GPs that say 'if you think/want'

[strawberrycake]

Does anyone else find this fucking annoying. My GP never says 'I think', but if YOU want/think.

Today saw nurse for flu jab, talking about DS and wheezing for 4 months. She listened to his chest, said she thinks he needs an inhaler and called GP in. He disagreed that he was wheezing said he was congested and speculated that a chest infection 3 months ago didn't clear. Then starts with as usual 'I could prescribe antibiotics if you want to see if it will clear' I said 'I don't know, I'm not a doctor, do YOU think he needs them?' we went round like this with him putting the onus on ME. He always does. I don't know if it means:

a- he doesn't need them but I'll prescribe to stop you worrying
b-I don't know, hey lets try it
c-He needs them for sure but I'm non-committal.

I find it so weird. I asked the nurse after he left and asked her if she thought I should use the prescription (she said yes). She didn't undermine the GP but reading between the lines she disagrees. She told me about ventalin inhalers and maskes and asked me a few times if I was happy with what doc said and said to bring him back next week if no change. She's an intelligent woman who deals with asthma/ wheezing daily. GP really bugs me with his vague attitude and non-commiment to an opinion.

Oh, and he always tries to push onto out of hours/ hospital rather than answering. Even gave me their number in writing. Just weird. Always 'ring them later if you think you need to'

I'll try them, not that I think the nurse is right but in the past few weeks I've been told by a GP the cough/ wheeze is allergy related, and been given piriton, the nurse said vetolin and now this GP says it's an infection. Seems like whoever you see gives a different idea.

It doesn't feel like he's asking if I'm ok, more just vague and this is something we can try if you want it. I just want a firm decision I guess. Another time he said 'If you want you can take him to A&E now to assess him', I found that weird as surely if it's big enough to require hospital admission then I should be advised it. I wondered if I said 'no thanks' he'd react. He gave the prescription today and wandered off saying to use it if he needed it...

I'm just reluctant to keep giving unecessary antibiotics iyswim

Modern GP training places heavy emphasis on the patient's ideas/concerns/expectations, and the patient centred model of healthcare. One one hand, you get a doctor who wants to know what you think. On another you get someone putting the moral responsibility for treatment onto the patient whilst spending a million pounds a year on shit trousers and cornish pastie shoes.

I had this with a consultant who said 'we can dilate her eyes, if you want.'

It's not up to me! You have trained for how many years? Do you think it is clinically necessary?

Very annoying!

Pixie, I'm dead serious about hospital. He was 6 weeks and had severe diarrhea and signs of dehydration (turned out he was allergic to milk, I'd started him on formula earlier in the day). Exmined him and asked if I wanted to take him in, I was VERY confused! (I did)

I keep meaning to re-register, for many reasons.

bruxeur- the modern idea is awful! I don't have expectations beyond 'you are a trained doctor, advise me'

lol, forget to say about hospital...as he seemed laid back I said 'Should I make an appointment? What day will he be seen?' And the GP said 'NOW, drive straight there' I was [shick]

To be honest I do think that medics place quite a lot of trust in the mother's instinct - especially with young children. I remember doing some work experience in Paedeatrics years ago and listening to a senior consultant training a group of junior doctors and he said 'whatever you think is wrong with the child, always listen to the mother, even if you think there's nothing wrong, if the mother is concerned then she probably has reason to be'.

I think you're being a bit unfair to the GP (although I admit it's annoying). A lot of infections clear up without ABs and the advice is not to give them. He is trying to let you trust your instincts.

Our gps and nurses often give us AB prescriptions 'just in case' or say 'ring out of hours' and make sure we have the number. Some cases, AB will sort out an infection, sometimes the child need the hospital 4 hours later.

I realise that it's annoying for things to be phrased this way but a lot of children would go needlessly to hospital (or take too many antibiotics) if the GP just sent everyone up there.

It would be a perfect world where doctors could be 100% certain and 100% correct in their diagnosis, but its not and their not. Poor old GP was just giving antibiotics to rule out infection, before going down the inhaler route, which in the long term would mean difficulties for you in administering them. I've seen plenty of kids given antibiotics and inhalers and its not made a drop of difference - they still cough!

I have spent too much time in the company of doctors who refused to listen to anything I was saying and put any observation of mine down to "mother anxious" to be happy with "you are a trained doctor, you advise me".

What I want is: "I am a trained doctor, but you know this child, let's talk it through together". Even occasionally "I am a trained doctor, but I have never studied this particular condition and you clearly have so I will listen to you before I make my mind up".

I wouldn't want a vague GP, as in the OP, but don't want one who thinks he is omniscient either.

Chaotica, totally agree about unnecessary ABs, I could understand if I asked for them and he seemed unsure. However it was a routine jab and he was called in and offered them. I made it clear my instinct was he didn't need them but he kept asking if I wanted them and printed prescription out. So I then got impression he thought he did need them, hence the confusion! Personally I don't think he even has an infection, he's coughing all the time and mucusy due to allergies. No yellow/ green snot/ temp/ signs of cold/ grumpiness etc. so was surprised with ABs and wanted more info really.

The nurse sat their and read out previous notes to him pointing to allergies etc. but he'd made up his mind before looking.

On a side note the GP tries to avoid us and his face fell a bit when walked in and saw DS after nurse called him in. Don't think he knows what to do with ds, get the impression he hopes hospital will deal with everything now he's been reffered (he does see them regularly)

Mental picture of GP hiding from strawb and ministrawb!!

lol sneezescake, dh said we'll book an appointment and he said to quote:
'I'm booked up for ages, out of hours are great and they can make appointments at the walk-in, much quicker than you can here'
then gave their number. He looks wide eyed at the sight of ds and squeaks 'oh, hello again'. The nurse asked me why he was like that after! Last two times I've seen him he's referred very quickly. Said he doesn't even know what 'this stuff' (neocate) is that ds is on and the hospital 'are great, do try them if you need too..'

I can take a hint!

Actually, OP, this approach has worked really well in my ds case and I have often gone in with my own gut feeling what I would like done and was glad dr didn't try to dissuade me; sometimes I would discuss/ask about other options before deciding what I would like done.
I woud hate if dr told me we need to do THIS if I had something else in mind.
I think they need to listen to the patient, inc what the patient wants (or doesn't) and, as my Mum used to say, they don't know everything.

Nightcat, it's only good if you know about possible treatments etc. I have practically never been to a GP, never taken ABs until in labour nor was I even registered. I don't feel great at making judgements regarding care tbh, I have so little experience of illness in my self/ family.

As it's always mums who have to live with the situation from day to day, it's best that we are OK with the treatment, sometimes you just have to use your best judgment, this is art, not science - after all mum knows the child best. You don't always have to agree to all tests as some can be invasive. Our paed made a point of asking my ds if he was OK with blood tests etc, when he was old enough to make his likes/dislikes known.