[Locke_211]

I had what I thought was really bad anxiety disorder but what my GP said was mild to moderate. I asked him for anti-anxiety medication and he said no, but if I came back and asked again after a month of counselling, he'd prescribe me some. Having read how addictive they can be (and how in some cases they can even make anxiety disorder worse) that was probably the most responsible thing he could possible have done.

[GungHo]

I've been feeling extremely sick as of late and because of it, I was unable to do my exam today. College policy is you require a medical note. They didn't give me one. Now I'm worried I will fail. I missed the exam. The GP didn't have any suggestions other than 'ride it out', and didn't offer me the note, because apparently, the NHS doesn't provide sick notes. Yes, this is why I'm pissed. I hope to enter maxfax surgery too. I don't want my career jeopardised just because I was feeling sick on the actual exam date. Has the doctor helped me at all? NO. If they truly cared about helping people, he would have offered to write a statement that I saw him, and explained to him my symptoms. But no. Yes, I'm pissed. Hope this explains everything.

Maybe you should see a gynecologist.

[Adam Blade]

OP, your fault for buying into the medicopharmaceutical bunkum. You should have gone to your local naturopath or homeopath instead. I'm sure you would have gotten better care and would have gotten a sick note.

The years of medical school and residency the so-called medical "professionals" (who are GPs) are nothing but scam-filled years designed to provide cheap labor for most hospitals, which is tantamount to white-collar slavery.

After all, a quick Google search is far more illuminating and informative than any visit to such a medical quack would be.

[bill0527]

My wife is a GP so I'll just have to disagree.

In the U.S., GPs are the lowest paid doctors and have to see about twice as many patients per day compared to the next higher specialty on the pay ladder.

My wife used to be employed by a hospital. But thanks to the shenanigans of hospital administration, she quit and vowed never to be employed by a hospital again.

She signed a three year contract with them at a guaranteed pay level, but after a year, the hospital administration wanted to renegotiate the contracts of all physicians and put them on..in simple terms, a commission based pay schedule. For her to make the amount of money she was making before, she would have to see at least 55 patients a day compared to the 35 patients she was currently seeing.

Do the math. At 35 patients a day during the 8 hours her office was open, that's a little over 4 patients per hour. She got around 12-15 minutes with each patient. Under the new deal, she would have to see almost 7 patients per hour and each patient would only get around 8 1/2 minutes of her time. She was not comfortable doing this because she felt it would jeopardize the quality of care she could give and she feared it may lead to lawsuits.

Plus she had to be on call 3 days a week. It gets kind of old getting phone calls waking up the house at 3am from people who have a headache and don't know what to do. Well..if its bad enough go to the emergency room because there's nothing she can do for you at 3am laying in bed and being 30 minutes from her office.

She has been working in rural emergency rooms now for a few years and likes it a lot better. You can be a GP and work in low level ERs with ATLS certification, make about 40% better pay, never have to be on call, and never get pressured from hospital administration to see more more more and more patients every day.

[hockeypuck]

A single good GP who can control his/her patients' blood pressures, maintain low hemoglobin A1Cs, and reduce hyperlipidemia does more for the health of the community than five specialists combined.

OP's stories don't make sense. He felt "extremely sick," didn't get a sick note (didn't get admitted as an inpatient, either), then argued with his GP about his grandmother's arthritis? Wha? By the way, what was this "certain treatment" whose efficacy and certain side-effects you were arguing about?

It's far more plausible that a second year medical student doesn't know shit about what he is talking about, compared to a GP actually practicing for years.

Of course, it figures that the guy who doesn't think history-taking (behind a desk or otherwise) is 'real medicine' wants to go into surgery.

Hey now.
If his post history is any indication then he's not cut out for a surgical career.

[Nevasleep]

Fact is some GP's are rubbish, likewise with dentists.
Change if your not happy or confident.

[Indrid Cold1]

So if GP's are overworked and underpaid compared to other MD's is it safe to assume that they are the dunces of medical school? Cause they sure as fuck can't be doing that shit by choice if other more glamorous specialisations were available to them.

