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

Sasta

Very poor, but I’m not in the least surprised. I received an email from our surgery requesting I complete a survey online. This was I realised, the new style annual asthma check up. I’ve been seeing the asthma nurse in person annually for years, and in between if necessary. I fear we are in a race to the bottom of everything.

When you've had a traditional check up, how many times have the results of your check up changed your treatment?

I've been having diabetes check ups for years. Most times the nurse says everything is fine and sends me off for another year. I have separate foot, eye and blood tests (which obviously need to be done face-to-face), but the actual consultation with the nurse is usually a waste of everybody's time.

growstuff In DDs case if she had physically been seen by he doctor the relevant test would not have been forgotten because if she had been sitting in front of the doctor he would have been able to see at a glance just how severely anaemic she was and a blood test would have been ordered. Her skin was going a yellowy bronze because there was so little iron in her blood that bile had become the main skin colourant.

Because the doctor did not see her, a blood test did not take place for another 2 months, by which time her iron count was so low that she was on the boundary between life and inevitable death and even after diagnosis and treatment she was on that boundary for several months.

Many doctors have pointed out again and again that seeing the patient is a key part of diagnosis. not just because of what they see that helps them make a correct diagnosis, but also because the parting comment by the patient as they leave the consulting room, leads to them immediately being called back in and the serious problem the patient really has is revealed.

My FiL's Parkinsons was diagnosed because the doctor saw him for a prescription check and noticed the symptoms of Parkinsons when he was in the surgery, and acted upon them. A telephone check would have meant he would have been considerable more unwell before any treatment began.

DD is not the only person to end up critically ill because the doctor did not see the patient. Similar cases are reported almost weekly, diagnosis was done over the phone, and the patient later died because either the illness was not diagnosed correctly or its severity was under esstimated. Misdiagnosis of sepsis, is a regular with these deaths.

This is ridiculous!

Your daughter has been asked to give the practice her blood pressure reading. That's all! She's not going to end up being critically ill if she takes the reading herself! If it's high (and I guess there are some people - not your daughter - who don't know what the threshold for high BP is), I'm sure she would have been recalled for a f2f appointment.

I'm not sure whether you're moaning about her being asked to submit her BP when she says there's nothing wrong with her or whether you're just peeved she's being asked to do what everybody else does. Or just having a moan about her treatment in the past. Hopefully, the GP can use the time more efficiently to see somebody who's really ill.

Your daughter hasn't got Parkinsons or sepsis!! she's been asked as a matter of routine to submit a BP reading, which is no big deal.

You don't know whether or not the blood test would have been ordered. It was human error.

I know that if my skin was yellow/bronze, I'd be in A & E like a shot - Covid or not! If she was expecting to have a blood test, but didn't receive an appointment for on, I don't understand why she didn't follow it up.

grow stuff she did follow it up, again and again and again but the GP refused to see her until some scans were complete. The local hospital had closed its A&E and radiography department, it was during COVID. She ended up ringing whoever further up could organise scans, every day for a month, until they were so fed up with her and gave in and offered a scan 25 miles away the following morning. She got there. Then blood tests were done, then there was a major panic when the doctors realised she could in their words 'have a fatal heart attack at any moment'.

How well would you respond to bad treatment if you were seriously ill, struggling to manage, in fact struggling to stay alive, Would you be as determined to keep going at all costs day after day to try and get treatment, or would you be so tired exhausted and feeling so ill you just gave up?

I’ve just come out of a weeks stay in hospital after collapsing in A&E a week earlier, being sent home to my GP who had no appointments for at least 3 weeks. So I collapsed at home and was rushed in as an emergency with adrenal insufficiency. A GP worth their salt should have picked up the seriousness of my condition. The practice nurse did not.

Light touch GP services can lead to missed serious cases. The paramedic said I’d have been dead in another fortnight…

M0nica

*grow stuff* she did follow it up, again and again and again but the GP refused to see her until some scans were complete. The local hospital had closed its A&E and radiography department, it was during COVID. She ended up ringing whoever further up could organise scans, every day for a month, until they were so fed up with her and gave in and offered a scan 25 miles away the following morning. She got there. Then blood tests were done, then there was a major panic when the doctors realised she could in their words 'have a fatal heart attack at any moment'.

How well would you respond to bad treatment if you were seriously ill, struggling to manage, in fact struggling to stay alive, Would you be as determined to keep going at all costs day after day to try and get treatment, or would you be so tired exhausted and feeling so ill you just gave up?

I know perfectly well how I'd keep going!

I know how I coped when I had a heart attack (and i lived on my own). I know how I coped with breast cancer. I know how I'm coping at this very minute waiting for the result of a melanoma biopsy. I know how I cope with excrutiating diabetic neuropathy every single day

How dare you even ask me? Some of us just get on with it.

What I do know is that however your daughter was treated in the past is absolutely nothing to do with a simple request to submit a BP reading. Why does she (and you) think she needs to waste valuable GP (or nurse) time, when (as you've already stated) she has access to BP testing.

I cannot understand why anybody would put up with being yellow/bronze for two weeks. However busy I've been, I'm intelligent enough to make medical emergencies a priority.

