NHS=Negligent Health Service

[Minstadave]

As a GP maybe you can tell me why so few surgeries are offering a normal level of face to face consultations and patients are forced to hang on their phones for hours in the hope of being selected for one of the few slots each morning.

At the same time the low paid supermarket and shop worker staff have made themselves available every day to thousands of face to face transactions with the general public.

Had the supermarket staff elected to provide such a crippled level of service as GP's are currently doing we'd be eating rats.

Regarding face to face appointments the main issue is being in close contact in a small room without screens (atleast I don't think many have screens) with unwell people with a reasonable chance of having COVID. Moving a lot of things to remote consultations means less risk to the GPs but also if the GPs aren't getting COVID they're aren't going off sick and the service can be maintained. Stuff that needs go be seen F2F can still be seen if the GP wants to after the remote consultations and I see many do this.

Bringing lots of people to the practice for F2F appointments is an issue. Lots of patients are clinically vulnerable and maintaining social distancing for waiting patients without just having a load of elderly people queuing in the cold outside is not easy.

You also have problems with cleaning the rooms after a patient has been in which needs more staff and there are limits on pts in a room per hour so you can't get much done.

Hospital staffing is dire at the moment, either because of staff with COVID or more commonly their kids getting COVID at the moment. Trying to minimise F2F contact is important in keeping people at work.

Even now I regularly have children come to my clinic with longstanding problems and parents ask if I can check them over as they've had a cough/fever. None of them have had a COVID swab and all should be isolating but people either don't know or can't be bothered to do this anymore. I can only imagine it's worse in GP land.

Now some practices take the mickey with remote working (sorry tres!) but most are just following national guidance and trying to keep staff safe.

Regarding the issues of getting appointments that's a national issue. Lots of non urgent things went unaddressed through the lockdowns and now many people want medical help, on top of winter infections being in full swing and the backlog is huge across the NHS.

 

[hurfdurf]

As a GP maybe you can tell me why so few surgeries are offering a normal level of face to face consultations and patients are forced to hang on their phones for hours in the hope of being selected for one of the few slots each morning.

At the same time the low paid supermarket and shop worker staff have made themselves available every day to thousands of face to face transactions with the general public.

Had the supermarket staff elected to provide such a crippled level of service as GP's are currently doing we'd be eating rats.

The Tory government has underfunded the nhs to the point it’s been crippled, add in the little pandemic we’ve got going on you may have heard about Chris and things are a bit tight at the moment for GP’s. Surprised you have to even ask as it’s really obvious.

But I guess as you are comparing supermarkets to GP’s in a pandemic, your level of understanding basic things is going to be on the low side. Any other questions I can help with?

 

[arknor]

The Tory government has underfunded the nhs to the point it’s been crippled, add in the little pandemic we’ve got going on you may have heard about Chris and things are a bit tight at the moment for GP’s. Surprised you have to even ask as it’s really obvious.

But I guess as you are comparing supermarkets to GP’s in a pandemic, your level of understanding basic things is going to be on the low side. Any other questions I can help with?

I got chastised earlier this week for only doing lateral flow tests and not taking a "PCR as it's the gold standard"..

I would have thought 4 lateral flows over the course of a week with one being on the same day as I saw a GP and all being negative was good enough, got diagnosed with bronchitis which is what I said I think it is according to google
it was a nurse who told me off, the actual doctor was incredibly nice and friendly..

it's like nurses are more worried about catching it than GPs are

 

[Minstadave]

I got chastised earlier this week for only doing lateral flow tests and not taking a "PCR as it's the gold standard"..

I would have thought 4 lateral flows over the course of a week with one being on the same day as I saw a GP and all being negative was good enough, got diagnosed with bronchitis which is what I said I think it is according to google
it was a nurse who told me off, the actual doctor was incredibly nice and friendly..

it's like nurses are more worried about catching it than GPs are

They're right, lateral flows aren't what you're meant to do if symptomatic. Google could have told you that too.

 

[Werewolf]

As a GP maybe you can tell me why so few surgeries are offering a normal level of face to face consultations and patients are forced to hang on their phones for hours in the hope of being selected for one of the few slots each morning.

