My GP has told me that 80% of their appointments don't need a GP appointment.

[Hiptothisjive]

So I get that there are always people that need reassurance but this number shocked me. Basically a lot of people are visiting their GP for reasons they don't need to and taking up a lot of GP time.

It's great some of the prescriptions that can be given via a pharmacy now, but surely there needs to be a re-addressing of when to visit a doctor?

YABU - to expect people to know better than go to their GP when they don't need to
YANBU - people should go to the doctor whenever they want to no matter what the issue

I agree. DH has had recurrent ear infections for as long as I've known him. When it gets bad and "wait and see" hasn't worked, it's always a matter of him needing a GP appointment for a specific antibacterial ear spray which does clear it up. What a monumental waste of a GP appointment for something a pharmacist should be able to sell him. Same happened back in the day in the 80s when he was grossly overweight and got really bad chest infections for which the GP prescribed a very strong cough medicine - why not available via the pharmacist to save a wasted GP appointment? Even more so when there's a record of past prescriptions/medications that have proved to work with no side effects.

Well our GP partners make profits out of the drugs they prescribe through their attached pharmacy (which happens to be owned "on paper" by the GP partner spouses!).

I thought the whole point of their funding system being capitation, i.e. £x per patient per year was for prevention and monitoring as that was the big thing back 2/3 decades ago, i.e. to move away from being reactive to proactive. That's simply never happened. Now they pocket the money and still do everything possible to avoid seeing the patients they're being paid to "monitor".

We need to go to a system where they're paid for what they do, i.e. per consultation, per treatment, etc., so that they aren't disincentivised from actually seeing patients.

Why do people keep talking about opticians as if they are health professionals rather than people who sell glasses? It is not as if they examine your eyes or anything.

I haven’t read the entire thread - but I’m simply sceptical of that 80% figure. I would not be surprised if confirmation bias is in play. There’s good reason to suspect that the GP is not accurately reporting numbers. How did they arrive at that figure? Was it through review of data - or gut feel?

Others have further raised the issue of what does - not needing to be there mean? If a child is suspected of having swallowed a battery but it turns out they swallowed a lolly - did they need to go to emergency? If a woman finds a lump in her breast but it’s not cancer - was that an unnecessary visit? What if a person is feeling unwell after starting new medication (but turns out they just got a cold) was that unnecessary?

I’m sure there are time wasters and hypochondriacs (but that’s a medical condition). I suspect they aren’t 80% of appointments.

I’m also sure there are beauracratic silliness that makes people attend appointments that aren’t necessary medically but are administratively. Im not in the UK, but we have a referral system for specialist. I have an incurable medical condition. The treatment cannot be prescribed by my GP. Every so often my specialist tells me I need to get my gp to refer me to my specialist so the specialist can treat me. This is a genuinely unnecessary appointment - cause the specialist is the one who determines that I can be treated and need treatment.

Optometrists charge for eye tests. You only get them free if you’re young/old/on benefits/a few other categories, and then they’re paid for by the NHS.

Pharmacies can’t sell thrush treatments to older women, because the symptoms are the same as cancer. A pharmacist can’t do an internal to check, whereas a GP can.

Pharmacy staff don’t like to tell customers

“It could be cancer at your age, and we can’t tell!”

It would cause women to worry, maybe unnecessarily!

Some drugs are only licensed for certain conditions or people. So, eye drops are not licensed for use on children under 2. Parents have to see a GP, who can make the decision to prescribe it, despite it not being licensed.

Likewise, pharmacies are supposed to tell customers, who have tried all the otc remedies, with a cough going on more than 3 weeks to go see a GP, in case its something like lung cancer. Again, pharmacy staff don’t want to worry customers, by talking about worst case scenarios.

Pharmacy staff don’t make up drug licensing rules or pharmacy guidelines for the fun of it - there are good reasons for them and customers need to accept this.

No doubt, families would be looking to sue the pharmacy for negligence, if their relative died from cancer, because the pharmacy preferred to keep selling them otc treatments, without question?

Goodness knows how they manage that. My GP gatekeeps himself more securely than the criwn jewels. If my friend hadnt caught a gimpse of him last May, I'd strongly suspect he was the receptionist's imaginary friend.

95% of prescriptions are dispensed free though so I expect a high percentage of people get free eye checks. Added to this the people who are entitled to a free eye check through their employer I bet very few people are paying out of their own pocket to see an optometrist.

Just as a PSA - if a close relative has glaucoma, you get eye tests for free. My mother has it so all my eye tests are free, I just had to tell the optician.

I know. You'd think they had the brains to work out that we go to the GP to get expert advice because we dont have the knowledge ourselves and are worried. But apparently not. I've literally had a GP speak to me as if I already knew all the ins and outs of the thing I was worried about and therefore why was I worried. Um duh!!!!!

What is bonkers, is that you access a lot of prescriptions via on-line pharmacies, that you can't in an actual pharmacy, as they are processed via a doctor. The cost is often less than a prescription too.

