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Thread: I am interested - what do you think of GPs in this country? (long read)

  1. #1
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    I am interested - what do you think of GPs in this country? (long read)

    Full disclosure - I am a GP trainee.

    Now, this may or may not be a good forum to gauge a bit of actual opinion but I am curious nonetheless. There has been a huge amount of vilification of GPs in the right wing media of late - mostly Daily Mail and Telegraph - the government has been very happy to sit back and let this happen. Now, I haven't actually felt this hate from my patients (apart from the odd person but that has always been the case) by and large my patients seem very happy. So, what are people's actual opinions?

    So, there is a national shortage of GPs at the moment and there has been for some time - the current government promised to increase GP numbers by 20,000 (I think) since that policy started numbers have actually fallen. The demand for appointments has skyrocketed during this time of dwindling numbers. The current media response to this is that GPs are lazy, should be paid less and should work more. I find this astounding. How is it that when there is a lorry driver shortage people can clearly see that the blame doesn't lie with the drivers but with the circumstances and government; however when there is a crisis in GP, the government and chronic underfunding of the health and social care system is not to blame but it is the GPs themselves?

    There is this argument that "well if all the GPs just worked full-time then there would be no shortage", or even "well if we paid the GPs less they would have to work full-time, we pay them too much". It is true a lot of GPs don't work "full-time" except that they do... and then some. It used to be that 9 sessions (each half day of clinical work is 1 session) was full time - so 4.5 days seeing patients and half a day of admin. Lovely. Except that if you did that with the current demands on GP you would work in excess of 80-100 hours a week and only be paid for 40. Now, actually, we can work that much because we have all done it in the past but the actual content of the work is so intense and stressful that honestly I do not think it is physically possible to do it without making yourself very ill very quickly. Perhaps some may think that is a pathetic sob story - fine, but you're wrong - doctors as a whole are pretty resilient people and the levels of burnout, depression and suicide speak for themselves. I reckon nowadays 7 sessions equals about a max for most people and it would still equate to 50+ hours a week.

    There are some that genuinely work part-time i.e. 2-4 sessions a week. For most people that do this, it is because of child care or other commitments (maybe they also have a role in a CCG or at a medical school) - the point is that if you made these people work full-time - they would just leave general practice all together - you'd have less GPs.

    What about paying the GPs less? As a salaried GP you could expect to earn 8-10k per session per year. So if you worked that 7 session 50+ hour a week you'd be on £70k/year at the top end. A good wage for sure. A very low wage when comparing to other developed countries. I just cannot see how that much money is too much for the amount of training (5-6 years med school, 2 years foundation training, 3 years GP training) and the amount of risk and responsibility a GP takes. Partners can earn more - the average partner would take home about 100k/year but they would work way more hours and have to worry about the business side of the practice. Some very lucky partners might earn 150+ but they really are outliers.

    Honestly - if GP is so well paid and so easy why on earth is there a recruitment crisis... it is because the job is extremely difficult and getting harder and many of my medical school friends "couldn't be paid enough" to do this job.

    "But my GP refuses to see me!" - I guess this is where I can only speak from person experience. But some background - there has been a long term push for GPs to offer more virtual contact and this was heightened with covid. We were told to be prioritising remote consults. Now I think the situation mostly works in that if need an appt you will get a phone call first and then the doctor will decide if need a f2f. In my practice that is mostly because pre-covid the waiting was packed and I mean packed at all times - we just can't have a coughing 30 year old sat next to an immunosuppressed 70 year old with breast cancer - there needs to be triage. To be clear - I hate remote consultations - sometimes I feel like I am working in a call centre and it is not what I became a doctor to do, but it is something that, at the moment, we can't get around. Even with all this - if a patient is sick and needs to see me in person - they see me or another doctor in person, the same day, without fail.

    Let me be clear, I do not need anyone to feel sorry for me an my colleagues. We choose to do the work we do. But I do resent the finger being pointed at us when it should be pointed at the government that is underfunding the whole interconnected health and social care system. The anti-GP rhetoric, I believe, is beautifully convenient for the government - when the NHS reaches breaking point (and make no mistake, it will, if nothing changes) what a lovely scapegoat to have - those lazy GPs off playing golf on a Wednesday afternoon.

    So, I don't want anyone's sympathy (or applause for that matter), but I do hope people actually question where the real problems lie and don't just swallow what the media ask them to swallow.
    Last edited by watchstudent; 30th September 2021 at 10:27.

