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Douglas Prom

'Serious' GP shortage on horizon

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Do we need GPs now we have google?

 

The last time I went to the Docs all he did was type my symptoms into a PC anyway, he didn't even look at me the whole time I was there, had his back to me typing away. We don't needs humans for this job. In fact a PC is probably a lot more human than most GPs anyway.

They have a better website than you.

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Do we need GPs now we have google?

 

The last time I went to the Docs all he did was type my symptoms into a PC anyway, he didn't even look at me the whole time I was there, had his back to me typing away. We don't needs humans for this job. In fact a PC is probably a lot more human than most GPs anyway.

 

It might be in jest but it's not actually that far from the mark.

 

That is, in effect, exactly what NHS Direct was. People using computer algorithms to sort through symptoms and trying to reach a diagnosis. It was closed down in England in 2014 after 15 years of trying to make it work because it turns out that the computer algorithm can't work out whether your cold is actually something more serious, so 'to be on the safe side' hoards of people with minor illnesses ended up getting ambulances sent to them, or being advised to attend A+E. It would also ask hundreds of questions and take forever to reach the conclusion that you needed to see someone to be assessed because it couldn't rule out meningitis or some other such horror. A real success!

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I didn't realise nhs direct shut down. Bit of a silly name as it was more like NHS <if you're calling you probably aren't that sick>

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Locally, overthe years,I understand there have been several "strategic plans" regarding provision of Primary care.

In the early 90s there was the idea of 3 regions South West and North each providing Gp cover.

Suspect at sometime a variation on the theme will remerge as some sort of trio of primary care polyclinics or whatever the current choice of term is

so expect the word "Hub " in there somewhere

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I didn't realise nhs direct shut down. Bit of a silly name as it was more like NHS <if you're calling you probably aren't that sick>

It shut down in England in 2014 and was replaced by NHS111 which is essentially a signposting service, to direct people to the appropriate part of the NHS rather than giving actual advice, so it is far less ambitious in it's aims, and certainly doesn't replace any part of the service (in fact it relies upon them because it needs to have somewhere to direct people)

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On 3/14/2017 at 8:30 AM, RIchard Britten said:

Could you not use someone along the lines of a higher trained nurse/paramedic type to act as a "triage" at a surgery.

 

A sort of pre-screening to see if you actually need a doctor or just need to be sent to the chemist for some cough medicine?

 

I know some surgery secretaries act like they are the gatekeepers to an appointment, but being told by someone that they think you aren't dying just yet rather than a phone operator with a spreadsheet is a bit more reassuring.

"Triage" is a  word that sounds so sensible and reasonable and   just common sense, really.

Reflect, though on its origins in the French military way of dealing with overwhelming battle  casualties for the benefit of the army,rather than the individual by dividing them  into three groups:

1 those who would respond best to immediate treatment and could be quickly returned to duty.

2 those whose treatment could be delayed.

3  the third group ,who where deemed beyond any effective treatment and denied active treatment, were  effectively  left to die.

The use of the term  and practice extended into WW1 for the Allies on a massive and  initially on a very tragic scale.

Transposing this to  our  more enlightened   and caring , modern times, then all serious illness  and  especially anything afflicating the elderly or disabled would be triaged as 3

Illness  requiring a differential diagnosisis , investigation and treatment would be caregory 2

Which would leave the service focussed on  category 1

These  are the  "Worried Well".

Get them back to work swiftly, reassuring them of its "viral" origin; that there  is a "lot  of it about"  and of it is "self limiting" nature and convincing them  "plenty of fluids , paracetamol or ibuprofen "and  buying  cough medicines and other over the counter medicines  actually work - but do not merit an NHS prescription,

The problem  here  is the 'attrition rate" -the unfortunates who are wrongly "triaged'

The burden on the telephone "Triager" to get it right most of the time and not miss the mengititis, the encephalitis , the early sepsis  and other off the beaten track,  but lethal conditions, is a heavy one.

It ain't  easy ,it ain't simple

 

 

 

Edited by hampsterkahn
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It's so difficult to get a GP appointment these days that I have, like many people, fallen back on the internet to diagnose my ailments. So far I've had smallpox, typhoid, sleeping sickness, beri beri, leprosy, malaria, yellow fever, West Nile fever and Aids. Luckily red wine seems to cure them all.   

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10 minutes ago, Max Power said:

It's so difficult to get a GP appointment these days that I have, like many people, fallen back on the internet to diagnose my ailments. So far I've had smallpox, typhoid, sleeping sickness, beri beri, leprosy, malaria, yellow fever, West Nile fever and Aids. Luckily red wine seems to cure them all.   

I hardly bother it's at least a week whenever I try and I always think I'll be better by then and never bother booking an appointment. They really need to sort out the GP situation. I would agree with you red wine is usually a good remedy for a lot of ailments. 

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On 7/8/2017 at 1:14 PM, Max Power said:

It's so difficult to get a GP appointment these days that I have, like many people, fallen back on the internet to diagnose my ailments. So far I've had smallpox, typhoid, sleeping sickness, beri beri, leprosy, malaria, yellow fever, West Nile fever and Aids. Luckily red wine seems to cure them all.   

They need to clear the clutter of the 'regulars' that visit the doctor every time they sneeze or fart...and concentrate on the list that don't visit that often....get them in for medicals/checks etc. too...save a fortune long term identifying illnesses before they come to full fruition.

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27 minutes ago, Albert Tatlock said:

They need to clear the clutter of the 'regulars' that visit the doctor every time they sneeze or fart...and concentrate on the list that don't visit that often....get them in for medicals/checks etc. too...save a fortune long term identifying illnesses before they come to full fruition.

So it's Dr Albert Tatlock is it?

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1 hour ago, Albert Tatlock said:

I might not be a gynecologist...but yes, I'll certainly have a good look.

find a mirror then.

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20 hours ago, Albert Tatlock said:

They need to clear the clutter of the 'regulars' that visit the doctor every time they sneeze or fart...and concentrate on the list that don't visit that often....get them in for medicals/checks etc. too...save a fortune long term identifying illnesses before they come to full fruition.

All that will do is identify ones with relatively easy to solve ailments but instead of the patients making the necessary lifestyle changes needed they'll just prescribe some pills to take to store the problem up until a later date. The only winners will be the pharmaceutical companies and IOMG will end up spending more money.

Edited by Lxxx

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