Why your GP practice is struggling ... A (very lo... - PMRGCAuk


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Why your GP practice is struggling ... A (very long) letter from a practice to its patients

PMRpro profile image


We have talked a lot about problems in seeing doctors. There is stuff in this letter which I find concerning - but most of it refers to the patients who think they are more important than others. The other thing is that by no means all practices are as available as this one appears to be/have been.

But it does explain why you are now getting calls from a pharmacist who often needs some education about PMR and pred!

32 Replies

I had a chuckle at some of the comments. It's been such a hard time for everyone. I'll say one thing though, since Covid and docs have been making calls to their patients instead of seeing them, I bet it's got rid of a lot of malingers.

PMRpro profile image
PMRproAmbassador in reply to Staplehurst

Not so sure - they seem to suggest there are still people clogging up the system who need to be heading somewhere other than the direct to GP route.

Well after reading all that I need a doctor.Not really, but some people I know would rush to get an appointment. I think that it was well written and needed spelling out to some folks so that that understand the difficulty that the health service is under, but then many will not understand even when it is spelt out to them, that is the problem. Thanks for the Post.

Staplehurst profile image
Staplehurst in reply to Pastit


PMRpro profile image
PMRproAmbassador in reply to Pastit

I watch a lot of healthservice observational documentaries and it never ceases to amaze me the number of people who haven't tried anything before calling in the GP or 999 - not even a painkiller. Or who turn up at A&E or for a prescription hoping to get free paracetamol ...

They sorted that here - normal painkillers aren't reimbursed by the healthcare system - special script used for the high dose ones you can't get OTC. AND only the pharmacy sells them and they charge the full price, no 20p at Lidl options.

MamaBeagle profile image
MamaBeagle in reply to PMRpro

On one of those Doc's, on a Christmas Day some time ago, a caller asked how she should cook her turkey!

PMRpro profile image
PMRproAmbassador in reply to MamaBeagle

They sometimes show excerpts from emergency service calls for broken nails, one ambo was sent to someone who couldn't be bothered to get up and get the remote control for the TV - and myriad ones where people are screaming to "get here quick" and it will be the call handlers fault if someone dies without having told them where the emergency is! Obviously think DrWho is a paramedic ;)

Longtimer profile image
Longtimer in reply to PMRpro

I have a friend who is a receptionist at a "walkin"medical centre.....she is never amazed anymore what they ask to see.a doctor for......a sore ear they have woken up with , a spot on the chin, a headache....and wanting aspirins etc.....Interesting comments after what the surgery had written....

Pastit profile image
Pastit in reply to PMRpro

It's a nightmare what people expect. Some of them need locking up! Sorry rant over.

piglette profile image
piglette in reply to PMRpro

The idiots are nothing new, they have always done it and will carry on. It does seem that A&E visits last year have reduced and perhaps the whingers have been thinking twice in that area. My nephew’s girlfriend who is a doctor in A&E has had one mother coming in because her small son had got dog poo on his shoe. I have always had doctor friends complaining about people with broken nails and paper cuts. I think the letter might be blowing things up a bit. Our Office Manager asked me to put some items on our village website which I run as more people looked at it than the surgery one. Most people complain about e-consult as it is so difficult to fill in as it does not ask the right questions, which all seem to have tick off answers.

PMRpro profile image
PMRproAmbassador in reply to piglette

Sounds about right - designed by professionals and not checked against the knowledge of Joe Public.

piglette profile image
piglette in reply to PMRpro

I get so angry about these apps, which are costing us a fortune and half of us can’t use them.

I read it, smiled and decided to see if my GP practice had it. Yes.

I then decided to try 'Repeat Prescriptions'. As on Monday next I need to call for a repeat.

I make requests every two weeks even though I have been on Warfarin and other meds for more years than I care to remember.

Practice site reply "We found 1 condition, symptom or topic that may relate to repeat prescriptions".

Followed the link zilch.

So back to 'no ring back' and trying for anything up to a couple of hours to make contact.

Hopefully maybe they will sort it out and stop my blood pressure from going sky high every two weeks. 😈

PS: Loved the photo of the smart phone..............don't have one. Wrong generation.

PMRpro profile image
PMRproAmbassador in reply to jinasc

Me neither - but most over 80s here have one ...

piglette profile image
piglette in reply to PMRpro

I have one but it is too old to run the Track and Trace system, even if you have a brand new Windows phone it won’t work for you. I have just installed the NHS app which they are supposed to planning to use for the Covid passport. It involves accessing my doctors’ surgery first. I have trued to access it three times in the last couple of days and it worked once, the other times it said there was a problem with the surgery’s computer system. That should be good when you are trying to get on a plane!!

Constance13 profile image
Constance13 in reply to jinasc

Wrong generation indeed! I've had one for years.🤪

Very interesting indeed. No sign of eConsult at my surgery; it’s the phone abyss or nothing because the inline booking slots are always taken. Re the golf playing - I have worked for two GP’s at different surgeries that used to keep their golf clubs in their car for Friday afternoon golf, while salaried GP’s had to deal with the extras on top of their afternoon surgery list.

I do agree with this attitude to health being seen as a commodity and that self responsibility being lacking in many. I remember indignant patients who could not be fixed or took exception to being told to give up habits that were clearly doing them harm. I would say that a list of issues can be useful if given at the start because the urgent thing can be spotted. The worst is when a patient has already taken more than 10 minutes but then brings up a big problem as they are putting their coat on, that can’t be ignored because they might not come back.

