in that situation we'd all be in a much worse position with resistance. The GP definitely should have given you advice on what to do if it gets worse, so you could have sought treatment sooner when it was clear it wasn't resolving itself.

I'm surprised the op is getting so much stick here. Surely if you have ear pain someone needs to actually look in it?

No. If the pain has just started, they'll tell you to wait as it might clear up itself. If it continues to develop, they can prescribe antibiotics. Which 111 offered, but for some bizarre reason, which she hasn't come back to explain, the OP refused. If she had taken those when first prescribed, things could be very different now.

1. My last 2 specialist appointments were zoom calls

2. Secondary care services are horrendously delayed. My dd has been waiting over a year to see a specialist and had to fight tooth and nail with the hosptital receptionists just to get her on this waiting list

3. All doctors do training. It's an essential part of their job. Hospital doctors will take regular time out to do this as well you just don't see it

4. Everything you've described above can be explained by a staffing crisis not a staffing 'unwillingness to pull their weight'

People that spout such nonsense have no idea what it does to GP's morale to hear it. It's really deflating when you're video calling your own child for the umpteenth time that week to say goodnight because you've not been able to tuck them in, or you're looking at your triage list literally in tears because you know you actually won't be able to see all these patients before midnight tonight and you're trying to decide which are safest to 'cut corners' with. None of this is GPs fault it's the people who fund all of this, by which I mean the government and the public, both of whom seem to want 5 star treatment but seem allergic to the tax that is needed to pay for it.

It would help if the receptionist actually listened to what the patient tells them though. I went to A&E with a Bartholins cyst as I couldn't get through to my GP (I tried minor injuries first but they sent me to A&E before I'm accused of wasting NHS time). The next day the pain was worse so, rather than go back to A&E I managed to get through to my GP. I explained exactly what had happened and what was wrong but the appointment notes said 'some kind of cyst'. What's the point of telling them if they don't listen?!

There have been LOADS of examples like this over the past 2 years @lCantHearYou I am really sorry you're suffering. Hope you feel well soon.

DEFINITELY a really stern email/letter to the practice manager though. Unfortunately, whilst there are some good GPs/HCPs out there, there are some who CBA to do much and should really not be in the job they're in. The covid/lockdown thing made some of them complacent and a bit slack. NOT ALL, before anyone starts! Just some.

Urgh I did a post the other day about this.

im ok about phone appointments in very obvious cases.

however… when it comes to ear infections, kids or anything like that… we need to have face to face.

Im sorry, it just isn’t working like it should be and like it was before covid.

I went to my Gp last week with a kid after a dumb phone appointment and it was shut… I kid you not. It was empty as they had shut for “training” something they frequently do.

last few times I’ve been it’s been empty in waiting room. It’s almost like an intense reluctance to see people in person.

Everything you've described above can be explained by a staffing crisis not a staffing 'unwillingness to pull their weight'

IME it’s one leading to the other.

i used to work in a department with 22 staff.

one left, no funding for replacement, staff closed the gap and the sept ran on 21 staff.

another left. No funding to replace. Staff closed the gap, increased their workload and the dept ran on 20 staff.

bear in mind this is shift work so the fewer people the worse the working pattern, and the harder it becomes to take al/ml/sl.

then another member of staff left. No funding to replace. Now the staff start to burn out, can’t take a/l and still provide a full service.

i left when we got to 12 -yes that’s twelve- staff. The shifts were not maintainable, there was no one to cover leave, everyone was burned out. Not so much “not pulling their weight”, but each person pulling two peoples weight so yes, they did get annoyed and snippy when asked to take on yet another task.

my maternity ward “fully staffed” was 4 m/w to a 32 bed ward. With one usually off with sections etc.

the govt needs to stop throwing money in the general NHS direction which then gets spent on new it systems, committees to plan how to better run the nhs, and management to come up with those plans.

start with using that money to get more staff. Once units are staffed properly they’ll find a lot of these issues disappear.

All other NHS services haven't routinely gone back to f2f. Our health visiting run baby clinics, physio and dietetic services off the top of my head.
GP's are as entitled as any other profession to work pt, particularly considering the nature of their job. Enforcing 'full time' working would result in a mass exodus and even more mistakes than there are now.
After working over twenty years in primary care I have never been so busy. Not just our own work, but picking up that from secondary care whose clinics such as those for phlebotomy or wound care have no capacity. We even get sent patients for treatment from employers with no occupational health service. 'See your GP' cop out.

