GP Moan

There is a GP out there that I'm not very happy with. But I'm not sure what I want to do about it.

Our call was to a sixty year old female who'd had a seizure in the GP office. Now, if you were a doctor, what would you do with someone having a fit? Would you provide the immediate care of giving them oxygen? Would you check more of their vital signs than their blood pressure, maybe even their blood sugar? Once the fit had subsided would you then lay them on the couch in your examination room in case they had another fit? Would you write a good letter to the hospital explaining what had happened? Would you volunteer to talk to the ambulance crew when they arrived in order to provide a professional handover?

Or would you leave the patient sitting in the busy waiting room with the receptionists to 'keep an eye on'?. Would you scribble a letter that had just a blood pressure written on it – no description of the actual seizure, how long it lasted for, no previous medical history or current medications? Would you write that the patient smells strongly of alcohol even when they don't? Would you hide in your consulting room when the ambulance arrives and let the receptionists deal with us?

Guess what decisions this doctor made?

I did challenge the doctor, he hand-waved about 'being busy' (the three other patients in the waiting room were obviously more important than the woman having a seizure). I decided to talk to the doctor about the presentation of the seizure – I'm not entirely sure that he was truthful to me. He told me that she was on no medications, something I later found out to not be true.

I'm sure that he's very good at dealing with sore throats and nappy rash – but surely his medical training wasn't so long ago that he's forgotten how to deal with a seizure?

It's too late for me to put in a formal complaint against him – but should I have done more than been sarcastic to him, if only because I think said sarcasm probably went straight over his head…

I mean, I'm just a big white taxi driver.


It's Eid tomorrow, so…erm… Happy end of Ramadan? What this means in a more practical fashion for me, as I start work on a run of night-shifts, is that hopefully some of the people of Newham might actually be asleep at night and not calling me. I live in hope.

18 thoughts on “GP Moan”

  1. Last week I attended a male in his 60,s with “Abdo pains”. This was on blues and twos. When we got to the chaps address he and his wife both said….”The doctors just left not more than a minute before you arrived.”So I asked if the doctor had left a letter?….”No”….

    Did the doctor say what was wrong with you?….”No”

    So what did the doctor do exactly?….”He had a feel of my stomach and said I should go to hospital.”

    And at no time did he say what might be happening or do any other examination of you?….”No.”

    Thanks very much doctor….

    So we started a full exam gaining base line obs and gaining a history…..

    3 day gradual onset of abdo pains/vomitted once today/loss of appetite/not sleeping/looks pale/not on any meds/no previous medical history/smokes maybe twenty a day/drinks very occassionaly.

    Pulse…110/Resps…20/Blood Pressure….120 over 68/Oxygen Saturation…78% on air….84% on oxygen

    Examination of stomach….slightly distended. Upon placing hand over umbilical area…”boom, boom, boom, boom, boom etc”

    Oh oh! I arranged for this chap to be seen straight away in resus and we blued him in.

    Later found out that he was in theatre within the hour to repair an 11cm AAA! (abdominal aortic aneurism)

    Now if I had missed this and this chap had died….I would have been hauled over the coals and probably sacked. The doctor on the other hand would have been let off scot free!

    One rule for them and one rule for us…..

  2. GPs' simple inability to see the obvious ruined a large part of my childhood, which had obvious knock-on effects for the rest of my life. I'm happy to expand on this by e-mail if anyone is interested, though not in any actionable, legal way, as I now have a life.Nothing bad about them surprises me, they are NOT all “saints in white coats” and I just hope that the next time this irresponsible twit does something similar, he gets booted out of his job.

  3. Happy Eid, or “Eid Mubarak” (pretty much said the way its spelt) if you wanna impress pretty much most muslims…And it might not be tomorrow, there is a chance its Sunday, depends on if the moon is sighted tonight (which might not be possible)….

