GPs

[andrewducker]

[Poll #1187634]

Comments

[drplokta]

Having not been to a GP (other than to register) in over ten years, I don't really feel I can comment on the level of service.

[autopope.livejournal.com]

Am on a first-name basis with my GP of, um, 12-13 years?

On the other hand, I see him probably every 6-8 weeks on average. (Having a chronic health condition will do that to you.)

I suspect the answers you get to this quiz will correlate with frequency of usage of the family practitioner service.

[andrewducker]

I suspect you're right.

This was prompted by chatting to johncoxon about polyclinics - where the main objection is that you won't get personal service any more. As I've never had personal service from my GP, and largely _want_ a conveyor-belt approach to things, I think polyclinics are a great idea - those people who do get personal service will likely feel different, of course :->

[autopope.livejournal.com]

I tend to disagree. Patients are not bundles of unconnected symptoms; this is especially true of the elderly, where you get multiple interlocking pathologies that aggravate each other. Having a single point of contact for primary care is a good thing if they're seeing the GP regularly because at that point the GP gets to see all their problems, and can work out that, e.g. lack of mobility caused by the need for a new hip joint is aggravating the circulatory problems that are implicated in the DVTs that are blocking the hip joint op, for example. Whereas a polyclinic with separate specialists will have the patient seeing a circulatory specialist one day and an orthopaedic expert the next and nobody putting together the big picture.

As long as the general practitioner is versatile and knows how and when to bring in the specialists, that's a far better model. Polyclinics, as far as I can tell, are a cost-saving measure ... and a bad one that will backfire in the long run because it doesn't address the medical requirements of the patients well, and will fail to cope effectively with chronic cases.

[andrewducker]

Surelt the point is that they'll be seeing all of those specialists anyway - only with a polyclinic they'll all be under the same roof, without having to send people off to hospitals. Which should make it easier to keep track of the various problems, rather than harder.

[autopope.livejournal.com]

Not necessarily. Having specialists on tap is good, but generalists are just as important -- if not more so.

(I've got a personal anecdote about the uselessness of relying on specialists for diagnosis; ask me about it in the pub some time.)

[andrewducker]

Oh, I'm entirely in favour of generalists. But my point was more that I never got to see the same GP twice in a row (not that I'm in often) and I wanted to hear other people's experiences (hence the poll). Most of what I hear is complaining about how someone went to the GP and saw someone who had never seen them before, hadn't read their notes, etc. (One of those on my friends list just this morning).

At which point articles complaining that polyclinics will mean the end of the personal touch seemed a tad silly - so I thought I'd find out if this was a general experience, or if some people actually got great service, but never blogged about it...

[autopope.livejournal.com]

Well, I tend to ask for my GP by name. He's available 80% of the time when I need to see him; the other 20% of the time, I'm willing to wait a day or two, unless my need to see a GP, any GP, is urgent. I've had about two such must-see-a-doctor incidents in the past two years, and usually it's "help, I've got an infection, need antibiotics" rather than "about my ongoing condition ..."

Again, there's a difference in usage patterns between acute one-off stuff (typical of younger, healthy people) and the usage made by folks with chronic conditions (including the elderly, who account for something like 50% of all GP face-time).

The young'n'healthy who go in because they need a morning-after pill or some antibiotics probably don't need to see the same GP every time, but the old guy with the high blood pressure, dodgy ticker, incipient diabetes, and prostate that needs checking every 12 months for cancer really needs to see someone who knows his history.

I suspect LJ is the wrong place to look for a representative sample because that second category is underrepresented here.

[giantbedsprings.livejournal.com]

I think it depends on the specialist. I used to live in a small town where I saw my GP regularly (asthma checkups). I remember I had an issue with my knees for a long time. There were no local hospitals, so I ended up waiting 6 months or so for a specialist to come to the GPs office, whilst I still had issues.

Where I now live is perfect. The GP and the hospital are literally down the road from me and are next to each other. This means that communication between the two works well. My GP is very willing (unlike lots of UK GPs) to send me to a specialist. Yay for partially privatised care!

I also have a comparison story in terms of care for a chest infection, if you are interested.

Rachel

[andrewducker]

I'd be interested, if you have the time :->

The whole point of the poll was to inform me better.

[giantbedsprings.livejournal.com]

UK:
Chest infection started with a cold, that during a night out became a tight-chested feeling. Didn't sleep much and was still incredibly tight-chested the next day. Took lots of ventolin (reliever) - it didn't help. We made an appointment (Saturday) with an emergency doctor in a village about 15 minutes drive away. I was put on a ventilator. This helped me for about 2 hours and then I was just as bad as I was before I left. The doctor would only see me again after 6 hours for the next ventilator session. When I saw her again, she put me on a double dose on the ventilator. After that didn't work, she called the hospital. My dad had to drive me there, because I needed oxygen. 5 days oxygen, some antibiotics and prednisilone (oral cortico-steriods)

NL:
I had had bronchitus for a few days. Mattia realised that my breathing changed overnight and he wanted to listen to my chest. I hadn't noticed anything myself. My breathing was difficult, but no different to when I had bronchitus. Mattia suspected a chest infection, so we went to the GP to get it diagnosed. Doctor listened to my chest, suspected a chest infection too, gave me antibiotics and sent me to the hospital to get an x-ray to confirm it.

I guess what I wanted to demonstrate is that I got quicker care for a less serious infection.

I have no idea if this helps in terms of informing you about GP care. I got a lung-function test to see if my medication was working properly for the first time in this country. (You take no preventors for 24 hours, you blow in a tube, you take a reliever, you blow in the tube again - if you are medicated properly, there will be no difference).