  2. #2
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    I virtually never go to the GP, I enjoy good health. When I have been the service has been pretty good although I have been kicked out of the room when I have tried to raise a second issue I have been told to make a second appointment. The receptionists are obstructive and excessively nosey, I swear they think they are actually doctors.

    My mate who is a partner in a GP practice makes a lot of money and always seems to be in the pub … so I don’t know how that works but he’s earning considerably more than you suggest above and he’s not doing many hours.

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    Yet another thread started in the wrong place.
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  4. #4
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    I know nothing about it but imo:

    99.9 % (probably more) of doctors are wonderful.
    I would assume - as in many professions - there is a huge range of salaries, working hours etc. depending on age and experience. Towards the start of my career in engineering (I am a Chartered Engineer with the IMechE) when I went offshore I would work 72 hours plus a week for a pittance, in my latter years of going offshore it was nearer four figures a day.

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    Quote Originally Posted by watchstudent View Post
    Full disclosure - I am a GP trainee.

    Now, this may or may not be a good forum to gauge a bit of actual opinion but I am curious nonetheless. There has been a huge amount of vilification of GPs in the right wing media of late - mostly Daily Mail and Telegraph - the government has been very happy to sit back and let this happen.
    What would you like the government to do - install a political officer at every newspaper office, to check and approve the content of their editorials?

  6. #6
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    I think GPs generally get into it because they want to do something good. In fact, that probably goes for nurses, police officers, anyone whose role is one of public service. From that point of view, I have nothing but respect for GPs.

    Humans become jaded though. Police officers become brutalised by dealing with scum all day, nurses become disillusioned having completed their degree to spend time wiping up blood and s**t, ambulance crews can't get to genuinely ill people because they're picking some drunk up who has passed out in the street again and GPs are constantly seeing drug-seeking behaviour and malingerers, the Google generation "knowing" everything, constantly pushed for time, frustrated by missed appointments, budgetary constraints etc etc etc. If people have a negative perception of GPs it's because they have little insight into the pressures of the job, or probably any job for that matter.

    I have seen one GP in my life I didn't like, I have seen two others who I will never forget for saving my life.

  7. #7
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    Quote Originally Posted by monogroover View Post
    What would you like the government to do - install a political officer at every newspaper office, to check and approve the content of their editorials?
    I would like the government to fund the health and social care system properly.

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    When I first registered with my GP in 1976, there was a single doctor running 3 consultation sessions a day, 2 on Saturdays and home visits were common. You didn't need an appointment, you just turned up at the surgery, took a lollipop stick with a number on it and waited your turn. Fast forward to 2021 and the last time I tried to make an appointment I was told it would be 7 weeks. The practice now has 6 doctors, 4 nurses and 3 receptionists.

    What happened?

    Eddie
    Whole chunks of my life come under the heading "it seemed like a good idea at the time".

  9. #9
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    Quote Originally Posted by swanbourne View Post
    When I first registered with my GP in 1976, there was a single doctor running 3 consultation sessions a day, 2 on Saturdays and home visits were common. You didn't need an appointment, you just turned up at the surgery, took a lollipop stick with a number on it and waited your turn. Fast forward to 2021 and the last time I tried to make an appointment I was told it would be 7 weeks. The practice now has 6 doctors, 4 nurses and 3 receptionists.

    What happened?

    Eddie
    A less healthy and older population, reduced funding (in real terms), more demanding patients, A and E departments broken, longer waiting lists for operations, social care systems failing, lots more mental health, more issues being directed by “go to your GP”, more admin and on and on


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    I thought this thread was going to be about Girard Perregaux...
    'Against stupidity, the gods themselves struggle in vain' - Schiller.

  11. #11
    currently my GP practice is offering no face to face consultations and getting through on the phone has taken me a few weeks at an hr on the phone at a time and we have receptionists with no medical training acting as gatekeepers if you even manage to get through ,at this point personally i want to know why i can goto a supermarket or stadium but my GP remains closed -the system is broken and needs a major overhaul.

  12. #12
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    I am interested - what do you think of GPs in this country? (long read)

    Quote Originally Posted by pugster View Post
    currently my GP practice is offering no face to face consultations and getting through on the phone has taken me a few weeks at an hr on the phone at a time and we have receptionists with no medical training acting as gatekeepers if you even manage to get through ,at this point personally i want to know why i can goto a supermarket or stadium but my GP remains closed -the system is broken and needs a major overhaul.
    I obviously don’t know your surgery’s exact situation but I can be pretty sure that they will be seeing patients face to face, you will just need a phone consult first. The reason is as I stated above, you can’t have everyone just waking into the surgery coughing when there are very vulnerable people at the surgery, it would just be unethical. The supermarket is very different as you do not go to the supermarket specifically when you are ill.