[pax217]

Read this thread last night, had nothing to post. Had girlfriend pass out in shower this morning, complications due to what seems to be an early case of pneumonia. Took her to her Group Health practitioner... no help. Didn't even care that she was short of breath, gave her an antibiotic and sent her out within 10 min.

No wonder this country can't afford stupid medical care.

[Scullibundo]

I have a GP who won't tell you your blood test results unless you come in. So I go in and he tells me the results are clean and there's nothing wrong with me. $75 for that little piece of thirty second insight.

Motherfucker.

[pax217]

I have a GP who won't tell you your blood test results unless you come in. So I go in and he tells me the results are clean and there's nothing wrong with me. $75 for that little piece of thirty second insight. Motherfucker.

Exactly what they did to my girlfriend this morning.

Fuck off, we're not coming back.

[bill0527]

So if GP's are overworked and underpaid compared to other MD's is it safe to assume that they are the dunces of medical school? Cause they sure as fuck can't be doing that shit by choice if other more glamorous specialisations were available to them.

There are no dunces in medical school. I can't recall the exact details of the conversation I had with my wife on the grading system, but the courses are done on something like a highly proficient-fail basis, with maybe a satisfactory level in between.

The reason why they are overworked and underpaid has nothing to do with their education level. It has to do with the massive shortage of family practice doctor's available in the U.S. because nobody wants to go into the field. The reason why nobody wants to go into the field is because of the fact the pay is low and the hours and headaches are high. Its a nasty cycle.

http://www.usatoday.com/news/health/...shortage_N.htm

Longer days, lower pay, less prestige and more administrative headaches have turned doctors away in droves from family medicine, presumed to be the frontline for wellness and preventive-care programs that can help reduce health care costs. The number of U.S. medical school students going into primary care has dropped 51.8% since 1997, according to the American Academy of Family Physicians (AAFP). Considering it takes 10 to 11 years to educate a doctor, the drying up of the pipeline is a big concern to health-care experts. The AAFP is predicting a shortage of 40,000 family physicians in 2020, when the demand is expected to spike.

[bill0527]

I have a GP who won't tell you your blood test results unless you come in. So I go in and he tells me the results are clean and there's nothing wrong with me. $75 for that little piece of thirty second insight. Motherfucker.

If you're in the U.S., its not the doctor's fault, nor the doctor's LPN, nor the receptionist.

You can thank the U.S. Federal Government and its insane regulations for your inconvenience.

HIPPA

[Orayn]

OP, your fault for buying into the medicopharmaceutical bunkum. You should have gone to your local naturopath or homeopath instead. I'm sure you would have gotten better care and would have gotten a sick note. The years of medical school and residency the so-called medical "professionals" (who are GPs) are nothing but scam-filled years designed to provide cheap labor for most hospitals, which is tantamount to white-collar slavery. After all, a quick Google search is far more illuminating and informative than any visit to such a medical quack would be.

I'm sad that this will inevitably be your only post in the thread. Why won't you have a conspiratorial meltdown for GAF's entertainment, already?

[hockeypuck]

So if GP's are overworked and underpaid compared to other MD's is it safe to assume that they are the dunces of medical school? Cause they sure as fuck can't be doing that shit by choice if other more glamorous specialisations were available to them.

No, it's not safe to assume. In the NHS the GP position (especially in the bigger cities) is one of the more competitive fields. Reimbursements there are such that if certain health targets are met, GPs get paid more. It's a merit-based system focused on making patients healthier. Compare that with the American system, where private health insurance reimbursements are based mostly on how many procedures you can do.

There are many specialities that work more hours than the average GP. A GP resident also has more time during residency to actually raise a family. Since American residents are paid the same amount no matter the specialty, a GP resident actually makes more money per hour than any surgical specialty resident. What makes a certain specialty "glamorous?" I don't understand that description. A bigger salary in the end? Is being a neurosurgeon more glamorous? Because he's probably more likely going to be bald before finishing training, divorced three times, and die an earlier death compared to the GP. There's your glamor.

