Doctors [whiny rant]

[j4]

I've been putting off making a doctor's appointment for a while. I'm like that about doctor's appointments. I find the process stressful and I rarely have much hope that it'll do any good anyway.

But this morning I finally phoned the practice, and said "I'd like to make an appointment please". "Certainly," says the receptionist. "Could I ask what the nature of the problem is?" I say as politely as I can (which at 8:30am unfortunately probably isn't that polite) that I was hoping to talk about that to a doctor, not a receptionist; and she says something about how they need to know the nature of the problem so that they know who to give me an appointment with, and when to fit me in. (This is a far cry from when I actually asked the receptionist if I could see a doctor who specialised in depression, and was told rather patronisingly "They're all general practitioners, I think you'll find that they're all knowledgeable about that".) So I express surprise at this "new system" and am told that it is "surgery policy" and has always been like this. "Well, it hasn't any of the other times I've phoned up for an appointment..." Silence, before she launches back into the script.

Anyway, I make it quite clear that I don't want to talk about it, and eventually she asks for my name and phone number and says that somebody will ring me back to "advise me of an appointment". Huh? Wouldn't it have been easier for them to just give me a bloody appointment? Obviously not.

10 minutes later, the phone rings. It's the nurse from the practice. "What seems to be the problem?" I don't believe this. "I'd really rather not discuss it on the phone." More nonsense about how they have to know what the problem is otherwise they can't give me an appointment.

By this time I've had enough. "I think it's best if I just cancel the appointment." Suddenly everything's different. "Do you want to see a doctor or a nurse?" "I'd like to cancel the appointment." "No, no, we can make you an appointment, do you want to --" "I'd like to cancel the appointment, please." I have to repeat this six times to actually get through to the woman, who by this time is just blethering about how I can see anybody I want to see and she'll make me an appointment. When she finally gets the message, her final "O-kay, THANK you, GOOD bye" sounds like a primary school teacher trying to resist strangling a particularly annoying small child.

I don't like phones. I do not want to have a phone conversation about something that's a bit awkward to talk about anyway. All I wanted was 10 minutes in which to talk to a qualified doctor, and I should not have to threaten to cancel the appointment to even be offered that. I don't want to deal with these people if that's the new modus operandi. (Except, of course, it's not new; it's always been like that... and we have always been at war with Eurasia.) It has become steadily harder and harder to get an appointment at this practice over the last two years, and this is just the last straw.

Yes, I probably should have just given in when they started offering appointments, but frankly I just didn't want anything to do with them by that point. And the really worrying thing is that I know there's no way I could deal with that system if I was actually ill (rather than, as at the moment, needing a doctor's advice about an ongoing condition) -- I wouldn't have the energy to argue with them.

I wonder how easy it is to change practices. <sigh>

Update: Very easy. :-) Went to the practice that sion_a is registered with, said "I'd like to join", they said they weren't taking new patients (but would give me the address of a practice nearby which was); I said my partner was registered at their practice, and they said "Oh, that's okay then, we take family of existing patients". Filled in the forms, and that's it. And have made an appointment for first thing Monday morning. (They're happy to do appointments up to 6 weeks in advance, which is really very civilised.)

Comments

[meirion.livejournal.com]

god. *shudders*. i'd be a complete gibbering wreck were that to happen to me; i'd be lucky to have actually managed to get off the phone prior to bursting into tears (i dislike phones too).

what planet are these people from ? (presumably the same one as the people from the job centre who demanded to see my actual redundancy letter before they'll tell me i haven't paid enough ni contribusions to get any job-seekers' allowance; and weren't impressed with "i threw it away because it made me feel depressed every time i happened to catch sight of it" and demanded that i get a copy of it within a week or they'd make me fill the same form out again).

gah. sympathy.

