Gp Appointments

[Gladys]

I agree Lone Wolf, but like I said in my opening post, I kind of save up complaints until there is enough to justify a trip to the quack! My social life is sad enough, but I don't count seeing the doctor as a highlight!

 

I do also chat to a pharmacist about the common ailments (and always did long before that was the public service advice). But there are times when you just need to see a GP, not urgently, not the same day, but perhaps in a few days to go through the minor irritants to see if anything can, or should, be done.

 

When I tried to get this mythical appointment a colleague asked "is it urgent", to which the reply has to be " I don't bleeding know because I can't get to a doctor who will tell me"!

[LoneWolf]

I agree Lone Wolf, but like I said in my opening post, I kind of save up complaints until there is enough to justify a trip to the quack! My social life is sad enough, but I don't count seeing the doctor as a highlight!

 

I do also chat to a pharmacist about the common ailments (and always did long before that was the public service advice). But there are times when you just need to see a GP, not urgently, not the same day, but perhaps in a few days to go through the minor irritants to see if anything can, or should, be done.

 

When I tried to get this mythical appointment a colleague asked "is it urgent", to which the reply has to be " I don't bleeding know because I can't get to a doctor who will tell me"!

 

I have an old auntie who is in robust health but imagines all sorts of ailments. She must have cost the NHS thousands of pounds over the lat 20 years and has had all sorts of tests performed on her.

My mother in Law tells me that when the NHS started up a lot of folk were rushing to the dentist to get their teeth out because they could do ! (doesnt bear thinking about) Others were obtaing huge jugs of medicine etc etc.

Just that I wonder if some of that still exists and if so what could be done about it.

[Charles Flynn]

I agree Lone Wolf, but like I said in my opening post, I kind of save up complaints until there is enough to justify a trip to the quack! My social life is sad enough, but I don't count seeing the doctor as a highlight!

 

I do also chat to a pharmacist about the common ailments (and always did long before that was the public service advice). But there are times when you just need to see a GP, not urgently, not the same day, but perhaps in a few days to go through the minor irritants to see if anything can, or should, be done.

 

When I tried to get this mythical appointment a colleague asked "is it urgent", to which the reply has to be " I don't bleeding know because I can't get to a doctor who will tell me"!

 

 

Years ago one of the local GP's crossed about 1500 patients off his list overnight so that he could concentrate on temporary residents who flocked to the Island in the holiday season. He used to go from boarding house to boarding house seeing one patient who called and treating others as well who happened to be staying at the same hotel for sunburn and other minor ailments. He made more money this way than looking after some of the troublesome locals all year round.

 

Things have improved since those days but the doctor should not be held in awe and if there are problems talk to him so that he can reassure you by explaining or changing the system.

[Gladys]

Thank you Charles, too busy railing to read your posts. But I do not have the time to set up a GP user group (and why the f*** should I?). I thought I was being pretty canny by calling the DHSS GP service department to find out what their take was on the matter, and apart from the response I posted above, they gave me the name and 'phone number of the Practice Manager! What use would that be! It is practice policy, obviously!

 

If the new system was set up to stop missed/unnecessary appointments etc. then I would have every sympathy and would support it, but to my simple mind it is just a statistic bending exercise which has the unfortunate by-product of failing to deliver to a very infrequent user!

[Charles Flynn]

Thank you Charles, too busy railing to read your posts. But I do not have the time to set up a GP user group (and why the f*** should I?). I thought I was being pretty canny by calling the DHSS GP service department to find out what their take was on the matter, and apart from the response I posted above, they gave me the name and 'phone number of the Practice Manager! What use would that be! It is practice policy, obviously!

 

If the new system was set up to stop missed/unnecessary appointments etc. then I would have every sympathy and would support it, but to my simple mind it is just a statistic bending exercise which has the unfortunate by-product of failing to deliver to a very infrequent user!

 

 

Yes sorting out these problems is very time consuming and does not always work.