[Buttchin]

So if GP's are overworked and underpaid compared to other MD's is it safe to assume that they are the dunces of medical school? Cause they sure as fuck can't be doing that shit by choice if other more glamorous specialisations were available to them.

not even close... some of the brightest people in my medical school class went into Family medicine cause its what they wanted to do. However people that were on the fence (read as "i would like to do Family medicine or __________" would be more likely to pick the other thing due to the reasons mentioned above by another poster. Also the other problem is people that go into internal medicine (The other primary source of General Practioners and primary care) are going into IM with the specific goal of going into the more lucrative and prestigious subspecialties like GI or Cardiology.

Similar things are happening with other fields of medicine by the way like psychiatry and OB/GYN's. I've heard mention of a similar thing happening with General surgeons but I'm less familiar with that side of medicine and other posters would probably be more knowledgable.

[jbueno]

I am a General Practitioner. What have I ever done to you to deserve this kind of hate?

[hockeypuck]

If you're in the U.S., its not the doctor's fault, nor the doctor's LPN, nor the receptionist. You can thank the U.S. Federal Government and its insane regulations for your inconvenience. HIPPA

What? You're blaming HIPAA for Scullibundo's justified complaint? You can totally give test results over the phone, especially negative ones that can save time and money for the patient. I and every other frickin' resident in this country do this ALL THE TIME. As long as we're comfortable with believing that the person on the other end of the line is who they say they are, then we're fully capable in our right to discuss test results. Hell, I can even do a simple follow-up visit over the phone and the patient doesn't even need to come to clinic to get a simple bandage removed.

Poor effort on trying to blame HIPAA on this one, since HIPAA is actually a good rule and actually gives the patient more rights and offers more privacy protection.

[Emerson]

A single good GP who can control his/her patients' blood pressures, maintain low hemoglobin A1Cs, and reduce hyperlipidemia does more for the health of the community than five specialists combined. OP's stories don't make sense. He felt "extremely sick," didn't get a sick note (didn't get admitted as an inpatient, either), then argued with his GP about his grandmother's arthritis? Wha? By the way, what was this "certain treatment" whose efficacy and certain side-effects you were arguing about? It's far more plausible that a second year medical student doesn't know shit about what he is talking about, compared to a GP actually practicing for years. Hey now. If his post history is any indication then he's not cut out for a surgical career.

Totally agree. Then again, the implication that it's okay for even a 2nd year med student to be this ignorant is still upsetting to me. And the circumcision thing is certainly not explained away with "I was a first year!" unless by that you mean your first year of life.

I have a GP who won't tell you your blood test results unless you come in. So I go in and he tells me the results are clean and there's nothing wrong with me. $75 for that little piece of thirty second insight. Motherfucker.

I'm not going to say this is the right thing to do, as it's obviously not. But just to play devil's advocate, consider that unless you come into the office the doctor receives $0. Certainly the ideal balance would be somewhere between there and $75 (closer to 0 of course).

[Mr. B Natural]

There are a lot of GPs out there that take wild (or too obvious) guesses, give you pills and send you home. The world needs more honed specialists and insurance that allows you to go straight to the specialist but there simply aren't enough of them. It would save money and lives.

If you have an auto-immune issue, most likely your GP is going to guess wrong 3,4,5 times until recognizing it. Then there's anti-biotics and sleep disorders...in which "take one of these a day" could make things worse. If you have something obvious then they're a great option, but these days, if you have something obvious, Mr. Interwebs M.D could be just as helpful.

[Emerson]

There are a lot of GPs out there that take wild (or too obvious) guesses, give you pills and send you home. The world needs more honed specialists and insurance that allows you to go straight to the specialist but there simply aren't enough of them. It would save money and lives. If you have an auto-immune issue, most likely your GP is going to guess wrong 3,4,5 times until recognizing it. Then there's anti-biotics and sleep disorders...if you have something obvious then they're a great option, but these days, if you have something obvious, mr. interenet phd could be just as helpful.

"More specialists" is exactly the wrong solution and is a big part of the issues that the American system has. You're right, there are primary care doctors who use outdated material, plain aren't very good physicians, etc. But the solution to that problem is better primary care, not more specialists. Doctors need to recognize when a specialist is needed and refer, not try to "guess" (though I'd contend that happens much less frequently than you think).

Medicine is frustrating because everyone out there thinks they know better than their doctor and they are wrong 99.9% of the time. The lay public simply does not understand how medicine actually works and it leads to opinions like this where people think that doctors with 30 years of medical experience are pulling ideas out of their ass. It doesn't exist to nearly the same degree in other fields.

