If I am unhappy with my own GP I can take a number of actions. I can complain to the practice manager of my surgery, I can complete a friends and family test, anonymously as well as leaving messages on the NHS Choices website, again anonymously. I can also use social media to talk about my GP, call a newspaper or even lodge a complaint with General Medical Council. One of my own patients has written directly to the Parliamentary Ombudsmen and brings in the acknowledgement slip with her each time she comes in.
That I can’t reveal anything more about her, in an effort to protect her confidentiality illustrates the issues that doctors, including GPs, have in talking about the minority of patients that make their life and work a struggle at times. Reported case studies need patient permission and many bloggers who write in the medical press change the details of patients that are rude, inappropriate or simply daft, in order to protect their identity.
When it comes to the issue of trying to provoke debate about what some patients actually come to the GP about, this issue makes it very hard to know what to do. It seems that GPs are to “See no evil, hear no evil and speak no evil (of)” their patients. The customer, sorry patient, is always right and according to the health secretary knows better than the doctor. How can you compile a record of how the GP system in the UK is, albeit in some cases inadvertently, abused by patients.
Resilent GP debated the posting of the “inappropriate use of GP appointments” survey report. After being posted on the website, it was withdrawn after concerns about whether patients’ confidentiality was being breached. Careful reading of the report will show that this is not the case. It was restored so that healthy debate can continue. The Resilient GP partners have stated publicly that they feel that it is not unethical to raise real life examples of inappropriate appointment use. This is done by the ambulance service..
Although there are concerns that there is no fixed definition of an inappropriate consultation and that “naming and shaming” such inappropriate uses will discourage patients from attending their GP with vague symptoms that could belie some serious cause, I would argue that we don’t seriously think that speaking to your GP about the colour of the fluff you find in your belly button (true story) or any of the “symptoms” listed in the survey could result in a medical diagnosis other than health anxiety. Furthermore, by educating patients not to use up appointments with such things we may actually improve access for those that actually need it, for their serious, even life threatening conditions. Therefore, in order to improve access for patients in need, we need to first identify and discuss the problem of inappropriate GP appointment use, then decide how this problem should be tackled by the general practice, public health authorities and society as a whole.