Are our Doctors competent?

Toothsmith

In general, they have 10 mins to assess what is in front of them and to make a judgement.

Access to secondary diagnostic and screening services is patchy at best, and there are bean-counters breathing down their necks if they send too many patients for these services.

In the vast majority of cases, the person in front of them will get better in a few days anyway.

So who do they send for these extra tests and who do they not? Based on a 10 min (at best) check in stressfull surroundings?

It's a system based on Russian Roulette!

And the new 'competition' being introduced in the NHS reforms will make it worse.

melancholly

i think it's hard to knock all doctors - they do have to be bright to get on the degree, work very hard to stay on it and have a lot of training. i think medicine isn't a precise science. it's the balance of probabilities based on often, self report of symptoms...... they'll never get everything right as sometimes it really just is the very unlikely outcome that happens. i'm not sure that that will fundamentally change by going private - perhaps there will be more time to speak to people and expensive tests for unlikely causes might be more likely to happen, but every doctor is human and no human will ever be perfect....no bedside manner will suit everyone either.

the idea of patients rating GPs is quite scary.... i don't think everything should turn into the X factor. people might be angry that they're not giving antibiotics for a viral infection and be negative, when really, they don't understand what the treatment should be used for. how many people refer to the 'MRSA virus' when it's actually a bacterial infection?! someone liking their GP and their GP being competent/negligent are two completely separate issues.

anyone who has had problems with a GP should go through the system to complain - without that, nothing with change. complain to a practice manager and if needed, escalate to PALS. patients do have power to deal with issues. there are some bad doctors out there (there are bad people in every job) but there are systems to weed them out. getting people to actively engage with the exising system is important, rather than demanding new ideas.

Red_Doe

anyone who has had problems with a GP should go through the system to complain - without that, nothing with change. complain to a practice manager and if needed, escalate to PALS. patients do have power to deal with issues.

I had to do this very thing, when the doc here refused to treat my daughter for a medical condition claiming "I`m not an expert" yet refused to refer her, and abruptly withdrew medication she had been receiving from our previous doc which led to emotional and physical distress. I complained all the way up to the medical ombudsman yet the complaint was not upheld. This, mind, from the doctor who has repeatedly misdiagnosed serious and often life threatening illnesses.
She`s still there, still practicing. (In my view, needs a damn sight more `practice`....)
Legal avenues and processes aside, often, medical folks band together and DO stick up for themselves. And it makes no sense to me for the final sayso on malpractice to be given by a medical official, surely it should be someone independant of, but with knowledge of, medical practice?
The `system`, as with so many other systems, often simply does not work.

antonia1

I'm going to stand up for doctors here. Whilst there are some very poor doctors (like in any profession) I have myself been treated by 4 different GPs (I've moved around lots) and in each case I have been treated really well. By the laws of randomness some people will encounter many instances of truly appalling medical professionals, but there are some of us who have never encountered any such thing.

thebigg

I think its really important to remember that GPs are generalists not specialists and most importantly are only human. As we know with all humans comes human error.
What GPs are looking for in your consultations are red flags signs that something serious is going on which helps to judge the severity of your condition and the speed at which it has to be investigated. Having repeat reviews allows them to see how things have progressed/changed. If you're unhappy that your set of symptoms has not been well dealt with then see another GP as sometimes a fresh pair of eyes is really helpful. Most GP practices work as a team and wouldnt object to a 2nd opinion within the practice.

Give the GPs a break!

bargainbetty

I have a GP who I will only see under absolute sufferance as he is grumpy and heavy-handed (he left bruises on me checking for swollen throat glands!)

I went in as an emergency having collapsed the previous night with a crippling migraine, my third in a couple of weeks, and I had to have him as the other doctors were busy. He checked my head and neck for muscle cramps and then took my blood pressure. The machine didn't work, so he tried again, chatting away gently about my family as he did it. Still didn't register, so he swapped the cuff onto my other arm and tried it there, randomly chatting about my life and then work as he made two more attempts.