    Monty

  4. Hi there,I m reading your blog occasionally but with great intrest and it inspired me to even start my own Ambulance Blog.Even if it s not helpfull at all….doctors in germany aren`t any better and i do experience stories like yours almost on a daily base.I don`t bother at all putting in formal complaints, since most of the times they`re leading nowhere. I just do my work as good as possible and try to remain true to myself.Just don`t let them spoil the fun you have in your job.

  5. I did complain about a GP once and action was taken!It was a locum ( retired 20 years!!) who prescribed me a decongestant for pleurodema! And then told me to go and buy a nice ice cream to cheer myself up with! Outcome – surgery never used him again.

    My surgery is usually very good at treating crisis inhouse – eg giving me s/c terbutaline, nebs & O2 when my asthma kicks off or parking my friend in a quiet room with 15 min obs to sleep off one of her many fits she has.

    Same friend fitted last Sunday in church! I protected her head, the recovery possition, checked her pulse, meds list etc etc etc Didn't leave her until I and another friend had deposited her at home with her call care bell on and phoned an hour later to see if she was OK! Oh and I would have given her my O2 if she went blue! ( she does have it prescribed BTW)

    I think you should put in a report – that is appalling behaviour from a GP!

    I think GPs should cover basic life saving skills and first aid on a regular basis then they will realise that you can't just plonk a post ictal (??) epileptic in a waiting room. ( I sat on the church floor for over 40 minutes with my friend incase she fitted again and when we moved her I made sure I had a person on each side in case shw went over again)

    I think it must vary from practice to practice the quality of care. My only bugbear is getting latex free gloves provided – I phone 24 hrs before so they have time to find the box of nitrile gloves they bought for latex sensitive patients! LOL! (I do carry my own in case)

    Anyway, Have ranted on enough!

    Kate

  6. Hi TomYou might not be able to do anything now about this incident, but you could make sure everyone knows about it anyway? These sorts of people are usually repeat offenders, and perhaps next time he does something quite that dumb he can be suitably punished.

    Hope your weekend goes better 🙂

  7. I went to an “unwell” lady with a Dr on scene. When I got there he greeted us with….”She's not really with it and I can't get a blood pressure”.

    Not surprising really since she had a GCS of 8, was cyanosed and had no radial pulse. After sorting out her airway and putting her on O2, we started getting her out and he said “Oh, you're taking her in then?”

    What do you think moron?

  8. I went into a surgery recently for a patient with chest pain, I had to have a sit down when I saw the patient, they had him on o2, had given him aspirin, and the doctor gave me a verbal handover. Unfortunately he didn't write a letter for the hospital, but in just over a year that's the closest I've got to the full set.

  9. I recall going to a GP once who was performing CPR according to the update, when i got there he was sitting next to the patient on a springy bed, doing a poor excuse for a compression with one hand whilst writing a note at the same time with the other hand !!! sticking out of the patients mouth was an emty toilet roll tube, whehn i moved the pt onto the floor and empties the gallon of vomitus out the pt surprisingly was asystolic and the doctor called it….laughable tretament ny this so called medical proffesional… Im sure we could all go on and on about GP's being absolutley useless at times, sometimes they can do great work too…it just seems all to infreuently though

  10. I agree with Kate – you should definitely put in a complaint – surely it can't be too late for something that serious can it? If not you, then why on earth wouldn't the patient complain, if they knew what 'should' have been done they'll be a lot more aware next time !And as for kingmagic's story – surely the patient could complain on that one and name him saviour of the year !

    It's bad enough it happening once – but for it to happen a second time with no effort been done to prevent it but anyone able, is a tragedy. The crappy tabloids need to be used to our advantage sometimes !!

