Are GPs overworked or not interested?

[Pugwash]

Had to contact a relative's GP last week as he had a temperature of 39.7 and a sore throat for more than 3 weeks. He has a history of anxiety and depression which manifests itself in panic attacks. As a recovering alcoholic who has been dry since 2019 prolonged series of panic attacks results in him returning to drink. He also has a diagnosed medical condition of pre cancerous cells of throat /stomach. He spoke to the GP asking for a face to face appointment to diagnose the sore throat if strep throat/mumps (as swollen glands) etc or whether his medical conditioned had got worse. My relative explained that he was having numerous panic attacks a day and that unfortunately had returned to drinking again, he wanted reassurance that his medical condition had not deteriorated. GP not interested so I spoke with her and said regardless of the drinking and panic attacks - having a temperature of 39.7 over several days needed investigation. He had done a covid test which was negative. GP refused an appointment and told me to take him to A & E as he was dehydrated. I explained that the last few times he went to A & E the long wait brought on panic attacks and he had fainted. If after examining him she was still concerned we would go. She refused again to give an appointment

With high incidents of poor mental health, I would have expected more sympathy from the GP who had my relatives full medical history over the past few years and even a recent letter from Kings dated May. My daughter who works in a mental health unit was not surprised at the GP's reaction as admissions to her ward had increased over the past few weeks as patients unable to get face to face appointments with their GPs were turning up in A & E departments as last resorts. Unfortunately to get referrals to a mental health professional, you need a GPs letter. There are Liaison Psychiatrists based in A & E at Kings but from experience it it the few hours wait in A & E before you see them.

I am in two minds as to whether to make a complaint re GPs reaction - all my relative needed to calm the panic attacks was reassurance that he had a sore throat which could be helped by medication.

[Monkey]

I?m sorry to hear your relative is having such a tough time. I?ve no advice to offer other than call the practice again, and if all else fails, speak to the practice manager.

[intexasatthe moment]

That sounds so frustrating Pugwash .I'm so sorry .

I think you should speak to the practice manager ( if that's what they are called and there is one ) and if nothing is resolved make a complaint ,the GP in question sounds very unhelpful and inflexible .

Individual GPs vary so much in in how they interact with patients .Would it be possible to avoid this particular one in future ,is there an alternative one at the practice ? Failing that I would urge your relative to change surgeries .

[Penguin68]

GPs, and their gatekeepers, in my experience are paranoid about Covid - to the extent that they refuse admission to the very few patients who can actually get physical appointments (and those mainly with practice nurses) if they have temperatures - as if a high temperature is a symptom only of Covid. As much as is possible they push patients to A&E - where you certainly have a good chance of catching Covid should you not already have it, especially as you have to wait hours in unventilated (in the main) spaces. GPs are not, of course, the NHS we have been urged to 'save' (they are private contractors into the NHS) - nevertheless it is mainly they who have been saved. People actually directly employed by the NHS (i.e. in hospitals) have been very vulnerable of course. Large numbers of retired GPs have stood up for the vaccination programme (and more power to them) - but our own working GPs (and I feel I use the word 'working' quite wrongly in this instance) have done nothing to shine in this outbreak - from the anecdotal evidence I have seen.

[bonaome]

A&E are actually taking fixed appointments at the moment.

Access through calling 111.

My experience ...

I tore a calf muscle a few weeks ago (running - stupid idea) called 111 (thought I'd snapped my Achille's) spent 10 mins convincing them that I didn't have covid (screening questionnaire) got to speak to a Dr, who then referred me to King's A&E with fixed appointment - I was to turn up at 19:38 (note the very specific time).

Turned up, couple of minutes early. Hand gel in reception, social distancing in place, I registered my arrival with receptionist and has just taken my coat off to sit in the socially distanced waiting area - I hadn't even sat down - when I was called to see the Dr.

I'm sure I'd have got absolutely nowhere with my GP so I think I was lucky it happened on a Sunday really, otherwise 111 might have just referred me to GP.

@Pugwash - Might be helpful if there's further health problems with your relative, albeit their issues are obviously significantly more complicated than a torn muscle.

[Fitzgeraldo]

With much better standards of education, most of us know that a dermatologist looks after skin and likewise we understand the function of a gynaecologist. Can we not be relied on to select the specialist that we require rather than wait to see a GP and then wait for a referral?

