How to get the best from your GP… Part 1

Today I want to give you some insider insight and tips from my perspective, not only as a young woman (can I still say that now I’m thirty?!,) but as one that also happens to be a GP. One of the things that has surprised me the most since I have come out of the closet and revealed my job, is the relationship that other people have with their family doctor. Because most of all, that’s what I think of myself as. I see people as kids, then as young women who need contraception, through their pregnancy and if I’m lucky I get to do the six week check on their new baby. Even though I haven’t been practicing that long, I’ve already enjoyed giving that continuity of care. It’s made me sad on occasion to hear that other people don’t feel satisfied with the experience they have at their GP’s. I guess because a lot of my training focuses heavily on communication skills and I’ve been lucky enough to work at some great practices, I forget there are perhaps practices out there that don’t suit some of their patient population as well. Whilst I’m definitely not opening the door here to hear your opinion of your GP, I do think that I might have some tips for you to help you get more out of your experience of going to see the GP.


Snapped on my last visit to the GP, this poem tickled me! Supplied by Poems in the Waiting Room, a registered charity supplying leaflets with poetry to hospital waiting rooms across the country.

So here goes…

Tell them why you’re there.
This might sound obvious but it’s a well documented phenomenon that people often save the important problem they want to discuss until the end of the consultation. It’s known as the ‘door handle problem’, when they turn back as they’re about to leave and say ‘and I also found a breast lump…‘ It goes without saying we would much rather have dealt with that first rather than checked your ears for wax. Psychologists think people often do this because they ‘test’ the GP with something that isn’t important to them and when they feel the GP is trustworthy and won’t laugh/tell them off, they open up about the more important problem.

If you’ve got a list, ‘fess up.
I understand. You’re busy, it’s a nightmare to get an appointment, let alone one that fits in with your working hours and once you have got it, you value the opportunity to quickly discuss a couple of minor niggles you have. If you come in and confess, we can often decide on the spot if it’s feasible for us to get through all of that in the 10 minute appointment we have available. Honestly, this is not about us running to time. It’s about doing your problems justice and having the available time to address them all adequately. Sometimes, a mole that needs the once over, an itchy toe and a quick look in your throat can take a few minutes max and we’ll get through them all, but if you’re really worried that mole is skin cancer and you want to know why I think it’s normal and find out how to keep an eye on it yourself at home, I can’t do that without rushing you AND do the other things properly in 10 minutes. Most surgeries will let you book a double appointment if you have several things to discuss, or come back – we really don’t mind seeing you again!

Don’t read about your problems on the internet.
This should come with the sub-heading ‘or if you’re going to, read a reputable source.
Again, I get it, you’re educated and why shouldn’t you read up on a problem that is affecting you? I bet you’re thinking you might not need to go to the doctors after all right? In an ideal world that would be the case but in reality one of 2 things will happen. The internet is a scary place and when it comes to medical information there are 2 broad categories it fits into. The professionally written sites, and opposite. Even professionally written sites, like NHS direct for example have to cover their backs. Any bit of information will be prefaced by a disclaimer and no doubt a list of reasons why you should disregard the forthcoming information and see your GP to get checked out anyway. If that’s not enough to make you think the worst, then I don’t know what is.

The second option is that you read a non-professional site where people share their personal experinces. There’s nothing worng with poeple doing that, the problem is the unintended influence it has on people who read it – that’s you by the way. Every patient is very different, from the subtlties of their medical history to the social and personal factors that may have influenced the doctors choice of treatment for them. There are guidelines and protocols for so many conditions but as doctors, we then use our knowledge of the guidelines and evidence and balance it with our knowledge of the patient as an individual. For example, someone with a hectic shift pattern for a job might not be suited to a medication like the pill that needs to be taken regularly and jump at the chance to try a method that they can forget about for a longer period of time. That’s just an example but I hope it illustrates why nothing substitutes actually talking to your doctor.