PMRpro profile image
PMRproAmbassador in reply to SnazzyD

I think that is often the thing they actually made the appointment for but took the whole time to screw up courage.

I agree about the golf - though Wed pm golf was fair enough in Scotland as like a lot of things, Wed was half day! Of course - golf is a lot cheaper and a way of life there ...

And then there is the patient with asthma or heart failure who calls 999 with DIB - with the packet of fags on the coffee table - and who get stroppy when told they cannot smoke because they are given oxygen!!!

I remember a GPs appointment some years ago, and after he had dealt with my first issue I started to explain another issue where he stopped me and told me to make another appointment to deal with the second issue. Yet you can make a double appointment at my practice.

MrsNails profile image
MrsNails in reply to Theziggy

I’ve had that happen so booked a double slot the next time but sometimes these things can be related & are not always a single condition in isolation!.....

I thought that was an excellent and well written article. Think I'm pretty lucky with my practice.

Longtimer profile image
Longtimer in reply to Bcol

I'm lucky too....have emailed for blood tests, and got a reply within two hours.....I go on their website to get repeat prescriptions, and if need an appointment that can wait, do the same also....not had to lately though....

Not sure about just looking at one symptom per appointment ( ideally). Leg pain and headache on Google got me to GCA, very different symptoms of same disease.

PMRpro profile image
PMRproAmbassador in reply to RoadTrip

What concerns me is the potential to not join up dots with apparently (to the patient at least) unrelated symptoms.

RoadTrip profile image
RoadTrip in reply to PMRpro

Agreed, means they may miss things as patient will not know which is important or not. That should be doctors job when they are aware of all the facts.

I read the whole letter. I doubt it will amount to any significant change. I wouldn't know where to begin in attempting to address all the issues that were raised. I don't think any non-medical person can fully comprehend all of the problems.

I do want to highlight one issue that seems relevant to internet users and the Dr. Google phenomenon. Nowadays, almost anyone can claim to be a medical expert based on their status of being a patient and without ever taking care of a single patient except for themselves.

"We have many instances where patients have readily contacted us for our specialist professional advice on a health matter, but who will then promptly choose to dismiss or ignore the advice because they are unhappy with the answer or with what we have said."

I'm guilty of this but I think my doctors treated me as a co-equal based on my medical background. If anything, I sometimes felt like my doctors assumed I knew more than I actually did. I never accused them of being stupid or dismissed their recommendations because of their lack of knowledge. I would preface my assertions with "I don't really know". Most doctors responded accordingly and shared information with me and that allowed me to learn.

I once wrote my GP a note questioning a diagnosis. His response was that he didn't know the answer but he believed what my rheumatologist told him. He said that he would forward my concern to my rheumatologist.

I think the wording of my question was, "Did you diagnose PMR just because I said that I needed prednisone?" Sometimes, I suspect doctors tell their patients what they want to hear in spite of evidence to the contrary. My rheumatologist quickly responded with a friendly note saying that I did indeed have PMR.

In my case, I didn't know anything about PMR. I was just having a difficult time grasping how I could possibly have any additional problems.

A very interesting article emphasising with some clarity the constraints GP services are up against. For the most part I really do sympathise and understand their issues and completely agree with what they're saying, but also as an ex nurse, I realise the importance for many patients of feeling that they're speaking to the organ grinder and not the monkey! That sounds a little disrespectful and it's really not meant to, but many patients would have trouble knowing which medical professional would be most appropriate to see even with help, and there's nothing more frustrating than having had to jump through hoops to discover you've still not seen the right person! This new way of delivering health care is a product of our times though! Some of the letter felt a little condescending but I guess that's probably borne out of frustration and therefore understandable.

Like several others, I also really liked the part describing how people should take responsibility for their own health and well-being too. It's so true that many of today's health issues arise as a result of our own unwillingness to make good choices. We all know the proven risks of smoking, drinking, obesity etc and yet so many people continue that pattern of self destruction and then expect the medical profession to sort it all out for them. Just imagine how much money would be saved if we didn't have smoking related illnesses, or drink related illnesses etc. All quite controversial but definitely food for thought!

This GP practice sounds great. Mine on the other hand are awful.

They score 1 out of 5.

I never bother them, managed to speak to a locum who said he’d write to me , but haven’t heard a thing since .

I’ll change I think .

Even if we could email it would be something.

Very interesting. I’m involved in giving feedback to eConsult in an attempt to make the online process simpler for the patient. Some of the concerns expressed may be helped if the GPS understood why some patients struggle - it isn’t all to do with age, incompetence, laziness and habit. In my case I wanted an appointment and it took 40 minutes and 38 ‘windows’, a section for self diagnosis and queries about my gambling and alcohol habits. I gave up in the end and rang the practice..

PMRpro profile image
PMRproAmbassador in reply to Thelmarina

Hardly surprising - I think I would have! And I know how to deal with such things ...

A very interesting piece. I am not one to bother my GP unless I have no other option. My surgery hasn't used e-Consult as far as I know. However when I have needed to speak to my GP I have been able to by either booking a same day call or an advance call appointment. I have only had 2 urgent calls and 2 non urgent calls in over 12 months. I do try to deal with my own symptoms but sometimes you need a chat with a professional!

Well written. An epic attempt to educate and set some boundaries. That could apply to many countries, not just the UK. Here in the states, people are calling the Dr. early, acting out of fear of Covid which also makes them anxious and less patient. Thanks for sharing this.💖

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