Stop telling people to go to A&E!

[Miriad]

I see it on here a lot. Someone is getting fobbed off by their GP and not getting diagnosed. So they get told to go to A&E, where they have the ability to do blood tests and urine tests and scans to figure out what’s going on.

I’ve been sobbing in agony for three weeks and my GP isn’t helping me, and I can’t get another GP appointment for a fortnight, so posters advised me to go to A&E.

I waited six hours only to get yelled at by an angry doctor, saying my condition is neither an accident nor an emergency. According to him I don’t need urgent treatment even if I’m crying with pain - because pain isn’t urgent. If I’m stable and not at risk then I need to go home and see my GP.

A&E can not be used to bypass a useless GP and access tests and scans. They will not diagnose you or refer you. Their job is to give you the minimum care to make you stable so you’re not at risk, then send you home.

So stop telling people to go there. Maybe in the olden days you could go there for help if your GP was rubbish, but not any more.

I’ve said it before and I’ll say it again: Sometimes it’s patient attitudes that are a bit “crap”.

I'm not a doctor (GP/Emergency Med) or anything medical but saying that leg pain "= not so much" is just bad advice.

Just because a pain manifests itself in your leg doesn't mean that something more serious isn't happening. A leg pain could be arterial in nature (femoral artery), it could be a fracture, torn ligaments, a blood clot or the start of DVT (if the patient has been using air travel recently), a sprain, whatever.

An A&E doctor should examine the patient and only when they have examined what the patient has presented with should the patient be discharged, in my opinion.

After all, chest pain could be something innocuous like trapped wind or heartburn just as easily.

My sister in law has been having concering issues for a while. She’s (luckily) seen her gp a couple of times and had bloods done which showed nothing. She’s also had an ultrasound which was unremarkable.

She went back to him last week as the symptoms haven’t gone away and are quite debilitating and he asked her what she thinks is needed! She suggested a CT scan or an MRI (not really knowing as she’s not medically trained). His response “as I know you I will refer, because for most people we’ve been told to refer them to a&e”.

It’s utterly bonkers.

Please tell me you're not in anyway involved in the treatment of people who are distressed/in pain/scared.

You know you were stable because you have had and they are all clear but your advice to others who may not know is not to go to A and E. You are in no position to tell others not to go. Someone in pain may be put off by you saying they will be shouted at when they should be going.

Also to all those saying call 111 - shall I tell you what they say when they can't help further. They tell you to go to A and E.

I can't imagine any doctor shouting at a patient, worked with enough of them over 30 years, and no matter how tired and exasperated they might be, I've never witnessed them yelling at a patient, so I think you should put in a complaint, because that is totally unprofessional behaviour.
Pain absolutely can be an emergency, so you are wrong to tell people not to go to A & E. the fact that you were seen, your heart checked etc, suggests that they were taking you seriously, so I can't fathom why a dr would shout at you.

No, just a knackered and frustrated A&E doctor at the end of their tether in a ward full of patients and not enough staff.

It still isn't acceptable behaviour.
You shouldn't be taking your frustrations out on ill, vulnerable patients. And that is what the op was. She was in pain, upset, had no where to turn to to get help. She'd,followed medical advice as to where to go to find help only to be shouted at by someone who is supposed to help;p and care for patients. Regardless of how tired and frustrated at the system you are - you simply don't shout and take that out in vulnerable patients! That's basic common sense and courtesy.

I went to a walk in centre when really poorly and couldn't get a GP appointment. It has a massive queue so I had to just sit it out, for hours. One of the tired, frustrated doctors did just that - came out to the waiting room and, in the top of his voice, shouted and ranted at the waiting room about the queues and there not being enough staff. Feeling so rotten at the time I just got up and left - I couldn't face dealing with an angry man when my time eventually came. I ended up being admitted into hospital with pneumonia the next day when really this could have been avoided had I got sympathetic care the morning before,

So, I went to the right place but the angry doctor taking his frustrations out on waiting patients actually made everything so much worse and led me to need higher level medical attention later on.

And posters often don't realise that not all areas have all the different options available to them, and especially not in evenings and weekends.

I'm lucky in that we have three adult nhs hospitals, a couple of private hospitals, a separate children's hospital and children's A&E, minor injuries for both adults and children, walk in GP surgeries open from very early to very late, late night pharmacies, and I can generally get a same day GP appointment (system we have means these aren't just for urgent care), etc. It still falls apart at times though and isn't working anywhere near like it should, or like it used to, not so long ago.

However, where my parents live they don't have most of these things - and what they do have are a longer drive away. They don't have things like walk in centres and minor injuries available, let alone separate A&E facilities and same day GP services.

OP I'm sorry for the experience you've had but the doctor who yelled at you was wrong.

I went into A&E with sudden unbearable pain due to endometriosis and was given morphine, treated with kindness and offered a bed for the night. Unbearable, unlivable pain IS an emergency both on it's own and as a potential symptom of something more serious.

