GPs that wind me up. Part 2 of 2
My list continues:
7. GPs that prescribe long term benzodiazepines.
A source of constant pain in substance misuse clinics but not limited to them by a long chalk. Unlicensed (not that that necessarily means much) and the evidence suggests that it is damaging to patients. Stop it, stop it.
8. Practices that employ salaried GPs and nurse practitioners when what they really need is another partner.
This is primary care on the cheap and is often primarily motivated by the profit share for the existing partners. This pill is often sugared to ease the conscience (for the more sensitive souls) with mealy-mouthed excuses about skill mix. This letter agrees.
We could be more honest as a profession – few patients realise that GP surgeries are run as businesses for the profit of the partners. Maybe that’s why GP principals are kicking up a fuss?
If GP principals pursue this policy then the endpoint will be a fully salaried GP profession. Of course, it probably won’t be in the current GPs’ working life so why should they care?
9. Any practice (but especially the large ones) where patients struggle to see the same doctor twice.
Many patients may not be too bothered by which doctor they see. In many conditions it may not matter. But most patients with any kind of chronic condition will really benefit from continuity of care. Sadly, odious access targets do nothing to encourage behaviours in GP practices that will foster continuity of care.
10. GP principals that place their salary above the needs of patients.
This is rarely explicit but some of the previous gripes have this at their core. What I am really referring to here is the explicit money-grabbing tight wad GPs. I am sure that everyone knows one or two local practices where this description could be applied. They will often deploy this two-sided defence when fiscally threatened.
They will try :
1. We are a business and if we do xxxxxxxx we will have to pay for electricity/heating/staff costs etc.”
Or alternatively they can try:
2. We have to provide patient care and we should not have to compete/be protected from other pharmacies/private companies.
GPs are in a unique position where there is a difficult and delicate balance between maintaining patient care and looking after their own legitimate business interests. Most manage it admirably and receive a fair and deserved salary. Quite a few take the mick.
11. GPs that see pharmacy reps
They are usually very young and naive or old and complacent. Or they may be dispensing and business orientated. (See No 10. above). These GPs will usually claim they are unaffected by the reps, er, representations. Hogwash. There are innumerable sources to pick up information on prescribing that are impartial. Grow a conscience.
There now, I feel better for that.
#9 – absolutely. My local practice (in East London) has something like 9 GPs. I’m supposed to see the same one every time for my anti-depressant repeat prescription. Over the last five appointments, I’ve managed to see ‘my’ GP twice. The other three times I’ve seen three different individuals, only one of whom had ever seen me before in my life. Continuity of care – ha!