My favourite site for patients to use to read up on their problems (once diagnosed,) is Patient.co.uk. I use it as a professional, but there are tons of patient leaflets there with clear and thorough explanations about many conditions.

I’m going to leave it there for now, but as and when the thoughts occur to me I’ll add more. In the meantime, if there’s something about doctor-patient etiquette that you’ve always wondered about then fire away, or just let me know if this post has been helpful. I’ll put my best GP hat on and see if I can explain some things for you. πŸ˜‰

Love,
Rebecca
xo

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34 thoughts on “How to get the best from your GP… Part 1

  1. I was JUST thinking about this! My question about doctor-patient etiquette is, is it true that doctors have really “seen it all before”?? I’m seeing my doctor this afternoon so thatshe can check that the antibiotics and antihistamines she prescribed last week to deal with an outrageous allergic reaction to some insect bites in Cuba have worked, and it occurred to me that the leg in question isn’t quite as presentable as it could be and she’ll be wanting to take a look at it!

    I don’t normally suffer from embarassment when talking to a doctor because I always assume they’ve “seen it all before” and will almost always have seen worse….but is that really true?!

    • Absolutely!

      There is very little that shocks me now and if it does, we’re trained to pretend that is hasn’t! Honestly, though, it’s very rare!

      And you’re right, we have almost always seen worse too!

  2. Hey Rebecca,
    Bit of a tricky one but is there an ettiquette about talking to your doc about someone else (who has the same doc)? I don’t want to waist my GP’s time and I don’t need him to give me anybody elses personal info but my Grandparents need help that they won’t admit too. Very sensitive situation, as you can imagine!
    Em

    • No this is quite common and very useful for us.

      The elderly often dont want to accept help, or certainly dont want to discuss it with their relatives wheras we know how to broach the subject and suggest ways of intervening that might not trigger their fears about accepting help. Most GP’s will give you a call to chat aboutt his, or just make an appointment – we see people for the same reason quite commonly don’t worry!

  3. Top tips, Rebecca!

    What is it about GP’s surgeries that gives people The Fear? Whenever I go (and that’s very often) I feel like whichever GP I see will tell me off for waisting their time, even though I know I’m not. Funny, isn’t it? ‘White Coat Syndrome’, perhaps?

    I like my current GP. He offers me biscuits from his top drawer.

    • People apologise to me every day for ‘wasting my time’ and really they shouldn’t – it’s my job. If you really have wasted a GP’s time, they will tell you, but it’s very hard to actually justify that from a Dr’s point of view. Even if it’s completely non-medical or nothing to worry about, if it’s concerning the patient, it’s our problem too.

  4. You sound like the worlds best GP! Is it too far to register at your practice if I live say 80 miles away??? And are the receptionists at your practice also medically trained like mine seem to think they are? It is hilarious the advice they dish out and how they seem to think they know better than me if I need to see a doctor that day.

    Seriously though, my GP practice as a whole could do with a big kick up the backside, I won’t bore you with the details.

    Having moved around a lot it was impossible for me to have that consistency of one GP all along, I imagine that must be so lovely to have a GP that knows you well. A bit peak practice like haha, my mum loved that show!!

    I also work shifts therefore meaning I just have to grab any appt that is going when I can if I need to see someone.

    Agreed that the internet can be a nightmare, more so for people who have the potential to be hyperchondriacs!! I am a nurse and my husband a musculoskeletal specialist and the amount of times a relative has looked on the internet, diagnosed themselves with something horrific and then rung one of us for confirmation is scary!!

    xx

  5. I visted my GP for the first time as an adult recently and I definitely was worried I was wasting their time – even though I’d booked it to get a referral to a midwife so was a valid reason.

    But is it ok to book an appointment just to ask questions? I am trying to decide where to give birth and have no one to turn to as the midwife I have seen is attached to a particular hospital and doesn’t know about the others, I can’t google it as it’s just a load of horror stories and I don’t know anyone with a baby in my area.