 

I know of relatives who have complained about some professional health service and have simply added to their distress and got nothing for their time and trouble. The system works against the patient.

 

As for handing out loads of medicine - this was extravagantly done by the doctor I mentioned but systems are considerably tighter now. The main problem nowadays is patient compliance - where the patient doesn't take the medicine at the time and frequency which he should do so that the illness is not treated properly and tablets accumulate because they have not been used. a complete waste of scarce NHS resources to the detriment of countless deserving patients who cannot get the service - the operation - they need.

[LoneWolf]

Yes sorting out these problems is very time consuming and does not always work.

 

I know of relatives who have complained about some professional health service and have simply added to their distress and got nothing for their time and trouble. The system works against the patient.

 

As for handing out loads of medicine - this was extravagantly done by the doctor I mentioned but systems are considerably tighter now. The main problem nowadays is patient compliance - where the patient doesn't take the medicine at the time and frequency which he should do so that the illness is not treated properly and tablets accumulate because they have not been used. a complete waste of scarce NHS resources to the detriment of countless deserving patients who cannot get the service - the operation - they need.

 

You are the expert Charles,

what is the answer ?

[Charles Flynn]

 

Yes sorting out these problems is very time consuming and does not always work.

 

I know of relatives who have complained about some professional health service and have simply added to their distress and got nothing for their time and trouble. The system works against the patient.

 

As for handing out loads of medicine - this was extravagantly done by the doctor I mentioned but systems are considerably tighter now. The main problem nowadays is patient compliance - where the patient doesn't take the medicine at the time and frequency which he should do so that the illness is not treated properly and tablets accumulate because they have not been used. a complete waste of scarce NHS resources to the detriment of countless deserving patients who cannot get the service - the operation - they need.

 

You are the expert Charles,

what is the answer ?

[LoneWolf]

I think something went astray with your reply ?

[Charles Flynn]

A lot of good people have over the years tried to improve services and I would say the present day service is far more professional than in the past. Doctors, nurses, pharmacists are more tightly controlled and have to keep up with professional training including assessment by their peers to retain their licenses to practice.

 

However patients are more demanding. Patients are more knowledgeable and the doctors etc are swamped with adminstration that procedures need to be constantly monitored for improvement to come about.

 

There is a monitoring service for instance for medicines - side effects - where the doctor, pharmacist records any strange effects and this is reported to a central body for appropriate action. Perhaps a similar simple monitoring system - complaints system - needs to be set up so that patients who have received treatment which they believe is inadequate could report it to a service panel who would then be charged to take appropriate quck action to correct the matter. Forms to make suggestions would be readily available at surgeries, hospitals and pharmacies and be relatively easy to complete.The service could be a no blame system so that neither doctors, phamacists or nurses would fear it and would co-operate with patients and the NHS to improve the service.

 

The other obvious answers would involve more administation, more heavy complaints procedures, more penalties, more staff to operate. Necessary in some cases but my recommendation would be to try out the less expensive easy system first and see if it works.

[LoneWolf]

A lot of good people have over the years tried to improve services and I would say the present day service is far more professional than in the past. Doctors, nurses, pharmacists are more tightly controlled and have to keep up with professional training including assessment by their peers to retain their licenses to practice.

 

However patients are more demanding. Patients are more knowledgeable and the doctors etc are swamped with adminstration that procedures need to be constantly monitored for improvement to come about.

 

There is a monitoring service for instance for medicines - side effects - where the doctor, pharmacist records any strange effects and this is reported to a central body for appropriate action. Perhaps a similar simple monitoring system - complaints system - needs to be set up so that patients who have received treatment which they believe is inadequate could report it to a service panel who would then be charged to take appropriate quck action to correct the matter. Forms to make suggestions would be readily available at surgeries, hospitals and pharmacies and be relatively easy to complete.The service could be a no blame system so that neither doctors, phamacists or nurses would fear it and would co-operate with patients and the NHS to improve the service.