I was also referred to the local GUM clinic for persistent thrush. They were brilliant. I struggle to believe that was only a local service. My brother was also sent there years ago with a weird infection on the basis they were good with infectious diseases (turns out he had HSP).

I'd make a complaint through PALS about the A&E doctor and go the GUM drop in centre.

I think pain is a concern if it impacts your ability to do normal activities. The only time I have ever had an "emergency" that's what they kept asking me, like a scale of pain. The impression I got was that if you can't do normal activities then it is serious and is treated seriously. The A and E doctor sounds horrible. I know this is controversial but I would go to a private GP. Yes there's a cost but your continuing pain is costing you a lot in terms of well being. I would also complain about your GP and see if you can move practice. I would definitely complain about A and E too.

Seems like the OP wanted a&e to diagnose her - as in, a fast-track to gynae uro tests. This is not what A&e is for.

The op followed the medical advice she'd been given.
She called for medical advice and was advised to go to A&E.

Over the last few months, dealing with a health issue that is affecting my every waking (and sleeping) moment, I have realised that the NHS often have no idea on what to do about pain. The level of pain people are expected to live with, with little or no help given, is totally unacceptable ime.

@Barney16 if you go to a private GP you need to have the money to opt into private healthcare. Because the OP may need further tests to work out what is wrong. Its not a case of just getting an antibiotic prescription.

@LookItsMeAgain I agree. But an assessment would involve asking questions about other potential symptoms. Swelling, redness, etc. If the only symptom is pain then the part of the body it is in does matter.

Most of our GPs are going to be missing this week school holidays. Ditto hospital cover and pharmacy. It's a bad week to get sick.

My friend has offspring both junior doctors, one is in Greece with his junior doctor partner so that's two missing. Consultants off too . All Newcastle based.

I think term time you've better odds being seen

True, you're right. I just figured some types of pain are taken more seriously in hospital than others. But they shouldn't be, you're right. Any type of pain should be investigated and taken seriously.

@DaisyCat33 but all of those other things would have other symptoms as well. Not just pain.

Pain is just a symptom. It is not a diagnosis. Pain that is ongoing is different from pain that is sudden. Sudden pain needs to be evaluated to see if the cause is something that needs to be dealt with immediately. The OP's pain is not sudden and has already been evaluated as being non-urgent. She is already on antibiotics, just in case apparently. All A&E will do is give her pain relief and send her home to use the appropriate service for her needs. That is her GP, who can then refer her on if necessary. It's shit that it's so difficult to see a GP these days, but that doesn't change the fact that A&E is a completely different service. It is not a way to bypass your GP, nor is it an alternative route to get a referal. It's no more appropriate to use A&E for your GP needs than it is to use any other service.

Agreed - though shouting at the patient doesn't help matters.
I agree that the doctor should have done more than a cursory check over a patient. What has happened to taking a full work-up and asking more than a few questions? Even with pain, it's a symptom of something else and if it's been ongoing for weeks and 111 has advised of a visit to A&E over getting an emergency appointment with the GP then the A&E doctor should have done more in this situation.

@Miriad - I do hope you're getting the proper medical help you need and that your issue is being properly handled now.

@LookItsMeAgain what makes you think it was cursory? The Dr presumably ruled out anything that was an emergency. The A and E Drs role is not to diagnose an ongoing condition.
Lots of things cause bad pain that are not at all serious. I suggested earlier that if she is old enough, it could be vaginal atrophy. This is a very common condition, can be very painful, and can take months of trying different creams and pessaries to manage.

@YourPinkDog - I'm basing that on what the OP has posted this far. I have no way to know if the examination by the A&E doc was more than a cursory one or not. Due to the OP saying that she had been waiting for 6 hours to be seen and then the doctor shouting at her, I jumped to the conclusion that there wasn't a full work up done and that the OP was discharged from A&E shortly after the doctor saw her. Apologies if this is not correct because I'm basing it entirely on the OP's posts and trying to fill in the gaps.

Depends what you mean by a full workup.
They checked her heart, temperature, and blood pressure. Presumably to rule out any emergency reasons for her pain.

My cousin is an A&E doctor and would never shout or have a go at someone for being there! Ridiculous. Do you not have a walk in centre? I’ve got 3 around me about 6-10 miles away and a hospital 5 miles away. Why not complain to the doctors and see another? Get a second opinion? Walk in centre? You obviously have inflammation even without infection and you need a scan or something more than a poxy blood test. Jesus Christ!

Then what should you do OP if your GP won't see you?
We were offered a nurse, we are consistently offered a nurse. My relative died are his cancer wasn't diagnosed for months because the GP wouldn't see him and offered a nurse practitioner who kept prescribing antacids while his tumour was growing and cancer spreading. Healthcare in this country is a joke unfortunately.