GP Ratings in England

It baffles me too.
It also effectively means that patient satisfaction surveys cannot be totally relied on. Well they can, but they cant iyswim.

Yes. The problem is that GP practice income can depend on patient satisfaction so practices suffering from this patient ignorance lose funds. As you say, soon, there could hardly be a clearer illustration of how stupid it is to use patient satisfaction surveys in the assessment of GP practices.

Perhaps some (most?) GPs simply don't have time to explain to patients why antibiotics would be inappropriate in their cases. I suspect that those who do prescribe unnecessary antibiotics are just too hard-pressed to have time to spend with patients and it's so much easier to press a key on the computer, sign a prescription and, hey presto! Another satisfied patient.

But how can they have missed the coverage in the media?

Not everyone believes the media

I do not see the link. Perhaps those doctors are unsatisfactory in other ways, too. Antibiotic prescribing could just be coincidence.

They don't believe that it applies to them. Their ailment is one which really needs those antibiotics to clear it up PDQ. All that stuff about making things resistant only applies to other people.

Just as not leaving litter applies to other people - their little bit of chewing gum, one drinks can, one takeaway container, one bus ticket, isn't going to make any difference to the vast amounts that other people leave. Other people defraud the Inland Revenue of millions, so they are justified in only cheating on a few hundres or thousands. Other people park in antisocial places. Other people skip appointments that could go to those who would turn up.

It is amazing just how much is down to these other people.

Elegran

Durhamjen ...I agree, my GP surgery is a nightmare and really not very good..... I don't want anti-biotics, just some good doctoring!

That does not surprise me at all.

Anno I can imagine GPs having to explain to some patients until they are blue in the face that antibiotics will not help viral infections.

It is the same problem as some patients demanding branded drugs when there are a lot of quite as effective unbranded alternatives.

MY practice nurse friend use to be very aware of how in the very working class surgery where she worked, that the demand for uneccesary medication was far greater than in our local practice.

Far more public education is needed about this. They should teach this basic stuff in schools. (In an ideal world where pigs fly.)
It's taking some responsibilty for ones own health.

Idly watching 24 hrs in a/e last week, there were a couple of people turning up at a/e critically ill, who had not done anything about a health issue with definate warning signs, they had noticed months ago.

As long ago as the '70s, we had an Egyptian GP who had trained in the USA. She prescribed antibiotics for my children for every little sniffle or splutter, so I regretfully decided to consult one of the other doctors in the practice (Scottish) who was less inclined to over-prescribe even in those days.

The old days of doctors on pedestals and patients doing what they are told because doc is always right- were wrong. But like so many things- like discipline in schools and at home, things have swung too far the other way. There is huge pressure on doctors now to do what the patient wants, has read on the internet, including medication, be it antiobitcs, sleeping pills or HRT- against their better judgement. This is even much more so here where people are not registered with a GP, but can roam at their heart's content. So if a patient has bronchitis for the 2nd time in a few months- many patients will not accept to be told their heavy smoking has to stop. Or that being overweight is not helping those aching knees - etc. They will keep shopping around until they find a doctor that will tell them what they want to hear- even if it is not the best medicine.

And even if long-term, it is a disaster for humanity... I worked for Beechams in London who first made antibiotics available to the masses- and yet now, due to abuse- it could be our undoing. A friend of mine is recovering from throat cancer and has developed an infection- and they just can't find an antibiotic that he is not allergic to.

The problem is in my view as someone who has managed GP practices is that the payment system works in reverse in cases like this rewarding them for poor practice. Its only one of many anomalies in the contract and with the Quality and Outcomes Payment Framework- a bonus system to you and I.

The link is the first six words of the OP, dj. We keep telling HQ that the blue doesn't show up well enough.

Agreed- I didn't spot the link at first.

One thing I have noticed, is so many people agree that giving antibiotics all the time against medical judgment, will then say 'ah but not for me, because I am a special case, and I, ME, need them asap'.

At a coffee morning at a good friend's, some of the mums started to discuss GPs, etc. And one of them said 'ah getting antibiotics from Dr Jura is like looking for hens' teeth' and went on, with others nudging each other- until my friend said 'Oh you don't know Jura, do you' - we all laughed- now that was in the 70s, before we became so aware of resistance.

Teetime is right- the new contract was aimed at reducing poor practice- but did the opposite- and more importantly, put the trust between GP and patient at risk. So many patients say 'you want to immunise my child' or 'put me on statins' so you can get more money- which is so so wrong, and an insult to al those really well qualified, up-to-date and caring GPs out there.

Not being really fair to people. If GP's have stuffed patients up with anti biotics over decades and with the problems of cut backs in the NHS not so easy to think suddenly , - I have had them before a sore throat but now I don't need them because the doctor has changed his mind

But surely one's 'thinking' has to change with new and compelling information re the dangers, surely- makes sense.

I agree granjura but not everyone thinks the same , not everyone trusts their GP's, not everyone follows the news

I don't think it's as simple as doctors just changing their minds as if on a whim (not that anyone actually mentioned whims). They have changed their minds about antibiotic use, certainly, but the change is based on research done since antibiotics were first introduced. Treatments change in medical care all the time as more is found out and more is understood. Operations (e.g. dilation & curettage under general anaesthetic after an early miscarriage was once standard treatment; it isn't any more) change, medicines change, knowledge changes.

I trust my GP. He doesn't know everything but I think he does his best and he's very good about explaining things. What more can one ask of a mere human?

I'm not sure one would have to literally 'follow the news' (telly, radio) to have picked up the changes with regard to antibiotic use. The information has been around for a good number of years. The subject has been covered in ordinary magazines and GP surgeries often have posters about colds and sore throats not only not needing antiBs but antiBs actually being useless to combat that type of infection.

I did not mean I did not see the link in the OP, bags. I meant I did not see the link between doctors who under-prescribe antibiotics and patient satisfaction. GPs who under-prescribe antibiotics could be perceived as unsatisfactory for lots of other reasons. They are assuming cause and effect where there might be none.

Surely it's wrong that GPs are paid according to patient satisfaction. That can depend on many factors, including the area in which you work.

The survey didn't see causal link either, dj, only that the same phenomenon (lower patient satisfaction where GPs prescribe fewer antiBs) showed in "other studies in other countries". I may have misunderstood the funding thing but it did seem to depend a little on patient satisfaction.

x posts. I agree that paying GPs according to Patient satisfaction doesn't seem quite right.