[giantbedsprings.livejournal.com]

I do have a boyfriend who studies medicine here - I didn't have that advantage in the UK. Slight advantage to NL ;)

[andrewducker]

Cheers!

Do you know why the GP wouldn't see you for 6 hours?

[johncoxon.livejournal.com]

That's not the main objection at all. The main objection is that surgeries are designed to be accessible in local communities. Someone who's getting on in years is not going to want a twenty or thirty minute bus ride into town as opposed to nipping down to the local clinic. We already have polyclinics, they're called hospitals and walk-in centres, and they exist in town centres up and down the country.

This proposal not only discourages GPs from practicing (or, at least, all the ones I've heard an opinion from), it centralises the process in a way that the people who need it most won't benefit from. Two very good reasons for abolishing the plans.

[andrewducker]

We already have polyclinics, they're called hospitals and walk-in centres, and they exist in town centres up and down the country.

Last I checked I can't see a GP in my hospital. I hadn't encountered walk-in centres before - and we don't see to have any in Edinburgh yet. Something I'll have to look forward to :->

[laserboy.livejournal.com]

I'd worry that a GP who did not have a more long term relationship with me could easily misdiagnose me or, frankly, be less interested in helping me.

I'm very happy with my current GP and feel that she bothers to read my history and takes me seriously as a human being.

[a-pawson.livejournal.com]

I must have registered with at least 4 GP's in the past few years, but have not met any of them. I haven't seen any GP in over 12 years so can't really comment.

[cdave]

Likewise.

[captainlucy.livejournal.com]

Not so much at the reception, but definitely when I get to the doctor he or she usually at least tries to personalise the service, normally by spending about 30 seconds skimming over the last few entries on the file before calling me in so that they are at least passingly familiar with my history. That being said, it is an exceptionally busy practice and my appointments there rarely last more than about 5 minutes.

[bohemiancoast.livejournal.com]

What I really want is for the person I'm seeing on any given occasion to be able to see my entire medical history. My GP's computer believes that I haven't had a blood pressure check for 11 years, despite the fact that in that time I've had two children, an operation, a couple of trips to A&E, various family planning, and given blood at least half a dozen times.

[accordingly.livejournal.com]

I've been registered with 2 GP's surgeries and been to pretty much every GP in the place {usually because when I need to go to the doctor I just phone up in the morning and get a standby appointment, so I don't have much choice} and every time I've felt like I've been treated with care and personal interest. I want to move back to Tollcross so I can go to my old GP, they were especially great!

[pennski.livejournal.com]

Apparently in the UK we average 4 GP visits a year. I used my share up with my 8 week chest infection earlier this year.

There are 4 GPs at my local surgery. The one I've registered with is the one I specifically ask for if it's something gyny or nebulous where I'll need more time - but she's always really booked up because she gives people the time they need. The other 3 I'll take on the "need to see a doctor now" basis. One of them is head and shoulders above the other 2. And young camp doctor is always good for an anecdote (like going "Ooh, I love the embroidery detail on that skirt" while pressing my tummy).

The specialists I've encountered have on the whole been much more focussed on just the individual section of me they're looking at - which is a tad worrying if there's more than one thing going on as per autopope 's comments.

[ias.livejournal.com]

I put yes but too be fair that's based on my old GP's and in particular a couple of doctors there (Drs James and Wilson). The old practice changed its boundaries, hence the forced move otherwise I would have stayed with them - I cried when I got the letter saying we were to be de-registered.

I haven't seen my new GP yet so I can't comment on what they are like.

[yalovetz]

I could legitimately answer Yes, No, and I don't live in the UK!, but opted for other, in the end. Some GPs I've not had to visit regularly and it was definitely anonymous conveyor belt service when I've gone. Other GPs who I both visited regularly and trusted enough to actually open up to about various medical issues I'd otherwise been ignoring; very much personal service then, and I was very glad of it. So basically, depends on the GP and on my health at the time.

[ishkhara.livejournal.com]

I'm sick (excuse the pun) of having to explain my history to every single GP at my practice because I haven't seen them there before and they haven't had the decency to take the time to read my notes. It also raises problems when they try to prescribe me medication that it clearly states in my record that I am allergic to.

My old practice in Bo'ness was the exact opposite - where possible you always saw the same GP and they always checked your notes before prescribing medication.

[johanna-alice.livejournal.com]

My GP is really fab - she tells me when things are a bad idea, and has referred me for a million and one NHS services so far. Apparently I'm teaching her a lot about transsexuals :)

[cybik.livejournal.com]

My doctor is fab - very friendly and actually makes me feel like he cares. So much so I've recommended him to other people.

[cangetmad.livejournal.com]

Difficult. Yes, I do feel I'm known and treated as an individual, but then I have chronic mental health problems and two very small kids. And actually, what's great about my GP surgery is the fact that it already has a lot under one roof - I've seen the midwife, practice nurse, health visitor and CPN there as well as a variety of GPs. So in some ways, polyclinics aren't that far from a very positive current reality. But this is very small-scale, and that's the important thing, particularly for things like maternity care and child surveillance stuff. Seeing medical people who know my kids' version of "normal" is pretty important to me.

[ninox.livejournal.com]

Think I had a whine about the last time I went. They didn't read my medical notes. I phoned to go hey you haven't read my notes, went in and they still hadn't read them.

Decided to keep me on a prescription that I came off over a year ago - because it was producing good results. Phoned me up a month later to say they were going to change the prescription I wasn't on to something I am allergic to.

Some one felt a bit of a pillock when I pointed it out in a firm manner, and told them to go off and actually read my notes properly. It didn't help when they asked me what I did, then offered me a patient information leaflet.

My last doctor had a listening problem at first, but came around and was fairly decent after a while.

I have had a fair few run-ins with bad system management and the failure to read notes or listen.