Author Topic: Todays view from General Practice  (Read 7487 times)

ian

  • camera nazi
Re: Todays view from General Practice
« Reply #50 on: 07 July, 2021, 06:08:52 pm »
I don't see doctors often (luckily), but the last consultation was by phone so I did need to see anyone*, which was effective. The only gripe was the clunky web science method of acquiring the callback, which was one step away from chiselling my request in cuneiform into a stone tablet and leaving it in the surgery car park in hope that someone from the team would stumble over it.

*it really throws them when you answer, hey Kate, how are you?, probably more so if her name wasn't Kate, but it was. I got Kate-dar.
Authoritarian Thought Leader, the Pol Pot of Powerpoint, the Stalin of Spreadsheets

Gattopardo

  • Lord of the sith
  • Overseaing the building of the death star
Re: Todays view from General Practice
« Reply #51 on: 07 July, 2021, 06:11:06 pm »
my sympathy gland withered and died years ago


Like most nurses.

My mum was a srn?

Feanor

  • It's mostly downhill from here.
Re: Todays view from General Practice
« Reply #52 on: 07 July, 2021, 06:32:07 pm »
My mum was a srn?

Dunno.
I'm sure she'd tell you if you asked :-)

FifeingEejit

  • Not Small
Re: Todays view from General Practice
« Reply #53 on: 07 July, 2021, 07:24:08 pm »
That's part of the problem though, receptionists shouldn't be doing triage. You may as well show your rash to the postman to see if thinks it's serious.

Where Medical Receptionists do Triage they're trained in it. (or at least should be)

Problem with receptionist triage is that it's effectively a magic word system, that just filters out those who don't know you have to say 'urgent' (and that it isn't the same thing as 'serious', because that gets you sent to A&E).

So is any that involves only words and doesn't involve some level of physical examination (Which you're only going to get at A&E or MIU reception')
Patient: "Hello Doctors, yeah I need an appointment"
Doctor/Nurse/Receptionist/GeneralPlebe on Triage: "Why?"
Patient: "My arms hinging aff"
Doctor/Nurse/Receptionist/GeneralPlebe on Triage: "Erm MIU for that, bugger off"

What may be different is the judgement differences between the receptionist and practitioners.

What also probably doesn't help is the patients who just want to see a doctor for the sake of seeing a doctor, have probably figured out how to tell Triage something that lets them see the doctor for anything.


Like:

That's the problem with receptionist triage, effectively if you're someone like me, who knows enough medicine to be annoyingly assertive*, you can break through the receptionist barricades and storm the castle (I also call all my doctors by their first names to annoy them, we still have a curiously deferential relationship to medical care which I think isn't helpful in involving people in their care). Little old ladies who don't want to bother that nice GP with their gangrenous leg will get forever trumped by shouty mothers demanding Jaxxon's sore throat be attended to NOW!

Triage should be clinically informed by people who know to triage. And it's not really triage if it gets passed back to the GP to make the decision.

*recent phone consultation with consultant ended with him saying 'I don't know why we're bothering with this' to which my only response was 'well, I don't have access to an MRI machine and you do.' He was forced to acknowledge my wisdom on this matter.

At my previous practice all the doctors started introducing themselves with their first names after the previous partners (Who I remember jsut starting (it was thier Dad's practice)) retired.

I've not met or even spoken to my new doctors yet, think I'm going to need to about this bloody ankle though, I've been ignoring it for 15 years because I believed "there's nothing can be done about a buggered ankle once it's buggered" from otherwise reliable sources.
Although I might possible need to speak to a physio first, it doesn't appear on the pharmacy first list and... My new GPs is basically closed because they're all down with Covid.

Re: Todays view from General Practice
« Reply #54 on: 08 July, 2021, 09:11:09 am »
My first port of call for all musculoskeletal issues is the physio. They have more time to examine you and spend more time dealing with this sort of thing (and in the past some old school doctors have taken the "if it hurts then stop doing it" attitude to sport/exercise which rather put me off).

Re: Todays view from General Practice
« Reply #55 on: 08 July, 2021, 09:36:35 am »
My local GP has a self referral to the NHS physio in the next road.

I learned this after wasting the GP's time on an appointment where he/she (can't remember who I saw) simply wrote a website URL down on a scrap of torn off paper.    Had I known in advance I'd have simply booked there first.     The physio was excellent, and I'm starting to consider (8 years later) trying another self referral to get me sorted out again - just waiting for TEH PLAGUE to finish.

It's not urgent enough, just lack of mobility and daily minor pain, but I know he can sort it - and looking long term the sooner it's sorted the better it'll be to stop me being a crippled pensioner.