At the same time the low paid supermarket and shop worker staff have made themselves available every day to thousands of face to face transactions with the general public.

Had the supermarket staff elected to provide such a crippled level of service as GP's are currently doing we'd be eating rats.

Not a GP but even I can see why GP's are trying to do as much via phone as possible.

As Minstadave says being in a small, confined, often poorly ventilated space with people who are ill is not great for keeping the GP's actually able to see anyone in the middle of a pandemic with a highly infectious disease.
Our GP's practice had to close multiple times early in the pandemic as despite the fact they had signs on the door, messages on the phone system (and online booking portal), and the receptionists asked both when booking appointments and when people tuned up, people were turning up with obvious covid symptoms. I can't remember if any of our GP's got ill directly because of it, but they IIRC had to deep clean at least twice early on, and had to have several staff isolate (meaning they definitely were not available to see anyone for 10 days at a time).

Our surgery is still open for face to face if needed, but wherever possible they're dealing with stuff initially via phone, then if they think you need a face to face they're having people go in - oddly it actually seems faster than the normal system at times as they're not stuck dealing with patients who book an appointment then turn up late or not at all, and they can go straight from one phone appointment to the next vs having to space them out which they have to try and do for face to face ones (to reduce the number of people in waiting rooms).
IIRC our surgery is "lucky" they expanded to a much larger building a few years back with the expectation of providing a lot of additional services (that the local trust then decided they didn't want to fund), so have loads of examination rooms and something like 8 waiting areas across 3 floors, so they've been able to arrange it so at most there is usually one or two people waiting in each common area, their older building has two waiting rooms and no room to properly space people out (they might manage 4-6 people in each if keeping to 2 meters distancing).

Working retail you're usually in a larger area with more airflow and not actively having to sit within a few feet of people for a prolonged period of time, and unfortunately in a pandemic retail staff are far easier to replace than medical staff if you look at it purely as trying to keep things running to some extent and ignore the personal costs (a member of retail staff being ill doesn't affect your ability to treat the ill, and there is a far larger pool of people who can work retail).

If you can't understand this sort of thing, it's not a problem with the NHS or GP's being lazy, it's a complete lack of understanding the difference between the risks, practical requirements and staffing levels involved in the two jobs.
You've also possibly forgotten that retailers were actively limiting the number of people allowed into stores at one point to try and protect their staff/limit exposure, and many retailers went hard into providing additional "remote" shopping options in pretty much the same way GP's went for more "remote" services.

 

[arknor]

They're right, lateral flows aren't what you're meant to do if symptomatic. Google could have told you that too.

so they only diagnose people without symptoms ? I've been ill for like 2 weeks with bronchitis symptoms, now diagnosed.

surely a lateral flow if performed correctly as per the instructions they should work? aren;'t they meant to have 80-90% accuracy?

for the record I have ASD it effects me very badly to the point I have amost null executive skills, I barely can arrange daily normal things.

just going to seek help for a medical condition is almost too much for me which is why it took almost 2 weeks

 

[Minstadave]

so they only diagnose people without symptoms ? I've been ill for like 2 weeks with bronchitis symptoms, now diagnosed.

surely a lateral flow if performed correctly as per the instructions they should work? aren;'t they meant to have 80-90% accuracy?

No lateral flows used in the community can miss upto 50% or more of cases depending on what source you look at.

PCR is much more sensitive but also remains positive for much longer after COVID than lateral flow tests. So a positive test when unwell might actually be due to an earlier infection, possibly asymptomatic with COVID.

There is some information recently about a positive LF being a better marker of you being infective to others than a positive PCR. This is the main reason lateral flows are used for staff and school kids. It's not great for diagnosis but it probably picks up the most infective and gets them to stay at home.

