Just how arm's length and offhand can GPs get?

ginny

Blood pressure , high or low thyroid ,cholesterol and diabetes
often show no discernible effects for the patient until …. they do.
I was asked in for blood tests a few months ago and having mentioned a couple of things was tested and I have two diagnoses that need medication.
It seems for some that the doctors are wrong if they ignore you and wrong if they try to take preventive action.

I agree with your last sentence. If I were a GP, it would drive me bonkers that some patients seem to think they're out to 'get them'.

I'm quite happy to take some responsibility for my own health. Taking my own blood pressure and monitoring my blood sugar are easy to do in the comfort of my own home. It's not a problem letting the surgery know and, hopefully, release some time for people who are acutely ill and/or can't monitor themselves.

keepingquiet

growstuff

62Granny

Simple answer they get paid to submit certain stats about patients, by doing this they can tick a box and they have met their target. I used to work in a GP practice with 2 GPs and a practise nurse, we were on a big housing estate , morning surgery was open no appointments required, we were busy most days they used to see 20/30 patients each. Afternoons appointments could be made and inbetween they would do house calls and paperwork . It worked , what has changed? The senior partner knew his patients and their families they appreciated this.

But, to get paid they need to show results ie bring down the BP (or, at least, make an attempt to do so).

GPs are not paid on results.

Government money is allocated for various initiatives which GPs can choose to focus on, particularly if they are based in areas where there are common health issues like obesity, diabetes, heart disease, smoking, mental health etc.

They set targets to show how they have reached them but it is mostly a paper exercise. They don't need to show if the initiative has been successful or not, just that they've spent the money.

This is why governments always say they've made money available for certain things but often it gets spent on leaflets which no one reads.

As a long-term T2 diabetic, who has had a heart attack and cancer (and possible a second one - waiting for the results) and has now had progressive osteopenia confirmed, I'm very happy that the government makes money available for GPs to take care of me. My practice spends its money on consultations and non-leaflet treatment to try and make sure I'm in the best shape I can be.

PS. GP practices do need to show that BP and blood sugar have improved for a certain percentage of patients.

I’ve had to update surgery a few times re BP readings- think it’s good practice for the surgeries to do this- why would you not want to comply?

I'm quite happy to take some responsibility for my own health.

Me too. I wear a FitBit daily and scan the results every now and again to check that there is nothing out of the ordinary. I eat a low-carb diet and exercise daily which keeps my weight down and keeps me active and flexible. There is always the possibility that something could go wrong in the future but there's nothing a doctor can do about that either.

I think this was more about these messages coming out of the blue with no explanation than anything else. Sending a more detailed explanation would have been a start. I could afford to buy a monitor if I needed one - many people couldn't. Plus I can imagine a lot of people worrying about it now.

I agree with every word. If the parents have a blood pressure monitor what's the problem. ?

AreWeThereYet

^I'm quite happy to take some responsibility for my own health. ^

Me too. I wear a FitBit daily and scan the results every now and again to check that there is nothing out of the ordinary. I eat a low-carb diet and exercise daily which keeps my weight down and keeps me active and flexible. There is always the possibility that something could go wrong in the future but there's nothing a doctor can do about that either.

I think this was more about these messages coming out of the blue with no explanation than anything else. Sending a more detailed explanation would have been a start. I could afford to buy a monitor if I needed one - many people couldn't. Plus I can imagine a lot of people worrying about it now.

Blood pressure monitors are about £15.

I think the bigger problem is that there are some patients who don't have the capacity to take their own blood pressure or get in a muddle with prescribed medication. They really do need face-to-face care, so hopefully those of us who can monitor our own health and follow through on advice, will release time for those patients in greatest need.

Aveline

Seems fine by me. Obviously the GP surgery is wanting to start monitoring her as she's now over 50. It's in her interests to make this tiny effort on her own behalf. It would be useful for her medical notes to have a baseline BP for future reference. Not sure why you are so cross about it.

I am cross about it because if the doctor wants to know DD blood pressure then DD should be invited down to the surgery to have her blood pressure taken by the nurse - which is what our surgery does.

If she sends her own reading the doctor has no knowledge as to whether it was taken accurately, or even taken at all. Someone could just make up figures and submit them.

If the surgery think it is important enough to have her blood pressure on record then it is important enough for them to make sure they have an accurate reading.

As i said she has her blood pressure read in other settings several times a year, so knows she does not have a problem.

