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Independents' Day

Half of patients expect GPs to prescribe or refer in line with their demands

Half of the public think that their GP should always give them the prescription, treatment, or referral to a specialist that they request, a survey has indicated.

The YouGov poll of 2,000 British adults, commissioned by Medical Protection, also found that one in five members of the public (21%) has challenged their GP’s diagnosis and almost half (47%) of patients attempt self-diagnosis by googling their symptoms before seeing a GP

This comes as nine in ten (86%) of Medical Protection GP members said that they ’sometimes, most of the time or always’ have challenging experiences with patients when they do not provide the prescription, treatment, or referral to a specialist they request.

In what is likely to come as more positive news, some 80% of the public agreed that their GP does ‘meet their needs and expectations’.

But Medical Protection senior medico-legal adviser Dr Pallavi Bradshaw warned that patients consulting ‘Dr Google’ before turning to their GP may be more likely to submit negligence claims as a result.

She said: ‘Patients who search their symptoms and possible diagnosis online before visiting their GP may have a preconceived idea of what their diagnosis is and how the condition should be treated.

’When these expectations are not met, it can lead to patients feeling dissatisfied, a breakdown in the doctor-patient relationship and a greater risk of the patient pursuing a complaint or claim against the GP.’

To best try to avoid such claims, Medical Protection advises that GPs ’always try to establish exactly what their patient’s expectations are’ and make sure that they ’focus on clearly addressing expectations throughout the consultation and involving the patient in decisions around how to manage any issues’.

Dr Bradshaw said GPs have a 'a professional, legal and ethical obligation to involve patients in decisions around their own care' and that 'where a patient has a false belief or unrealistic expectation, it should not be dismissed without a discussion and explanation of how and why an alternative option is in the patient’s best interests'.

But she added: 'During the consultation, it may also be appropriate for GPs to encourage patients to be cautious about self-diagnosis via the internet.

'They can also guide patients to useful health resources and patient group sites which may help with their ongoing healthcare.'

The advice comes as experts have warned that unrealistic Government targets for savings in the NHS will lead to widespread rationing of services.

In a recent example of NHS rationing, one CCG attempted to block all non-urgent referrals of patients to hospital this winter.

Meanwhile, a host of CCGs have recently advised GPs they should no longer prescribe over-the-counter medicines for self-limiting illnesses.

GP treatment expectations survey results

  • 47% of the public has looked up their symptoms online;
  • 50% think GPs should give them the treatment, referral or prescription they want;
  • 21% of the public have challenged their GP's diagnosis;
  • 80% of the public agree their GP meets their needs and expectations;
  • 86% of Medical Protection GP members sometimes, most of the time or always have challenging experiences with patients when they do not provide the prescription, treatment of referral to a specialist they request.

Source: YouGov poll of 2,000 British adults, and a survey of Medical Protection members

Readers' comments (22)

  • Vinci Ho

    With all the health news on BBC and Pulse today about NHS and general practice as well as A/E, you wonder how many people have finally waken up about this government handling the whole business of health and care . At least , David Behan , chief executive of CQC , ' dare' to stand up to question the government not spending enough on NHS:
    'Safety fears in two-thirds of England's A&Es, inspectors say'
    By Nick Triggle on BBC news
    Nick , interestingly , commented
    ''In an unprecedented step for the regulator, he called on ministers to pump more money into the council care system.''
    As I said before , Auntie May and the Chancellor are waiting for the whole system to get even worse before they would come out to play the 'saviour'. If Labour still has some political wisdom left behind after recent own civil war, this is the area of arguments to win them some political brawny points. But then again , politicians are still politicians and only politicians.......

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  • Daily Mail headline "GPs are all monsters and responsible for all society's ills. Total Bastar.. ! Blah, Blah....
    No wonder we are more hated than bankers and ISIS combined...

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  • We are just public servants (slaves) and should give them what they want. Why argue with them? It really doesn,t matter. The NHS is doomed whatever we do.

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  • No one ever thanks you for not prescribing and referring. If however something goes wrong and you hadn't prescribed/admitted/referred the patient, you can guarantee multiple jeopardy,starting with a complaint locally, followed by NHSE, GMC, CQC, Ombudsman and finally the lawyers. Keep it simple and keep it real. Looks like the MDO's are offering the same advice if you read between the lines.

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  • Some of this is due to unfortunately terminology being used- encouraging patients to be "empowered", "pushy" or "assertive" is somewhat counter-productive.

    It was only two years ago we were getting headlines like "Patients should be pushier with GPs, says watchdog chairman"

    "But Prof Haslam told the Telegraph: "When products have been approved for use by the NHS by NICE, patients have a legal right to those drugs - as long as they are clinically appropriate.... "The fundamental point is, it's your body," he said.

    Which of course isn't strictly true. It's only NICE's Technology Appraisals that are binding..... NICE just reminds me of when at school I was "guided" out of the classroom by my teacher with my arm in a half-nelson..... But anything other than arms-length management would require attached funding.....

    From two weeks ago...

    "The Choosing Wisely Wales Programme urges patients to be more assertive when visiting their GP, playing a bigger role in decisions about their care."

    Using words like Pushy and Assertive really doesn't help! Bizarrely the second link suggests that patients being "Assertive" might reduce excessive intervention or treatment. Really??? If patients don't want an xray they don't go for it, if they don't want the meds they don't take them? Telling people to be assertive makes them think they should bully and harass in order to get what they don't need. Good intentions but don't see the logic personally.

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  • In the last few years I have changed my practice. If it is not too unreasonable, I acquiesce to their demands.

    Why should I be a gatekeeper when I am no longer supported to do so ?

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  • Time for the gatekeepers to open the flood gates and see if the system can cope!No it can't ah well time the change the system.Pay per process,can we afford it doubt so private system it is.

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  • Give them what they want and when they get problems remind them it was their choice. Let the NHS fail.

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  • Nothing new here, it's free after all!
    Can anyone honestly still make the arguement that the NHS is not out of date and still fit for purpose??

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  • I think that patients self-diagnosing, coming up with treatment plans and deciding on referrals can only be a good thing. Before too long there won't be any GP's left to see so these self-help skills will be very useful. The NHS ship is sinking fast and there may not be enough lifeboats for everyone so don't be the last to leave, I walked away at 49yrs old last year. Good luck if you stay onboard.

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