Patient care not targets

I’m the biggest fan of GPs. My old family GP who recently retired knew me for about 35 years. He also treated my mother, father, brother and grandmother and was adored by all of us. Not once in those 35 years did we ever fall out or see him in a bad mood. He made us feel looked after, cared for, listened to and most of all, he made us feel important. He knew who we were as a family and had been there for us at every stage of our illnesses as we were growing up. As a newly qualified young GP he was there when my brother was fighting to breathe with croup, when I had measles during my O levels, when my father had a suspected heart attack and all the other minor ailments in between.

In the last five years I have seen an alarming increase in the number of people consulting with me who are disatisfied with the time they have with their own GP. I would guess that this is around 60% of people I see. If there are any GPs reading this, this is not a GP bashing blog but there are concerns from many quarters that what used to be a caring service is now turning into a prescription writing service. That is not to say that there are not fantastic GPs out there doing amazing work who care for their patients. And I dont blame the GPs either, I blame government targets for the short time that you get with your GP.

I have recently changed doctors surgeries as I never saw the same doctor twice. For me having a relationship with one GP is key. Going from one person to another is not continuity of care in my book. Changing GPs sadly got me nowhere as my new doctor had me in tears by the time I was ushered out having taken up about 7 minutes of their time. 7 minutes was not long enough to say what I had to say and 10 minutes is not nearly long enough to assess a patient if they have more than one complaint. Which is why of course, you have to book another appointment if you have another complaint. It just so happened that my one complaint was causing the other – to me that is one medical issue not two.

I fear that the old fashioned type of doctoring went when my doctor retired. You remember the ones that actually looked you in the face, looked at the colour of your skin, listened to you, rather than tapping away at the computer, turned their chair round to face you, got you up on the couch and examined you properly. Basically took time to see if you were ok. I fear GPs are so time-poor that you go in with a problem, a prescription is written – job done, figures met. Two of my patients recently came to see me and they were bright lemon yellow – a sign of either B12 anaemia or pernicious anaemia. I’m not a GP but I saw it, they saw it, their families saw it but why didn’t their GP see it? Because they told me the doctors barely looked at them when there were in the surgery.

I am not saying in any way that GPs are negligent but things have to change. Many people are so much better informed than they used to be and want to find out why they are ill, and whats causing their symptoms not just to take a pill and shut up.

I’m lucky – I get an hour or an hour and a half with people so get to know them very well indeed. I think the time with patients needs to be extended to at least 15 minutes and double appointments which some surgeries to be an option for more complicated cases. What this does to the figures and targets and waiting lists is anyone’s guess. I spoke to a sonographer recently who said the waiting lists were way down but the time with each patient was just too short. I suppose its a toss up between seeing someone sooner for less time or waiting longer and seeing them for longer. I have found in the last ten years that the placebo effect of listening and reassuring people is extraordinary. The biggest compliment I can get is if a person leaves me saying – I feel better already. I’m not sure what the answers are and am clearly still living in nostalgic la la land of a time gone by!!

I would welcome the comments you have on the time allowed with GPs.

previous post: Bread – what is it we are actually eating?

next post: The Organic Argument