Refused appt to diagnose rash (might be chickenpox) is this right?

[springintheair]

I tried to make an appt for dd1 today but the practice manager said as her spots could potentially be chickenpox she couldn't come in. I was offered a health visitor appt instead (bizarrely the contagion thing didn't apply in this case because dd1 could be isolated apparently). When I said I was entitled to see a GP I was told I wasn't allowed to and this was nationaly policy. Is this right? Has anyone else been refused an appointment. Even when I said that I wasn't in a position to diagnose which is why I wanted to see a doctor and the spots could be anything including meningitis I was still refused. Told health visitors experienced and able to diagnose but I want to see a doctor about this and other things (dd2 has excema and 4 or 5 weird skin tags).

This is not the 1st time I've had probs with this practice. I have tried to make doctor appts several times before and been given a time to come down only to find this wasn't a doctor appt at all instead I had to wait in a queue to see a health visitor. The health visitor is nice and I'm sure highly competent and trained but as a health visitor not a doctor. Aren't I entitled to see a doctor if that's what I ask for? When I asked the health visitor to be referred to an alergy clinic for dd2 she said she would find out if this was possible, try to refer me to a dietiician and phone in a week to tell me about these things and check if hydrocortisione cream was working for dd2's excema. She never called back. Again is this just one of those things or should I be angry?

Advice please.

Personally, I would be rather upset if I took own of my young children into a GP waiting room and had to wait in a small room (often over half an hour) with a child covered in infectious chicken pox spots. In fact, I wouldn’t be upset - I would be furious. sorry if that sounds unreasonable, but it is my honest reaction. I would never dream of taking my child to see a GP for a routine appt with what I suspected as a highly infectious disease as it is just not fair on the other patients (most who will be highly vulnerable being elderly/young/already ill with low immune systems).
If you really need professional diagnosis (and I don’t think many people out there need it for chicken pox really, not with access to the internet and so many on line photos etc) then a HV with a separate waiting room "in and out" with no contact with any other patients sounds very sensible to me.
sorry springintheair, not the post you were hoping for, but an honest one not meant to offend, just how I feel.

moyasmum - what a sensible GP, to come out to the carpark - brilliant solution. Proper diagnosis and no risk to other patients (presuming GP has already had it!)

to be fair to springinthe air, a gp service is ther to give treatment and re-assurance. allot of mothers dont really know how best to dal with chicken pox and for that purpose you are right a HV could be very usfull.
She has been triaged over the phone by someone who is not medically qualified, and is unsure herself if the problem is actually chicken pox.
I think she did the sensible thing warning them that her child could potentially have an infectious disease. I stress the word potentially, It would be impossible if not unethical for someone with little or no medical training to diagnose the condition and severity of it over the phone
However it is not nationally policy to have children with chicken pox seen by a health visitor instead of a dr. Chicken pox can be very serious and in some rare cases lead to fatal complications.
She was worried as this practise did not seem to take her concerns seriously.
I do not see a problem with the appointment being with the HV is that is there protocol for separating infectious patints. But TBH if I was having my child s/b a health visior I would want to know that they were appropriately qulified to be dealing with the problem. And that the proper triage systems were in place should the child need further attention.
You do not have to view this as a complaint springy mearly a check on pratice for your own peac of mind

It's fascinating the range of experiences people have and the differences between surgeries. I have lived in the same city for two years and have never seen a doctor. If you phone for an appointment, you get grilled by trout faced receptionist on what is wrong and without fail told that 'Oh you don't need to bother a doctor with that, we'll book you in with whoever's available.' Usually this is a nurse or a hv (which personally I don't mind at all if they can sort out the problem). What worries me is the receptionist's attitude and her wilful invention of 'policy'. I had a smear last year and was told by a very lovely nurse that they would write and tell me the outcome in about eight weeks, earlier if there was a problem. Eight weeks came and went so I phoned the receptionist. She told me off for ringing when I wasn't ill, informed me that 'policy' was not to let us know smear test results and that no news was good news. On pointedly telling her that I wanted to start ttc, she said I could send them a stamped addressed envelope and she would send the results out to me. Now, I live a two minute walk from the surgery and offered to drop in and find out the results in person. Apparently, that is not allowed either as I could be 'anyone' and don't I know she's 'busy'? Yes, very hard work it is being a sanctimonious old prig, I'm sure. I insisted on speaking to the nurse in the end who breezily said 'yes it was all clear, did the receptionist not send you your letter, she sometimes does that, I don't know why.'

sanctimonius old pig

DH, who is a GP, would NOT have been keen to have seen a child with possible chickepox. There are also no spare rooms to put"infected" patients in. If it's not "typical" chickenpox rash I doubt whether he would have been able no make a firm diagnosis (without blood tests)anyway.
They have been trying to get new premises for his surgery, his rooms is upstairs and lot of eldery patients struggle to walk upstairs.

