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Really bad experiences with GP surgery

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Original post by Pectorac
Why do you not realise that stomach cramps and throwing up are not worthy of a GP appointment?


In fairness, you can't really say that to the guy.
Original post by BeanofJelly
GPs are trained in and specifically qualified to deliver mental health care. Amongst doctors, they deal with the greatest bulk of mental health problems and develop a great deal of experience. Limited, regular appointments with one doctor is not an unusual policy (in fact it is commonplace) for helping patients with untractable health anxiety. Mental health nurses are also brilliant, of course but with this type of anxiety there is often no magic wand. The OP says she has already had more active/intensive mental health treatments. There would be no point continually re-referring to these services if they can't give any further help. The GP is exactly the right professional to manage a patient with chronic anxiety issues like the OP.


The OP says they do not find the GP appointments helpful, so there is no point of going to them. Unless they cooperate with the more active/intensive treatments offered to her, there is nothing a GP or anyone else can do except sit and listen to the same old things again and again, which is a waste of everybody's time.
Original post by Pectorac
Health anxiety should be treated by a referral to a mental health nurse and continual appointments with them, not bi-weekly visits to a GP, then expecting more appointments. There's nothing the GP can physically do, because they are not mental health trained and cannot actually deal with health anxiety.


OP said they have tried all other forms of treatment (although I am skeptical of this). It is the GP who makes the call if they can accommodate such an arrangement, not you or I. Evidently the GP has taken their resources into account and have agreed to bi-weekly visits, because they can, and because they feel it is appropriate.

Secondly, just the act of the GP listening and probing can make someone with health anxiety feel a lot better. This on its own is worth the visits (although I think telephone consultations could work better). GP's must be trained in mental health, or they would not be allowed to practice ... they are not switchboard operators who simply refer every health issue. They are definately trained to deal with health anxiety, moreover, a patient with health anxiety has every right to visit their GP (as long as the GP agrees) to recieve treatments - which in this case is in form of a consultation.
Original post by shiggydiggy
In fairness, you can't really say that to the guy.


Yes you can, because it's the truth. In some A&E departments, there are massive posters which say that vomiting, stomach cramps and headaches are not worthy of A&E and GP visits.
Original post by Pectorac
Yes you can, because it's the truth. In some A&E departments, there are massive posters which say that vomiting, stomach cramps and headaches are not worthy of A&E and GP visits.


The choose well posters are a little more specific than this for very good reason.

One person can say 'stomach cramp' and mean a touch of constipation on going for a few weeks. Another can say the same thing and actually be describing acute appendicits.

You can't really say he doesn't need to go to A&E/doctors/etc. The best advice he has to follow is the advice given to him by the nurse who took his call.
Original post by shiggydiggy
The choose well posters are a little more specific than this for very good reason.

One person can say 'stomach cramp' and mean a touch of constipation on going for a few weeks. Another can say the same thing and actually be describing acute appendicits.

You can't really say he doesn't need to go to A&E/doctors/etc. The best advice he has to follow is the advice given to him by the nurse who took his call.


http://www.leedswestccg.nhs.uk/Images/Choose%20Well%20poster.PNG 'Go to pharmacy' and 'Stay at home' can't be any clearer than that. Buy Lemsip and go to bed, rather than wasting a GP or A&E's time.
Original post by Pectorac
The OP says they do not find the GP appointments helpful, so there is no point of going to them. Unless they cooperate with the more active/intensive treatments offered to her, there is nothing a GP or anyone else can do except sit and listen to the same old things again and again, which is a waste of everybody's time.


Yet she also describes how regular pre-arranged appointments with one GP have made the number of appointments she has drop from almost every day to twice per week. That's not just saving GP appointments, but also helping her anxiety not to dominate her life so much. It's not very easy to hold down a job, or a social life or any hobbies if your health anxiety is driving you to go to the GP almost every day. Just because that's a mental health issue doesn't make it less important or disabling than if a physical problem was producing the same effect. So it sounds to me like a very justified intervention.

The OP is currently frustrated with her GP because she can't have an appointment straight away when she has a more serious (if still not urgent) symptom that is very anxiety provoking for her. It's difficult for anyone else to understand how unpleasant and life changing having this kind of anxiety can be. Vomiting for the OP is not just vomiting, it's thinking you might be dying and noone's doing anything about it. It's unfortunate that her regular GP is away, but very possible that they can make some extra arrangement to help if this happens in future. I think a collaborative approach to address this specific scenario should it happen again, is much more likely to be beneficial advice for the OP than the radical option of destroying what seems to be a mostly successful arrangement with her GP.
(edited 9 years ago)
I'm inclined to believe the OP. From my own experience GP surgeries aren't very pleasant. The staff is supposed to create a helpful atmosphere, instead what you get is a hostile atmosphere that treats every single case suspiciously until it's proven that you are making an appointment for a genuine reason. Kind of like 'guilty until proven innocent'.