 

The other obvious answers would involve more administation, more heavy complaints procedures, more penalties, more staff to operate. Necessary in some cases but my recommendation would be to try out the less expensive easy system first and see if it works.

 

I suspect you may go off on one at this Charles but in Spain, for example, I can walk into the pharmacist shop describe my symptoms and be given drugs which in the UK are only available on prescription.

This is also the case in many other countries I have had the honour of visiting.

The result is far less pressure on doctors.

I dont know if you think this is a good thing or a bad thing ? I have a relative who is a micro biologist who thinks it is a bad thing. My point is it might be better to have some of our medical expertise more widely available by allowing professionals such as yourself to deal with a defined range of problems.

Any opinions on that ?

[Charles Flynn]

A lot of good people have over the years tried to improve services and I would say the present day service is far more professional than in the past. Doctors, nurses, pharmacists are more tightly controlled and have to keep up with professional training including assessment by their peers to retain their licenses to practice.

 

However patients are more demanding. Patients are more knowledgeable and the doctors etc are swamped with adminstration that procedures need to be constantly monitored for improvement to come about.

 

There is a monitoring service for instance for medicines - side effects - where the doctor, pharmacist records any strange effects and this is reported to a central body for appropriate action. Perhaps a similar simple monitoring system - complaints system - needs to be set up so that patients who have received treatment which they believe is inadequate could report it to a service panel who would then be charged to take appropriate quck action to correct the matter. Forms to make suggestions would be readily available at surgeries, hospitals and pharmacies and be relatively easy to complete.The service could be a no blame system so that neither doctors, phamacists or nurses would fear it and would co-operate with patients and the NHS to improve the service.

 

The other obvious answers would involve more administation, more heavy complaints procedures, more penalties, more staff to operate. Necessary in some cases but my recommendation would be to try out the less expensive easy system first and see if it works.

 

I suspect you may go off on one at this Charles but in Spain, for example, I can walk into the pharmacist shop describe my symptoms and be given drugs which in the UK are only available on prescription.

This is also the case in many other countries I have had the honour of visiting.

The result is far less pressure on doctors.

I dont know if you think this is a good thing or a bad thing ? I have a relative who is a micro biologist who thinks it is a bad thing. My point is it might be better to have some of our medical expertise more widely available by allowing professionals such as yourself to deal with a defined range of problems.

Any opinions on that ?

 

 

Yes I am sure this is one of the answers.

 

Over the years pharmacists have been underused and their professional expertise been wasted. This is now getting remedied to a large extent and you will see far more medicines available from the local pharmacy. I remember some years ago I had some dust in one of my eyes when I was in Barcelona. I knew the local pharmacist would not be able to help and it required a doctor. I was in agony. Anyhow as a desperate measure I went into a pharmacy and was given eye drops which would have required a prescription in the UK. Within 15 minutes I was as right as rain and so I have no problem with more pharmacist/ nurse prescribing for minor ailments within their competence to treat. This as I say is now happening and a good thing too always remembering modern medicines are very potent and can have serious side effects if not used according to their indication and in the doasage which is recommended. Also sometimes serious illnesses can be masked by medicines so it is always necessary to ensure that doctors are readily available to treat them when a more complex cause of the illness is thought to be present.

 

So provided there are adequate safguards I am definitely in favour of the pharmacist doing more professional work and spending less time selling extraneous products such as perfumes. They cost a lot of money to train. Let's use them.

[LoneWolf]

They cost a lot of money to train. Let's use them.

 

Thats what I was hoping you would say. I too believe pharmacists have been under utilised.

I do have a slightly humourous story which might run counter to this this but worth the telling ...

In Calangute, Goa, a few years ago, my better half required some sleeping pills. She is prescribed them at home for a good reason. In an extremely shabby "Chemistry" shop the pharmacist gave her what she required and then enquired would the gentleman wish anything such as Viagra. We thought it funny. Giving her sleeping tablets and offering me Viagra. She refused on my behalf!

