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Nhs Unrealistic Expectations
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TV progs like Embarrassing Bodies & GPs Behind Closed Doors show patients having removal of skin tags, warts etc (& acupuncture) at their local surgery which most GPs say are cosmetic treatments and not available on the NHS. Fair enough Emb Bodies probably pays for private treatments but surely the GPs BHCD is giving folks unrealistic expectations? Or is it a case of postcode lottery?
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//She said "Your BPs a bit high, which one of your meds would you like to increase!". Beggar me!//
Indeed, and for that she is being paid £100k pa (probably pro-rata as it is unlikely she works full time. At that rate of pay she doesn't need to).
Mrs NJ had occasion to call into our (so-called) doctors' surgery today on an administrative matter. This is a practice with (when I last looked) six GPs in its employ. Two floors, eight or ten consulting rooms, etc., extended about two or three years ago at a cost a little north of £1.5m. There was not a single patient in the (quite large) waiting area. Not a soul. This was at about 10am this morning. Yet everybody I speak to who are patients there say that they are unable to make an appointment for love or money. One of my neighbours had been trying to get a proper consultation for over six weeks. Terrible abdominal pain - diagnosed over the phone as a water infection. She eventually finished up carted off by ambulance late at night for emergency surgery for a serious intestinal problem which, if left any longer would probably have killed her and which has left her with a colostomy bag.
The GP service needs abandoning.
Indeed, and for that she is being paid £100k pa (probably pro-rata as it is unlikely she works full time. At that rate of pay she doesn't need to).
Mrs NJ had occasion to call into our (so-called) doctors' surgery today on an administrative matter. This is a practice with (when I last looked) six GPs in its employ. Two floors, eight or ten consulting rooms, etc., extended about two or three years ago at a cost a little north of £1.5m. There was not a single patient in the (quite large) waiting area. Not a soul. This was at about 10am this morning. Yet everybody I speak to who are patients there say that they are unable to make an appointment for love or money. One of my neighbours had been trying to get a proper consultation for over six weeks. Terrible abdominal pain - diagnosed over the phone as a water infection. She eventually finished up carted off by ambulance late at night for emergency surgery for a serious intestinal problem which, if left any longer would probably have killed her and which has left her with a colostomy bag.
The GP service needs abandoning.
NJ....all these anecdotal stories about GP's....good fun, amusing, but how accurate? Just follow Body and Soul on AB, they could be dying one day and the next day fine.
Serious bowel condition going on for six weeks, just can't think of one and why not phone GP again or 111 (whatever) or or to A&E ?
Blood pressure adjustments, I just feel that it may be a sensible question for the patient to decide....not ideal....I wouldn't......but no big deal.
NJ you are correct in the GP,s need re-organising, they have nedded this for 40-50 years and now Covid has shown them the way.
Serious bowel condition going on for six weeks, just can't think of one and why not phone GP again or 111 (whatever) or or to A&E ?
Blood pressure adjustments, I just feel that it may be a sensible question for the patient to decide....not ideal....I wouldn't......but no big deal.
NJ you are correct in the GP,s need re-organising, they have nedded this for 40-50 years and now Covid has shown them the way.
I think we may be lucky. I have phoned my doctor many times over the last couple of years first with problems with infections in my shins, then with what I thought was a pulled thigh muscle which turned out to be severe arthritis. Granted it can take 15 to 20 minutes to get through at 8.30. True, I've seen nurse practitioners rather than doctors but I have been seen or asked, by tge receptionist, if I want face to face latterly, been sent for xrays and physio and am now waiting on orthopaedic surgeon. We are trying to find the right pain killers to help and are going through the list!
//Serious bowel condition going on for six weeks, just can't think of one and why not phone GP again or 111 (whatever) or or to A&E ?//
Nor can I, sqad, ‘cos I’m not a doctor. My neighbour tried to get a proper diagnosis from someone who is, and failed. Of course these stories are anecdotal. Everybody’s individual experience is anecdotal. But I would be interested to learn why my doctors’ surgery was deserted at 10am (I too visited the surgery a few week’s ago and found it in a similar state) when people like my neighbour are begging for a face to face consultation. She did try 111 (complete waste of time as they referred her back to her GP who again refused to see her). I’m not talking about attention-seekers on the telly. I’m talking about real people whom I know and believe.