    And I totally agree, broken system, my point is is that the broken system should not be blamed on the GPs, it should be blamed on the people funding and running the system.


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    Last edited by watchstudent; 30th September 2021 at 11:02.

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    Quote Originally Posted by monogroover View Post
    What would you like the government to do - install a political officer at every newspaper office, to check and approve the content of their editorials?
    No, but a law stopping oligarch using newspapers as personal propaganda tools would be helpful.

  14. #14
    To become a GP you have to be the cream of the crop academically, spend a long time at university and then in training to then provide a service that drains you emotionally and physically. After all that you earn less than the cream of the crop would get as a graduate actuary.

    3 years of software or data engineering experience gets you the same money even without a degree.

    The public sector wages haven't kept up with reality.

    To answer your original question, I love my interactions with my GP. Never had a bad one. The practice around the GP is pretty poor and underfunded though. It's clear it's a volume/funding problem and I wish you well under future governments.

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    Quote Originally Posted by markbannister View Post
    I know nothing about it but imo:

    99.9 % (probably more) of doctors are wonderful.
    For an engineer, that’s an odd thing to say because (a) it’s not true and (b) you have no evidence to back it up. Unless you were being sarcastic.

    I assume the usual normal distribution would apply so 60% in the middle are adequate, 20% poor and 20% good.

    Are 99.9% of engineers wonderful? No, of course not. Are 99.9% of politicians wonderful? No. Etc., etc..

    In all my years working, I doubt I have come across more than 5% of people - professionals and otherwise - who were wonderful. I try hard but don’t think I ever achieved those heights.
    Last edited by David_D; 30th September 2021 at 11:34.

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    I think they're mostly good people, mostly trying to do their best against a rising tide and a backdrop of insufficent support and resources...but they're only human, there's only so much bandwidth.

    Good luck to you OP.

  17. #17
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    Touch wood, I am lucky enough not to have needed much medical attention over the past couple of years (I'm sure I'm therefore about to be struck down!). I have found my local GP practice virtually impossible to schedule an appointment for ages, though - I had some fairly interesting mental health issues a few years ago and despite a pretty urgent need for support, couldn't access anything via the local surgery. I should make clear that I don't blame the doctors in any way, but rather the system itself and the presumably enormous patient numbers in the catchment area.

    I am also fortunate in now being able to access private GP consultations (virtual and in-person if needed) via my work medical insurance, and my interactions with GPs via that channel have without exception been excellent, hence my view that the issue lies not with the clinicians (though they are, as noted, a convenient Aunt Sally for HMG) but with the system in which they have to operate.

    As an example, I would be interested to know what proportion of GPs' time is taken up with essentially administrative stuff like referrals to consultants; I understand that this gatekeeper role was pretty much written into the NHS from inception to keep the GPs onside at the time, and I'm not sure it's necessary these days. I may of course be wrong on that, but I'm sure there are some structural issues which could be fixed if only there were the will and the resources to do so.

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    Barely used the NHS for a couple decades, having had a child and also getting older has seen more recent usage of our surgery.

    Cannot really fault the GPs themselves, majority always helpful and caring but the background organisation seems quite lacking. I realise NHS underfunding bla bla but it always strikes me that proper management is the key failure point of the NHS. The model needs significant polishing, then it would be the fabulous system that many claim it to be.

    Good luck in your career

  19. #19
    Quote Originally Posted by swanbourne View Post
    When I first registered with my GP in 1976, there was a single doctor running 3 consultation sessions a day, 2 on Saturdays and home visits were common. You didn't need an appointment, you just turned up at the surgery, took a lollipop stick with a number on it and waited your turn. Fast forward to 2021 and the last time I tried to make an appointment I was told it would be 7 weeks. The practice now has 6 doctors, 4 nurses and 3 receptionists.

    What happened?

    Eddie
    Bluntly, people realised that working 70-80 hours per week, with little time for family life in between, was a quick way to burnout and death.

    Also, the medical knowledge and complexity of systems was so basic back in the 70s compared with now. You might have had a heart attack and been prescribed bed rest by that GP. Nowadays, you'll be on 4 different medications with routine follow-ups and blood investigations that the GP will be expected to manage. One person simply could not do that now. And that's one example of one specific illness. You could times that by 1,000 today and still not get close.
    Last edited by j0hnbarker; 30th September 2021 at 12:04.