Mixed, so what does your dh suggest patients with rashes do?

he will talk to them on the phone. If not a meningitis rash he wuold not be keen to see them. It could be cp or it could be some other viral infection, neither case would require any specific treatment.

springintheair, how ridiculous! CP can range from barely noticeable to extremely debilitating and only the GP knows if you're wasting his/her time not the receptionist! When my ds had Cp i thought fair enough, he's hardly complaining just let is run its course - when dd caught it 2 weeks later I knew she had to have medical attention. She wa plastered in the spots, she even had them in her eyes and mouth and had so many in her ears that they caused a nasty ear infection. I explained all this to the receptionist who gave me an emergency appointment and discreetly led me to a corner of the waiting room where we were alone and away from old people and pregnant women. The GP said it was an incredibly bad case and gave us anti-biotics for the ears and another lotion 9can't remember the name) and strict instructions about when to take her to A and E. This was quite an extreme case and hopefully your dd isn't on thei scale but all I'm saying is how can the receptionist be the judge of how serious it is? I only tell the receptionist why I want an appt. if it's an on-the-day emergency slot I'm after.

mixed. I am appalled. Your dh should not be a gp if he thinks that it is appropriate to pick and choose between which patients and types of diseases he would like to see and diagnose. Disgusting! and even more shameful that it's ok for the "lowly" hv to catch whatever is going, and not the doctor. Anyway, an hv is not a doctor and not qualified to act as one.

Chickenpox is not always a mild disease. My stepson was in hospital for many days with it and some children even DIE.

Springinthe air, is there any chance of switching gp's. I had a gp like yours and they were so awful to me, grilling me everytime I wanted to bring my ds in (like somehow a 6 month old with a temperature of 105 who is listless and floppy is not an emergency). I ended up going to a&e most of the time. And when I finally switched gp's (they kicked my off the register when I complained to the practice manager about the difficulty in seeing the gp for emergencies), I ended up with a wonderful gp surgery where they are completely receptive and friendly.

Best of luck.

well, I would not recommend anyone to be a doctor but that is a different story.
Sometimes DH has 10 messages of patients waiting to be called back as they have not been able to be fitted in an emergency appointment. What is he supposed to do??? Considering he is apparently not able to judge by a phone call how serious it is. And, yes, of course chickenpox can be serious, like flu etc, people can die from it,, doesn't mean they all need to be seen I would have thought???? (Well, lots of them do actually). Lots of DH patients are eldery patients and although most of them would have had CP, I don't think you would do them a favour to expose them to it.
BTW he doesn't like making phone calls, because of that very fact, it takes more time to judge a patient's state face to face than on the phone.
Anyway, one of the points to make is also that lot of children with rashes never get a proper diagnosis anyway. Hence lots of people will say they have had rubella, chickenpox etc twice because "that was what the doctor said".

Mixed, I think the point of the visit is being overlooked. A diagnosis is not always neccesary, treatment advice is. Not all mothers are born natural nurses.
I understand that some GP surgerys may not be able to deal properly with patients who have infectious diseases. This is not the patients fault, and simply not seeing them may end up with a anxious mother turning up at a and e which is even more inappropriate.
The point of this matter was not to say that the gP shoudl have seen the child, it was to establish that there was some kind of system in place that would give the advice neccessary whilst treating the child by an appropirately qualified practitioner.
Some of you may feel it is time wasting, but I as a mother and an NHS worker have attended the GP emergency serivce when my child had a rash and a temperature. I was concerned about him. I was not looking for definative diagnosis but re-assurance and treatment advice.
The GP practise (as a whole, not just the drs)
are there to give holistic care. Diagnosis treatment prevention and support.
This obviously did not happen in this case or the poster would not still have been anxious.

sure,as a mother and NHS worker myself as wellI sometimes want reassurenace, knowing objectively the seriousness/or not seriousness of it. It seems however to me without reading all posts again that just the fact that a surgery refuses to see a patient is inexcusble. I said DH might well refuse to see a child with cp but he may well talk to the mother on the phone etc. The response was that he shouldn't have been a GP, refusing to see apatient.

ahh thats where we are being confused!
I dont think that she was refused by the GP, it was the practise manager that said national policy stipulated she should see the HV not the dr if she suspected cp.

