That GPs do not have endless capacity

[memorial]

The number of threads slating GPs for not seeing or doing this or that is saddening.
They may say they don't blame "GPs" but that's very much how it feels.
There are less GPs doing far more work day on day. Secondary care is almost at a standstill and we are picking up a lot of that slack. Add the can't be too careful/rather safe than sorry, the aging multimorbid population and the deluge of mental health problems....
GPs are retiring and leaving in their droves, it is near impossible to recruit and locums are expensive and do much less.
Other HCP can help but a recent study has shown they don't actually reduce workload or pressure.
We are seeing many FTF but in order to manage the demand we do have to do some kind of triage.
Those of us left are working 14/15 hr days and yes I know other professionals do as well. But do you want to be the 50th contact of the day, the 200th prescription, the 100th blood result of a tired stressed doctor. Would you be happy their decision making is on point. Pilots who make safety critical decisions have enforced time and rest periods. GP are expected to provide immediate access for everyone but also not allowed to miss anything/make a mistake/be short....
I ask those who are demanding to be seen what they think the solution is? What is the priority?
I am ill after a week of seeing numerous ill kids strep or otherwise. I probably shouldn't be working tomorrow but we have one GP on well earned leave and one who has a family emergency. I can absolutely guarantee that we will have numerous complaints and abusive behaviour tomorrow. What do you suggest we do?

This thread is really about GP provision.

My partner has telephone consultations with his cardiologist, my brother has f2f with his oncologist. I suspect it depends on the stage at which the condition is at - active/monitoring.

My partner's niece has a tremendously complex medical situation. Her day-to-day management is undertaken by local consultants - hybrid f2f and telephone. Additionally, she has six-monthly f2f check-ups with the head honcho some hundreds of miles away.

Maybe the consultant in your question just has God-Complex - very often the situation with consultants, btw! 😂

Botttom line: ask the consultant.

Make nurse practitioners doctors and make doctors into "physicians". That way there will be a lot more doctors and the doctors can refer very serious cases to the expert physicians.

Yebbut it happens. You're allowed to moan about awful folks

Whose going to pay the nurses the extra salary?

Honestly I think some folks still believe in the magic money tree

Actually you often can. You can just email senior management in most organisations if customer services are useless.

It's the kind that causes much relief within the reception staff group and is only indulged by the GP for the protection of said staff group.

Oh, and the poster is the office joke who is recognised by everyone, including the poor GP, as a 'stupid, arrogant bitch' .... 😂

Lol. And you wonder why people don't want to speak to such rude, unprofessional people and share confidential information with them.

I think GPs might find their workload decreases significantly if all receptionists vanished into thin air tbh.

What extra salary? Pay them the same as now, just change the job title. Most stuff people go to see doctors for can be dealt with by a nurse practitioner.

Nurses aren't going to want to take on the extra responsibility for no pay rise.

You mean lie, Florenz?

Theoretically, doctor is a courtesy title.

In practice, it has a very specific meaning to the general public when accessing healthcare, which is that this person has done a medical degree, meaning that they are educated, and have been assessed competent in, all aspects of physical and mental health — to the extent that people can sometimes feel misled if a nurse, psychotherapist, or other non-medic who has a PhD is introduced as "Doctor So-and-So", because they assumed that in that context, Dr Somebody would be a medical doctor.

If you started just calling nurse practitioners doctors in an attempt to manipulate patients, you'd piss off nurses, doctors and patients.

I cocked up my commas there and ended up implying something I didn't mean. It should have read: meaning that they are educated, and have been assessed competent, in all aspects of physical and mental health.

How will changing the name of nurse practitioners help? They do a very valuable job but it isn’t the same job that a GP can do. I’m a GP - if there were a shortage of surgeons you wouldn’t change my job title to surgeon and think it was a helpful strategy.

Oh and virtually none of the patients I see can be sorted by a nurse practitioner. Those who can be helped by our lovely nurse practitioner have already been triaged to her by the fabulous reception staff.

Tbh I do not know the answer, but I and my family pay for whatever we can privately.

*Half the population are struggling to pay their essential bills as it is so how do you propose they'd afford this too?

Ultimately the people who just above the limits for financial support are going to be the ones who end up sick or dead if we go down this route - and they tend to be the ones we need the most.*

I am sure the French and Germans have worked out a way round it. I’ve never read of poor French and German people going without healthcare? Isn’t the French healthcare system rated the best in the world?

