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Independents' Day

GP group releases 200 accounts of patients using general practice 'inappropriately'

GP support organisation Resilient GP has found examples of patients requesting sick notes to cover up infidelity and booking appointments to complain they had previously been unable to book an appointment for a sore throat that had since cleared up.

Its report sets out to highlight the public’s inappropriate use of general practice by publishing a list of almost 200 GP experiences that the group deemed an ‘inappropriate use of their time and skills’.

The report recounts anonymised and, reportedly, recent experiences GPs have had with their patients, including a formal complaint for giving unsatisfactory advice on emigrating to Australia.

It follows a fierce debate over patient demand at the Pulse Live 2015 conference last week, where Resilient GP co-founder Dr Stephanie De Giorgio told the audience ‘some patients take the piss’.

The Resilient GP report stated that it was ‘now time to ask whether general practice is being used appropriately’.

The survey found a series of inappropriate patient demands, including a woman asking for an operation as her chin ‘looks too fat on Facebook’ and a man asking for a sick note after going on holiday with his mistress.

The report added: ‘These may sound like extreme examples, but they are all genuine, recent events. GPs report that while such requests are not new, they now occur far more frequently.’

It concluded: ‘It is increasingly difficult to justify spending so much time dealing with matters such as those listed above.’

Speaking at Pulse Live last week, Dr De Giorgio said: ‘You can blame some patients, and I am absolutely sick to death of every time I go on Twitter and say something about patients using the system inappropriately, someone accuses me of patient blaming. Until we deal with that attitude we’re not going to be able to have a reasonable debate.

‘Yes, some patients take the piss, quite frankly. They do. And we have to address those ones.’

Former RCGP chair Professor Clare Gerada said: ‘You’re on a sticky wicket to do that. Last week, I was spat at in the face by a patient; they always have and you have to deal with them.

‘But when you have adverts on the back of buses, saying “go and see your GP if you’ve had a cough for 30 seconds”, do not blame them. That’s what they’re told to do.’

Pulse Live 2015 Scotland plug

Readers' comments (34)

  • There will always be inappropriate use of GP appointments. However the demand for our time has increased enormously. This makes us angry when we then do not have enough time to spend with patients who urgently need our attention.

    Quite frankly I believe we will have to start charging patients. In fact I wonder whether it would be possible to only charge patients when they make inappropriate use of our time. The idea being to educate patients as to what we are paid to do.

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  • No one is blaming patients for being ill but the NHS is a finite resource and its use has to be rationed appropriately. This means we have to talk about this sort of stuff even though it's really hard and emotive. A debate on managing demand is essential if the NHS is to survive, people have to accept the need to triage out unreasonable requests like those above. There are simply not enough doctors and nurses in the UK to meet the desires of a consumer culture so something will have to change. It would help enormously if more of the medical leadership were supportive of grass roots doctors doing their best to bail out an NHS where crisis has become a normal. No is not a four letter word and sometimes it needs to be said loud and clear.

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  • The problem can be solved in an instant. £30 fee to book the appointment, non-refundable, no exceptions. Every other civilised country does.

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  • What about the malingerer who comes in for backache and you see him running on the street in the evening in a park. After months of investigations when radiologist writes MRI is normal and no explanation found for this gentleman's pain, the patient says but I am depressed and suicidal and grins you in the face. Hapless and helpless?

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  • Fees won't work. What if a patient turns up in pain with no money? Turn them away? Not workable.

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  • You couldn't make it up - or could have already told this story Sanjeev =but added a bit extra on this time

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  • >> GPs report that while such requests are not new, they now occur far more frequently.

    What's the evidence for this? I'm familiar with the admin requests, but I say know if it's beyond contract. Doesn't take a great deal of time.

    The clinical queries in the list are fairly extreme - I can't recall anything in last 3 months of this ilk. Maybe 1-2 cases per year. And I'm full time, dealing with anything from 40-100 contacts per day.

    I have plenty of frustrations with workload (mostly related to political issues) but I don't see this as is our greatest problem.

    Also conscious of numerous patients apologising for wasting my time when they patently are not. Far more worried this debate could push some of the needy and frightened away than I am about a minuscule fraction of my workload.

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  • I have noticed a huge increase in 'timewasters' in the last year. I have no idea why that should be.

    Much could be dealt with by their grannies.

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  • Primary care has expanded its access only in the past few years. This includes non-funded extra hours worked by GPs and funded GP extended hours, walk-in centres etc. Patients have filled this greater access just in the same way as building another lane on the motorway will be filled with more traffic. Yet patients still want greater access to health care. The issue is that 80 to 90% of this demand Is for self-limiting conditions. In the past if you told the patient they had a viral infection It was more readily accepted.. Today patients want second, third or even more frequent opinions during the course of an URTI infection lasting many weeks. Exactly the same for periods of anxiety, depression, back pain etc.

    This is the real change and is plainly not affordable. Perhaps charging is the only way. After all this works everywhere else in the world. What makes this country different?

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  • ResilientGP (the Daily Mail of GP forums) have published an ethically dubious "survey" resulting in a decontexualised, sensationalised and one-sided "list of shame", that breaks patient confidentiality in order to promote a patient-blaming agenda.

    Not sure how this does GPs any favours.

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