I had a f2f appointment with my GP this morning to discuss osteopenia (exacerbated by cancer treatment drugs) and the way forward for a painful hip. Thank goodness she had time to see me (at her request) and wasn't faffing about taking BP readings.

Blinko

I’ve just come out of a weeks stay in hospital after collapsing in A&E a week earlier, being sent home to my GP who had no appointments for at least 3 weeks. So I collapsed at home and was rushed in as an emergency with adrenal insufficiency. A GP worth their salt should have picked up the seriousness of my condition. The practice nurse did not.

Light touch GP services can lead to missed serious cases. The paramedic said I’d have been dead in another fortnight…

Which is precisely why GPs mustn't waste their time doing tests and procedures which the patient could do at home. Their time is at a premium and should be used to maximum effect with patients who actually need them.

I give up.

We must be very lucky our surgery is excellent , once a year they request some BP readings and our weight, my husbands BP was a bit high , he saw a Dr the same week and is now on BP pills. Sometimes it is hard to get an appointment which is not surprising as our little village is now more like a town but I have never waited more than 5 days . My 95 yr old mother had the start of a urine infection , it was 6 pm on a Friday when she told me, I phoned the surgery thinking they were probably closed , the receptionist said they were just locking up but could I hang on for a minute , she chased after one of the nurses and asked if I could get my mother there in next 10 mins , we whizzed her down , the nurse tested mums urine and wrote out a prescription there and then , what service my mother would have got much worse over the weekend so we probably would have had to go the after hours Dr which a bit of a drive and more stress for my mother.

growstuff

GPs don't get paid every time they take somebody's blood pressure. However, if a patient is know to have high blood pressure (as keepingquiet does), it's the GP's responsibility to treat it. They will only get paid if the blood pressure comes down.

It's everybody's right to refuse recommended treatment, but hopefully they won't blame the GP, if they then have a medical issue as a result.

Who said they did? They get paid for monitoring and treating blood pressure.

I am fed up with the record keeping at our surgery. A few weeks ago I looked at my notes on Patient Access. It said I was a smoker and they had given me smoking cessation advice.

I was angry about this as I gave up smoking 20 years ago. It also concerns me that if for example I had an accident and needed to claim on insurance they would probably not pay out as I was “a smoker”. I told them and they have corrected it.

Now my adult son has received a letter asking him to make an appt for smoking cessation advice as he is a smoker. He has NEVER smoked so no idea where they got that from!

They get extra money for getting people to quit so I can see why they are doing this but they should not be storing incorrect information.

Primrose53 It's a very serious issue if the surgery is adding incorrect information on your record especially if you think it may be used to fraudulently claim money and for your son to have it recorded as well, that would make me very suspicious. My records are very accurate and surprisingly detailed, I even have information about discussions between my GP and Pharmacist so I feel really well informed.
I was asked at my last f2f interaction about my smoking, what I told them was added correctly ie I am an ex smoker and have been for 40 years.
Smoking costs the NHS £2.6billion a year, in 2016 it caused 79K deaths and nearly half a million hospital admissions, I'm really pleased that GP surgeries are being incentivised to help people quit. It is these sort of initiatives that should be the backbone of primary health care. Info about how it's funded below.
Local authorities currently receive funding to provide local stop smoking services and support through the public health grant. This new funding is in addition to that and will be provided through a new section 31 grant on top of the current public health grant allocations. DHSC will provide the grant.

Primrose53

growstuff

GPs don't get paid every time they take somebody's blood pressure. However, if a patient is know to have high blood pressure (as keepingquiet does), it's the GP's responsibility to treat it. They will only get paid if the blood pressure comes down.

It's everybody's right to refuse recommended treatment, but hopefully they won't blame the GP, if they then have a medical issue as a result.

Who said they did? They get paid for monitoring and treating blood pressure.

They get paid if they reduce the blood pressure of people on the hypertension register.

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.

GP’s should not assume everyone has a monitor. If they want her blood pressure reading they should invite her in to surgery to have it done. Some surgeries do have BP monitor in public areas but they aren’t alway as accurate as proper machine. Sorry but since Covid a lot of GP’s are out sourcing some test to patients them selves. I had to change surgeries as former GP’s basically barricaded themselves in post covid, lucky if you could get phone consultation. New surgery is great, can always see doctor if necessary.

My dad had a medical at work and the doctor said “your blood pressure is very high, you should see your GP”. My dads reply was “you are my GP”. The doctor told him to make an appointment. My dads response when he got home what rubbish I’m fine. A few years later he was dead a direct result of his high blood pressure.

You may feel fine but high blood pressure is a killer.

WelwynWitch3

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.

GP’s should not assume everyone has a monitor. If they want her blood pressure reading they should invite her in to surgery to have it done. Some surgeries do have BP monitor in public areas but they aren’t alway as accurate as proper machine. Sorry but since Covid a lot of GP’s are out sourcing some test to patients them selves. I had to change surgeries as former GP’s basically barricaded themselves in post covid, lucky if you could get phone consultation. New surgery is great, can always see doctor if necessary.

It clearly states in the OP that the GP surgery did not assume everyone has a monitor
At the bottom of the letter, it did mention that if did not own a suitable device, contact the surgery and they would send you a information sheet telling you how else to obtain a monitor or get a blood pressure reading