Is it any wonder that doctors don't want to be GPs? This attitude that GPs are just out to "get you" or "earn money" off you is just so depressing. High BP does not normally have any symptoms but can damage the heart, the kidneys and every organ in the body including the vascular system. Why would anyone object to taking their own BP and feeding it back to their GP? It's easy to take your own BP, it is often more accurate than when it is taken by a professional as you are often more relaxed and if you have high BP there are really safe drugs that can reduce it and prevent the worst effects of hypertension. Words fail me!

My husband has been on blood pressure tablets and statins for many years.
He used to be very overweight but accepted the 12 week free referral to Slimming World offered by the GP, has kept going for three years and has now lost five stone.

We were advised by our surgery to buy a home BP monitor, and to make sure it is one that is clinically validated.
We have an Omron machine, it's the same one the practice nurses use. All of their models are clinically validated.

We also have an oximeter, as does my daughter. Our little grandson has been hospitalised several times this year with asthma so the oximeter is a very useful aid.

My practice nurse calls me in every year for an asthma review. This includes peak flow, inhaler technique, blood pressure, height and weight.

This year I asked for a blood test as my cholesterol had been borderline high, pre-Covid, so she agreed that was warranted as well, although they've stopped doing them routinely now.
Again it was borderline high, mainly because the acceptable levels have now been reduced.
We agreed I could take plant sterols and watch my diet for six months then repeat the blood test. If it's still high then she will probably recommend statins.

We're happy with our surgery and perfectly happy to play our part in monitoring our own health concerns where we are able.

If your daughter went to the surgery, though, it would be a one-off reading, which isn't as useful as am & pm readings spread across 7 days. My BP is always lower in the pm.Also most people have a degree of white coat syndrome when it's taken by a nurse or doctor.
I think it's a good initiative, high blood pressure is known as the "silent killer" , is really common and is usually straightforward to treat. Your daughter's BP is monitored at work, but her GP doesn't know that.

valdavi

If your daughter went to the surgery, though, it would be a one-off reading, which isn't as useful as am & pm readings spread across 7 days. My BP is always lower in the pm.Also most people have a degree of white coat syndrome when it's taken by a nurse or doctor.
I think it's a good initiative, high blood pressure is known as the "silent killer" , is really common and is usually straightforward to treat. Your daughter's BP is monitored at work, but her GP doesn't know that.

A one-off reading is all the GP wants. It isn't as if her blood pressure is not measured several times a year. It is, but not in relation to her GP. Her sports club offers them every so often and health initatives at work offer them as well. If her blood pressure went up she would visit her surgery.

To be fair her surgery have a track record with her. During COVID they nearly killed her when on a telephone appointment, the GP forgot to order a vital test, and then refused any further appointments until scans took place even though she rang regularly with increasingly worrying symptoms.

In the end she badgered her local hospital to do the scans. A blood test was finally ordered followed by panic stations when it was realised she was so anaemic that' she could have a fatal heart attack at any moment' - this is what the GP actually said. She survived but was described as being critically ill- which means survival hoped for but not guaranteed.

GPs are required to have collected certain data on patients for their Quality and Outcomes Framework payments. This includes BP, height, weight, smoking and alcohol status, as well as evidence of chonic conditions care such as asthma and diabetes. If you haven't provided these recently enough an alert will flash up on the computer screen when your records are accessed. It is mildly irritating to have to confirm my height and weight, that I have never smoked and alcohol usage is minimal,every single time I request an HRT prescription, but I bear with it. The BP check is obviously necessary, and probably far more accurate in the privacy of your own home, that the stresses of attending the surgery.

My surgery emails me to ask for a BP reading about once a year, and has done for some time. I have a machine because we needed one for DH, but there is one we can use at the surgery. I'm currently attending one of the pre diabetic groups which so far hasn't told me much I don't know, but is making me concentrate more on what I am eating. The diabetes sessions are my own fault because I asked for a blood test when I realised I hadn't had one for a while. But if I hadn't had the test I would have had no idea about the prediabetes until it developed into Type 2, so I shall be happy if I avoid that.

Funny how different people see the same situation from different perspectives isn't it? OP sees her GP making contact for a routine health check as being offhand and unexpected, whereas I see it as having a pro active GP who is trying to pre empt a patient having a heart attack or a stroke. Funny old world.

M0nica

valdavi

If your daughter went to the surgery, though, it would be a one-off reading, which isn't as useful as am & pm readings spread across 7 days. My BP is always lower in the pm.Also most people have a degree of white coat syndrome when it's taken by a nurse or doctor.
I think it's a good initiative, high blood pressure is known as the "silent killer" , is really common and is usually straightforward to treat. Your daughter's BP is monitored at work, but her GP doesn't know that.

