"A visit to my new GP"

About: Nottinghamshire County Teaching PCT

(as the patient),

I went to my local GP service (Middleton Lodge Surgery) today for an appointment; when I arrived my first impressions were on how crowded and busy it was and made me reflect that this is the only surgery for this village and that I often see patients queuing outside to enter in the morning. When I asked for the toilet and was shown to an annex, as the toilet in the surgery had broken for the third time; which made me comment that maybe it would be worth changing the contractor. If the same contractor fixes a toilet but it keeps breaking, then maybe it would be prudent to try another, rather than have a receptionist make continual trips outside with patients to allow them access to one - I think she made at least 4-6 trips within half an hour. I also noted a lack of confidentiality, as I heard one receptionist mention ‘Aspergers’ which made me realise when they were discussing anyone's personal information other patients could and probably would hear it, though granted they may not know who it was. I also noted one of the nurses looked annoyed and I thought maybe she is having a bad day or was simply tired, but must admit would deter me from visiting her.

Then I went into see a GP I explained my symptoms and that I had been experiencing them for a while, and at my previous GP I had been advised by a specialist, but I was not referred. But the symptoms were getting worse; I was informed that they did not have my notes and it may take a few weeks to a few months to get them. When I inquired also about a blood test, which my previous GP had done and had told me my bloods were absolutely fine. But when I saw a summary to hand into this GP, five components all had warning signs. I inquired why I was not asked back to check them again, to see whether there was an improvement or a deterioration. This GP said they couldn't comment, which I would agree with. Then suggested I ask my previous GP, but later on advised me not to speak to the previous practice manager, as it would be a waste of energy.

When I told the current GP my diagnosis, they informed me the summary received from the previous GP did not reflect this and instead told me my previous diagnosis, which has since been refuted with more up to date assessments made by specialists. I was also informed that they would want to go through my notes with a fine tooth comb before doing anything. Another comment which I found unhelpful was "if you keep moving surgery" I have moved surgery three times since 2011 for personal reasons, not choice.

I ended up apologising repeatedly, because I felt so uncomfortable for wasting his time. I felt my interpersonal skills were not great when I first arrived, and I was told “I am trained to deal with that". This kind of comment, and they way it was said, made me concerned about the opinion this GP had of me. I was apprehensive about going to a GP as I have had to deal with inaccurate assumptions and stereotyping, which have in the past deterred me from seeking medical attention when necessary. When I said that I had felt ignored and that I was angry because the symptoms had got worse, I was not being a bull in a china shop, but in fact I was expressing my frustration and disappointment. And, when I cried when relating my experience, although I was handed a tissue there was a coldness and lack of empathy.

I am concerned that this GP bases their assumptions on notes, and though notes are necessary and it is important to read them, they are not always accurate and do not necessarily reflect an accurate picture of the person sitting in front of you. Individuals are not a diagnosis, and that diagnosis can also be wrong or indeed change with more current assessments, and that the person sitting in front of you has feelings. The judgments a GP makes may affect whether the patient seeks medical intervention in the future. Also, noted often personal opinion, rather than fact (as I am sure ‘challenging young person’ is not a medical term).

All in all I can see and understand the GP point of view, it would be unwise and foolish to make any referrals or start any treatments without notes to read. However, my personal experience over many years has taught me when doctors or any professorial do not take the time to know you as a person, but instead rely on notes, this is unhelpful and causes many problems. I appreciate it when that they will not treat me unless it is life threatening, because they do not have my notes. I appreciate they will have to speak to other professionals for more information, however, I do not misinform anyone intentionally.

I also wonder if there may be scope for this area (which is quite large) to have another surgery, so that patients have more choice. Also having one surgery in one town does not allow choice as, without transport, realistically there is no where else to go. I also would like to know if there is a means for patients to appraise and choose the surgery based on that surgery's ethos in certain areas, as it is not always physical health that’s important, but how the GP deals with other disabilities.

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