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    Quote Originally Posted by oldoakknives View Post
    I hear my doctor has won the area Hide and Seek competition and will be going through to the finals.

    I think people who decided to train as a GP, and then want to avoid contact with people who are ill, chose the wrong profession.
    “The more I learn about people, the more I like my dog.”

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    Quote Originally Posted by j0hnbarker View Post
    Bluntly, people realised that working 70-80 hours per week, with little time for family life in between, was a quick way to burnout and death.

    Also, the medical knowledge and complexity of systems was so basic back in the 70s compared with now. You might have had a heart attack and been prescribed bed rest by that GP. Nowadays, you'll be on 4 different medications with routine follow-ups and blood investigations that the GP will be expected to manage. One person simply could not do that now. And that's one example of one specific illness. You could times that by 1,000 today and still not get close.
    This sums up the position really; medicine and health care has become so complex that the NHS system can't cope ... the NHS is very broken but it continues to muddle along in an incredibly inefficient fashion. They seem great at critical health emergencies but managing my father-in-laws Parkinsons over the last 16 years has been nothing short of tragic / comedic depending on how you look at it ...

  22. #22
    Quote Originally Posted by watchstudent View Post
    I obviously don’t know your surgery’s exact situation but I can be pretty sure that they will be seeing patients face to face, you will just need a phone consult first. The reason is as I stated above, you can’t have everyone just waking into the surgery coughing when there are very vulnerable people at the surgery, it would just be unethical. The supermarket is very different as you do not go to the supermarket specifically when you are ill.

    And I totally agree, broken system, my point is is that the broken system should not be blamed on the GPs, it should be blamed on the people funding and running the system.


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    the point being you cant even get through on the phone or book online , re supermarkets and other large areas have the capability to spread to a lot more people than an enclosed GP practice yet they are 'fine' .
    the system was made to fail - to give some context in the past (in the time of PCT's ) i sat on both partnership and comissioning boards for my local PCT for a few years - i saw firsthand the amount of wastage and half arsed systems (contract) nevermind the debacle of the switchover to a CCG where millions in golden handshakes was wasted only to employ the same people the next week under a different banner , ive worked with and met many GP's and consultants over the years and theres some very good ones out there that are very frustrated with the system.

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    Quote Originally Posted by oldoakknives View Post
    I think people who decided to train as a GP, and then want to avoid contact with people who are ill, chose the wrong profession.
    You don’t have to be medically qualified to know that you cannot properly diagnose on the phone or via Zoom.

    I received a communication for a follow up appointment with a consultant for joint issues I’ve had. It turned out it was going to be a phone call so I said not to bother.

  24. #24
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    Quote Originally Posted by oldoakknives View Post
    I think people who decided to train as a GP, and then want to avoid contact with people who are ill, chose the wrong profession.
    I genuinely have never met a GP who wants to avoid contact with people.

    I think this just sums up what I find so depressing. So many people don't seem to be seeing the system failure but just point directly at the GP. Someone not being able to get an appointment is a symptom of over a decade of real term cuts, not the cause of the problem.

  25. #25
    I have long-term health issues. I have not seen a listed Partner doctor for about three years, once they rise to Partner status they seem to disappear from doing consultations and are replaced by locums. In fact I haven't seen a fully qualified GP during that time. All of my recent appointments have been with Nurse-Practitioners or specialist nurses.

    It can only be assumed that the Partner GPs are earning enough money (share of the profits) to semi/fully retire from day-to-day consulting. Perhaps they would not want to employ extra Doctors to meet demand as this would affect their practice profits?

    I've written elswhere about the difficulties of actually getting an appointment at all with my GP practice.

    I'm beginning to think that the practice 'gatekeepers' are partially to blame. It appears to me that Practice Managers put in place procedures that try to keep patients away from actual medical practitioners.

    At my GP practice you have to explain your medical issue to the Receptionist (by phone) who will then decide if you're ill enough to have a telephone call-back chat with an actual Doctor (or Nurse -see above). This can lead to patients either exaggerating their symptoms to try to get an appointment or being fobbed off and thinking that there is nothing really wrong with them. Since when did telephone receptionists become qualified as to who get medical treatment or who doesn't?
    Are Receptionists bound by Patient Confidentiality regulations? How is this policed?

    It's interesting to compare and contrast the service provided by a vetinary practice. I know vets are private commercial practices, but most GP practices are run like commercial businesses these days.