 

[Django x2]

We all hear about hospitals and doctores being sued for grossincompetence and neglligence.
My own experience of a Negligent Health Service comes form earlier this year and before that. I'd been having inexplicable pains in my left side for a few years. Every time I saw a doctor they just fobbed me off with painkillers that didn't work, despite me telling them that.. Anyway, thigs got to a point this year when |I went again, told them what the problem was and they said there was nothing wrong with me deppite me telling them I kept on having the same pains three times a day, every day. A coupile of weeks later, I HAD to be taken to the hospital TWICE by ambulance in the samer week and still got the same depite me telling them that there was something wrong somewhere and I knew there was. Anyway two weeks later, I ended up in another hopsital where they found out what the problem was (build up of stimach acidand these pains really hurt).
Now the doctor's decided that that I'm not due an inhaler for my athsma yet. Im know when I'm due for an inhaler and it won't be the doctor gasping for breath and needing an inhaler.
There was another case recently where somebody contracted aids after being injected with a needle which had been dropped and picked off on the floor and used on him.

National Health Service? Negligent Health Service more like

Good job you don't have to pay for any of it then. You can go as often as you like.

 

[hurfdurf]

If you can't understand this sort of thing, it's not a problem with the NHS or GP's being lazy, it's a complete lack of understanding the difference between both the risks and staffing levels involved in the two jobs.

The post he made reeks of Karenism, surprised he’s not asking to speak to the managers of this forum.

 

[hurfdurf]

Good job you don't have to pay for any of it then. You can go as often as you like.

The op is full of rubbish, has done a post and run on the thread and what he’s talked about is easily debunkable.

 

[SexyGreyFox]

Is there? Damn, been a doctor for 5 years, worked in 6 hospitals and 4 GP practices, med school for another 5 years and no one bothered to show me that! I feel cheated

Brilliant.
If there was such software our department would have it.

I bet you can't name all the software used for medical records either, does that mean they aren't real?

I can name 99% of the software used for medical records at my Trust because I have access to them all but I wouldn't expect Clinicians to know all of them.
I quite regularly tell Clinicians where they can find a piece of information when they need to write reports or I'll send it to them.

I've seen a GP search Google when I told her I had symptoms while taking a certain tablet, she just said "Oh yeah" and moved me to another one.
I'd rather see that than a Clinician taking no notice of me.

 

[Chris Wilson]

I think the gist of the replies is to suggest they are not seeing many people for our own good, with an aside that being a doctor on a very substantial wage does not imply they'll take any risk to their own safety in a global crisis. Luckily my parents and grandparents put their own safety aside when faced with two world wars they had to fight for the greater good.

God knows what these medical professionals will do if they get called up to the front lines in a war. Probably ask the enemy to approach one by one, after checking they are not armed whilst they reluctantly tend the health vetted injured and sick. I think the public have a pretty jaundiced view of how resolute many GP's have been in facing this situation. And I think comparison with other workers who have not shied away from their duties is perfectly reasonable. The government having to bribe GP's to administer the vaccine with a promise of £15 a shot on top of their wages is not a very good sign of dedication either. It's amazing how many GP's seem willing to see patients privately who they would only see remotely under the NHS system, too.

 

[Werewolf]

No the point people are trying to make is that it is reckless and pointless for a medical professional to put themselves at preventable risk for something that could very easily be done over the phone when we're in a situation where medical resources are scarce and stretched to breaking point as it is.
They're still seeing patients when appropriate, just not for things like medicine reviews or other things where there is very rarely any need to see the patient in person, you can do a lot over the phone, especially with the ability to easily send things like pictures and video.

Your thing about the war is actually a good point, we had a whole host of professions in both world wars where people were explicitly exempt from the draft or when they were in the armed forces they would not normally be sent to the front lines because they were far more valuable doing their job "behind the lines (once again someone brings up how things were different in the good old days of the war, and show they don't know much about it).
Oddly enough doctors didn't tend to get sent to the front lines in WW1 or 2 either, you normally had "medics" (people with a fairly short course in first aid) as part of a unit on/near the front lines, and then the doctors were usually mainly back from the front lines where they, as an expensive and hard to replace asset were less likely to be killed by random chance and able to do the most good in places like forward medical facilities.
IIRC the list included Miners (and you could get drafted to work as one), ship fitters, plumbers, electricians, doctors, engineers, teachers and railway workers, basically any profession where your contribution to the war effort on the front lines would have been considerably less valuable than staying at home and doing the job you spent years learning to do or where the lack of trained personal would have crippled the country's ability to continue to fight the war.

