GP vindictive and out of order?

[GilmoreGirl84]

Yesterday I was diagnosed with a bacterial chest infection - mild pneumonia. My doctor spent lots of time taking my stats and listening to my lungs to make sure his diagnosis was correct. He then urged me to convince DH (same symptoms) to be seen asap, especially with his asthma condition. He suggested DH could be seen today during DD's routine appointment, to speed up waiting times. In the evening, DH feels unwell with violent coughing, white as a sheet, I got so scared - he was out of breath and frequently needing the inhaler.

Today I get a call from another lady GP saying they want to move the visit to Thursday. I say it's important they keep our slot as her colleague thought DH should be seen asap and he was poorly yesterday. She begrudgingly says OK, come along.

DH goes in and she acts all annoyed we haven't agreed to move the appointment, as there are lots of people on the emergency list. She doesn't bother checking his temp (he's been having fevers), doesn't take blood pressure, just listens quickly to his lungs and says no antibiotics necessary as it's probably viral. DH was weirded out at this behaviour, he got barely seen and then dismissed super quickly.

Is this negligent behaviour from the GP's part? My own doctor said there is 90% chance DH and I have the same illness. He has been coughing very badly for three weeks and he is asthmatic. He said all these things to the lady GP and got promptly sent off like he was wasting her time!

“Lady GP” - also known as “GP”

anyway. It’s pretty unusual here to be let in with someone else’s appointment as they don’t have time to discuss multiple issues within one appointment, so I could see how second GP wouldn’t have as much time as the first. However it’s their job to check to what degree they think is needed so I’d trust her judgement.

If he’s really unwell though seek a second opinion and rebook another appt.

Your doctor can’t really say your husband has a 90% chance of having the same thing without examining him though.

Why would the GP be vindictive?

The first port of call to diagnose a chest infection is listening to the chest so the GP wasn’t wrong. The GP should be able to differentiate between a general wheeze, particularly asthma induced or a bacterial chest infection which is a totally different sound.
Why would the gp need to take his temp? Is he not regularly controlling his temperature with paracetamol and ibuprofen?

Yes sorry this was irking me too.

I think you just need to be very clear sometimes. Obviously something got lost in translation between the two GPs.

I only specified "lady GP" to differentiate her from my "man GP", no other reason!

As for the double appointment, I was following the instructions of my own doctor from the same GP practice. He said they are trying to save time as waiting lists are long.

Name change file, OP?

Pretty sure GPs are too busy to be arsed being vindictive.

It certainly sounds like a very focused exam which I suppose is in keeping with being squeezed into someone elses appointment. It may have been better to tell him to make his own appointment if he really felt like he needed to be seen.

Some GPs/ACPs have different prescribing thresholds than others. The huge majority of chest infections are self limiting and don't require any treatment in an otherwise healthy adult. The evidence is there for treatment guidelines to call for a significant reduction in antibiotic prescription so as time goes on we'll be seeing much less prescribing of them. If you haven't had something more definitive like a chest xray or swab sent off yourself it's quite possible the second GP having read the notes didn't think either of you should be prescribed to.

It's quite unusual to plan to squeeze two people into one appointment. There's normally barely enough time to cover a single patient let alone two so really a second appointment should have been made or guidance to goto a WIC. I think I would be quite annoyed myself if someone had planned to do this to me. It's bad enough when patient's think they can do this and expect you to assess multiple people for different issues in the one 15minute appointment.

SATS, pulse and a respiratory exam would be the minimum after taking a history that's suggestive of chest infection. Temp can occur with bacterial and viral so doesn't really differentiate and the degree of a temperature doesn't correlate well with severity of infection i.e. you can have a normal temp and be septic, you have have a temp of 40C with a simple viral. BP would only really be needed if thinking sepsis or other differentials. At the practice I work at it's rare to see someone taking a BP for a young adult with normal chest symptoms.

People still think the antibiotics work because it's around 2 weeks into an infection that people often make the appointment as getting really fed up with the symptoms, a 'bad' viral infection typically don't resolve till around 3-4 weeks. So when a patient is prescribed to they're finishing the course at the time their symptoms would have improved anyway and naturally attribute it to the antibiotics.

That said with your husbands asthma, if he feels persistently short of breath - easily exacerbating with minor exertion, isn't getting good relief with his inhaler anymore, you notice him persistently sounding wheezy or breathing quickly then he could benefit from a further review, not just in regards to antibiotics but he may benefit from a short course of steroids to settle his asthma during the course of the infection. If he can't get an appointment with GP then a walk in centre would be a good alternative.

I’m not sure if she was being vindictive, but I do think he should seek a second opinion.

My daughter was once similarly dismissed by a GP, by the time I took her to another one it had become pneumonia and she was in hospital for 3 days. She also had asthma - thought that first doctor had claimed children under 2 (3? I forget) can’t get asthma. They can, it just can’t be formally diagnosed at that age, they can still be treated though, funnily enough.

Oooo a 'lady' GP when did they start letting them in....

Do you honestly think ANY GP would have the current headspace and time to plot being vindictive to you?

How long are GP appointments supposed to be these days?
Is over 10 mins longer than most?