[Scullibundo]

I'm not going to say this is the right thing to do, as it's obviously not. But just to play devil's advocate, consider that unless you come into the office the doctor receives $0. Certainly the ideal balance would be somewhere between there and $75 (closer to 0 of course).

Joke? I pay to go in for the consult and blood test before that. I shouldn't have to pay a goddamn thing for him to say 'There is nothing wrong.' He absolutely should receive $0 for that. It should end after me ringing up and finding out. It is a disgusting practice.

[Zefah]

I'm sure there are plenty of great GPs who really care and research their patient's issues, but the reality is that they are mostly overworked and underpaid. I imagine it's easy to get very jaded in a short amount of time in that position, especially when you're going through dozens of a patients every day.

That's why there are a lot of guys out there who will just take a guess and send you home with whatever big pharma is currently recommending. A lot of patients are shitty, too, and demand some kind of drug prescription before leaving the office. I'm sure this plays into a lot of GPs just not giving a fuck anymore.

In the end, as a patient, don't blindly trust a GP or let them give you drugs just to get you out of their office.

[Emerson]

Joke? I pay to go in for the consult and blood test before that. I shouldn't have to pay a goddamn thing for him to say 'There is nothing wrong.' He absolutely should receive $0 for that. It should end after me ringing up and finding out. It is a disgusting practice.

OK, I am not disagreeing that it's a bad practice. But seriously consider how many patients he has to see and that calling you takes up some of his time. A family practice doctor is not salaried, he gets paid for what he does. His time is worth something. Also consider that many patients like to use phone calls as a substitute to coming in when they need to come in, and since doctors cannot bill for phone time, many of them like to avoid talking on the phone if possible.

[MThanded]

I have now come to the conclusion, after seeing a few GPs, that they do not care about helping people or patients, but rather are here for their own interests. I wonder what bullshit they used when they applied to medical school themselves. 'I WANT TO BE A DOCTOR SO I CAN HEAL THE WORLD'. I remember when I had my interview for medical school - the ethical scenario was all about doing what is right for the patient. Apparently it is all about the best interests in the patient. I guess not. Fuck GPs. However, I have far more respect for actual physicians who work in a hospital, as they are real Doctors. Now they truly help patients. Not some asshole who suits behind a desk in a suit. To be frank, I probably have more medical knowledge than a GP.

Thats a pretty scathing attack post.

[Mr. B Natural]

"More specialists" is exactly the wrong solution and is a big part of the issues that the American system has. You're right, there are primary care doctors who use outdated material, plain aren't very good physicians, etc. But the solution to that problem is better primary care, not more specialists. Doctors need to recognize when a specialist is needed and refer, not try to "guess" (though I'd contend that happens much less frequently than you think). Medicine is frustrating because everyone out there thinks they know better than their doctor and they are wrong 99.9% of the time. The lay public simply does not understand how medicine actually works and it leads to opinions like this where people think that doctors with 30 years of medical experience are pulling ideas out of their ass. It doesn't exist to nearly the same degree in other fields.

Even if you agree with me or not, we need more specialists. If you want to see a specialist in just about anything, referred or not, you will be waiting for months in america. Months. The reason why specialists cost so damn much, more than a general practitioner, is because there aren't enough of them. Their time should all be roughly the same price...a doctor's time is a doctor's time.
There's a lot of stuff that isn't guess work. If your jaw hurts, your jaw hurts. Ear infection is an ear infection and it would be better to see a doctor that specializes in the part of the body that has symptoms than a GP, which in my opinion, is an outdated idea and shit like anti-bacterial immune bacteria wouldnt' exist if it wasn't for GP's that are overwhelmed with new drugs, new proceedures, new ideas and concepts. It is literally too much to follow unless your GP is an IBM super-computer.

Nobody is a "scientist" anymore. A scientist of what? Nobody is just a general engineer anymore. And nobody should be a "doctor" anymore or a surgeon. A doctor of what? Times have changed. Time to move on just like we did with pediatricians, just like we did with animal doctors, surgeons, psychiatrists (and then psychologists and psychiatrists being divided), etc. Those were all evolutions that were not only necessary but forced upon us.