IJL

Re: Todays view from General Practice
« Reply #56 on: 08 July, 2021, 10:06:24 pm »
Quote
Mrs M was in a different life a School Nurse, and she gave plenty of HPV vaccinations to girls of a certain age who would delight in causing & benefiting from the very definition of mass hysteria! She was (apparently) the very model of nasty-nurse! (She moved on to being a Looked After Children's Nurse which had it's own set of interesting features).

We did the HPV vaccines in the surgery until a few years ago when they were taken over by the school nurses and done in school
It was a role that I was very glad to see the back of, if it wasn't a waiting room full of 13 years old working themselves into a frenzy it was endless conversations with parents who "weren't sure or didn't believe In it".
70% of cervical cancer is HPV related the vaccine will make a huge impact

Gattopardo

  • Lord of the sith
  • Overseaing the building of the death star
Re: Todays view from General Practice
« Reply #57 on: 08 July, 2021, 10:21:09 pm »
My mum was a srn?

Dunno.
I'm sure she'd tell you if you asked :-)

Not without a quija board

I think she was state registered nurse...but am probably wrong.

IJL

Re: Todays view from General Practice
« Reply #58 on: 09 July, 2021, 09:15:26 am »
Todays theme involves Lateral flow tests
a fairly reasonable way to screen well people but....
If you unwell a PCR test is needed
they're far more accurate.
I seem doomed to repeat this every 10 minutes today

This weeks positive test numbers are now the highest since the week of the 15th of Feb and this week still has a bit to go



Gattopardo

  • Lord of the sith
  • Overseaing the building of the death star
Re: Todays view from General Practice
« Reply #59 on: 09 July, 2021, 12:28:06 pm »
Todays theme involves Lateral flow tests
a fairly reasonable way to screen well people but....
If you unwell a PCR test is needed
they're far more accurate.
I seem doomed to repeat this every 10 minutes today

This weeks positive test numbers are now the highest since the week of the 15th of Feb and this week still has a bit to go

Yep.  Lowest common denominator.

IJL

Re: Todays view from General Practice
« Reply #60 on: 12 July, 2021, 08:32:14 am »
As we approach the end of Covid restrictions,

I ran the searches when I got in this morning

Last week saw a tripling in the number of positive Covid PCR tests compared to the week before

we have only seen this type of jump in numbers once before.

There are an awful lot of assumptions being made about, the impact of Covid infection both on children and those who have been vaccinated.  Not clear how safe those assumptions are 


barakta

  • Bastard lovechild of Yomiko Readman and Johnny 5
Re: Todays view from General Practice
« Reply #61 on: 12 July, 2021, 09:15:05 pm »
Everyone in healthcare has my biggest sympathies right now. Horrendous, utterly horrendous.

FifeingEejit

  • Not Small
Re: Todays view from General Practice
« Reply #62 on: 12 July, 2021, 09:38:31 pm »
I shat myself when an e-mail landed this afternoon that said "We need YOU", throwing visions of the deceased Lord Kitchener pointing and guilt tripping people from the grave.
Thankfully it was just from HWL looking for volunteers for one of their latest things to try and get people exercising rather than slobbing at their desk all day.
Still feels like someday soon it'll be worth the fleg, I'm really not sure I can meet the professional standards of a porter, I mean I know where Ward 13 is and would take someone there if they pissed me off.

IJL

Re: Todays view from General Practice
« Reply #63 on: 19 July, 2021, 09:01:29 am »
We're bracing ourselves for an influx of calls about sunburn this morning.
There seems to be a belief that we have some medical marvel to deal with sunburn.
I'm not sure sarcasm counts as a medical marvel, but it's cheap and we have a very good supply

Re: Todays view from General Practice
« Reply #64 on: 19 July, 2021, 10:14:00 am »
We're bracing ourselves for an influx of calls about sunburn this morning.
There seems to be a belief that we have some medical marvel to deal with sunburn.
I'm not sure sarcasm counts as a medical marvel, but it's cheap and we have a very good supply

Q How bad can sunburn be?
A very bad

My cousin-by-marriage had very fair-skinned, red haired twins. Standing instructions to school, in writing, not to make them stand outside in summer.

School sports day. Twins are ordered to stand with classmates. They are wearing T shirts and sunblock on arms/faces, so that is fine, right?

Hospitalised with 2nd degree burns.

(I have little sympathy for people who go out without sunscreen and get burnt, be it in Oz or the UK.)
<i>Marmite slave</i>

Mrs Pingu

  • Who ate all the pies? Me
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Re: Todays view from General Practice
« Reply #65 on: 19 July, 2021, 06:43:12 pm »
Best advice I ever had about sunburn was 'treat it like a burn and run it under cold water'.
Came in handy during our first holiday together when Pingu was to be found standing next to the campsite water tap one evening while I poured bottle after bottle over him.
Do not clench. It only makes it worse.

