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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

To think this is a rather strange and stupid rule for a doctors practise to have?

120 replies

BigBadMousey · 31/07/2008 09:29

DD1 4.3 been up all night very ill with suspected tonsilitis. Been sick several times and had a high temp.

I asked the docs for a home visit (she gets car sick as it is and is feeling dizzy plus she would be incredibly upset if she was sick in public) and they said 'no, we have a policy whereby we don't do home visits for children'.

wtf?

I don't get it - seems ridiculous to me but AIBU?

OP posts:
macdoodle · 02/08/2008 10:30

My tetchiness (yes it touched a cord I am a GP a very kind conscientous one IMO I work bloody hard for the benefit of my patients and have taken a pay cut the last 3 years despite what the Daily Wail believes)....but hijack aside what annoyed me was not the OP at all - she seems sensible and reasonable I agree a policy seems absurd (as there are always exceptions to every rule)...but my guess is it was the receptionists "trying to be helpful to GP"....
What riled me was this bloody knee jerk reaction to complain to the health authority - and seems so much more common nowadays - people have no idea what it is like being on the receiving end of a vexatious/groundless complaint taken formally without even contacting the surgery ....FWIW I haven't but I know some good doctors who have been driven to the brink of despair by groundless complaints

amicissima · 02/08/2008 12:08

This reply has been deleted

Message withdrawn at poster's request.

Bronze · 02/08/2008 12:13

The excuse that children have an adult to take them is rubbish. I don't drive, I have to use the community cars if I need the doctors nd wouldn't want to take such an ill child in someone elses car. They might refuse to take me again seeing as they are nice volunteers.

emma1977 · 02/08/2008 12:15

Hi macdoodle!

I'm also a GP and mostly heartened by the responses on here that a visit was not warranted.

We frequently get requests for HVs for children, which are mostly inappropriate. For the following reasons:

  1. HVs are for the genuinely housebound. Children are small and easily portable.
  1. The child will usually get seen quicker if brought to the surgery instead of waiting until the end when the GP does their visits, thus reducing delay.
  1. You cannot offer the same standard of diagnostic ability and care in the home setting no matter what you take with you. It is impossible to examine someone fully and accurately with the curtains half-drawn, on a saggy bed, with the family pets and children racing around. This is how bad medicine and accidents can happen. I have known serious rashes and meningitis be missed because of trying to examine a child in near-darkness in a chaotic home.
  1. Time constraints. It may take 30 to 60 minutes to travel to and from and conduct a HV (depending on how far from the surgery and traffic). In that time, 6 patients could have been seen at the surgery.
overthemill · 02/08/2008 12:18

my father in law is a now retired gp who is saddened by he fact that 2 or his children who are gps don't do home visits. he spent have his time doing them, day or night. and he always got home for cooked lunch provided by his wife who was chief message taker and giver of unqualified but friendly medical advice!

i wish they would do them - my solution is A&E or else a phone call to f in law who often tells me to go to A&E or else bring her to him (2 hour journey tho no very practical)

overthemill · 02/08/2008 12:19

agree with emma though, kids are easy to take to and fro.

emma1977 · 02/08/2008 12:25

overthemill- I do fricking tons of home visits!!! Ageing population and all that.

Sadly the days when your FIL practiced are long-gone. He probably didn't have QOF, appraisals, complaints procedures, prescribing budgets and the threat of litigation from patients who don't get their own way to deal with. He probably had fewer medicines to know about and patients who were grateful and undemanding.

Going home for lunch??? WTF!!!

scottishmum007 · 02/08/2008 12:40

NHS 24 or equivalent and then you'll get an appointment made for you at A&E.

scottishmum007 · 02/08/2008 12:41

i tend to use this route, cheating a bit, but you tend to get seen quicker by a GP rather than your own surgery.

overthemill · 02/08/2008 13:17

emma, so sorry i was being ironic but it didnt work on MN! he is a lovely if old fashioned chap. he is really good at sensible advice stuff but you are right, useless on 'modern' stuff. he is, though, proud of his kids.

and i know you do home visits - lots of them. my mum was very grateful for them and my dad gets them now from his lovely gp who keeps an eye on him now he is all alone

oi · 02/08/2008 13:24

gee emma, you didn't half jump down her throat there!

I thought overthemill's post about her FIL was lovely and quite clearly a post about how it used to be very different many moons ago!

MsHighwater · 02/08/2008 21:35

Macdoodle and emma1977, I freely accept that home visits for children are less likely to be appropriate than for other age groups. I'm sure I didn't suggest otherwise.

Nevertheless, I would consider that a GP surgery that refused to accept that it would ever be appropriate to visit a sick child at home, and has a policy to prove it, is in the wrong. A complaint to the Health Authority about such a policy would not be groundless.

It's not a kneejerk reaction, macdoodle (I thought you must be a GP from the defensiveness of your reaction). I work in a service that can tend to attract complaints`too - and I do know what it is like to be the subject of a groundless complaint myself - but I also firmly believe that public services that are provided free to the user have a responsibility to treat their users with respect and consideration (and that goes for the receptionist, as well).