[hockeypuck]

There are a lot of GPs out there that take wild (or too obvious) guesses, give you pills and send you home. The world needs more honed specialists and insurance that allows you to go straight to the specialist but there simply aren't enough of them. It would save money and lives. If you have an auto-immune issue, most likely your GP is going to guess wrong 3,4,5 times until recognizing it. Then there's anti-biotics and sleep disorders...in which "take one of these a day" could make things worse. If you have something obvious then they're a great option, but these days, if you have something obvious, Mr. Interwebs M.D could be just as helpful.

Wrong, wrong, wrong. The worst solution.

You have pain under the breast bone. Do you go to the gastroenterologist or the cardiologist? Do you go to both? Talk about increased healthcare expenditures. The patient who self-refers is often the patient in the wrong place.

Or let's use your auto-immune example. Which specialist were you thinking of seeing, using your own wits. The rheumatologist? The dermatologist? The gastroenterologist? How about the hematologist? All four commonly deal with autoimmune disorders.

What people don't realize is that a good GP will formulate good relationships with specialists. These two parties are always communicating with each other. GP will say, "I have a patient with this problem. Can I send him to see you?" The specialist will say, "Sure, but order these tests first in the mean time."

Specialists often want certain tests done prior to seeing the patient, otherwise it's a waste of time and no plan can be formulated from the initial visit. Using your proposal, a self-referred patient has NO information ready.

Edit: Sure, there aren't enough specialists in this country. There also aren't enough GPs, which is worse.

[kharma45]

For work yes, but not uni.

We've always been told at uni that GPs will provide us with one.

[Emerson]

Even if you agree with me or not, we need more specialists. If you want to see a specialist in just about anything, referred or not, you will be waiting for months in america. Months. The reason why specialists cost so damn much, more than a general practitioner, is because there aren't enough of them. Their time should all be roughly the same price...a doctor's time is a doctor's time. There's a lot of stuff that isn't guess work. If your jaw hurts, your jaw hurts. Ear infection is an ear infection and it would be better to see a doctor that specializes in the part of the body that has symptoms than a GP, which in my opinion, is an outdated idea and shit like anti-bacterial immune bacteria wouldnt' exist if it wasn't for GP's that are overwhelmed with new drugs, new proceedures, new ideas and concepts. It is literally too much to follow unless your GP is an IBM super-computer. Nobody is a "scientist" anymore. A scientist of what? Nobody is just a general engineer anymore. And nobody should be a "doctor" anymore or a surgeon. A doctor of what? Times have changed. Time to move on just like we did with pediatricians, just like we did with animal doctors, surgeons, psychiatrists (and then psychologists and psychiatrists being divided), etc. Those were all evolutions that were not only necessary but forced upon us.

I could not possibly disagree more with you and I don't think it's even possible to explain why without trying to explain to you the fundamentals of the practice of medicine. But you are seriously wrong. With that I'll step out of this debate and if other people want to respond to you they may do so.

[Mr. B Natural]

Wrong, wrong, wrong. The worst solution. You have pain under the breast bone. Do you go to the gastroenterologist or the cardiologist? Do you go to both? Talk about increased healthcare expenditures. The patient who self-refers is often the patient in the wrong place. Or let's use your auto-immune example. Which specialist were you thinking of seeing, using your own wits. The rheumatologist? The dermatologist? The gastroenterologist? How about the hematologist? All four commonly deal with autoimmune disorders. What people don't realize is that a good GP will formulate good relationships with specialists. These two parties are always communicating with each other. GP will say, "I have a patient with this problem. Can I send him to see you?" The specialist will say, "Sure, but order these tests first in the mean time." Specialists often want certain tests done prior to seeing the patient, otherwise it's a waste of time and no plan can be formulated from the initial visit. Using your proposal, a self-referred patient has NO information ready. Edit: Sure, there aren't enough specialists in this country. There also are aren't enough GPs, which is worse.

The future of GPs, in my opinion, would be to do exactly that and little else.

There would be far fewer GPs and far more specialists...plenty so, "wasting a specialists time" would not be any worse than "wasting a GPs time."

