Advice for GP appointment

[CDreamer]

Hope this link works -

which.co.uk/news/2018/08/wh...

[heartmatters1]

Good advice thanks

[jennydog]

Yes, it does work. Thank you.

[ILowe]

Nice link. The pdf file in the article has different information so is worth downloading. I found the browser Vivaldi failed, but firefox worked.

Even I find the stress of planning and seeing a doctor to be very high, even though part of my educational job is to give consultations with students! So any mutually agreed advice is helpful.

It is very interesting how much the patient can direct the interview. I often go to interviews with a one page summary, with loads of headings, including my top three questions. If I do not prioritise, I lose out.

I usually go with someone. The non-patient takes notes, and is usually calmer, and can often get more out of the doctors, who often think that someone under time pressure in a confrontation is the nervous type, therefore needs emotional calming, instead of needing calm blunt informed dialogue.

I have asked in other threads, what rights the patient has. This is important. As I understand it the patient has the right:

** to information, especially the results of any tests done. It is very important these days, especially in a big file, to have your own copies, so as to field the comments of the doctor. For instance, I have data going back decades that shows my Potassium level is usually high. So, a low figure, within the norms, requires investigation, and a high figure can be ignored.

** to double check doses

** to double check drug interactions.

** to state how they want to be treated, eg, no antibiotics, take it slow, I have a high pain threshold, etc

** The patient has a right to refuse treatment, but not the right to insist on treatment (sigh)

** to ask for scenarios -- what could it be? Why? What options are there for treatment + reasons?

[CDreamer in reply to ILowe]

Excellent advice.

[Buffafly in reply to ILowe]

Google and Adobe Acrobat work.

[Buffafly]

Very helpful, thanks. I have always struggled with GP appointments and I think it would be a good idea if surgeries handed out a leaflet with this sort of information on.

[ILowe]

I am not a doctor, but I am often in a similar situation to them in my work. I supervise many students. I could keep detailed tracking records. I do not bother. I rely on years of skill and experience, which enables me to rapidly think my way into the research of each student, as if it were entirely new to me. Then my experience, my grasp of thinking etc means I can (usually) make helpful remarks. Doctors bring a wider perspective. They also have a different take on how to interpret facts, what importance to give to the facts.

Unlike doctors, I do my supervisions publicly. When I get stuck, I say so, and ask other students for help. I would trust a doctor who said they did not know something.

Doctors are only able to dip into a file. Therefore, as the Which Guide says, it is crucial that the patient presents key information succinctly. Doctors have repeatedly told me that I must become my own doctor, because there is only me who has fully mastered my case history.

There is therefore a balance: two experts are interacting. Each of us have different skill sets. One of the major tension points is persuading the doctor to come up to this level of discussion. It is not so much a total beginner consulting an expert. it is one expert consulting another expert. We both come to the discussion as experts, but with differing skill and knowledge sets.

[Maril1]

The problem we have here is getting an appointment .You have to phone on the dot at 8 oclock each morning if you don't get through in under 10 mins all appointments have gone . It doesn't help when your shift starts at 7 and all mobiles are now band! I was on afternoons so asthe doctors is just around the corner I waited outside between 8.15 and 9 stalking as I could not get an appointment .There were no big fancy cars or beamers, suffice to say no doctors .The first one turned up at 8.35 them the next at 8.45. The next day told at 8.05 all appointments gone around I went again 8.20 the first BMW turned up then one at 8.40 then some big massive sparklingly ugly big wheeled monstrosity turned up at 8.55.All three doctors in today. On the third no appointments stalking again no doctors before 9 but all 3 were in when I passed after getting my paper at 9.15 .Fourth day two doctors 8.15 and 8.35 disrespectfully. The fifth day I didn't bother if you can't beat them join them! No wonder A and E is chokker. Our surgery is Indian (after being sold on from a previous Indian owner who retired early )they just play the game if you can't get an appointment there is no queue! no waiting list! problems solved they have to ship them in from these countries because it's cheaper than training our own.

Coincidentally My niece recently during training to be a doctor was told that she would stand more chance of getting a job if she done some work overseas.They were crying out for doctors ,she chose India .She said it opened her eyes she couldn't believe how bad it was we were welcomed with open arms, she was treated brilliantly almost like a god even making some horrendous mistakes they would literally queue up for days coming from miles around.She found out the if you don't have money you had to rely on charities and foreign placements. She got talking to an Indian doctors who said it was all about the race and class system and also what religion you were whether you lived or died .Also many of their doctors go for for the more lucrative or get touted for western countries for the money.

[CDreamer in reply to Maril1]

I guess it will all depend upon your options within a country. This is predominantly, but not exclusively UK based - hence the advice would only apply here - and obviously to make the most out of a 10 min time limited appointment.

Have you tried to contact the surgery manager with your concerns? Is there a Patient Liaason Group? Is there an on-line booking option?