Absolutely.

People need to move away from the idea they need a doctor as their HCP for every single issue they have.

Some would be demanding GPs undertake smear/blood tests just because that's what they want of the NHS.

Every single day I become more despairing of the ignorance and entitlement within the population. For example, "GPs aren't seeing anyone!!" (ignorance) and "Some people just want to see a GP rather than a phone call." (entitlement). 🙄

As an aside, and because I'm endlessly curious, as a GP what sort of patient would be invited to email you directly? 😂

@Trez1510 honestly I wouldn’t invite any patient to email me directly (or colleagues either if it’s about clinical issues) because there’s always the risk then that I won’t see something crucial because it’s a day off / I’m off sick etc. I’d much rather it came via the practice E consult system which is monitored and then got directed to me if I was the best person to deal with it and I was in that day.

They already have access to your confidential information and deal with such professionally.

However, as people who are verbally abused, spoken to like shite, and whilst carrying out the GPs directions are told they are 'lesser' by some screeching, entitled bitch of course they will ensure their colleagues are aware to not take it personally when said screeching, entitled bitch decides to take out her frustration at the rules in place on them. Nothing unprofessional about that, it's called maintaining good group morale.

Goodness. Where I work, we would never refer to patients as arrogant bitches etc, however great our frustration and the level of abuse.

However, as people who are verbally abused, spoken to like shite, and whilst carrying out the GPs directions are told they are 'lesser' by some screeching, entitled bitch of course they will ensure their colleagues are aware to not take it personally when said screeching, entitled bitch decides to take out her frustration at the rules in place on them. Nothing unprofessional about that, it's called maintaining good group morale.

Ummmm... ok? I am sure it's horrible when people are rude. I have never been abusive to a receptionist, or "screetched" at them or raised my voice. Bit of a presumption. I am nothing but polite. The issue was just that they kept messing things up so GP suggested it would be easier for us both if I send her an email with things that need doing directly, so I do. Her suggestion, because they messed things up so many times. No mistakes have been made since I communicate directly with her, so it was a good idea of hers and has saved us both a lot of time and hassle.

Your attitude to your job is appalling though and I pity the people - often vulnerable - who have to speak to you when clearly you make assumptions about them and insult them behind their backs. How awful.

Nothing unprofessional about that, it's called maintaining good group morale.

Seriously? Insulting patients is the only way you maintain morale?? Shameful.

Sorry I wasn’t clear. This is the system that the GP is operating. You have a telephone appointment and then if deemed necessary they will ‘allow’ a f2f appointment. There is no way that the GP could diagnose over the phone with DS’ issues at the moment. How is it appropriate that the GP has a phone consolation with only me as DS is at school?

It still stands I can’t get any kind of appointment for my DS, we’ve been registered for over 5 years and they’ve never seen DS.

Well looking at how they work out how much tax is paid means they pay less tax then we do.

www.service-public.fr/particuliers/vosdroits/F1419?lang=en

That’s also assuming that the PP has taken into account if the people who are taking up time in GP’s surgery would be required to pay based on their system. If the reasons we are generally given are true, ie aging population then I don’t see how precluding them from paying will reduce numbers of people accessing GPs.

I wouldn’t have a problem with a phone consultation (sorry to jump on someone else’s point!) but the only way to book a phone consultation with a doctor is - you’ve guessed it - to phone at 8am for a same day appointment. If I phoned at any other time, requesting to speak to the doctor, perfectly prepared to wait a few days / weeks, I’d be told to call back tomorrow at 8. There is literally no other way to see or speak to any hcp at my practice (I’m more than happy to see a nurse, but that isn’t an option either). But anything non emergent doesn’t make it past triage, as of course urgent cases are prioritised.

Stupid isn't it. I kept forgetting or missing the 8am exact time for about 2 weeks.
I was concerned about something.
I phoned about 11am and was told to fill in E consult form as I said it's urgent. Obviously I didn't fill in the form correctly as no one called me back.
Finally got a telephone appointment then seen later in day. Was told the spot didn't look worrying and to come back in a month.
It's still there but smaller and wasn't told anything else.

Our surgery doesn’t even have the e-consult option 🙄 so how I’m meant to speak to anyone about my (I suspect) peri menopause symptoms I have no clue! It’s never going to be “urgent” but I would like to know if that is the issue, or some other hormonal thing, and if they can do anything.