Not all of them do it as well as they might.

ggglimpopo · 02/08/2008 21:43

Where I live GPs routinely homevisit sick kids....

macdoodle · 02/08/2008 21:49

It is a kneejerk reaction though - if it is an automatic reaction to every slight real or perceived....
Surely the sensible way to address a perceived wrong is a complaint to the surgery manager and if it cannot be resolved in this manner then onto the health authority....it is almost as if patients hold a threat over the GP if you don't do as WE want then we will complain to the health authority - almost certainly an over reaction in this case
As I can see the surgery would react in one of 3 ways (1) there is no such policy and the receptionist will be reprimanded/trained as to correct action
(2) there is such a policy and they accept that it is unreasonable and there may be some cases in which a child will need a visit (though no offence I am afraid that transport problems are not a medical problem and under the new contract a GP is entitled to decide the most appropriate place of the consult, surely there is some way to get to the surgery how will you get the medication if prescribed, shopping etc)
(3) they have no insight and cannot see that the policy needs changing (in my experience of GP this is the least likely outcome) and only then would the next step be justified

Hi Emma [waves]

paolosgirl · 02/08/2008 21:51

I'm fascinated by the earlier post from the GP who's had a pay cut. Crikey - when did that happen?

macdoodle · 02/08/2008 21:58

In 2004 there was a new GP contract - with subsequent new funding streams which resulted in a large pay increase (bringing GP's a little closer to other professionals but not anywhere near to solicitors/actuaries etc)....however since then there has been NO increase in practice income from the health authority - despite this we still have to maintain inflation rises for our overheads (building, utilities, equipment etc), we also continue to give our staff pay rises in excess of inflation (in line with NHS staff although we are clearly small fry in comparison to NHS trusts)....a obvious result of this has been a drop in GP profits of approx 10% a year since then as a result our pay is almost back to where it started...of course this story sells far less newspapers than the greedy obnoxious fat cat GP ones
Happy ??

MsHighwater · 02/08/2008 22:01

But you do at least agree, macdoodle, that a surgery that had a policy like this would be in the wrong and that, in some circumstances, a complaint to the health authority would be reasonable.

I'm ignoring the rest as the result of your defensiveness. If the policy were real then the "slight" would be equally real, too.

In my experience, lack of insight into customer service matters is a far from rare occurrence in public services.

SimpleAsABC · 02/08/2008 22:04

Makes sense however inconvienient

scottishmum007 · 03/08/2008 11:17

GPs earn plenty, there's no point complaining about your salary..

emma1977 · 03/08/2008 12:09

Overthemill, I got your irony. My post meant to be TIC, but that seems to have been missed by a few. I often wish I could live a week in the life of an old-fashioned GP as it sounds a lot more fun and homely than what I do.

It seems GPs aren't allowed to have opinions on here unless we wish to be branded as greedy or defensive. Hey ho.

falcon · 03/08/2008 12:25

GPS certainly do have a considerably larger salary than average but as Macdoodle said they've taken a considerable paycut and I think they have the right to complain about that as anyone would, the pay is less but I'm sure the workload hasn't lessened either.

A good GP earns every penny they get imho, they work their tails off, seeing perhaps 30 patients a day, home visits,signing prescriptions, recording notes for the transcriptionist,often giving advice over the telephone, filling in tons of paperwork etc.

I've been a former medical receptionist and I'm amazed some of them get the time to breathe.

scottishmum007 · 03/08/2008 13:53

sorry, still not getting the violin out...

qwertpoiuy · 03/08/2008 19:17

Here in Ireland we have to pay our doctor e70 for a home visit, but they will still only visit elderly housebound people- which makes sense. As one doctor covers the whole county after hours, I would be furious if my child was ill and I couldn't see the doctor ASAP, if he was gone doing a home visit for a young child who could easily be driven in by their parents.

MsHighwater · 03/08/2008 22:34

Emma1977, I've been on MN for long enough to recognise that the "am I not allowed to have an opinion?" line is usually the last refuge of the one who has lost the argument.

Seriously, though, I have no doubt that GPs work extremely hard and I, for one, am happy that they should be well paid for it. In my book, though, that in no way excuses a practice neglecting basic "customer" service which is, after all, no more nor less than basic consideration for one's fellow man/woman/child.

emma1977 · 03/08/2008 22:51

MsHighwater, thanks for that. I wasn't trying to win an argument, just trying to make a statement of fact and explain why some GPs act in the way they do.

I was just minorly irritated that I get accused of jumping down someone's throat when I was trying to do nothing of the sort. BTW, it was macdoodle who was accused of being defensive not me.

There seems to be a lot of media-led GP hatred and spin which seems to infilrate threads from time to time and I find it a bit wearing at times. I find the concept of having "customers" instead of "patients" an odd one too. I have agree with the concept of good "customer service" (if I have to call it that), however, that is not the same as jumping to whatever requests a patient may make no matter how inappropriate. Policies are made merely for guidance and consistency and exceptions are sometimes justifyably made.

I shall now go back to the health forum where I get nowhere near as much grief.