    BTW you cannot go to the Doctors for minor first aid these days - when a relative turned up at the Doctors with a bad cut (required some butterfly stitches and a dressing) they where told to go to A&E. I'll say it again, is it any wonder that A&E Depts are said to be overwhelmed periodically?

    So what's the answer? I don't know as I am not a 'patient flow' expert. If you want a lottery organising, that is my specialist area of expertise.... hang on, come to think of it....
    Last edited by Alpha4; 30th September 2021 at 15:17.

  26. #26
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    Quote Originally Posted by oldoakknives View Post
    I think people who decided to train as a GP, and then want to avoid contact with people who are ill, chose the wrong profession.
    Officially they will do it to avoid contaminating their often very vulnerable patients. The idea of a germaphobic GP is an amusing one, though
    'Against stupidity, the gods themselves struggle in vain' - Schiller.

  27. #27
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    Quote Originally Posted by David_D View Post
    You don’t have to be medically qualified to know that you cannot properly diagnose on the phone or via Zoom.

    I received a communication for a follow up appointment with a consultant for joint issues I’ve had. It turned out it was going to be a phone call so I said not to bother.
    Yes and no, somethings you can, most things I agree, I want to see in person.

    By choice I would see every single patient in person, it is not my/our choice, the demands are just too high to do that at present.

  28. #28
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    Quote Originally Posted by watchstudent View Post
    I genuinely have never met a GP who wants to avoid contact with people.
    I can introduce you to mine!

    Quote Originally Posted by watchstudent View Post
    Someone not being able to get an appointment is a symptom of over a decade of real term cuts, not the cause of the problem.
    Pre-pandemic it was possible (with some wait) and that was “only” 18 months ago.

  29. #29
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    Quote Originally Posted by watchstudent View Post
    I genuinely have never met a GP who wants to avoid contact with people.

    I think this just sums up what I find so depressing. So many people don't seem to be seeing the system failure but just point directly at the GP. Someone not being able to get an appointment is a symptom of over a decade of real term cuts, not the cause of the problem.
    I think this is correct - my in=laws are habitual attendees at our local GP surgery, now this is not as quick or as simple they have huge frustrations. I believe that there are a portion of 'customers' who do waste GP time, but the current situation will hopefully filter out some of this.

    As regards my personal experiences, some bad, some good - the GP I used to see regularly up until aged 20ish was locked up for sexual assault! I always felt ill at ease when I saw him, but thankfully I very rarely see a GP. Latterly, the experience has been pretty good, but as I said, I am not one of their best/regular customers.

    A increasing number of GP practices use Specialist Paramedics to see people at home for some of the more mundane stuff.
    When you look long into an abyss, the abyss looks long into you.........

  30. #30
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    Quote Originally Posted by David_D View Post
    Pre-pandemic it was possible (with some wait) and that was “only” 18 months ago.
    Yes but quite a significant 18 months no? In that time, despite the media claiming GPs have been doing nothing in actual fact demand has skyrocketed - probably due to a complex list of failings (read under-funding) in primary, secondary and social care.

  31. #31
    Why do people keep saying the NHS is inefficient when it's one of the most efficient healthcare providers on the planet.

    Government after government have brought in consultancy after consultancy and make very little difference.

    Yes, there are superficial things that people hold up as examples of waste, bit overall it provides exceptional value for money.

  32. #32
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    The very existence of this meme is probably reflective of how the situation is perceived by at least a portion of the population, and the frustration it generates.

    My GP was supposed to call me this morning...

    'Against stupidity, the gods themselves struggle in vain' - Schiller.

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    Quote Originally Posted by watchstudent View Post
    Yes but quite a significant 18 months no? In that time, despite the media claiming GPs have been doing nothing in actual fact demand has skyrocketed - probably due to a complex list of failings (read under-funding) in primary, secondary and social care.
    Hasn´t the 18 months also led to quite a few GP's calling it a day, stress and frustration, also early retirement? I imagine this´ll exacerbate the current shortage...

  34. #34
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    Quote Originally Posted by Saint-Just View Post
    The very existence of this meme is probably reflective of how the situation is perceived by at least a portion of the population, and the frustration it generates.

    My GP was supposed to call me this morning...

    Yep and it is very clever of the media and govt to pin that on the GPs themselves.

    Your GP was supposed to call you and hasn't - that'll be because they are swamped with work... because the system is broken... because the govt won't fund it properly... see what I am getting at?