-m-

[taimatsu]

Hmm. How much in the way of NI contributions *do* you have to pay before you get any JSA? Because technically I have been jobless for the past two months, and if I had wanted to claim JSA, well, I haven't paid much in the way of NI at all, really... B

[duncanneko.livejournal.com]

I think it's two years' worth to claim 'Contribution Based JSA' or something. Otherwise you get a much smaller one, but you can still claim.

Though this is based of my own experiences, most of which I have blanked in annoyance, so may not be entirely accurate - I know there are basically two grades of JSA though.

[lnr]

There are two sorts, contributions-based and income-based, but you never get both. If you're broke you get income-based, if you're not broke then you can only get contributions-based if you've made enough contributions (funny that) and even then you only get it for a certain number of weeks. Living with partners who have income tends to rule out the income-based version, though how this works if you're in the process of separating I dunno. Lucy I'd suspect would get income based.

[nevecat.livejournal.com]

Write a letter to your doctor and complain?

There's supposed to be a bond of confidentiality of some other such blah between practitioner & patient - forcing you to describe your reasoning to the receptionist is a breach of that.

Personally, I always ask for a appointment with a named doctor rather than just asking for an appointment, this stops them trying to make these kind of 'decisions' for me - I prefer to talk to the same doctor I've talked to in the past to at least get a consistent service, etc

Which reminds me (thanks), must make doctors appointment to get some more happy pills at some point (or rather, discuss the fact I'm taking myself off them and ask for a preseciption of lower dosage ones because breaking the big ones at the snap-point means they taste *foul* and I'm bad at pills to start with. Which means she'll probably wave counselling at me enthusiastically again. Joy.

[j4.livejournal.com]

Personally, I always ask for a appointment with a named doctor

I used to see one particular doctor, who was extremely good and I was happy to talk to him about even awkward stuff. Unfortunately, they won't give out any appointments with him any more -- he only works one day a week and they just said they couldn't give me an appointment with him at all. The other good doctor I've seen was only a locum. Other than that I've rarely seen the same doctor more than once; they ask who "my doctor" is and I tell them it's Dr P------ but that I've never actually seen her, and then they give me an appointment with somebody random. I don't really care for most things; surely it's much easier for them if I don't mind who I see, because then they can just give me an appointment with whoever's free!

Good luck with the ADs -- and with avoiding compulsory counselling. *hugs*

[karen2205]

I've always been very lucky in that I've not had ongoing problems I didn't want to talk about - so I don't mind being given random doctors, when all I want are some antibiotics for tonsellitis and a sick note, or some desloradatine for hayfever, I don't particularly care who I see, so long as I see someone who can sort it out.

[huskyteer.livejournal.com]

That's absolutely outrageous, not to mention pointless. And I thought I was unlucky having a medical student sit in on my consultation!

[nevecat.livejournal.com]

Didn't they ask whether you minded??

The only time that's happened to me, I've been asked whether it was OK by me (and was only for a blood-test appointment with the nurse anyway) - as it happened the student was actually the one who asked sensible questions which the nurse/doctor has missed!

But even so, *mutters at the idea that /anyone/ wouldn't be asked their feelings on people sitting in on things like that*

What /is/ the medical profession coming to? Grrr! Rah! Complain! :)

[simont]

You think that's bad. I once went for an appointment and found a medical student sitting in who was somebody I'd known at school! They did ask whether I'd rather he left (and presumably would have asked that even if we hadn't obviously recognised each other), but by that time the (theoretical) damage was already done...

[wechsler.livejournal.com]

I wonder how easy it is to change practices.

My understanding is that it's very tricky to change doctors if you've not moved away from the served area.

However some of them do seem to specialise in making it hard to book appointments - I believe dennyd's require him to call within a half-hour slot once a week... (might - but I'm unconvinced - be once a day, but either way, the phone lines are always solidly engaged for that half-hour)

[j4.livejournal.com]

My understanding is that it's very tricky to change doctors if you've not moved away from the served area.

Ah, that bit shouldn't be a problem -- I'm only just still in the right area for the current practice now, but I stayed there when I moved because it was easier than faffing around trying to change. I'm firmly in the middle of the area for a different practice (the one sion_a goes to).

