To ask where have all the GPs gone?

[Lolacat1234]

Got sent to an "urgent care walk in centre" by 111 today because my 3 year old daughter has a high temp and was very unwell earlier today. Got there and very soon realised I had been sent to A&E, there is no such thing as an urgent care walk in centre, it's just another name for A&E. Sat there for 6 hours before deciding she needed sleep and her own bed and that I would try my GP surgery in the morning. Please no comments about I should have stayed, when I left there were 25 people ahead of my daughter and I had already been there 6 hours, she had lost it and was having a breakdown. My instinct said it was OK to leave, dose her up and reassess in the morning.

As I was leaving (I was the 3rd mum with a sick child to give up and go within half an hour) the receptionist just said they can't manage an out of hours service at all because there are no GPs. My friend I was chatting to told me her local surgery has no GPs at all just nurse practitioners and they bring them in from another local surgery if needed. It all seems very scary.

Where have they all gone?

www.politico.eu/article/france-doctors-europe-too-far-too-old-too-few/

France is in a similar pickle to us. IN article

They have left or have died by suicide. I know of at least 10 this year that have been reported on the press, probably many more. There is a perception that they are doing nothing but in reality they are a broken profession.

Ha!! I wish!! He went to work at 7.30am and was home at 8pm most days Mo-Fri. He was on £67,000 a year before GMC fees, Insurance, RCGP Registration (about £10,000) was taken out. The nail in the coffin was when our family car was vandalised by a patient whilst parked in the 'Doctor" space at the surgery. We coped with our home being 'egged' in January, but the car ended it.

@memorial you're behaving like a wasp in a jam jar and losing credibility with every post

@memorial

I'm sorry I was being sarcastic of course. I hope he is recovering now. GP is beyond toxic

Ye that'll be my 13 hr day dealing with crisis after crisis and seeing the absolute shit on this thread. I dont want or need your credibility.

Your old boomer GP couldn't have done an hour of my current job. I hope he's enjoying his gold plated pension.

This.
Gp for nearly 30yrs and I’m offski asap . Mumsnet reflects the general attitude to gps .

I think you should put this thread to bed. It's doing you no good at all. I mean this kindly

*Apart from the fact we play massively into our pensions. GPs pay both employer and employee contributions for themselves. I pay 1/3 of my income into my pension which I can't take till I'm 67 and won't be like your husbands. The juniors after me are even worse off.

I will have to live to 97 to even break even what I've paid in*

Please humour me by putting in your “massive” contributions to a normal
pension calculator. Work out what your annuity would be and then compare it to what the NHS pension pays you. You’ll find it’s still remarkably generous relative to the plans most of us have.

i fully accept that the NHS pension is not as generous as it used to be, but it’s still stonkingly good relative to just about every scheme, even private sector DB ones (which are rare as rocking horse shit these days btw).

What needs to happen with the tax on pensions? Would GPs be happy with the choice of salary or pension contribution (easily fixed you'd think)or do they think they deserve preferential tax conditions - more controversial? I thought the punitive taxes kick in at pension pots over £1 million or contributions of more than £40k a year - that's a fairly privileged position.

USA is too - despite their private healthcare system

She is not here to give you a 'good service' though she is here to ensure your health care needs are met. That is the definition of good service!

Of course, but not according to the poster I was responding to who was suggesting that 'good service' is something more than meeting health care needs and was concerned that Dr's were addressing her on first name terms or that she might have to wait in the Dr's surgery if the appointment was delayed for any reason because her time is as important as theirs.

My brother is a senior experiences pension actuary so don't talk down to me. He has looked at it carefully for me when I got fed up paying 30k a year into my pension and I assure you the numbers are correct.

There's some evidence that good bedside manner leads to better health outcomes and there is some old-fashioned bullshit with titles in medicine and teaching, I'm not a fan of that either. Fundamentally life moves on - some professions (and gov policies) trail behind.

@ memorial for a super intelligent qualified doctor you seem to be having significant difficulty grasping the facts being shared on here.

I have said already that I am in my 60s and the old family Dr was middle aged in the 60s. He qualified before the war and I think was a year or two older than grannie. Probably born about 1910 and certainly not a boomer, certainly not on the end of a gold plated pension having done significant service prior to 1948.

They were simple and respectful times and I am not surprised you seem to find your role hard when you are so full of hatred and discontent.

Fact: GPs are not providing optimal services. It is far more their responsibility than that of the general public who may have no choice but to rely on them.

I have seen you eff, blind and be extremely rude on this thread. I hope very much it isn't how you behave in practice.

I am going to bed now and hope you have a good day tomorrow. Such a shame the med schools don't teach manners. Things may be better if they did.

You are cherry picking there @lifeturnsonadime. If the GP pr any other human on the other side of the desk to me, offers their first name, of course they may use mine. If they introduce themselves at Dr Quack and call me Mary, that is reductive and downright rude. I am not their subordinate I am their patient.