It's not that Doctors don't want to see patients, it's that they know they can't help anyone if they themselves become ill so they've taken sensible steps to try and avoid it, and I suspect a number of GP's have been helping out in hospitals and doing things like running vaccination clinics which leads to fewer to see patients face to face as normal.

 

[V F]

Not a GP but even I can see why GP's are trying to do as much via phone as possible.

As Minstadave says being in a small, confined, often poorly ventilated space with people who are ill is not great for keeping the GP's actually able to see anyone in the middle of a pandemic with a highly infectious disease.
Our GP's practice had to close multiple times early in the pandemic as despite the fact they had signs on the door, messages on the phone system (and online booking portal), and the receptionists asked both when booking appointments and when people tuned up, people were turning up with obvious covid symptoms. I can't remember if any of our GP's got ill directly because of it, but they IIRC had to deep clean at least twice early on, and had to have several staff isolate (meaning they definitely were not available to see anyone for 10 days at a time).

Our surgery is still open for face to face if needed, but wherever possible they're dealing with stuff initially via phone, then if they think you need a face to face they're having people go in - oddly it actually seems faster than the normal system at times as they're not stuck dealing with patients who book an appointment then turn up late or not at all, and they can go straight from one phone appointment to the next vs having to space them out which they have to try and do for face to face ones (to reduce the number of people in waiting rooms).
IIRC our surgery is "lucky" they expanded to a much larger building a few years back with the expectation of providing a lot of additional services (that the local trust then decided they didn't want to fund), so have loads of examination rooms and something like 8 waiting areas across 3 floors, so they've been able to arrange it so at most there is usually one or two people waiting in each common area, their older building has two waiting rooms and no room to properly space people out (they might manage 4-6 people in each if keeping to 2 meters distancing).

Working retail you're usually in a larger area with more airflow and not actively having to sit within a few feet of people for a prolonged period of time, and unfortunately in a pandemic retail staff are far easier to replace than medical staff if you look at it purely as trying to keep things running to some extent and ignore the personal costs (a member of retail staff being ill doesn't affect your ability to treat the ill, and there is a far larger pool of people who can work retail).

If you can't understand this sort of thing, it's not a problem with the NHS or GP's being lazy, it's a complete lack of understanding the difference between the risks, practical requirements and staffing levels involved in the two jobs.
You've also possibly forgotten that retailers were actively limiting the number of people allowed into stores at one point to try and protect their staff/limit exposure, and many retailers went hard into providing additional "remote" shopping options in pretty much the same way GP's went for more "remote" services.

Yeah, they are indeed very confined, warm and stuffy. I haven't been to one in a long time but I always thought how small and dense those rooms were now thinking of the pandemic. Never thought about it before.

Ours are still taking patients but only if you have an appointment. Even then you cannot get into the building until granted access. Or too early. Nobody can just walk in like it was 2 years ago.

 

[hurfdurf]

I think the gist of the replies is to suggest they are not seeing many people for our own good, with an aside that being a doctor on a very substantial wage does not imply they'll take any risk to their own safety in a global crisis. Luckily my parents and grandparents put their own safety aside when faced with two world wars they had to fight for the greater good.

God knows what these medical professionals will do if they get called up to the front lines in a war. Probably ask the enemy to approach one by one, after checking they are not armed whilst they reluctantly tend the health vetted injured and sick. I think the public have a pretty jaundiced view of how resolute many GP's have been in facing this situation. And I think comparison with other workers who have not shied away from their duties is perfectly reasonable. The government having to bribe GP's to administer the vaccine with a promise of £15 a shot on top of their wages is not a very good sign of dedication either. It's amazing how many GP's seem willing to see patients privately who they would only see remotely under the NHS system, too.

Look at you trying to rub off some stolen valour from your grandparents, as if you would do anything if you were called up.

It is incredibly stupid of you to compare WW2 with a pandemic. A GP protecting their health means they can treat more people, “sacrificing” themselves so Karen’s like you can complain to them in person is not a noble sacrifice, it’s utterly pointless. The NHS in general were applauded weekly by the general public and rightly so.

What do you do for a living?

 

[Lopéz]

Would you prefer a random list of questions in no particular order at all?