  35. #35
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    Quote Originally Posted by Passenger View Post
    Hasn´t the 18 months also led to quite a few GP's calling it a day, stress and frustration, also early retirement? I imagine this´ll exacerbate the current shortage...
    Early? More like forced due to said stress and frustration. But yes, the issues are massive. And to say the solution is to pay GPs less and make them work more? I am not sure that is how you solve a recruitment crisis... I am no economist or politician though...

  36. #36
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    Quote Originally Posted by monogroover View Post
    What would you like the government to do - install a political officer at every newspaper office, to check and approve the content of their editorials?
    I was under the impression that this ^^^ had already happened.
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  37. #37
    I’ve a lot of time for GP’s and nurses.great folk in my experience

    I do have a sensitive nose for inept/overstaffed management though…it’s my perception that there’s plenty of that in the NHS.
    The other issue I think is that medicine is always evolving and could literally soak up every pound of GDP- there’s always research and development that costs plenty.

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    In contrast to many on here my GP's surgery is a pretty luxurious place that has out patient surgeries as well as full ECG etc facilities.

    When I went for a check up a while ago my GP wanted me to have an ECG so instead of having to make a hospital appointment I just went into the next room.

    My main GP is mostly a pen pusher now although recently he was doing all the Covid jabs.

    He has around half a dozen GP's and quite a few nurses on his staff and I cannot praise the surgery highly enough.

    Phone in the morning and you'll get an appointment the same day.

    I think the "GP mini hospital" way is possibly the future.
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    Neil.

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  39. #39
    Master Christian's Avatar
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    Quote Originally Posted by GOAT View Post
    I’ve a lot of time for GP’s and nurses.great folk in my experience

    I do have a sensitive nose for inept/overstaffed management though…it’s my perception that there’s plenty of that in the NHS.
    The other issue I think is that medicine is always evolving and could literally soak up every pound of GDP- there’s always research and development that costs plenty.
    Sums it up for me.

    The pandemic finally forced me to take up BUPA. I had an infection about a year ago and needed a simple course of antibiotics. Couldn't even get through to my local GP. Their new online system effectively firewalled me from making human contact and said I should go to a pharmacy. The pharmacist told me "that's just going to get more painful unless you get antibiotics, you need to see a GP". Totally frustrating. The only NHS help I had was 111, who basically said A&E was the only place they were able to refer me to...which would have been a total drain on the hospitals resources.

    In the end used the BUPA iPhone app to get a video call within 10 minutes of asking and had the prescription I needed within the next 30 minutes. My NHS GP totally failed me and it was an example of how the system is broken.

  40. #40
    I have been unwell recently, my GP has been excellent, I think the routine stuff may be suffering, and for people demanding treatment the phrase go to A&E is over used, but if it's serious they deal with it quickly and efficiently, of course it is a bit of a post code lottery and depends on population density

  41. #41
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    Quote Originally Posted by watchstudent View Post
    Your GP was supposed to call you and hasn't - that'll be because they are swamped with work... because the system is broken... because the govt won't fund it properly... see what I am getting at?
    Sorry but no. All the points you make are real but not a valid excuse in this case: The surgery gave me the appointment (and it wasn't next day, urgent either so presumably they schedule them), not the other way around. You can't see your GP without a call first, and if it's urgent you are invited to go to A&E so it wasn't because of unscheduled emergencies either.
    It so happen that she is excellent, spends her morning between calls and face to face and called 10 minutes ago anyway. And the reason she had to call me is because I need blood test results for my next visit, it was on my record but the "highly qualified" Cerberus at the end of the line when I called decided it was worth wasting the GP's time to call me so that she ordered the blood test that was required on my file anyway, so that we have something to talk about at my next face to face appointment (if indeed the test results make it necessary).
    'Against stupidity, the gods themselves struggle in vain' - Schiller.

  42. #42
    Grand Master oldoakknives's Avatar
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    Quote Originally Posted by watchstudent View Post
    I genuinely have never met a GP who wants to avoid contact with people.

    I think this just sums up what I find so depressing. So many people don't seem to be seeing the system failure but just point directly at the GP. Someone not being able to get an appointment is a symptom of over a decade of real term cuts, not the cause of the problem.
    Really, you think you can get away with saying that everything is the fault of 'cuts'.

    Before the lockdown I never had a problem getting an appointment to see a GP. It would always either be same day or next day. Most of the time I could choose my favourite GP. Since the lockdown it's like they have gone into hiding and I'm lucky if a GP will phone me back within 10 days!

    Since GP practices are paid on the basis of the number of patients on their list, which presumably hasn't changed since lockdown how is that the fault of 'cuts'? The practice will still be getting the same income as before covid when the service was excellent.