//Blood pressure adjustments, I just feel that it may be a sensible question for the patient to decide…//
I’m sorry but I disagree. The idea of making drugs prescription only is so that their administration is controlled by a doctor. Lay people have no idea what the likely effect of each of the pills they pop might have on them.
//NJ you are correct in the GP,s need re-organising, they have nedded this for 40-50 years and now Covid has shown them the way.//
All Covid has done is shown them how they can get away with providing a very inferior service (which may have had some justification in the first half of 2020) and they are continuing that now when there is no such justification. My wife had to don a mask this morning to speak to a receptionist behind a glass screen, whilst standing in a deserted surgery. Instead of enforcing pathetic and ineffective rules, the practice would do better to concentrate on providing the service which it is paid handsomely to do.
Nor can I, sqad, ‘cos I’m not a doctor. My neighbour tried to get a proper diagnosis from someone who is, and failed. Of course these stories are anecdotal. Everybody’s individual experience is anecdotal. But I would be interested to learn why my doctors’ surgery was deserted at 10am (I too visited the surgery a few week’s ago and found it in a similar state) when people like my neighbour are begging for a face to face consultation. She did try 111 (complete waste of time as they referred her back to her GP who again refused to see her). I’m not talking about attention-seekers on the telly. I’m talking about real people whom I know and believe.
//Blood pressure adjustments, I just feel that it may be a sensible question for the patient to decide…//
I’m sorry but I disagree. The idea of making drugs prescription only is so that their administration is controlled by a doctor. Lay people have no idea what the likely effect of each of the pills they pop might have on them.
//NJ you are correct in the GP,s need re-organising, they have nedded this for 40-50 years and now Covid has shown them the way.//
All Covid has done is shown them how they can get away with providing a very inferior service (which may have had some justification in the first half of 2020) and they are continuing that now when there is no such justification. My wife had to don a mask this morning to speak to a receptionist behind a glass screen, whilst standing in a deserted surgery. Instead of enforcing pathetic and ineffective rules, the practice would do better to concentrate on providing the service which it is paid handsomely to do.
My doctors surgery is also pretty much empty because the vast majority of consultations are done over the phone these days (which I think is great) and the gp decides if you need to have a face to face appointment. He then makes that appointment while he (or she) is talking to you on the phone at a day and time to suit you.
I personally think it’s a better system than before. I much prefer not to have to sit in a crowded waiting room with all the germs of the great unwashed flying around.
I personally think it’s a better system than before. I much prefer not to have to sit in a crowded waiting room with all the germs of the great unwashed flying around.
NJ...Face to face consultations are an anachronism in the NHS. Just my recollections, but 90% of GP consultations face to face are unnecessary, maybe 10%...1 in 10 really needs the "face to face" and it is up to the GP to decide which is necessary.
Face masks.......I know your opinion.
Anecdotal........I have to disagree with your interpretation.
The difference between the anecdotal evealuation of a situation and the truth is quite often...most often so wide, that in many cases it is unbelievable.
GP's surgery empty? GP's are doing their admin work, organising advice or telephone consultations which in my opinion is far more productive than conducting a surgery being fed by a waiting room of mainly needless face to face consultations.
Face masks.......I know your opinion.
Anecdotal........I have to disagree with your interpretation.
The difference between the anecdotal evealuation of a situation and the truth is quite often...most often so wide, that in many cases it is unbelievable.
GP's surgery empty? GP's are doing their admin work, organising advice or telephone consultations which in my opinion is far more productive than conducting a surgery being fed by a waiting room of mainly needless face to face consultations.
I had a follow-up appointment with a nurse on Monday morning to finish what she couldn't the previous Wednesday.
Had a phone call about 8.45 telling me that one of the other nurses had phoned in sick so my nurse was having to phone everybody and try to make one list out of two and would it be okay if I was rescheduled.
Now in the past I'd have said no problem and moaned for a while but I stood my ground saying I'd be happy to hang around until she finished her admin provided it didn't spill over into afternoon to which she grumpily replied that she supposed she could do that.
Ten minutes later I wander into the waiting area of Community Health to find I'm the only patient and this is a centre for general, physiotherapy, pregnancy care, podiatry, eye care, mental health, drug and alcohol services and more.
My phone rings again and it's the receptionist who has wandered back from the coffee room, cup in hand telling me all about the problem that my nurse is supposedly handling alone.
I tell her I know about it and give her a little wave.
