GPs... is 2 weeks alright with everyone?

[LCG-xyz]

I've got an on-going digestive issue, acid reflux. It's making eating and even drinking a nightmare, I'm losing weight and have another condition that means I really can't afford to lose any muscle mass.

It's been dragging on for 6 months and this is mostly due to the fact you can't actually speak to a GP, let alone see one.

Every time I call I get 'the nearest appointment I've got is... 3 weeks away", if you're lucky it's two weeks.
"You can do an online consultation"
...fills it out and receive a message to call surgery.
"The doctor says they need to speak to you before making a referral"
Ok, great, let's do that
"Best I can do is February 17th"

Is this the norm? Is everyone ok with this?

If you've got something that can wait two weeks it'll probably clear up on its own or needs looking at.

I did ask the receptionist what the issue was, do they have too many patients or not enough doctors?

Doctors seem to work 3 days a week between 9 and 12pm then go on holiday for 2 weeks.

We pay for this service right?

Just frustrated and venting...

 

[LCG-xyz]

Thank you all for your thoughts.

It's a strange one, sudden onset reflux like nothing I've ever had before, relentless acid even in my nose, ears and I had to keep brushing my teeth because it was in my burning my lips and gums.

Docs prescribed medication over the phone (it's £1 a tablet in the pharmacy or 56 on prescription), I was eventually seen months later by a GP with referred for an ultrasound, which again took weeks and came back fine. Next step is barium swallow which they won't authorise without speaking, nothing's changed it's just the next logical step bar an endoscopy.

It's not a 'new issue' so I can't do an emergency appointment and they've said they only deal with one issue per appointment to me in the past too. What if the issues are connected?

Anyway it's incredibly frustrating. I have muscular dystrophy so my muscles are basically dying and there's nothing I can do about it and I was just about holding on until I got this issue where I can't eat. You lose weight from you muscles first so time really is of the essence for me. I don't have the time to jump through the normal hoops.

I know the NHS is straining at the seams, facing cut after cut whilst governments award jobs to companies they're in bed with. The whole thing is screwed really but it is something we pay for and it should be fit for purpose. I wonder how many lives have been lost having to wait and wait and wait.

 

[LCG-xyz]

GP is incredibly underfunded. They do 80-90% of consultations with less than 9% of the funding.
People are living longer, with more complex multiple co-morbidities. The funding hasn't increased in line with the demand.
The average number of complaints/conditions per consultation these days? 2.6 per patient per consultation.

The amount doctors work is irrelevant, whether they have many part time or fewer full time. They will have a certain number of sessions covered as needed for the population. They can't take on more than is DICTATED by the local health board/CCG. GP is attractive because it fits with working parents, multiple jobs etc.
The accepted max amount a GP should have on their list is 1600 patients. That is an ENORMOUS workload but it is expected.

My advice -

Are you under 40? 40-55? Over 50? (This determines the guidelines followed by the GP)
Did you try those tablets you were prescribed? Did you complete the full 8 weeks? The tablets are not 56 quid.
Have you had bloods done? Any vomiting?
Have you avoided all possible causes? Ibuprofen, aspirin, SSRIs, alcohol, etc

Make it clear on an e-consult that you a) have muscular dystrophy b) losing weight c) have tried 8 weeks of tablets (if you haven't, then take them) d) request referral for endoscopy due to i) persistent indigestion ii) persistent reflux iii) limiting oral intake iv) weight loss v) mention if any adverse blood results

Note - if you're under 40 and haven't tried the tablets, you won't get an endoscopy under the guidelines, but highlight the MD which should change things. It will look for pathology but dyspepsia and reflux could be part of MD progression.
Barium swallow doesn't have a role here.

So depressing to see so many bad experiences of GP though. I work bloody hard, as do my colleagues. I see 25+ patients a day and I'm still in training. I can guarantee every patient has multiple issues and I address every one I can. People get upset when they have to wait 45 minutes in the afternoon if I"m running late. It's because the previous 20 patients wanted to talk about more than one issue. But then have no hesitation about pulling out a list of five or six issues they want to talk about. It's a vicious circle that isn't fixable with current funding.

If you need to be seen same day, you'll be seen same day. All GPs will have a triage service of some sort but so many take advantage and say the right things to get their 3yr history of ankle pain seen the same day because it's convenient. Which means those people who actually do need a review sooner don't get seen. Vicious circle fuelled by the entitled.

And don't ring 111. That's for urgent medical advice. You become part of the problem if you abuse this.

Thank you for this helpful reply.

The point about the PPI was in response to someone suggesting I self diagnose and buy from the pharmacy, to buy PPIs OTC costs about £1 a tablet, my prescription is 56 tablets so much cheaper.

I've been on them for 6 months barring 2 weeks I had to come off them to check for h.pylori. Bloods normal. No other causes involved, not a drinker, no other meds.

Given the sudden onset my guess is hiatal hernia, hence wanting a barium swallow. I'd rather avoid endoscopy if possible, greatly increased risk for sedation also given my condition and I wouldn't want to go through it without it.

Without getting into my complete medical history on a computer forum (lol), I'll leave it there. Like I said I'm just incredibly frustrated and literally don't know how much longer I can hold on with all these delays.

It was good to get feedback and it's certainly not a simple equation: resources, funding, general practices etc.

Maybe I do need to look around at transferring to a different surgery.