The opticians I go to (various branches of Specsavers usually) have all sorts of fancy machines that check your eyes.
My husband has yearly eye checks due to diabetes done at the opticians.
So I don't understand your point?

I do find it irksome that the GP's preference for patients to just piss off somewhere else is so transparent from the get-go. The phone message that says "if you want health advice, visit [website] or "if you're ringing for test results, please HANG UP and dial [other number] BUT ONLY AFTER 2PM". No private company would operate in this way (and if they did, it would be insolvent in weeks). I think there is a strong case for payment by results.

I've also remembered a particularly ridiculous exchange with our surgery during Covid. DS had a nasty ear infection, so after a week on Calpol I contacted the GP to be told after examination that it was viral and to wait it out.

Another week of poorly, miserable DS and I tried again - tsk, no need to come back, it's viral, can't help and didn't I know that demanding antibiotics for every little thing was causing bacterial resistance?

Week 3 of ear pain - I call again and point out that the smell of rotting death has started to waft from DS' ear, and even DDog is swerving him. I got a call back from a very cross GP, who sounded aghast, and told me I must take him to OOH immediately and didn't I know that severe ear infections caused hearing loss. I was convinced I was going to get a visit from SS after that call, and I am as middle class (and grumpy) as they come!

There is absolutely no continuity or ownership, even from the most senior and highly paid GP partners. The obvious thing is to tell parents "if x happens bring him straight back, or go to A&E". Instead they focus on getting the patient out the door, then expect the same patient to complete another set of Krypton Factor-esque contortions to get another appointment with someone else who will start again. No wonder people are confused - sadly I don't think patients are solely to blame for the fact that so many GP's are obviously unsatisfied - their ways of working are often preposterous.

To cap it all, OOH sent me to Children's A&E because there were no appointments, then a few months later I received a "guidance" letter suggesting that DS' A&E visit was inappropriate!

It's the scolding and lecturing when you have followed advice that is particularly appalling.

Why have you done this? Because you told me to.
Why didn't you do this? Because you told me to

It's the lack of responsibility and it's everyone else's fault stench that emanates from NHS establishments. It's never their fault, always the stupid idiot public. It's the arrogance.

Genuinely it's utterly crap and the number of times I've had it I refuse to attend an appointment without DH due to the poor attitude. Women are very much more on the recieving end of it and I get completely different treatment when DH is present.

I sincerely hope you made a complaint because it's the only way they will start to take notice.

I've just read another thread where the OP is in hospital, the dr said she could go home, despite being in terrible pain, she cried, begged him not to discharge her, another doctor saw her and it seems she has sepsis!

And that reminded me of numerous times my mum went to the gp, got told it might be appendicitis, went to hospital and got sent home because they didn't think it was. They were right, it wasn't.

It turned out she had bowel cancer.

I think GPs are just the start of this dismissive attitude. It's endemic.

Yes and it affects women far more than men. It really is a feminist issue.

I was discharged 3 times from a&e /hospital. Finally my mum bullied them into doing an endoscopy (she's a nurse, her brother is a consultant) and it turned out I had a severe duodenal ulcer. When I read the symptoms I realised I had been describing them perfectly. They just didn't want to believe it because I was young and female. But I had had surgery in the year followed by heavy painkillers so they should have thought of it

I've just read another thread where the OP is in hospital, the dr said she could go home, despite being in terrible pain, she cried, begged him not to discharge her, another doctor saw her and it seems she has sepsis!

I read this too - iirc it was confirmed as sepsis and they sent her home anyway! 🤷‍♀️

I didn't say that I said go to the pharmacy. The pharmacist can advise them what to do. Remember you said we are not qualified to ask questions. We just signpost them.

One of my friends is a GP and basically said a lot of cases are people with the common cold and heartburn. And that two of his most common prescriptions are for ibuprofen and paracetamol which you can literally buy in a supermarket for 50p.

Women having heart attacks present as heartburn - what's your GP friend suggesting? That they ignore it and take a couple of Rennies or whatever?

The whole point of the GP is to see the person with symptoms, and rule out the heart attack. Not for the person having a heart attack to pop down to ASDA for indegestion tablets and hope for the best, so the GP doesn't have to bother with them.

I think what's happened to docs since COVID is appalling . Many issues need eyes
Thankfully soon i think we will get ai docs who can see us and do vitals maybe even instant blood tests and we can get proper care again

Maybe even ai house calls.

Christ I've just read that - poor woman! At least she did see another consultant who suspected sepsis and got her pumped full of antibiotics before she left, and gave her a course of them.

What might have happened if the first consultant had just sent her away?!

People go to "The Opticians" where different types of people work. Optometrists who deal with the tests, eye health etc... Opticians who fit and sell glasses etc.

And!? What's your point?

You think GP surgeries aren't run on a commercial basis? Wake up sweetheart.