If it has taken me 60-90 minutes to book and appointment because they don't answer the phone and tell me to ring back at 12.30, 2.30 and 4.30 and when a few day later I open their door to be greeted by a sign in huge capital letters that says IF YOU ARRIVE LATE, DON'T EXPECT THE DR TO SEE YOU, I find that poornservice and spectacularly rude. When I,'m then kept waiting for 45 minutes (what difference would it have made, had I been 5 minutes late), addressed as a subordinate by someone who doesn't bother to apologise for being late, I think that's really poor service. It's shoddy service.

It should not take a patient 135 minutes to make a 6 miinute appointment and to be treated like Sh1t by someone who doesn't listen after all that is spectacularly poor. If any GP thinks that's acceptable, they do not deserve the salary they are on. Not one little bit. It's poor and it's arrogant.

During covid our surgery went over to a symptom checker online and call back. Jakers what an improvement that was. I was actually called in twice put on a fast track cancer check.

I finally got to see an optician lockdowns my eye pressure was very high. Hadn't seen the eye clinic for two years . Opticians phoned the hospital was seen 48 hours later. I've had six operations to save my sight, malignant glaucoma. You name it they've done every operation available.

The worried well have clogged up the system. People expect the state and NHS etc to pick up where parents left off. We've been infantilized as a nation. It's a sickness that's crept in and weakened us.

As a consultant said to my MIL when she was admitted with a stomach bleed due to too many painkillers. He said "You have arthritis, so do I, it's bloody painful but the pills will kill you"

She had a silver tray in the kitchen loaded with bottles of different painkillers some from the doctor others from the chemist. Every twinge took a pill. She binned them all and lived another twenty years

@memorial - yes I can see my 10 year policy doesn't really work when you were trained elsewhere. !! I actually do have a lot of sympathy for GPS - I think many comments on here are due to frustration - I know myself I need to see a neurologist and quite quickly but need a referral and getting a GP appointment following a house move has been a challenge in itself- I can't wait months - so will pay -I've already had 2 visits to A&E and am a person who hadn't been to doctors for 18 years apart from a smear test. It's clear there is a shortage out there of ones working full time and it's a real issue

@RosesAndHellebores

I’ve had a look at Cromwell Hospital’s website, no mention of an A&E service.
I’d be delighted if you could link any British private hospital that can offer all the critical care provided by any NHS A&E department.

I’ve tried and can’t find any. There’s a big difference between urgent and critical care.

GP here of 17 years (waves)
The problems facing General practice today are myriad and are only getting worse. I've only just returned to work myself after a few months off with complete burn out. Out of 6 good friends who qualified alongside me only 2 of us are left working as GP's. One has moved to the EU, one has completely jacked it in and the others have retrained in other specialties.
The problem in my eyes isn't the pay, it's the impossible mission of trying to do a good job to the best of my ability in the current framework. It's has sucked all of the job satisfaction away and it now feels like constantly firefighting just to ensure you don't end up with a terrible outcome for a patient and justifying yourself to the GMC.

We operate a fully multidisciplinary team at my practice (senior partner). I have a nurse partner and my pm is also a partner. We have a GP consultancy led model where most patients are initially triaged by an advanced nurse practitioner then escalated to GP if the nurse can't deal with it. Our nurses are fabulous but at the end of the day they aren't GP's and there is a limit on their competencies, not to mention the framework they have to work within as well.

The consequence of this model however means that all of my appointments are now for the more complex patients. Gone are the days of a "quickie" appointment to sort out contraception/HRT or assess a poorly munchkin. This means that I invariably run late as I have nowhere to catch up and this obviously annoys the patients even more. I usually spend the first minute of every appointment apologising for the delay in getting through on the phone and the late appointment which then just further compounds the problem by me running even later!

The current huge waits for secondary care are also putting back pressure on us (no criticism of my colleagues in secondary care as their backs are up against the wall as much as ours are). At least 5 of my appointments today were for patients who are waiting on surgery or specialist input and I'm literally just keeping them circulating until they can get into the specialist. I've got a patient with bilateral cholesteatomas (yucky pussy tumours inside the ear) who is on a 90 week wait list to see ENT! He's already had 5 GP appointments in the last month which could have been avoided if he had already had the surgery.

And of course we have the issues of an ageing population, massive health anxiety amongst patients fired up by "Dr Google" combined with increased chronic disease case finding and monitoring which leads to ever increasing amounts of results to process.

We simply need more GP's on the ground to deal with the demand as one is outstripping the other at the moment. I'm technically classed as less than full time as I work 7 sessions a week but in reality this translates to around 50 hours, less than half of which is actually seeing patients. I have done more in the past but had to decrease as I felt my practice was becoming unsafe due to tiredness and my mental health was suffering due to anxiety about missing something and being overwhelmed with the sheer amount of work that needed doing. Add in 2 young kids , a husband who also works full time and nearest family being 300 miles away I had to join the daily mails favourite "part time women GP" brigade.

It's sad that it has come to this. I love my job and am so passionate about it but it really feels as if it's crumbling away now. If a job is like that then you aren't going to attract enthusiastic young people who will give it their all and deliver great patient care. You'll attract people who don't really care and are just in it for the (very good!) salary.

I could honestly write an essay about how I feel about this but I'll spare everyone the dramatics.

She clearly hasn't spent any/enough time working in general practice!