My mum, who is genuinely unwell and has been for some years, was treated like shlt not only by the receptionist (who reduced her to tears) but also by the doctor she saw. In fact the doctor stopped her from explaining what was wrong with her by cutting her off and saying 'oh stop making a big deal out of nothing' and sending her on her way.

My mum eventually managed to make an appointment with another doctor who actually bothered to take the time to listen to her and we found out she had a high blood pressure and needed to be on medication for it, we also found out she had one other illness (which I'd rather not mention here) she needed to be put on meds for. In addition to that she was told she needed an autopsy done.

It took us over two years to actually get these diagnosis because the GP wasn't willing to believe my mum when she said she was not well, so much so that he actually stopped her from describing symptoms and pretty much said she was making things up. On top of that every time my mum phones the surgery she has to deal with an abundantly rude receptionist who clearly thinks far too much of herself and like the GP doesn't know how to do her job properly. My mum actually stopped making appointments when she was very unwell because she didn't want to deal with the receptionist.

So yea, I believe the OP when he says both his GP and the GP receptionist are incompetent and rude. Op I would write a formal letter of complaint, that's what we did.
(edited 9 years ago)
Original post by Pectorac
http://www.leedswestccg.nhs.uk/Images/Choose%20Well%20poster.PNG 'Go to pharmacy' and 'Stay at home' can't be any clearer than that. Buy Lemsip and go to bed, rather than wasting a GP or A&E's time.


Do you not see how is this a world away from OP's case? Mental health and GPs are different from minor injuries and A&E. OP never wanted to visit A&E.
Original post by Pectorac
http://www.leedswestccg.nhs.uk/Images/Choose%20Well%20poster.PNG 'Go to pharmacy' and 'Stay at home' can't be any clearer than that. Buy Lemsip and go to bed, rather than wasting a GP or A&E's time.


Yeah actually, to be fair, you're right about what the posters say which is pretty worrying to be honest.

'Headache' and 'Stomach cramps' can mean a lot of things to people and can easily range from benign and self-limiting to a medical/surgical emergency.

Can't say I'm a fan of them.
Original post by KanKan
Do you not see how is this a world away from OP's case? Mental health and GPs are different from minor injuries and A&E. OP never wanted to visit A&E.


Actually if you read through the first post properly, the OP was going to go to A&E: 'I still feel sick and I will probably go to A&E for something that could have been addressed at the clinic.'
(edited 9 years ago)
Original post by starshine123
I'm inclined to believe the OP. From my own experience GP surgeries aren't very pleasant. The staff is supposed to create a helpful atmosphere, instead what you get is a hostile atmosphere that treats every single case suspiciously until it's proven that you are making an appointment for a genuine reason. Kind of like 'guilty until proven innocent'.

My mum, who is genuinely unwell and has been for some years, was treated like shlt not only by the receptionist (who reduced her to tears) but also by the doctor she saw. In fact the doctor stopped her from explaining what was wrong with her by cutting her off and saying 'oh stop making a big deal out of nothing' and sending her on her way.

My mum eventually managed to make an appointment with another doctor who actually bothered to take the time to listen to her and we found out she had a high blood pressure and needed to be on medication for it, we also found out she had one other illness (which I'd rather not mention here) she needed to be put on meds for. In addition to that she was told she needed an autopsy done.

It took us over two years to actually get these diagnosis because the GP wasn't willing to believe my mum when she said she was not well, so much so that he actually stopped her from describing symptoms and pretty much said she was making things up. On top of that every time my mum phones the surgery she has to deal with an abundantly rude receptionist who clearly thinks far too much of herself and like the GP doesn't know how to do her job properly. My mum actually stopped making appointments when she was very unwell because she didn't want to deal with the receptionist.

So yea, I believe the OP when he says both his GP and the GP receptionist are incompetent and rude. Op I would write a formal letter of complaint, that's what we did.

Sorry to hear about your mom. I hope she's ok now and has found a better surgery to go to. I have had my fair share of horrible experiences at the surgery I'm at, one time I did actually file a complaint against a doctor who behaved so unprofessionally that he actually called me "crazy" at one point. although it can be very upsetting you have to learn not to take the rudeness personally, the receptionists are just bitter and fed up of their daily grind, theyre not attacking you personally even though it can feel that way.
I think theres an epidemic of a terrible culture going round the NHS, and its not just limited to the receptionists. we have to combat it by making it absolutely clear we will not put up with such behaviour.
Original post by redferry
In which case you probably should look into moving.


you mean move house? or move surgeries?
Original post by BeanofJelly
Yet she also describes how regular pre-arranged appointments with one GP have made the number of appointments she has drop from almost every day to twice per week. That's not just saving GP appointments, but also helping her anxiety not to dominate her life so much. It's not very easy to hold down a job, or a social life or any hobbies if your health anxiety is driving you to go to the GP almost every day. Just because that's a mental health issue doesn't make it less important or disabling than if a physical problem was producing the same effect. So it sounds to me like a very justified intervention.