SpringIntheAir, I had chicken pox last year. I felt very ill and phoned my GP surgery for an appointment. I warned the receptionist over the phone I thought it was chickenpox. I sat in the main waiting area. Good job I did go to the doctor, as she sent me straight to the hospital as I was seriously ill. When I arrived in A&E I also warned them I had chickenpox and again I waited in the main waiting area. I think it is outrageous you were refused access to a doctor.

You are entitled to a choice of GP practice. If you contact your local Primary Care Trust they can advise you, if you do decide to change.

Mixed, i think you are missing the point. Just because some people abuse the system (i know plenty who trot off to the doctor everytime they get a cold), doesn't mean it's ok to refuse to see a patient. I don't believe that a doctor should ever (in normal circumstances) be allowed to refuse to see a patient. How on earth can any sort of reliable diagnosis be made without seeing the patient.

And in springintheair's case, the gp's have given the power to their practice manager to make the choice of whether a patient should be given medical treatment or not. (I don't buy the defense that they might not know what is going on...it's their practice, they shoudl make it their job to know what the person they hire to manage it is doing). Allowing a non-medical (or at least minimially trained) person to make medical decisions, is not only unwise, but in my opinion downright dangerous and criminal.

well, I can only say that dh refuses to see quite a few patients, after speaking to them on the phone he makes a judgment whether he needs to see them or not.
I also made the point that often no diagnosis is made anyway.
The receptioneist/practice manager may well follow at least practice guidelines by referring a patient with suspected cp to the HV. Lot of patients in DH's practice are seen by one of the nurses, if she is in doubt she will get one of the doctors to see the patient (BTW, I doubt dh has actually seen a case of cp during medical school anyway).
If after seeeing the HV, patients are not saisfied, fine, make a complaint

ha-ha, dh actually saw a child with cp yesterday!
Chatted with dh and for what it's worth, this is his opinion:
1.Often things are not as straightforward as they seem. The child he saw yesterday, wasn't a typical case of CP (blisters in mouth), but that wasn't the issue anyway. It transpired the mother was pregnant and wasn't sure whether she had had cp...So he spent more time dealing with that than the child.

1. He also says it's dangerous for receptionists to refuse appointments, they may negotiate with the patient but not blankly refuse.
2. However, to see the hv as an alternative is quite acceptable, they may well have seen more cases of CP and they can always ask the doctors for review.

I'm with chapsmum and edam, this seemingly common practice of receptionists asking what you want an appointment for really pisses me off. Wtf would they know? They're receptionists not trained medial professionals.

Relieved by your post, Mixed, your dh makes a good point about why it is important to actually see patients. Equally appreciate it's OK to see an HV as long as they can reliably judge when they need to call in the doc. There are loads and loads of different causes for rashes - the patient might think it's chickenpox but they could be wrong, that's why doctors train for at least eight years to be a GP and 11 to be a consultant. (And even then if it isn't something straightforward like chickenpox it can still be bloody hard to diagnose a rash. Often requires sending a skin scraping off to the lab).

As for receptionists, they have no business asking why you need an appointment. Your medical condition is confidential. They are crossing an ethical line and frankly deserve to be disciplined.

www, not disagreeing as such, just saying that hv may be better alternative in some patients.
And that not wanting to have a child with cp in a waiting room not unreasonable.
During my "health profrssonal" training I came aaccross a child with possible cp and as I wasn't sure whether I had had it before or not, I was not allowed on the wards or outpatient clinics til they had my blood results back.

oh mixed, I'm talking about receptionsists even asking the question 'why do you want to see the dr?' none of their business imo UNLESS they're medically trained.

Btw, think the OP asked about complaining and was told the person she was speaking to was the practice manager. You would normally complain to the practice manager, but if they are the problem, go to your local primary care trust's complaints service. Or write to the senior partner at the practice (ie GP) who may be interested to know what their employees are up to. Practice managers aren't doctors, they are just managers who run the business side of the practice.

If receptionists are not supposed to ask about what you want to see a GP, how are they supposed to know whether to make an emergency appointment or one for next week?
No experience my self as would never see a GP for something urgent, only see them if I want a referral letter to a hospital

Well, they're welcome to ask the question 'is it an emergency?' sure but I'm assuming that if it was, in most cases, you'd call an ambulance! Generally people call because they want a doctor's opinion, not a receptionist's!