    • Of course it is!

      Your GP may not know anymore but usually if they are establishing in the area they have some knowledge, either through friends who have had babies, maybe going through it themselves, or with their wives, or they may have trained in the local hospitals.

  6. I’ve moved around a lot and never seen the same GP twice in, what, 15 years. Would love to build up an understanding with one, but I have to say most of them have been great, really helpful.

    One small question – any advice on smear tests when they don’t go so well? The test I had over three years ago was painful and not helped by the comments the nurse made which made me uncomfortable (“…you’ve not had a baby yet then…”) *sigh*

    And receptionists. Advice on tackling them when they ask lots of questions about why you need an appointment and why that day? Sometimes it is very stressful just getting to see the doctor!

    • Phew! Where to start with this one?!

      Smear tests are, for most people embarrasing. There’s no getting over that. The more tense you are, the tighter the muscles in that area become and make it really difficult and uncomfortable to insert the speculum. Add to that the fact that lots of people go mad trying get super clean before their appointment and there’s a bit of a lack of natural lubricants. Also, when doing a smear test, we cant use KY jelly on the speculum as it skews the test result.

      Best advice possible is to relax, take a deep breath in, breathe out and as you do, sink your bottom into the bed. its impossible to contract those muscles while you are doing this and should help. πŸ™‚

      It’s nothing to do with babies!!

      • Thanks for the advice Rebecca, there are very few guides to this and to be honest in these situations its quite difficult to take in any advice they give you! Despite the experience I did go back for my most recent one, different nurse, much better experience, a clear result.

  7. This… “Don’t read about your problems on the internet.” …is important and interesting to me (as someone who writes about science and prescription drugs online). You see, I do think it pays to go into a GP appointment as well informed as possible, to avoid getting overwhelmed or being too intimidated to ask questions. I’m not entirely clueless, but I have felt afraid to question my GP in the past, because I didn’t know what I was talking about. I always try and understand as much as possible about what’s happening to my body before seeing my GP so that I can understand what they tell me, BUT (and this really is a HUGE BUT with flashing lights and arrows and shizz), I would absolutely never suggest that anyone self-diagnoses online, and I do always see my GP with any issues I have. I just always like to try and understand the issue myself as best as possible first.

    K x

    • Ok Katie, good point. I think I should have rounded that paragraph off saying, read about it by all means but be open to the fact that you may have misunderstood and dont jump to conclusions or worry yourself sick.

      I lose count of the poeple who I see every week who have got completely the wrong end of the stick after reading online, although talking to great Aunty Nelly or reading the newspapers are equal culprits. The problem is that people don’t just read something and accept it. Firstly they may not understand it, but more of a problem is how they process the information. Most normal peoples try to rationalise information they recieve and it is human nature that as part of processing it and seeking to understand they bring in their own experience. Much like a baby learns that last time something glowed red they burnt themselves touching it, people compare their pain (for example) to other peoples and think about what that lead that other person to experience. Next thing they’re in the GP’s surgery panicking they have cancer, are infertile or need a nasty operation.

      The other thing is that sometimes you just don’t need to understand the minute detail of why everything happens. I dont mean that in a paternalistic sense, just that even I don’t understand some of the science you write about and for me and my clinical daily practice a lot of it is irrelevant. We have sayings in medicine like ‘You don’t treat the blood test, you treat the patient’. There are always people like you for example with a science background who like to know the details (and often I have to go away and look it up, or take the lead from their findings then bring it back round to a relavent and useful discussion for what that means for them.) It’s about treating the person as a whole.

      Finally, no-one should ever feel afraid to question their GP. Whether you know what you are talking about or not. Bottom line, it’s our job to make sure you understand your condition, any medications we’re asking you to take and how we’re going to manage it from here, so if you understand a little or a lot or nothing at all, you should ask. If you feel that you can’t ask then your GP is doing something wrong.

