Friday, October 30, 2009

Where have all the GP's gone....

So, on Monday off I went to see the new GP. She's very nice, but then so is the other lady GP at this particular practice. Fortunately the new GP is also competent, which is always more important than nice. Unless you work in the department for health.

The quality of care provided by the NHS is much maligned in the UK, primarily because we're so spoilt by having universal health care, we have no idea how valuable it really is. A cornerstone of the NHS is General Practice. One of the many, current, back of a fag packet, political ideas is to 'open up' access to general practice by bringing in the idea of 'health care professionals' and supermarket style polyclinics. Of course, like all such ideas, it's been conceived by fit, healthy, younger people who have no idea what GP's do beyond the odd smear, travel vaccine or prescription for antibiotics. People who don't need to use General Practice services so don't understand why they are important.

My GP retired last year. He had never met anyone with Ehlers Danlos Syndrome prior to my joining the practice, but he went out of his way to educate himself on the condition. I changed practice so that he became my doctor a few months after I was first diagnosed, his patience and support were invaluable in my lengthy recovery. There have been many changes to the practice since he retired, mostly long overdue modernisation. Unfortunately the consequence to all this shiny new equipment and ways of working seems to be a drop in the standard of medical care.

If you have a long term condition, particularly a condition such as Ehlers Danlos Syndrome which is considered 'rare', it's very difficult every time you see a new doctor. Lengthy, complicated explanations are often required to get through the basics of a medical history, before the actual reason for the consultation is reached. Inevitably this forces appointments to overrun and puts the whole day behind. It also makes the job of the doctor much more difficult as they have to try and get up to speed on a condition they may not have heard of since medical school as well as understand the difference that makes to the diagnosis or treatment of the current problem. That's an incredibly tall order in a ten minute consultation.

It's not just people with rare conditions in this situation, an average day for a General Practitioner will include any or all of the following:

Granny who broke her leg last year, ended up in hospital for a month and now takes 7 different potentially interacting medications for conditions she can't say the name of, let alone recall when she was diagnosed or even what she's supposed to do with all these medicines. Yummy Mummy who's heard bad things in the press about MMR and is totally bewildered as to what she should do, needs reassurance and explanation about whether she should vaccinate her child. The 13 year old Vicky Pollard screaming and shouting in reception about her 'rights innit', competing with the middle aged man bawling out the receptionists for not getting the collapsed asthma attack out of the treatment room so he can have his travel vaccines.

A good GP would know Granny gets confused about her medications, because Granny comes to the surgery every month confused about her medications. That the Yummy Mummy is usually very sensible but has a nephew on the autistic spectrum and doesn't know if the things her friends say about MMR are credible. That Vicky Pollard was a sweet, well behaved little girl until her mum died last year and her dad hit the bottle hard and this is their first holiday since then.

My GP knew that if I had to even mention pain to him, it was serious. I miss the difference that background knowledge made to my medical care. Now I may be able to see a doctor any time I like, but the only people left who know whether my joints are in a good or bad phase are the receptionists.


steph said...

Brilliant snapshot of the NHS!

How I hate it when doctors dismiss EDS as if it's just a convenient label! I don't mind how much I have to explain about EDS as long as it's respected.

That's why, as you've pointed out, continuity of care is hugely important to anyone with a long term condition.

cogidubnus said...

I'm a very infrequent visitor to my GP...I hate going to the doctor so the last time was at least seven years ago...I'm nearer 60 than 50 and have probably visited a doctor only five or six times since childhood...

Nonetheless, when I last made a big removal and was forced to change GP Practice (1985) it was by applying the same sort of standards you do...I've not regretted it...but the old fella looks like retiring in a few years...oh dear...

PS Did you erase a posting?

Veronica said...

You've just described my GP's office perfectly.

Achelois said...

Brilliant post BG. I need to go to see 'my' gp who has known me for 20 years we are the same age about the EDS generally. however i keep being ill in the meantime and apparently whole family is ringing tomorrow to check if i have made appointment. I don't want to speak to the stranger gp whose eyebrows will raise at my meds and who will make facile ill informed comments on my 'rare' condition. I am hoping 'my gp' is on duty and he will ring me and we can chat so that i can reassure family that when you have had the flu plus extras it takes it out of the EDS person. I don't have the energy to get to the beep beep doctor and 'stranger doctor' can't come here - its too messy.

Loved this post, BG.

Sorry for my rant!

Anonymous said...

oh for dods sake you whinger whiner,

get off your lazy ass and do some work

I'm sick,..I'm in pain blah blah blah

so am I,..yet I work in a factory for 50 hours a week,..
not bullshitting people on a blog page