Seriously I have always found the local pharmacists to be a good sensible source of knowledge and advice and, at least in these Southern parts of the Island, they serve a valuable function advising folks to double check with distictly oddball prescribing from the group practice.

My opinion is that Pharmacists should be given an expanded role in line with their training and competency,

the same applies to nurse practitioners.

[Charles Flynn]

They cost a lot of money to train. Let's use them.

 

Thats what I was hoping you would say. I too believe pharmacists have been under utilised.

I do have a slightly humourous story which might run counter to this this but worth the telling ...

In Calangute, Goa, a few years ago, my better half required some sleeping pills. She is prescribed them at home for a good reason. In an extremely shabby "Chemistry" shop the pharmacist gave her what she required and then enquired would the gentleman wish anything such as Viagra. We thought it funny. Giving her sleeping tablets and offering me Viagra. She refused on my behalf!

Seriously I have always found the local pharmacists to be a good sensible source of knowledge and advice and, at least in these Southern parts of the Island, they serve a valuable function advising folks to double check with distictly oddball prescribing from the group practice.

My opinion is that Pharmacists should be given an expanded role in line with their training and competency,

the same applies to nurse practitioners.

 

 

Totally agree. Pharmacists and nurses are now able to prescribe provided they have completed a training course and the prescription is a repeat. The doctor will of course retain the overall control. I think there is one pharmacist on the Island who has already done the training and with luck others will follow.

 

Pharmacists have always performed a checking service for interactions and right dosages from the doctor. They do not sell medicines to increase their profits but only if they believe in their professional opinion it is necessary. They are just as likely to refer a patient to their doctor when appropriate than give them something which is not adequate. As for that pharmacist in Goa - well he would be crossed off in the UK.

[LoneWolf]

Totally agree. Pharmacists and nurses are now able to prescribe provided they have completed a training course and the prescription is a repeat. The doctor will of course retain the overall control. I think there is one pharmacist on the Island who has already done the training and with luck others will follow.

 

Fantastic. really glad to hear it.

 

Pharmacists have always performed a checking service for interactions and right dosages from the doctor. They do not sell medicines to increase their profits but only if they believe in their professional opinion it is necessary. They are just as likely to refer a patient to their doctor when appropriate than give them something which is not adequate.

No names but the village pharmacist in Port Erin (no not Maleys!) does a really good job as a "prescription firewall"

 

As for that pharmacist in Goa - well he would be crossed off in the UK.

 

I would hope folks take their common sense with them when they go to places such as India.

 

Damn this is getting boring Charles, cant we find something to disagree about !!

[Charles Flynn]

 

Totally agree. Pharmacists and nurses are now able to prescribe provided they have completed a training course and the prescription is a repeat. The doctor will of course retain the overall control. I think there is one pharmacist on the Island who has already done the training and with luck others will follow.

 

Fantastic. really glad to hear it.

 

Pharmacists have always performed a checking service for interactions and right dosages from the doctor. They do not sell medicines to increase their profits but only if they believe in their professional opinion it is necessary. They are just as likely to refer a patient to their doctor when appropriate than give them something which is not adequate.

No names but the village pharmacist in Port Erin (no not Maleys!) does a really good job as a "prescription firewall"

 

As for that pharmacist in Goa - well he would be crossed off in the UK.

 

I would hope folks take their common sense with them when they go to places such as India.

 

Damn this is getting boring Charles, cant we find something to disagree about !!

 

 

The village pharmacist in Port Erin started in one of my pharmacies. A good man and I am pleased to see he's providing an excellent service as indeed do Maley's and I believe all my colleagues on the Island. They work really hard and are a credit to their profession.

 

There are lots of things we could have an argument about but perhaps not tonight. I am going to say good night and look forward to future friendly discussions. Thank you once again Lone Wolf.