The OP is currently frustrated with her GP because she can't have an appointment straight away when she has a more serious (if still not urgent) symptom that is very anxiety provoking for her. It's difficult for anyone else to understand how unpleasant and life changing having this kind of anxiety can be. Vomiting for the OP is not just vomiting, it's thinking you might be dying and noone's doing anything about it. It's unfortunate that her regular GP is away, but very possible that they can make some extra arrangement to help if this happens in future. I think a collaborative approach to address this specific scenario should it happen again, is much more likely to be beneficial advice for the OP than the radical option of destroying what seems to be a mostly successful arrangement with her GP.

that's the point though, its not. because she automatically assumes that all the symptoms I described are due to my anxiety, she no longer takes me seriously, and I am not comforted by the fact that my symptoms are going to be investigated, because mostly theyre just ignored.
I agree with the rest of the post, particularly the bit about vomiting. it can be a horrible feeling, and part of health anxiety is that youre not able to distinguish symptoms that are benign from those that might be life threatening.
Original post by Anonymous
you mean move house? or move surgeries?


Surgeries. House seems a little extreme but if you feel its necessary! :tongue:
Original post by redferry
Surgeries. House seems a little extreme but if you feel its necessary! :tongue:


Yeah I think so too.
Where to start!

I'm a medical student and also work at a GP surgery as a receptionist over the summer holidays.

I have to say, your surgery sounds amazing compared to ours. An appointment twice a week !?! We have a 2 week wait for a routine appointment. And have to triage every single morning as emergency appointments are in such short supply.

You said the next person in the queue got an appointment - but you stated you actually telephoned so that sounds a bit strange?

You also talk about them only wanting to extract money from every patient. A lot of practices are "partner" surgeries and this is totally normal. They have to provide a service to many thousands of people and seem extremely fair. We certainly do not have this prior arrangement with any patient to my knowledge.

If you are very dissastified with your surgery, it is extremely easy to move surgery. I would encourage you to discuss this with alternative surgeries before making the move though, as I would be pleaseantly surprised if they could match what your current surgery offers.
Original post by Anonymous
that's the point though, its not. because she automatically assumes that all the symptoms I described are due to my anxiety, she no longer takes me seriously, and I am not comforted by the fact that my symptoms are going to be investigated, because mostly theyre just ignored.
I agree with the rest of the post, particularly the bit about vomiting. it can be a horrible feeling, and part of health anxiety is that youre not able to distinguish symptoms that are benign from those that might be life threatening.


It sounds as though your relationship with your GP isn't what it should be. That's a statement of fact which can be made without blaming either party.

Your GP is not under an obligation to refer you for investigations where this would be inappropriate and/or harmful. Without meaning offence, I suspect that your judgement of when an investigation is warranted is impaired by your anxiety. Your GP will be more informed and impartial about this, and has no incentive not to give you an investigation that is needed. In fact it will be quite tempting for a GP to cede to your desire for an investigation even if it isn't needed and will harm you.

Doctors who don't take the responsibility of limiting the investigations/treatments a patient with hypochondriasis receives because it makes them feel less anxious in the short term accrue serious cumulative harm to those patients, and ultimately still fail to eradicate the anxiety. Because there is always a new concern. To the extent that there are patients who have had 10 or more uneccessary operations, exposure to radiation, dangerous drugs, organs removed - all because doctors failed to say no to them.

It's a really difficult area of medicine because there is still always a need to be vigilant for symptoms which do require investigation. And to respect patients and to always take their problems seriously. Doctors are also human, and can be impatient or find it difficult to understand or empathise. Hence having a continual one on one relationship where the doctor (often one with an interest), can get to know you, your symptoms and what is "normal" are constantly monitored, and trust builds up is really helpful.

There is a difference between not doing every investigation that you want to feel better, and not taking your complaints seriously. Even if a problem is caused or compounded by anxiety, it's still important. Your doctor should try their best to understand you, respect you, and respond to your problems in a way which seem genuine, even if they can't ethically give you the investigation you want.

If your GP isn't satisfying you on that front, I would recommend speaking frankly with them about it. It doesn't have to be a confrontational encounter. Your GP is a human being who may struggle as much with the relationship, their communication, and understanding where you are coming from as much as you do them. But they probably want to help you more than you think. Tell them if there is something about their manner which makes you feel patronised or ignored. Trying to be understanding (even if you disagree) on the investigations front will help.

I hope I've explained a bit the "doctor's perspective" on investigations, but I don't know you or your symptoms so I am just giving a best guess based on the issues I've seen with patients who have health anxiety.

Sometimes a GP-patient relationship just can't work. If this is the case then you can ask to switch GP. I would really recommend sticking with a regular contact with a single GP model though.
(edited 9 years ago)
Original post by Pectorac
http://www.leedswestccg.nhs.uk/Images/Choose%20Well%20poster.PNG 'Go to pharmacy' and 'Stay at home' can't be any clearer than that. Buy Lemsip and go to bed, rather than wasting a GP or A&E's time.

On the vomiting one it says to call 111.
well I'm seeing my doctor tomorrow and ill discuss this with her. if I see that she gives me attitude and that in all likelihood this would happen again if I become ill, I'm changing surgeries.

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