The triage role currently fulfilled by GPs could surely be mostly handled by practice nurses or indeed pharmacists. Then GPs could employ their skills to the full in diagnosing and treating more complex problems rather than prescribing aspirin and contraceptives. Is getting a GP (requiring up to 10 years training at the taxpayer?s expense) to reassure worried mum that the ?spot? on little Jonny?s nose is not terminal, the best use of their time?

Today, the lengthy training that Pharmacists undergo seems almost completely irrelevant as they appear to merely dispense pre-packaged drugs and function as government subsidised retailers. Pharmacists play a much more important role in healthcare in other countries such as Ireland or France where they do the job that currently occupies much of a GP?s time.

Isn?t it time for a radical rethink of the way patient care is managed and give we laymen some credit for possessing a little intelligence? Queues for consultations would be much reduced and the skills of healthcare professionals like pharmacists and nurses (as well as doctors) could be much better utilised.

[ianr]

So what is it you want for Jonny's spotty nose? Triage, or allowing his mother to refer him to a consultant dermatologist?

[Fitzgeraldo]

Try using your brain ianr - speak to pharmacy or practice nurse first - they will advise. If no reassurance go to GP or specialist

[Froglander]

That sounds dreadful. Can you name the practice? I would definitely make a complaint.

[hellosailor]

I don?t understand. Have some posts been removed? This seems a total non sequitur....?

ianr Wrote:

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> So what is it you want for Jonny's spotty nose?

> Triage, or allowing his mother to refer him to a

> consultant dermatologist?

[ontheedge]

hellosailor Wrote:

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> I don?t understand. Have some posts been removed?

> This seems a total non sequitur....?

>

>

> ianr Wrote:

> --------------------------------------------------

> -----

> > So what is it you want for Jonny's spotty nose?

>

> > Triage, or allowing his mother to refer him to

> a

> > consultant dermatologist?

Yes think lots of posts removed,guess the message is think b4 going to GP

[hellosailor]

Ah, ok that makes sense if lots of posts have been removed! I thought ianr was comparing the situation described in the OP as like a teenager wanting a prescription for spot cream.

[Pugwash]

Many thanks for your replies. My relative went to stay with his girlfriend in Dartford and on Tuesday she found him collapsed and unconscious (his panic attacks can be very severe and he can faint from them)called 999 and he was admitted to Darenth Park Hospital where they kept him over night.We advised her to insist on seeing a liaison psych before he was discharged. He is registered with a Dulwich GP whose practice has been quite good upto 2020. He is under 2 specialist consultants in Kings who have been monitoring him with regular brain CT scans since 2019.

Not sure as yet the diagnosis from Darenth Park.

[intexasatthe moment]

I think I'd be sending that update to his GP surgery .

[JohnL]

If I wanted my moles tested I'd probably pay for a dermatologist as there's hundreds and they all flare up occasionally. I can't see a GP being interested if I got worried.

[Sue]

I have found 111 really helpful. They will make a hospital appointment for you if necessary without having to go via your GP.

And a GP recently spotted an iffy mole when she was examining me for something else. I was referred very quickly and had a biopsy very quickly (all OK tg).

Not everything in the NHS is bad! Though I've had my share of bad experiences as well ....

[Lynne]

Yes,, 101 sent me to Kings. But the doctor there said ti was something my GP should have sorted out. No wonder the queues at A&E are so bad.

[Pugwash]

Up date on my relative - he is still in hospital - I have no idea of the diagnosis. His sister spoke to him on the phone yesterday, and his other sister, on the spur of the moment came down from Scotland - not sure if they are both going to visit him in hospital. I hope they identified the cause of his 3 week old sore throat and high temperature and that he is being helped with his panic attacks.

Since he is spending more time in the Dartford area, he may decide to change GPs. He kept his ED GP as he was under Kings since he had a burst ulcer in 2019 and they found other significant medical conditions which reduced the quality of his life.

[Sue]

Lynne Wrote:

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> Yes,, 101 sent me to Kings. But the doctor there

> said ti was something my GP should have sorted

> out. No wonder the queues at A&E are so bad.

It was appropriate in my case. I had to have X-rays so it would have been a waste of my GP's time. In fact the reason I phoned 111 was to ask if I should go to A&E or my GP

Because I had an appointment I was seen very quickly.

It must often be difficult to decide what's best for someone you are just talking to on the phone.

Pugwash, I hope your relative gets the treatment he needs and feels a lot better soon. And can hopefully find a more supportive GP.