Tuesday, 4 November 2014

Why you cannot get to see your GP the same day.

When our new medical students and doctors in training start at ND Central we ask these bright, intelligent, enthusiastic young people who have thus far been only been groomed in hospital medicine where they are daily exposed to acute life threatening emergencies how many of our book on the same day patients to meet a political target of 48 hour access to a healthcare professional are true medical emergencies?

A simple definition of an emergency is that it is a medical condition which if it is not attended to urgently will result in death or serious physical harm. Examples being a heart attack, meningitis, appendicitis, stroke etc.

Another definition is where no treatment might result in serious pain or disability if a medical practitioner is not consulted. For example a urinary tract infection which might result in septicaemia, a broken bone, a suspected cancer etc.

The final definition from North of the Wall is that an emergency is a complete waste of medical time but needs to be seen within 48 hours whatever.

This is the Gordon and Tony (G&T) school of Scottish education whereby the wishes of the Vicky Pollard school of advanced socialized medicine which is whatever, whenever I want it NOW it is a f**king EMERGENCY and it is FREE with no come back has come from and if I shout at a receptionist I will get it.

Such G&T crap displaces true illness from general practice via book on the day or 48 hour access Party diktat via QOF the so called “Quality” and Outcomes Framework where points mean prizes for GPs but frustration for genuinely ill patients.

Of course Scotland produces more doctors, has more doctors per head of population and Scottish GPs have smaller lists of patients per GP so pandering to Vicky Pollard the pathetic is easier North of the wall. 

So at this week’s cafĂ© Michelle end of the week resistance meeting we pooled some of our something for the weekend need to be seen within 48 hours top 10 “emergency” consults in the forlorn hope that the architects of this retardation might see sense. However when you are busy doing nothing useful in the Middle East (other than kill British soldiers) and “educating the world” to your same low standards it is indeed a forlorn hope. But then nothing ventured nothing gained. 

Every day, in every surgery in the UK this is what GPs’ Party determined 48 hour access work is. So if you are ill then read on for this is why you cannot see your GP on the same day when you might be genuinely ill: 

1) I need my x-ray results from yesterday. 

Not available. You were told that we get an X-ray report from a consultant radiologist a week after the X-ray was taken.

Thank you for wasting our time. 

2) I need my blood tests from the hospital. The consultant said they would be available last week and if I came today I could get them because I have a letter saying so. 

Strange your letter came by the Royal Mail and we have not yet received your clinic letter but it was only 4 days ago not the week as you lied claim and it normally takes 2 weeks if we are lucky to get an outpatient clinic letter as it comes via the internal NHS post which takes forever. There is always a backlog of typing for no one including you wants to pay medical secretaries more than a pittance.

NB in the recent past there has been an upsurge in the pathetic trying to blag results sooner than they have been told using G&T appointments. Still if you don’t get it first time try again and displace ill patients from seeing Drs because you are more important than they are.

Thank you for wasting our time. 

3) My 5 year old child has an asymptomatic wart on a part of their body normally hidden by clothing. We have treated it with over the counter medication and it has not get better what should I do? 

Nothing. It will get better on its own given time.

Thank you for wasting our time once again to be told what you have been told more than once before at this surgery. A wart of 2 weeks duration does not merit 6 same day appointments in 2 weeks for a non-life threatening "emergency" because it is doing poor little Tarquin’s and his mother’s head in.

Thank you for wasting our time. 

4) I am due to have surgery next week and they have sent me a letter suggesting it will not be a day case job as I thought it would be. They sent me a leaflet all about it and I am confused. 

Ever thought of reading the leaflet that explains all about the surgery you are having and what happens on each of the 14 days after it? You have had numerous outpatient appointments leading up to this letter which all say it is not day case surgery it is MAJOR surgery. 

Thank you for booking a same day appointment to clarify this. 

5) I need my ultrasound report and x-ray reports and still have pain but have an NHS referral should I go private? 

All your test results done a month ago are normal as you already knEw (a month ago) so it is your call.

Thank you for wasting our time to clarify this. 

6) I saw a doctor over a month ago who told me to book an appointment to get my blood pressure checked after they put me on tablets. I have run out of tablets so need some more. I haven’t taken them for a week can you do my blood pressure? 