  8. funny you should post this today, the way our surgery is run I rarely see the same doctor twice anymore and I went to see one yesterday for the first time who was dismissive, rude and to top it off tried to make me feel bad about waiting 18 months to see a consultant dermatologist at my local hospital by guilt tripping me that “one of them has died didnt I know!” I was gobsmacked ! anyway not bad for 44 years of doctors appointments I suppose lol I never look at anything on the internet anymore. its terrifying. πŸ˜‰

  9. Great post Rebecca!

    I felt really silly about going to see my doc about a small lump I had found in my breast, and waited a good few months before going to get it checked out – I was convinced they’d laugh me out the door and say I was imagining it as it was so tiny!

    However really glad I went in the end, and defo won’t hesitate in the future. The doctor was great, and the consultant I had to see at the hospital was also fantastic.

    Bad thing is I’ve got to go for a biopsy tomorrow, which I’m papping my pants about (the actual procedure more than the result – they’ve already said they don’t think it’s cancerous, thank God). And I’ve been suffering from a cold all week, so now worried they may not even do the procedure if I’m not fully well as involves anaesthetic?!

    • I glad you went too – this is exactly the reason why NO problem is too small. To be honest, it’s usually the most valid problems that people are the most apologetic about!

      Best of luck tomorrow. Often when you’re scared about something, i’s not as bad as you thought and the Breast Unit nurses and doctors are amazing. Cross your fingers you’re fit for it and can get it over with. I’ll be thinking of you x

  10. Fab post Rebecca! Can I just say also from a GP (almost!) perspective that I definitely agree about saying from the start if you have a list & not waiting till you’re about to walk out the door to say what is really on your mind. We honestly don’t mind lists, if it looks like there’s too much on the list for us to cover in one appointment we can always choose with you which topics we could cover that day & arrange to see you again to cover the rest. Amazing the amount of people who feel they waste our time but as Rebecca said we never feel like that! I also love patient.co.uk, I print leaflets from there several times a day to give out during consultations as I think it really helps to be able to look back at it later to help remember what we’ve talked about when you get home.

    I love FF, keep up the amazing job Rebecca! Xx

  11. Its apt that you post this today as I’m having real issues with my GP practice at the moment. It’s the only one in my catchment area and so far I’ve seen two GP’s one who was great, but has left and the other who was awful! I visited him about some menstrual issues I am having and he told me to visit a family planning clinic! I was really shocked by his total refusal to help, especially as he then asked what I did for a living and how long I’d been with my partner.

    I’m thinking of making a formal complaint but have no idea how to go about it, in the meantime I may pay privately to get to the root of my problem before going back to my NHS practice.

    Anyway i WISH i had a doctor like you! x

  12. Hi Hannah,

    Hmm this is a tricky one. Some male GP’s become a bit ‘de-skilled’ in women’s health, partly through no fault of their own, because women self select to see women often. Others make use of their female GP colleagues to see female patients as it also presents a minor headache in needing chaperones to protect them from claims of harassment etc which is a very real problem. However in singlehanded or small practices this simply isn’t (or shouldn’t) be an option. Looking at it from another perspective, if a GP feels out of practice in one area or another, do you want to see them anyway?!

    If I’m honest, beyond pain killers and tablets which can help the bleeding pattern or heaviness of your period, before having children the best option is often the Pill, which may be why he is suggesting the Family Planning clinic. That said, the pill obviously isn’t suitable for everyone. The family planning clinic is largely staffed by GP’s with extra qualifications in sexual health and family planning, and often a fair interest in other women’s health and gynaecology areas too. Although it’s not what you wanted, I’d go there – you’re likely to get a lot more than family planning advice in a situation where they have a lot more time and understanding. FPC’s are brilliant places and not just for teens!

    • I’d like to echo this, I had a great experience with my family planning clinic after my (very good) GP suggested they’d be better able to help me than him.