Think I will go and try to sort that out now actually.

[taimatsu]

If you have an NHS medical card all you have to do (in theory) is take the card to the reception of another surgery accepting patients. If they do ask you for a reason (though I don't think you have to give one - at least, that's what it says on my card) you could always say 'My previous regular doctor at X practice has cut down his hours, so that it's now more convenient for me to change practice rather than travel X distance for a doctor I don't have an association with.' Or something lke that. But you don't have to give a reason.

I've been lucky, in that I have had the same doctor for for years and only once had to see someone else. I think they ask you the reason for the appointment on the phone because if it's 'I need a edical checkup for insurance reasons' it costs something, and if it's 'I want contraception' it's a job for the practice nurse, and that sort of thing. I've not had that problem, but then I do tend to tell the receptionists what the problem is (in brief no-detail terms). At least once, though, I haven't done that (because it really was too embarrassing) and I don't think they asked me.

I'm not looking forward to changing doctors. Dr. Ferguson has been so good, and I've got comfortable with her. I don't know how I'm going to find anyone like that again.

[mobbsy.livejournal.com]

There are decreasing numbers of people wanting to become GPs, so unfortunately this sort of triage is probably becoming ubiquitous.

It does sound like they could have handled the call better though.

[emperor]

The practice in Surrey would sometimes ask what the problem is; Newnham Walk (who are my GPs still, despite me living outside the catchment area) I just 'phone up and say "I'd like to see Dr foo", and usually get an appointment with Dr bar (since dr. Foo usually won't have an appointment for a week or so). They've never asked me what the problem is.

[karen2205]

Ooh, poor you;-(

It's *theoretically* very easy to change practices - just take your medical card (the one that's a kind of purple writing on a white card, giving your NHS number) and then go to your new doctor and ask to register. You don't have to give a reason.

The only problems are - some practices are full and might not be accepting new patients and it takes around six months for your records to catch up with you so you might have to do lots of explaining to your new doctor.

Talking about that - I remember being told while I was at uni to *not* register with a doctor at home during the summer, 'cos if I did my records would spend most of the time being transferred. If that's the case with you, you can see any doctor as a 'temporary resident' - they'll give you a form to fill in. Again, because s/he won't have your records you might have to explain it all from the beginning......

Sometimes when receptionists ask that 'what's the nature of your problem?' question, it's to find out how urgent it is - rather than what's actually wrong - the trick is to know what different words mean eg. if you say 'routine' then they won't give you an appointment for a week or two. If you say 'urgent' they fit you in almost immediately.

You could try phoning a surgery and asking to see a specific doctor, saying that you have a serious (eg. it's important that you're seen, it's not an ingrowing toe nail), but not urgent problem, and that you need an appointment in the next ?? days. If they want more information you could just say 'I need a repeat prescription for an ongoing problem'.

You could get someone else to make the appointment for you - I remember being with a friend who was so distressed that she couldn't phone the doctor herself - so I phoned for her - she was there, listening, as I pretended to have confidence I don't really have - I just said that she needed an appointment as soon as possible, and got given one for the following day. That was at uni, and they were really good - she was given anti depressants and an appointment with the counselling service almost immediately.

[duncanneko.livejournal.com]

*sympathy* sounds as bad as my doctors (You're not at the Newmarket Road practice too, are you?) - though I can usually get away with "It's a personal matter, I'd rather not discuss it" with the receptionist. Of course, then they just go for their other one which is getting a doctor to ring you back, which is next to useless *sigh* "Hi, I've got chronic fatigue and am sleeping 15 hours a day" "Well, it's not depression, nothing I can do. Eat less carbohydrates".

A lot of surgeries seem to have the idiosyncrosities these days, it's a matter of learning the ways to get around them I think - and being very firm with irritating recpetionists if you have to.