Nurse wanders from treatment room to reception four times then deigns to acknowledge my existence, ushers me through and has another (unsuccessful) go at the minor procedure.
Still a bit huffy she tells me she's done all she can and I may have to go private. There was a time when they could be arsed butthat seems to be long gone.
Exiting the building there's still nobody else waiting so they seem to have eased their burden short term anyway.
Then had cause to phone my GP to explain the situation and ask if, having seen him two weeks before, he could refer me to audiology in the local hospital and the receptionist had a quick look, saw that the nurse had already updated my records with her version and promtly stated that she thought the doc could indeed refer me without another appointment and someone would contact me shortly to confirm.
This is now Thursday and I'm still waiting. Maybe 'shortly' has been redefined.
There's more but I'm flagging now, I just wanted to back up NJs empty room comment.
Makes you proud.
Had a phone call about 8.45 telling me that one of the other nurses had phoned in sick so my nurse was having to phone everybody and try to make one list out of two and would it be okay if I was rescheduled.
Now in the past I'd have said no problem and moaned for a while but I stood my ground saying I'd be happy to hang around until she finished her admin provided it didn't spill over into afternoon to which she grumpily replied that she supposed she could do that.
Ten minutes later I wander into the waiting area of Community Health to find I'm the only patient and this is a centre for general, physiotherapy, pregnancy care, podiatry, eye care, mental health, drug and alcohol services and more.
My phone rings again and it's the receptionist who has wandered back from the coffee room, cup in hand telling me all about the problem that my nurse is supposedly handling alone.
I tell her I know about it and give her a little wave.
Nurse wanders from treatment room to reception four times then deigns to acknowledge my existence, ushers me through and has another (unsuccessful) go at the minor procedure.
Still a bit huffy she tells me she's done all she can and I may have to go private. There was a time when they could be arsed butthat seems to be long gone.
Exiting the building there's still nobody else waiting so they seem to have eased their burden short term anyway.
Then had cause to phone my GP to explain the situation and ask if, having seen him two weeks before, he could refer me to audiology in the local hospital and the receptionist had a quick look, saw that the nurse had already updated my records with her version and promtly stated that she thought the doc could indeed refer me without another appointment and someone would contact me shortly to confirm.
This is now Thursday and I'm still waiting. Maybe 'shortly' has been redefined.
There's more but I'm flagging now, I just wanted to back up NJs empty room comment.
Makes you proud.
//...and it is up to the GP to decide which is necessary.//
Er, no, The patient is the customer. The doctor is the provider. The customer decides what he wants. The provider provides it. That's the overwhelming problem with the NHS. It has that principal back to front. Patients are a nuisance and should take what they're given. And stand on the doorstep on Thursday evenings to show their gratitude by banging saucepans.
//The difference between the anecdotal evealuation of a situation and the truth is quite often...most often so wide, that in many cases it is unbelievable.//
That may be true in some cases. But my experience, and that of Mrs NJ witnessing a building empty of patients (which has a staff of 22 when I last looked) is not unbelievable. And, as above, my experience is not isolated.
//GP's are doing their admin work,...//
My surgery has one non-medical member of staff for every medic - nearer two to one if you calculate the doctors' full time equivalence. They should not be doing admin work, they should be healing the sick and whether they are doing so face to face or by telephone, my practice is failing spectacularly in that basic task.
Er, no, The patient is the customer. The doctor is the provider. The customer decides what he wants. The provider provides it. That's the overwhelming problem with the NHS. It has that principal back to front. Patients are a nuisance and should take what they're given. And stand on the doorstep on Thursday evenings to show their gratitude by banging saucepans.
//The difference between the anecdotal evealuation of a situation and the truth is quite often...most often so wide, that in many cases it is unbelievable.//
That may be true in some cases. But my experience, and that of Mrs NJ witnessing a building empty of patients (which has a staff of 22 when I last looked) is not unbelievable. And, as above, my experience is not isolated.
//GP's are doing their admin work,...//
My surgery has one non-medical member of staff for every medic - nearer two to one if you calculate the doctors' full time equivalence. They should not be doing admin work, they should be healing the sick and whether they are doing so face to face or by telephone, my practice is failing spectacularly in that basic task.
NJ
//// Er, no, The patient is the customer. The doctor is the provider. The customer decides what he wants.///
Er, good luck with that atitude to the medical profession, in a confrontation there will be only one winner.......and it ain't you.