      • Thanks! Thats made me feel a bit better now, there’s quite a few FP clinics near me so I’ll pop along to one, xx

  13. Great post. I think like any professional there are people who do a great job, people who don’t and then loads of people who fit in the middle. Anything we can do as patients (after all it is two way) to help the process is good. This post reminds me of a book I read called confessions of a GP which, whilst not a brilliantly written book, did make me understand my GP a lot more.

    Although – I did once get a telling off for needing a repeat prescription of a medicine that apparently cost the NHS Β£20 as I left the cream (by accident) at my parents….. I have to say as someone who always turns up for appointments and doesn’t mess my GP around I did think that was very rude! Oh well πŸ˜‰ I just ask for a different GP now.

  14. Fab post Rebecca and so true!! I would add that if you MUST read about stuff on the Internet etc before seeing your GP and you therefore have an opinion of what you have/what you want, please tell us!! We aren’t psychic and if you’ve come wanting the latest wonder drug we won’t be able to explain if it is or isn’t a good idea for you if we don’t know that’s what you’re thinking!

    Cost is a whole separate ballgame, suffice it to say that it’s part of a good GP’s job to worry about it, and also to find a sensitive and appropriate way of discussing it with you if it’s relevant πŸ˜‰

    • Well said Anita – thats probably something I should have made clearer. It’s most confusing when someone has brought preconceived ideas into the GP but then doesn’t actually divulge them and you can’t quite understand why they don’t believe what it is you’re trying to tell them!

  15. Really useful post. I am just about to move house and am leaving my GP who has been my doctor since I was a baby – is there objective ranking or other way of telling which surgeries in the new area are good? Am a bit nervous about it as over the next couple of years, with potential for babies and things, a doctor I like and trust could be pretty key. Thanks!

  16. Really relevant post for me as I did the textbook ‘door handle issue’ when I last went to the doctors. I had badly sprained my ankle but waited until he thanked me for my time until I blurted out that it became sprained when I collapsed out of the blue and am scared as to why it happened! He was excellent and very supportive. I should have told the truth at the start I guess!

  17. I’ve been to my surgery twice this week. HIGHLY unusual for me. (HORRIBLE cough that is making me feel like I’ve been run over). Anyway, much as I like my surgery, I don’t think I’ve ever seen the same doctor twice, there are about 10 of them, I reckon. I would love to have some consistency there.

    Also, Leon (my other half) went a few months ago and he never goes to a doctor, so he had a list of three things he wanted to talk about (they knew in advance). He said the male doctor was SO dismissive. Everything Leon brought up, the doc shot down in flames and rushed onto the next question. It’s really put Leon off going to see doctors again.

  18. Great post. I work for a community brain injury service & have a lot of dealings with GPs – mostly the contacts have been exceptionally good (just occasionally it can be the secretary or their overly rigid information sharing protocols that can be the problem….!)

    Personally I prefer it when I don’t know my GP that well! In the village I grew up in the GPs were parents of my classmates so I found that really embarrassing!

    I also did some work experience with a GP back in 6th form – the sheer range of things you guys have to deal with is incredible – I don’t envy that!

  19. Ps @ Alex – tell your mum that I was on Peak Practice with my school, they filmed an episode on my parents farm, the fish & chip shop I worked in was named Cardale Fish Bar (after the fictional village on the show) and Amanda Burton (one of the doctors) lived next door to us whilst filming…sad but true!

  20. Hi Rebecca,

    I’m so glad you enjoyed the Poems in the Waiting Room card recently, and it’s great to see your photo of the poem. We do choose the poems we publish very carefully, and this one was a *little* bit on the edge – so it’s great to have your endorsement! We sent a link to your site to Rob Lock, the poet so he can share your enjoyment of it too.
    You and your your readers might like to know that we’ve just overhauled our website, with the new address being http://www.poemsinthewaitingroom.org
    We’re delighted that donations from supporters up and down the country allow us to supply these cards to over 1,000 GPs waiting rooms.

    Thanks again
    Ed and Helen Lee
    Poems In The Waiting Room

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