Then he sat down, and gently informed me that each reading had been prefectly clear, and I had massively elevated blood pressure. His chat had shown a marked spike on work issues, so he was signing me off for two weeks, sending me for a battery of tests, and giving me medication to start taking immediately. He asked if anyone could come fetch me so i wouldn't have to drive home. To give you an idea of how bad it was, he actually told me not to exercise, since a slight increase at that point could bring on a stroke. I was 32 years old.

Yes, some are terrible. But every now and again one saves your life. They get 10 minutes with us, and they have to get it right every time - sadly the situations that tend to go wrong are the serious ones, which can take a long time to diagnose.

It's worth noting that the same doctor prescribed steroid suppositories for a friend of mine. He 'took' them for a week and then went back in for a follow up, but somehow ended up with a different doctor. She took one look at the prescription and said 'I'm not sure why you needed those, I wouldn't have bothered' and referred him to a specialist on the spot.

Oh how I laughed.

coldstreamalways

I have been correctly diagnosed several times and I bet if we all recounted episodes of correct diagnosis and treatment, they would far outweigh the incorrect ones (which are terribly sad). It is taught to every "medical sciences" student that "common things happen commonly" so stomach pain in 9999 out of 10000 cases would be IBS or indigestion or some such, 1 time it's pancreatic cancer. What you may not know are other factors which led the Dr to their diagnosis.

I can have a conversation with a patient for 30min, refer them on and have a letter back saying that person has denied ever seeing a dentist.... sometimes what a person says happened and what did happen are different and it is easy to jump to the conclusion that the Dr is at fault when there may be many compounding factors that can lead to an incorrect diagnosis.

vesper

Mmm I know of some very poor diagnosis, my MIL was having terrible stomach pains and had lost a hell of a lot of weight so she was almost skeletal. She could not eat without being ill. After 4 months of going to the Doctors and being told that it was just stress (the woman had no stress in her life at all, and was a very genuinely happy person) my FIL finally pushed the Doctor into making her a specialist appointment. 2 Months later she died of cancer of the stomach, liver, one lung and both of her breats and it was heading into her bones. I don't think it was the fault of that particular Doctor as our village's surgery has a hugh turnover of Doctors and Nurses and she had seen 5 in those 4 months, 4 of which left in that time.
On the other hand I am at a completely different Doctor's Surgery, one I have been with my entire life. I have had the same doctor my whole life. I think that in my MIL's case some things just got lost in translation, unfortunatly that will not bring her back.

Red_Doe

I can see the point of those supporting doctors, but look at it this way too..yes, they only have that ten minutes..but when a patient is repeatedly returning, with the same symptoms and asking for help, all those ten minutes add up. Are you telling me the doctor wouldn`t hear some alarm bells in more serious cases and seek further investigation?
Also, in the case of rural surgeries (of which I can only speak myself), the doctors get to know each patient pretty well over the years! So the pressed for time reason doesn`t always apply.
Sorry, I`m not dismissing the competence of every single doctor, but I do feel the `bad` ones are more prevalent than people realise.

dmg24

concerned43 wrote: »

I ask this question because over the last couple of months people I know have had mis-diagnosis from their doctors:
1) BIL saw GP 6 months ago as was having chest pains, doctor dismissed these pains for indigestion - 2 months later collapses and admitted to hospital, turns out he had a faulty heart valve and needed it replaced + triple heart bypass.
2) Colleague has been suffering from upper stomach pains for past year - GP diagnoses IBS, pain gets so bad she asks for more tests to be done, GP refuses. Last week diagnosed with pancreatic cancer and given months to live.
3) SIL has massive headache week, saw her GP who diagnosed Migrane, head does not get better and she is back at GP who gives her stronger pain killers, still no better and GP gives more painkillers. Headache still not better and sees GP again yesterday at 5pm, collapses at GPs - taken to hospital and dies hours later.

Does anyone know of similar mis-diagnosis? Do you trust your GP?

Are you suggesting that everyone who presents with chest pains/ tummy ache or a bad headache should be referred on? Medicine is not an exact science, GP's are not perfect but they also work within strict limits. Furthermore, if someone's symptoms were as severe as you imply, would did they not present themselves at A&E?