There is some admin work that can only be done by a medically qualified person, however admin staff you have.
But you are correct....NHS, GP's it's a shambles and no sign of improvement.
//// Er, no, The patient is the customer. The doctor is the provider. The customer decides what he wants.///
Er, good luck with that atitude to the medical profession, in a confrontation there will be only one winner.......and it ain't you.
There is some admin work that can only be done by a medically qualified person, however admin staff you have.
But you are correct....NHS, GP's it's a shambles and no sign of improvement.
//Er, good luck with that atitude to the medical profession, in a confrontation there will be only one winner.......and it ain't you.//
Yes, sqad, I'm quite aware of that. And that is the root of the problem.
In 1948 the population was won over by the notion that medical treatment, which they previously had to pay for, was henceforth to be free. Of course it was nothing of the sort, but it suited politicians of the time to portray that as a fact. During the intervening seventy-odd years, that belief has been retained and reinforced: the population are eternally grateful for their "free" healthcare service, they dare not complain about it (because, for the vast majority, they have no choice but to use it when they are ill), and the NHS has taken on the nearest philosophy to a religion that many people have. As an unfortunate byproduct of this subservience to their religion, many people view their doctors as demi-Gods, not to be crossed, and certainly not to be argued with.
So we arrive at the situation you describe. Patients are customers of the NHS. Far from the service being free, government funded healthcare costs the equivalent of more than £3,100 annually (and rising considerably) for every man, woman and child in the country. More than one pound in every four raised in taxes goes on healthcare. But in any dispute with the medical profession (e.g. somebody wanting to consult a primary care doctor face to face, with the doctor declining to agree) there will only be one winner.
If we're speaking of attitudes, it's that attitude that needs to be addressed. If I was paying £3k a year for any other service, I would expect it to do what I required. The big difference, of course, is that with any other service, if it failed to come up to scratch I would take my custom elsewhere. I can't realistically do that with the NHS although I have every expectation of having to pay privately if I need any routine procedures such as joint replacement, cataracts, etc. and will consider paying privately to see a GP if I thought it was necessary.
It's not my fault that GPs cannot distinguish between malingerers, hypochondriacs, those who want a chat with someone and those in genuine need of medical treatment. I don't trouble my GP for anything trivial. I've got better things to do that fanny about negotiating the ridiculous hurdles they have erected to prevent my consulting them. But if I ever do need to consult one it will be largely impossible (anecdotally, of course, but based on very reliable information). And it's a bloody scandal.
Yes, sqad, I'm quite aware of that. And that is the root of the problem.
In 1948 the population was won over by the notion that medical treatment, which they previously had to pay for, was henceforth to be free. Of course it was nothing of the sort, but it suited politicians of the time to portray that as a fact. During the intervening seventy-odd years, that belief has been retained and reinforced: the population are eternally grateful for their "free" healthcare service, they dare not complain about it (because, for the vast majority, they have no choice but to use it when they are ill), and the NHS has taken on the nearest philosophy to a religion that many people have. As an unfortunate byproduct of this subservience to their religion, many people view their doctors as demi-Gods, not to be crossed, and certainly not to be argued with.
So we arrive at the situation you describe. Patients are customers of the NHS. Far from the service being free, government funded healthcare costs the equivalent of more than £3,100 annually (and rising considerably) for every man, woman and child in the country. More than one pound in every four raised in taxes goes on healthcare. But in any dispute with the medical profession (e.g. somebody wanting to consult a primary care doctor face to face, with the doctor declining to agree) there will only be one winner.
If we're speaking of attitudes, it's that attitude that needs to be addressed. If I was paying £3k a year for any other service, I would expect it to do what I required. The big difference, of course, is that with any other service, if it failed to come up to scratch I would take my custom elsewhere. I can't realistically do that with the NHS although I have every expectation of having to pay privately if I need any routine procedures such as joint replacement, cataracts, etc. and will consider paying privately to see a GP if I thought it was necessary.
It's not my fault that GPs cannot distinguish between malingerers, hypochondriacs, those who want a chat with someone and those in genuine need of medical treatment. I don't trouble my GP for anything trivial. I've got better things to do that fanny about negotiating the ridiculous hurdles they have erected to prevent my consulting them. But if I ever do need to consult one it will be largely impossible (anecdotally, of course, but based on very reliable information). And it's a bloody scandal.
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