Thank you for wasting our time so you can have a prescription but which bit of the I need to check your blood pressure AFTER treatment did we or more importantly did you miss? And thank you for wasting our time today and for booking your next appointment when only one was needed.

Thank you for wasting our time. 

7) My sick note ran out a week ago but I couldn’t get in because I was “busy”. I need one today or I don’t get my money (to buy more drugs). 

Totally predictable sick note needs renewing and try and blag some drugs as well 2-3 appointments every Friday without fail all by those as high as kites and on top of all the extras. No is such a lovely word to say to them combined with a friendly cheery grunt expression ending in off and die. Lethal force would be even better and save everyone for a few pence of ammunition a fortune (Police, out of hours, A&E, prison, probation service, social services, council housing, council waste disposal etc.etc.  . .  .) all of whom will be consulted with the same degree of urgency daily (can you get me some more drugs, a letter to avoid court, get me rehoused etc.etc.).

Thank you for wasting our time for your emergency blag of something for the weekend. 

8) I have had this skin problem for years, have seen a consultant, have had biopsies and had treatment for it 10 years ago and if I do what I am told I can look after it but it is no better. 

Same day appointment for all of the above because you are not happy that you have an illness that is not in the least bit serious or harmful and is what is known as chronic and which you have omitted to treat hence need to be seen today?

Thank you for wasting our time. 

9) I need a repeat contraceptive pill prescription. 

So you had your last prescription a year ago and it was totally predictable when you would run out. Instead of planning ahead you needed a same day appointment for this? And during the course of your consultation you moan about how far in advance you have had to book your taxi for a wedding reception this weekend and how much it will cost you to go 33 miles to your best friend’s wedding?

Why not try booking it this weekend for free 5 minutes before you are due to be there?

Thank you for wasting NHS time. 

10) My relative has had an illness, usually not related by genetics, and a friend has told me I should see a GP urgently (on Friday afternoon at 18.27) to get a blood test – just in case. 

Would you like to book a flight in Concorde at the same time because your friend said it was urgent?

Thank you for wasting our time.

So please dear reader think about our definitions of emergencies above and think how many of the above examples qualify for the first definition? How many for the second? And how many of the above are G&Ts for the Daily Mail readers?

GPs as professionals used to be able to define what counted as emergencies and things like results, repeat prescriptions or sick notes were once not eligible for same day appointments but amazingly illness was allowed. However these GPs were not educated North of the wall and so are thick and are why the NHS and socialized medicine needed G&T Care.

And our final year medical students and doctors in training after just one book on the day surgery realize how much Sierra Hotel India Tangos GPs see each day and after several weeks think I want to see illness not crap. Does any politician wonder why no one wants to be a GP?

Praise be to the Party for ensuring that all NHS 48 hour access appointments are emergencies and so displace illness to ensure that patient selfishness is treated way before illness by politicians. Ask of your politician why you cannot see your GP when you are ill and yet crap gets seen in your place? What do you think they will say?

I’ll have a G&T, Bob . . . see me in my next 2 hour surgery next month for this month’s surgery is so full I am so busy.


GrumpyRN said...

So NHS Scotland gets it right (or at least better than you) and what is your answer? Racism, hyperbole and blaming a piss poor system for being piss poor. Results should be computerised - you know that thing sitting on your desk or lap that you are typing this drivel into, not sent by mail in 2014.
Stupid patients are endemic and part of a GP's life and I am sure you were - or should have been - taught about communication at that fancy medical school that you went to, perhaps you were sick that day.

If you want to just rant fine, feel free, but blaming Tony Blair and Gordon Brown and the whole Scottish education system is lazy at best and shows poor deduction skills. Treat the problem, not the symptoms. Or is that too radical for a poor northern GP?

Anonymous said...

Sounds like the typical surgeries that I have. These sorts of patients are becoming much more prevalent. I wonder whether patients are becoming more selfish and less stoical, or it is because receptionists are no longer allowed to use their judgement.

Carolyn Taylor said...

Interesting post. Thanks for it.

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Carolyn Taylor said...

Thanks so much for the impressive and amazing guide

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