Most of the surgeries in our area tend to be mostly on-line for appointments, repeat prescriptions and test results so the telephones can be kept for those without access. You can even get a Skype, text or e-mail consult but mainly for minor ailments. I have to say we have excellent service and our surgery is rated Outstanding by QCC.

[Maril1 in reply to CDreamer]

Our surgery is rated 5900 and something out of 7500 on the latest nhs patient survey(god help those below it!). I had a letter last year saying l was overdue my follow up for my AF (7 1/2 years actually since they last saw me!) They sent me for a blood test never heard anything so called the surgery and the receptionist looked at my notes and said everything was alright. I got a letter then last autumn to go for a flu jab actually saw the doctor( it must be a good money spinner) who said I should keep taking aspirin.

Actually you have to sign yourself in on a screen in ours as I was told by the receptionist when I went in as she was obviously annoyed I had disturbed her playing with herself.

I actually told the doctor that the appointment system is a farce and he said no one else has complained. I did notice when l passed that there is a sign outside saying new NHS patients welcome and someone had added' but no appointments'. Obviously some have done a runner. I was going to change to another doctors but one of them committed suicide a while back on all accounts she was a the only decent one! I am told

It does all sound rather cynical but it's not depressing we have a good laugh about it down the pub especially as one of the blokes is a doctor married to the head of the NHS northwest.

[CDreamer in reply to Maril1]

The sign in screen is normal practice nowadays but it does sound as though you aren’t having a good experience.

I feel blessed we have such a good service and rapport with the doctors and I can get a call back if I want to speak to a doctor within a few hours - but obviously only for emergencies. Annual check, monthly bloods - but you will never get any feedback on results unless you ask for it - I don’t know of a surgery in the country who will inform you - unless there is something flagged up but the doctors will only get involved if there is something flagged.

[Maril1]

Thanks for the quick reply.Yes you should thank your lucky stars especially if you heard some of the horror stories the doc has told us down the pub . No matter how bad ours are he always goes one better or should I say worse.

I am partly to blame as you say I tend to keep away as much as possible these days as between 2006/10 I was in and out of hospital like a yo-yo if it wasn't the AF it was the drugs , I was even told at one appointment with the cardiologist in 2006 I needed a heart transplant (actually it was the only words I could understand). I was a bit deflated when I left his room and an old fellow in the waiting room who obviously new the score said when he calls out your name no one answers. I realised then that he had picked up the notes of 2 others before mine and he told the nurse DNA and the nurse said they're probably still in the queue for an ECG.At a following scan six weeks later (the one with the jelly forget- the name) l asked the nurse was it ok she said 'you'll live' I replied that' the last one indicated that I needed a transplant. She opened a side two other nurses came in and confirmed that but all said it was fine now they were very puzzled as your heart doesn't get better.

Sorry about rambling on but just as I write this it's just come on the news that they stick plastic bags over the heads of the older patients at our local general hospital ! Says it all really. I think I'll thank my lucky stars as well!

[Hidden in reply to Maril1]

Ha! Just came across your post!! Do tell me the area you live in and I will give it a wide berth !🙁

I guess I'm really lucky living on South coast but also find Dr Google very handy....

[Maril1 in reply to Hidden]

I thought the 'sticking plastic bags over the heads of old patients 'would have been the give away as it was on the news that evening or maybe it was just the local news ,they like to keep these things under raps ( forgive the pun).Maybe I should give some more clues :

We have a new half built general hospital that is at a standstill (Carillion)

We had a 'pathway' named after the city (apparently used nationwide but they were more enthusiastic about it where I live hence the name) were if you went in hospital and past a certain age you were just left to die with no food or water .

If you were lucky they may have given you a few lethal injections to keep you quiet and help you on your way!

Any ideas yet?

[CDreamer in reply to Maril1]

My home town - ‘where we meet under a statue that’s exceedingly bare’.

Is that still there?

My father was the architect of the hospital being replaced - now that was a saga............

[Maril1 in reply to CDreamer]

In one!

Yes it is still there ,iconic building and meeting point . Unfortunately Lewis's the department store is now closed . I think the bottom floor is a gym and there are officers above. I'll have to check next time,l was only down there on Thursday. I was going to say it's a wonderful place to visit these days then I read your replies.

I would love to hear more about the saga as the latest half built one has a crack right down the centre no wonder Carillion went bust . I remember it being built back in the 70s spent many a night in the HEC between 2006 /10 .

[CDreamer in reply to Maril1]

Haven’t time now but will PM you later in week.

[Hidden]

Oh Yes! I get it. Think I'll stay south of Watford !🤤😁

[CDreamer in reply to Hidden]

Winderful city to visit these days

[CDreamer in reply to CDreamer]

Or even wonderful....

[Hidden]

Yes , I had heard this. Maybe when husband eventually retires!

[Maril1 in reply to Hidden]

Yes I second that, but of course I'm a bit biased, but don't wait until you retire because if you take bad and you unfortunately end up in hospital ,a plastic bag over the head seems the normal course of action .

[Hidden in reply to Maril1]

Haha! Yes....will remember that! Perhaps best to steer clear...