    During the lockdown I needed a review of my medical history to renew some licenses. I was told my GP practice don't co-operate with this so needed to find a GP willing to do so. It was fairly easy to find a GP willing to do this, and my files were sent to me, to forward to him. He read said files, filled out the necessary forms and I paid his fee of £50. When I spoke to him on the phone I said I appreciated him finding the time to do it. He said it wasn't a problem, the time involved was minimal and he couldn't understand why my GP surgery wouldn't do it, as thanks to covid GPs like him were mostly 'sitting around with nothing much to do'. His words not mine.

    What I find depressing is people hiding behind catchphrases like 'system failure', 'decade of real term cuts', etc to cover up their general unwillingness to do the job they signed up for, and are being paid for.
    “The more I learn about people, the more I like my dog.”

  43. #43
    Grand Master oldoakknives's Avatar
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    Quote Originally Posted by Christian View Post
    Sums it up for me.

    The pandemic finally forced me to take up BUPA. I had an infection about a year ago and needed a simple course of antibiotics. Couldn't even get through to my local GP. Their new online system effectively firewalled me from making human contact and said I should go to a pharmacy. The pharmacist told me "that's just going to get more painful unless you get antibiotics, you need to see a GP". Totally frustrating. The only NHS help I had was 111, who basically said A&E was the only place they were able to refer me to...which would have been a total drain on the hospitals resources.

    In the end used the BUPA iPhone app to get a video call within 10 minutes of asking and had the prescription I needed within the next 30 minutes. My NHS GP totally failed me and it was an example of how the system is broken.
    And yet GP practices will still be being paid on the basis of the number of patients on their list. For not providing the services they are getting paid for.
    “The more I learn about people, the more I like my dog.”

  44. #44
    Master Christian's Avatar
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    Quote Originally Posted by oldoakknives View Post
    And yet GP practices will still be being paid on the basis of the number of patients on their list. For not providing the services they are getting paid for.
    Yes, I think what irked me most is that technology can be used two ways. In BUPAs case, the app made it very easy to get what was a very straightforward diagnosis and the antibiotics I needed. In the NHS GPs case, the online system was clearly being used as a firewall to prevent direct communication - much like delivery companies use to prevent you actually speaking to someone...the type where they claim they have an open line of communication whereas actually it is a bot designed to prevent it.

  45. #45
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    Quote Originally Posted by oldoakknives View Post
    Really, you think you can get away with saying that everything is the fault of 'cuts'.

    Before the lockdown I never had a problem getting an appointment to see a GP. It would always either be same day or next day. Most of the time I could choose my favourite GP. Since the lockdown it's like they have gone into hiding and I'm lucky if a GP will phone me back within 10 days!

    Since GP practices are paid on the basis of the number of patients on their list, which presumably hasn't changed since lockdown how is that the fault of 'cuts'? The practice will still be getting the same income as before covid when the service was excellent.

    During the lockdown I needed a review of my medical history to renew some licenses. I was told my GP practice don't co-operate with this so needed to find a GP willing to do so. It was fairly easy to find a GP willing to do this, and my files were sent to me, to forward to him. He read said files, filled out the necessary forms and I paid his fee of £50. When I spoke to him on the phone I said I appreciated him finding the time to do it. He said it wasn't a problem, the time involved was minimal and he couldn't understand why my GP surgery wouldn't do it, as thanks to covid GPs like him were mostly 'sitting around with nothing much to do'. His words not mine.

    What I find depressing is people hiding behind catchphrases like 'system failure', 'decade of real term cuts', etc to cover up their general unwillingness to do the job they signed up for, and are being paid for.
    I am really not trying to get away with anything.

    It is because the complex consequences of covid within the healthcare system has seen a huge increase in demand for GP appointments. As an example - the surgery I work in used to have one duty doctor a day who would have to deal with perhaps 40 consults in a day. Now they need 2 or 3 duty doctors - sometimes the amount of consults can be 60-70 in one day, for one doctor. As you say, same number of patients. But there is a huge increase in demand.

    I probably do need to harden up I guess, it is just quite sad to see someone feel that GPs are unwilling to do the work when in actual fact we have never been so overstretched and so many are leaving the profession due to the unsustainability of the workload.

    You clearly don't believe me when I say that GPs have never been doing more work. All I can say is that it just is true.


    I think this is what I was wanting to find out about to be honest, are there people that genuinely hold these opinions, which clearly there are, but again it seems to be as I have seen in practice that most people realise what is going on and don't blame the actual GP.
    Last edited by watchstudent; 30th September 2021 at 14:52.