Re: Todays view from General Practice
« Reply #66 on: 19 July, 2021, 07:05:09 pm »
Also steroid cream in very low dose.

Gattopardo

  • Lord of the sith
  • Overseaing the building of the death star
Re: Todays view from General Practice
« Reply #67 on: 20 July, 2021, 02:01:38 am »
We're bracing ourselves for an influx of calls about sunburn this morning.
There seems to be a belief that we have some medical marvel to deal with sunburn.
I'm not sure sarcasm counts as a medical marvel, but it's cheap and we have a very good supply

I went to see a doctor once for a back skin issue, but that was diagnosed as second degree burns!.  In my defence I was wearing thin clothes and not sunbathing.

Regulator

  • That's Councillor Regulator to you...
Re: Todays view from General Practice
« Reply #68 on: 22 July, 2021, 01:59:10 pm »
I got a text from a GP at my practice this morning (text exactly as sent by the GP):

"I have an email from one of the clinical trail doctors you are involved in to say a liver blood test is raised.  Its not clear from the email what action they have told you to take.  If it is not clear to you please make a GP appointment".

I'll forgive him the typos but he seems to have overlooked that:

(a) I am copied into the email he is referring to; and
(b) the doctor from the clinical trial has clearly laid out a summary of what she said to me, what I said to her and what advice she gave (get the level checked again by my GP in about a month).

Unfortunately, thanks to the way my practice works, I can't get them to issue the forms for the required blood test without speaking to a GP - and the one who's reviewed the email and sent me the text is on holiday for the next two and a half weeks.  Not only that, but telephone appointments can only be booked a week in advance (and can't be booked on line - you have to phone the practice), so I've had to put a note in my diary for when the GP is back to arrange a telephone appointment to get some paperwork where they already have the clinical rationale for issuing it.   :facepalm:
Quote from: clarion
I completely agree with Reg.

Green Party Councillor

MikeFromLFE

  • Previously known as Millimole
Re: Todays view from General Practice
« Reply #69 on: 22 July, 2021, 06:15:19 pm »
That seems particularly convoluted.
Mrs M has a regular hospital mandated blood test for which they post the forms to her. All she has to do is to ring up the surgery and tell them the hospital consultant wants her to have bloods taken and she has the forms.
She takes the forms, and they take and send off the samples.

(I like to see these forms because they are for hand written requests that I designed and introduced some 14 years ago and they're still in use. I count that as one of my career successes)
Too many angry people - breathe & relax.

IJL

Re: Todays view from General Practice
« Reply #70 on: 31 August, 2021, 01:26:51 pm »
We normally get our pathology supplies from the local hospital, they do the tests and supply the consumables

Urine test bottles have been hard to get hold of for a while, could be something to do with the fact there made in Australia!

Blood sample bottles are now in very short supply so we're busy cancelling tests.  Not sure if due to Covid / Brexit / strike in the plastic mines

Jaded

  • The Codfather
  • Formerly known as Jaded
Re: Todays view from General Practice
« Reply #71 on: 31 August, 2021, 01:47:31 pm »
Sounds like I was lucky to get three blood tests done last week.
If you don't like your democracy, vote against it.

Kim

  • Timelord
Re: Todays view from General Practice
« Reply #72 on: 31 August, 2021, 02:02:25 pm »
I believe the tube shortage is one of those Brixit-compounded-by-Covid problems that the government are eager to spin as Covid-compounded-by-Covid.  Surprising that it hasn't been declared as an emergency.

Cudzoziemiec

  • Моя планета голубая, я люблю тебя и обнимаю
Re: Todays view from General Practice
« Reply #73 on: 31 August, 2021, 02:09:10 pm »
The slow end of long supply chains is either too slow or just fictitious.
Riding a bike through a city is like navigating the collective neural pathways of a vast global mind.

MikeFromLFE

  • Previously known as Millimole
Re: Todays view from General Practice
« Reply #74 on: 31 August, 2021, 04:13:21 pm »
I seem to recall being called a prophet of doom back in the dark ages when 'phlebotomy systems' were being introduced (Vacuutainers by BD, or the far superior Sarstedt system).
I had the temerity to ask "what happens if the manufacturer can't supply the tubes?" I don't recall a sensible answer, just being referred to the corporate vision of The Future.

In fairness, these tube systems revolutionised sample handling and the whole pre-analytical bottleneck was smoothed by their introduction. It's a pity that many of the analysers set up to handle BD Vacuutainers couldn't handle Sarstedt tubes and visa-versa (this may have changed in the last decade).
Too many angry people - breathe & relax.