"Any headaches or dizziness?"
"No? How's your stool looking?"
"Okay, say ahh"
"Right, any stiffness in the elbow?"

"Yeah sorry m8, I've not got the foggiest what's wrong with you."

 

[Naan_H]

I think the gist of the replies is to suggest they are not seeing many people for our own good, with an aside that being a doctor on a very substantial wage does not imply they'll take any risk to their own safety in a global crisis. Luckily my parents and grandparents put their own safety aside when faced with two world wars they had to fight for the greater good.

God knows what these medical professionals will do if they get called up to the front lines in a war. Probably ask the enemy to approach one by one, after checking they are not armed whilst they reluctantly tend the health vetted injured and sick. I think the public have a pretty jaundiced view of how resolute many GP's have been in facing this situation. And I think comparison with other workers who have not shied away from their duties is perfectly reasonable. The government having to bribe GP's to administer the vaccine with a promise of £15 a shot on top of their wages is not a very good sign of dedication either. It's amazing how many GP's seem willing to see patients privately who they would only see remotely under the NHS system, too.

You are actually serious ? what has someone's wage got to do with it ? you think GP's should work for free ? I'm sure you would work for free for 12 hours a day? Yeh off course. And so what if they are paid well? Shouldn't anybody who works their backside off from the age of 15 to get into medicine and then study and train for so many years be deserving of a good wage? its not as if its handed to them on a plate is it. I'd like to see you have that dedication to study and work so many hours, many of it unpaid.

And you mention about risk and safety. I almost died of covid in March 2020, as I had seen a patient who lied about their covid symptoms so that they could be seen. My daughter who was 7 weeks old at this time and born with problems also caught it at the same time too. You have no idea how it felt to feel so powerless to help my child while feeling so unwell myself. But by your logic its ok for me to be put at risk as well as my family.

You obviously have no idea how the NHS works or even general practice/private practice, so until you actually read and educate yourself, there is really no point in you commenting any further.

 

[Werewolf]

Yeah, they are indeed very confined, warm and stuffy. I haven't been to one in a long time but I always thought how small and dense those rooms were now thinking of the pandemic. Never thought about it before.

Ours are still taking patients but only if you have an appointment. Even then you cannot get into the building until granted access. Or too early. Nobody can just walk in like it was 2 years ago.

Aye our GP's new building is as I say fairly well laid out purely by coincidence due to it's size, previous use and how they wanted to use it (IE bloods and maternity/nurses clinics on the ground floor, doctors on 1st and 2nd), and they were able to implement a one way system, the old one I don't think they've used for patients at all since the start of the pandemic as they were reducing it's use before (it was not suited to disabled access*/parking), and the layout was basically a cramped corridor with closely packed exam rooms on one side, and the reception area/part of the admin on the other. One infected person could potentially have given it to half the staff in the building as well as the other patients.


*Half the GP exam rooms were up steep stairs which meant depending on who you were seeing you might have had to wait for them to be able to use a free downstairs room if you couldn't manage the stairs.

 

[arknor]

No the point people are trying to make is that it is reckless and pointless for a medical professional to put themselves at preventable risk for something that could very easily be done over the phone when we're in a situation where medical resources are scarce and stretched to breaking point as it is.

IDK how I feel about them it's kinda putting your health above the patients.

which I guess you could argue is the right thing to do because if the doctors/gps get ill no one will be seen anyway.

I'd like to see the Face2face statistics for private GPs vs ones that are doing NHS appointments.

I'd bet private is nearly all face 2 face still because when someone is paying 100 for 15minutes of someones time you can hardly relegate them to a phone.

it can't be that much better than phoning 111? all a GP can really do is say go to the hospital surely? or would they offer you an actual F2F consultation if they deem it necessary

I guess people should start buying oximeters, sphygmomanometer, HR meters etc for the home.

 

[Werewolf]

I suspect "private" GP's are probably seeing far fewer patients per day to begin with, and quite possibly have more spare money to spend on things like improving the ventilation of their offices, as whilst people like to go on about how much GP's get, IIRC the actual amount per patient a GP gets from the NHS is quite small and they have a lot of overheads.