  46. #46
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    From a personal view, I usually don’t go to the doctors because the couple I’ve seen were trainees and never helped. Recently I found an issue. On the Thursday I tried to get an appointment and was sent to nhs web app, referred back to phone docs, got a phone appointment the following Tuesday, got a physical appointment a few days later and saw a surgeon within a month for a consultation so I’m waiting for an op now. It’s not cancer but I was surprised how quick they acted. But I had to change surgeries to get a doctor that could be bothered.

    Can’t compare doctors and drivers, either in pay or conditions. We both do stupid hours, some of our lads were on minimum wage until recently. The great unwashed see drivers and the shortages on the shelves but they never usually see doctors so they cannot have any empathy with them.


    Sent from my iPhone using TZ-UK mobile app

  47. #47
    Grand Master oldoakknives's Avatar
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    Quote Originally Posted by watchstudent View Post
    I am really not trying to get away with anything.

    It is because the complex consequences of covid within the healthcare system has seen a huge increase in demand for GP appointments. As an example - the surgery I work in used to have one duty doctor a day who would have to deal with perhaps 40 consults in a day. Now they need 2 or 3 duty doctors - sometimes the amount of consults can be 60-70 in one day, for one doctor. As you say, same number of patients. But there is a huge increase in demand.

    Since they mostly aren't giving appointments any increase in demand is irrelevant.

    How long does a phone consultation take? 5 minutes, 10? My GP surgery lists 14 GPs on their staff. If 8 were working (the number of consulting rooms) at 10 mins a consultation, that would be 48 patients seen an hour. In an 8 hour day that would mean around 380 patients seen. Hard to believe when the waiting room was never very busy when you were able to visit in person.



    I probably do need to harden up I guess, it is just quite sad to see someone feel that GPs are unwilling to do the work when in actual fact we have never been so overstretched and so many are leaving the profession due to the unsustainability of the workload.

    You clearly don't believe me when I say that GPs have never been doing more work. All I can say is that it just is true.

    No I don't.


    I think this is what I was wanting to find out about to be honest, are there people that genuinely hold these opinions, which clearly there are, but again it seems to be as I have seen in practice that most people realise what is going on and don't blame the actual GP.
    “The more I learn about people, the more I like my dog.”

  48. #48
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    The reason you can’t get an appointment is because all the appointment slots are full… do you also not believe that? Not in an accusatory way, I am just curious. I am trying to understand where the ill-feeling in the vocal minority is coming from.

    Is it that you think we are turning patients away when we are sat doing naff all?

    My day at the surgery looks like this:
    8am - look through tasks, letters, labs and morning list
    8.30 - 11 - phone calls
    12- 1 - face to face appts
    1-2.30 home visits and try and eat something
    2.30 - 4 - phone calls
    4-6 face to face
    6-7 - admin, catch up and review day with my trainer

    I am a trainee so I am protected from the worst of it. But that is what I do.

    Also - as an aside, most patients actually want a remote consultation as it is far more convenient for them. Like I said, I prefer to see face to face as I don't like being on the phone and staring at screen all day, but most people do actually want the convenience of a phone call.

    Sent from my iPhone using Tapatalk
    Last edited by watchstudent; 30th September 2021 at 15:49.

  49. #49
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    I think what this thread has taught me is that, we, as a profession perhaps need to be more "visible" in what we are doing with the shift to more remote consulting I think that some people feel that because they don't see the GP as much then we must not be working. We need better PR basically!

    I just feel that having public support is going to be really important for the years to come as the NHS gets encroached upon by private contractors. I want to do everything in my power to stop this from happening because I don't want my medicine being contaminated with money in that way. Getting idea of why and how opinion turns against us is useful.

  50. #50
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    Pre-COVID our local practice was fine. Phone for an appointment in the morning and you’d always get an appointment if it was urgent and within a few days otherwise. Since the pandemic started, you have to use a ridiculous online triage system which invariably just tells you to phone the practice and make an appointment which now takes much longer. It’s now harder to actually see a doctor although phone consultations are reasonably available.

    What really annoys me is being in the waiting room listening to phone ring without being answered for five minutes while the office staff chat about TV, holidays and whatever else. I’ve absolutely no problem with the the doctors but unfortunately for them they are the public face of the practice so will invariably be the ones who get it in the neck from the public. No different from any organisation really.

    One thing that has been a big improvement is the ordering of repeat prescriptions via the NHS app.

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