A one-off reading is all the GP wants. It isn't as if her blood pressure is not measured several times a year. It is, but not in relation to her GP. Her sports club offers them every so often and health initatives at work offer them as well. If her blood pressure went up she would visit her surgery.

To be fair her surgery have a track record with her. During COVID they nearly killed her when on a telephone appointment, the GP forgot to order a vital test, and then refused any further appointments until scans took place even though she rang regularly with increasingly worrying symptoms.

In the end she badgered her local hospital to do the scans. A blood test was finally ordered followed by panic stations when it was realised she was so anaemic that' she could have a fatal heart attack at any moment' - this is what the GP actually said. She survived but was described as being critically ill- which means survival hoped for but not guaranteed.

The GP can't know that your daughter has had her blood pressure taken. Given her history with the practice, it's a positive that they are checking that her BP is OK. It doesn't matter that she doesn't have a machine at home because she can send the last reading from the sports club. Sorry, but I don't see a problem.

M0nica

Aveline

Seems fine by me. Obviously the GP surgery is wanting to start monitoring her as she's now over 50. It's in her interests to make this tiny effort on her own behalf. It would be useful for her medical notes to have a baseline BP for future reference. Not sure why you are so cross about it.

I am cross about it because if the doctor wants to know DD blood pressure then DD should be invited down to the surgery to have her blood pressure taken by the nurse - which is what our surgery does.

If she sends her own reading the doctor has no knowledge as to whether it was taken accurately, or even taken at all. Someone could just make up figures and submit them.

If the surgery think it is important enough to have her blood pressure on record then it is important enough for them to make sure they have an accurate reading.

As i said she has her blood pressure read in other settings several times a year, so knows she does not have a problem.

What a waste of time, especially as your daughter claims she doesn't have high BP! All she needs to do is send them the reading, which will be recorded, and if it's normal, she will hear nothing more for a few years. I would far rather the surgery used staff time more efficiently by saving face-to-face appointments for those who actually need them.

Our surgery has a machine in the waiting room. I imagine everyone’s reading is raised if taken there. Home readings are far more accurate.

I go to the hospital every two months and have to take my own blood pressure there. The machine is a beast, you put a plastic sleeve on your arm and insert it into the depths of the machine just like a vet sticking his arm into a cow! I have fragile skin and this monster hangs on to your arm like a crocodile getting its next meal, last time I ended up with a really bruised arm. The consultant now agrees that my own stats are more accurate as I am petrified of that monster machine.

I am happy to do my blood pressure but my last asthma review was to be over the phone, that I cannot see being of much use, I have no equipment to measure correctly. Fortunately I had a consultant appointment where I was properly assessed.

I understand that health checks commence at 50. Things like high blood pressure can be asymptomatic so a good idea to submit BP. Most pharmacies will take it for you.

I am very much in favour of preventative medicine in terms of monitoring of glucose, cholesterol and BP levels, but it would perhaps have been more useful or informative if MOnica's DD's GP practice had explained why they were asking for this information. My GP practice has never contacted me, no 50+, 60+ check, nothing at all.

Aveline

Seems fine by me. Obviously the GP surgery is wanting to start monitoring her as she's now over 50. It's in her interests to make this tiny effort on her own behalf. It would be useful for her medical notes to have a baseline BP for future reference. Not sure why you are so cross about it.

This is what I thought when I read the OP.
I think it’s a simple request for a blood pressure reading. If she prefers to go to the surgery, she could easily ask for a nurse to do it for her, but it is well known that blood pressure often goes up when a patient is confronted by a medic.

I’d be grateful they actually bothered. Probably they had an age group and asked all in that age group to do the same. She could refuse if she wanted to.

If an accurate reading is required then it should be taken at the surgery in my opinion., coupled with a few questions eg smoking status, alcohol consumption family history and weight. 5 minute job!

If your GP can't be arsed to do their job then why should we?

mae13

If your GP can't be arsed to do their job then why should we?

Maybe because your own health might be something you're concerned about! Anything which takes pressure off overworked GP services is a positive as far as I'm concerned. We're not all babies who don't understand our own bodies.

Sending a blood pressure reading is hardly an imposition or great hardship. It gives the GP a baseline, in case there are future problems. It also means that somebody who is actually ill (and needs a face-to-face appointment) can get an appointment more easily.