I moved to my home 3 years ago and had to move GPS. I haven’t seen the inside of the surgery in that time, although I’ve had four telephone appointments for different issues. It’s literally like trying to get into a prison. There are signs all over the surgery door telling patients under no circumstances can they cross the threshold without a pre arranged appointment. You have to ring a door bell to speak with the receptionist. God knows what your punishment would be for breaking the rule. The GP surgeries appear to have enjoyed the process during lockdown so much that they’re continuing it, at the expense of patient safety, because they’re probably wfh and not having to mix with the plebs.

waterSpider Spot on. They, GP's should do the job to the best of their abilities, just like other workers much lower down on the pay and social scale are expected too, and that includes seeing the patient in the flesh to make the best possible diagnosis. Even so called mundane illnesses like ear infections can become life threatening.

At the end of the day doctors in this case GP's are simply people like everyone else and are just luckier to have a better IQ than the average person in the street. GP's themselves have decided to become doctors, they could use their inherited
skills and get a good job somewhere else, an option and privileged quite a few other workers don't have. They, themselves choose to take Hippocratic oath and with that decision comes the responsibility to their patients wellbeing and actually doing their basic job and not fobbing patients off via their receptionist.

As to the NHS GP shortages some one mentioned, oddly that very rarely happens in the private sector. I can get to speak to a doctor today with BUPA and see a consultant (very often a senior NHS consultant at that) normally within two weeks yet the situation for patient and doctor is exactly the same, apart from more money being involved.

How completely ridiculous to blame the receptionist when you spoke to the GP. If the GP didn’t appear to feel the need to see you face to face, then why the hell do you think the receptionist should have forced the GP to see you face to face?! The receptionist will just be expected to follow a protocol given to them by the GP. You appear to want a receptionist to pretend to be a doctor themselves and go against protocol when they deem it medically necessary.

and why do you think that is the case in the private sector @FernlovingNodosaur ? (by the way, the private consultants you see are also NHS consultants)

What a drama.
Should have got antibiotics from the doctor rather than wait.

Please don’t blame the receptionist
I work in a gp surgery and we are given telephone appointments and face to face appointments if the patient has a telephone call and the doctor decides that they need to be seen then they will be that day
We are asked to triage the patient and put in the appointment the problem so then the doctor decides with the telephone call appointments who is more likely to need to be seen face to face then they prioritize those calls so they can be seen ASAP if need be
If the doctor chooses not to see someone that’s their decision nothing to do with the receptionist
It’s always the receptionists that get the blame but at the end of the day we are only following the instructions of the partners and management we don’t make the rules

You can't look in the ear, listen to the chest etc

zoom calls need to be f2f appointments.

blame the GP here though, not the receptionist. last time I bumped into an admin person from my surgery, she was furious about GPs not seeing patients in person.

@PinkSparklyPussyCat if you had said Bartholins cyst to me I would have typed it in and also if you had said extremely painful that had been on the notes too. However my colleagues who can't spell tonsillitis, prostate, ankle, steroids or other words they can easily look up I doubt if the Receptionist knew what you were talking about let alone be able to spell it. An extremely painful cyst down below could have been typed in if she didn't have a clue.

I know people belittle Receptionists by saying "they think they are Doctors" or "when did they go to med school" but being in the job 13 years I have learned things, as we all do in whatever jobs we do, to be able to pass on correct information to the GPs. I never give any medical advice, I'm not allowed to but listen what the patient says, may be ask for additional information and advise them of the best course of action.

sounds like an infection, I can prescribe antibiotics or you can just wait and see your own GP.

Whyyyyy did you not take the offered antibiotics at this point?! Maybe you have a reason but I’d have snapped the doctor’s hand off at that point in your story.

siyanasaysrelax. Thanks for asking. Simple, more money. Those NHS consultants get additional fees to add to their already large NHS salaries without any monetary penalties for not fully doing their other less well paid but just as important, actually scrub that, more important job because NHS patients have much fewer choices and the same health issues at least when it comes to doctors.

Here's how to tell me you've never had a bad ear infection without actually saying it.

Why did you not speak to a pharmacist in that time or accept 111s prescription?
If you thought it needed to be seen you could have spoken to the doctor every day, or maybe seen a walk in clinic or a practice nurse.

I think you need to take some responsibility for leaving it so long.

Not the receptionist fault but more on the GP. Seems very unfair how services vary so much, when they should all have the same standard. Our surgery is great, moved here in July, have called 3 times and each time had f2f appointments the same day, two of them after the gp called me back, one offered by the receptionist. My MIL who is 90 can't even get a phone call with a gp, and has to book weeks ahead to see a practice nurse.

Thats terrible. We should ALL insist that we see GPs face to face. They can’t keep getting away with this. I also absolutely don’t tell receptionists what my issue is, they’re not health practitioners and my healthcare is private. I just refuse. I don’t know why we all put up with this shit service.

Some people love being the victim.

I think you need to take some responsibility for leaving it so long.

No. The issue is both the doctor and the receptionist shouldn’t be deciding who needs an appointment.