[lnr]

Funnily enough the only time I ever went to that practice I didn't really have to explain to the receptionist what was wrong, only that I wasn't registered with them but could I please see a nurse anyway. The fact I was nearly dripping blood on their carpet might have had something to do with it though. They were very helpful :-)

[bopeepsheep.livejournal.com]

That's bloody stupid and insensitive as a policy, IMO. If you have no attachment to a specific doctor there, what is the harm in their giving you an appointment with any of them - if the GP then feels you'd be better off seeing one of the other doctors there then they can always tell you that at the time, can't they? I wouldn't have thought it was the receptionist's place to make that call (although having worked with doctors I can see how the receptionist might feel better qualified to judge the attitudes of the various GPs).

I had to ring my practice an hour ago, and had a little interrogation, mainly because I'm trying to get an emergency appointment today (which isn't "an emergency" really, it's just a timing issue). I did get asked why I had to be seen today, and all I needed to say was "the obstetrician said..." and that was fine, the receptionist took that as gospel (and I'm now waiting for them to call back, since talking to the midwife on the phone may suffice anyway, I might not need to go in). That's the level I can live with. I'd hate to feel that I had to start explaining just what is going on and how I feel to someone who doesn't have my notes in front of them. Much sympathy, and I'd recommend changing doctors if you feel comfortable doing that, you don't need extra hassle. I know how hard it can be to even make the decision to make an appointment, you really don't need it to be harder than it ought.

[ex-monkeyhan688.livejournal.com]

So glad to hear you've got an appointment now. I know exactly where you're coming from with doctors' receptionists - a lot of them start thinking they're God. My most recent hassle was when I tried to get new supplies of the Pill over Christmas.

"We can't give you an appoinment now."
"How about January?"
"No, there are no appointments in January, but ring back after Christmas and we'll see then."
"Well, if there are no appointments in January *now*, there won't be any after Christmas, will there?"
"Yes, because after Christmas our new diaries will arrive."

Basically, there weren't any appointments to be had because there weren't any blank spaces in their diaries, because there weren't any diaries.

I think the biggest reform needed is simply to have a centralised database of patients' details, that any doctor can access. This whole three-months-to-send-your-notes shit leaves students even more rootless and vulnerable, never mind homeless people.

[keirf.livejournal.com]

The current system has the advantage that there isn't a central database and therefore any old doctor can't get his/her hands on your notes. Imagine a situation where an insurance company or employer can use their pet doctor to do some digging around in your confidential records. Or the police can decide to search you on the basis of your medical past.

Mind you, when Blunkett brings in his ID card that's the world we'll be living in.

[bopeepsheep.livejournal.com]

My GPs have a database of current patients, and I've been told that if I transferred to a "compatible" practice, they'd be able to transfer my records (by disk, I assume) almost instantly. The hard copies would follow, but none of this months-of-waiting crap.

(Which was almost enough incentive to make me transfer from my old practice, where I've been for six years, to one nearer home. But then I discovered that the old practice aren't taking on new patients, and if we are going to move house in the next two years we might end up back down in that area, and then we would probably have to register somewhere else, and I like my current GP, and the "no new patients" doesn't apply to family so I can get DH and the baby registered there if necessary so...)

[bopeepsheep.livejournal.com]

Excellent that the new practice are clearly human beings. :-)

[k425.livejournal.com]

I'm glad you got into the new practice! It sounds far nicer and I have my fingers crossed that it is.

I realise that I'm very lucky indeed with my GP. He runs two surgeries, in my village and one down the road. Mornings in one and afternoons in the other, turn and turnabout. He has consulting hours and if you arrive within ten mintues of the end of the consulting period, you will be seen. No appointments, just turn up. He takes mental health as seriously as physical health, explains everything clearly and carefully and treats you like an intelligent person, and knows what's his responsibility (e.g. getting me referred to the hospital of my choice for specific care) and what isn't ("homebirth? Oh, I don't have anything to do with that. You want to talk to the midwives about that, they did one last weekend you know"). Unfortunately he's in his late 50s and I have no idea what will happen when he retires.

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