    Take care

    Jinky

  11. Maybe this is an exception to the rule but we were called for a patient with severe breathing difficulties at a surgery. The GP was excellent having put the patient (22 years old athletic male, no previous medical history ever) on 100% O2, had given him salbutamol through nebuliser, taken BP, RR, etc and copied his notes for handover to A&E.Only disappointment was at the other end when the nurse looked at us asking why we had brought him in. I realise the nurse hadnt seen our patient in the ambulance using all accessory muscles (and more) to breathe and sweating like a reformed alcoholic in a guiness factory, but why question us bringing the patient in?? We gave him some more salbutamol which eased his breathing considerably and made him look less like he was dying. Obviously looked too well to be treated by this nurse at this point

  12. Tom – Not all GPs are bad… as you know.I worked in general practice until 2 years ago and most of my colleagues and I had a good rapport with our local ambulance crews – we only called when necessary, always examined thoroughly, ECG'd and intubated patients and put in iv lines where appropriate and pre-warned the hospital of the patient's impending arrival. We always sent a letter outlining examination findings, together with a computer printout of PMH, meds and allergies etc (where time and circumstances permitted). We also updated our CPR skills annually.

    Unfortunately, there was one individual in the practice who didn't care two hoots and I can recall one day having a patient with a respiratory arrest, who the senior partner and myself were treating – along with the practice nurse, FRU pilot and land ambo crew. This individual stuck his head around the treatment room door and asked the paramedic to move his ambo so he could get his car off the car park! One of the reasons why I left medicine and the NHS…together with the increasing bureaucracy and crap produced by the local PCT!!

    Much of this GP behaviour is a sad reflection of the low morale as a result of this mindless pen pushing and box ticking exercise the job has become, together with the selection of med school candidates on academic merit rather than their motivation for the job – having five grade A's at 'A' level does not necessarily make a good doctor. Doctors are not taught first aid in med school – I enrolled on a local course (to much amusement and derision) but it should become compulsory.

    You should have reported the individual, as he will continue to practise 'bad medicine' – mind you, chances are he'll just get an admonishment anyway! Keep up the good work Tom, nice to know there are people who still care in the NHS.

  13. I must be one of the lucky ones- our GP is far more caring. I took my very hot, wheezy 9 month old baby to see him on Friday (after ringing the surgery and getting a pretty much immediate appointment). Poor little mite has bronchillitis. GP arranged for the practice nurse to pop him on the nubuliser straight away, and then came back and checked on him after 10 mins. He then gave me clear advice as to how to care for him, and what symptoms mean i should take him up to A & E.I'm happy to report he seems a lot better now.

  14. Oh I know they aren't all bad – it's just that I'm the one who tends to meet them…I mean, I do write about the good ones as well when I do meet them.

  15. Tom this was outrageous negligence on the doctor's part! How dare he treat another human being like a bit of rubbish that's become an annoyance to be swept from his presence without futher regard….. Oh and I'll bet she got charged for an office visit of “higher care” cos he called for ya'll.The toad wanker! It's not too late to file a report with documentation (from your pick up and delivery of the patient). Here in the States we report such MDs to the State Medical Board and The American Medical Association. Make no mistake, if it's let to pass it sends a message that “this is acceptable care”, & he'll do it again. He acted as if this was a rather trivial situation, so it's probably not his 1st time handling a patient's life and well being with such disregard. Damn, think of the other things he's mistreating & misdiagnosing! He's an accident looking for a good place to happen, or rather a good person to happen to, and he's going to happen to someone that is precious to someone's family. Please don't let that go. If it were a bridge that was out, you wouldn't let others go on to drown in the river. Report him! He won't lose his license, but it may rattle his cage enough, for him to straighten up and treat his patients properly.

  16. Sadly, having worked as a junior doc on a busy Surgical Assessment Unit, crap GP referrals are the norm.What we often get is a “Dear Doctor” letter, followed by a bit of barely legible scrawl and a request to “do the needful”. Oh, thanks!

    Occasionally, we get a really good one: a print out of the Pt's medications, recent history and, (yes dear reader!), sometimes even examination findings and differential diagnoses.

    The worst one I can think of is a lady with right upper quadrant pain & jaundice, with a past history of bladder cancer. The GP helpfully told the family (but not the Pt!) that this was definitely metastases from her previous cancer and that it was almost certainly inoperable.

    What did she actually have?

    Gall stones…

    I felt like ringing the GP up and giving her a bollocking. But that wouldn't have gotten me anywhere.

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