GPs do that already, btw, but they only do it with things that have plenty of doctors, like psychiatrists. GPs realized, whoa, mental health sky rocketed in terms of complications, they need someone that knows a thing or two about them...go to a psychiatrist. It use to be: I'm gonna gonna give you some samples I got of this and this and then ask you to come back a week later, only to give you samples of this and this and then a week later this and this and then, okay okay, 5 visits later, well, ok, let's see if a specialist could figure it out. No more, or at least, there is far less. They take you to the source now. Your meeting with the GP is short, sweet and once. But, you know what we have a lot of in america? Psychiatrists, so it's ok. If we had specialists in everything like we do pills for your head, GPs wouldn't feel the need to guess with antibiotics, or guess with body pain when you actually have fibromyalgia for instance or shove a pill down someone's throat no matter what the pill is, because the pill is most likely a brand new pill that just came on the market that they heard is like that previous pill for headaches but a little different.

Same case, we have a thing called an Anesthesiologist. Anesthesia got too complicated, so we invented that idea and nobody else can administer the stuff. Like it or not, disagree with me or not, but that's where everything is going. Good. GPs will always exist, people will always need a general opinion on something, but that, in the world I envision and the world I see happening, is all they'll give you. No more prescriptions. No more samples. No more returning for the third, fourth time until getting a specialist. We'll have specialists (and hopefully plenty of them to keep costs reasonable) that will take care of you from there. We'll all have multi-pronged doctors, all that use technology to work together, correspond data that know you as a whole. No more "it sounds to me like..." they'll know or not and they'll attack the issue with cost effective precision.

And this is already happening. Although specialists are dire in america, there are more than ever. With more knowledge comes the need for people that specialize in that knowledge. Even though many GPs are still reluctant to give up and let a specialist take care of the issue, it's happening more and more. We are in a very very slow and painful transition between the collective knowledge we have, the complications of being a doctor and, more than any of those, the patient's need and expectations. GPs are simply not going to be able to provide the way they use to with these expectations, and those expectations are not going to go down as they see more and more miracles happening out there. Their roles are changing already. What I'm talking about is already on its way. Is it going to be exactly as I'm saying? No, of course not, but things are changing and the GP's role in your life has and will continue to diminish just like the idea of your doctor being the one that took care of your grandma becoming more and more rare.

General anything in the future will be more rare and rare and less and less needed. I don't care if you want to talk about doctors, artists, marketers, programmers, farmers, pilots, musicians, translators, soldiers, etc. In the future, having a general knowledge of the subject will be a given...it's about what you know intimately. Like it or not, the uniting expanding world will not give you a choice.

[hockeypuck]

The future of GPs, in my opinion, would be to do exactly that and little else (as in, being a referral "specialist." Followed by a long post that is missing the point.)

Since you don't know how medicine works, I'll explain it to you another way.

There is this patient. She is a 50 year-old widow. She has high blood pressure, hypothyroidism, and acid reflux for her medical problems. Her husband died a year ago and she is still feeling a little depressed about it, and this includes difficulty sleeping. This can easily describe a million people in the U.S. right now. I'm making her medical problem list short on purpose.

Since you want more specialists, she will have to see:
1) A cardiologist to manage the blood pressure, and also checking lipid levels
2) An endocrinologist to check her thyroid function tests.
3) A gastroenterologist to manage her acid reflux and screening colonoscopy.
4) A psychiatrist for her depressive symptoms
5) A neurologist to manage her insomnia
6) A surgeon for breast cancer screening with mammograms
7) A gynecologist for her screening Pap smear.

That's seven specialists you want her to see when a GP is more than capable of managing every single one of those issues except for the screening colonoscopy. (Edit: A GP didn't come up with these medical innovations. Specialists did. But it all coalesced into being managed by a single GP, not a team of specialists. That's evidence directly contradicting your prediction) That's also potentially seven different doctors giving her prescriptions. A GP serves as the point person who knows the patient as a whole, as specialists only treat a piece of the pie.

Also, do you think specialists actually want to manage these primary care issues? Do you think overworked surgeons have extra time to now take care of screening mammograms? LMFAO.

Of course, as knowledge expands, specialization increases. But that makes the point person more important, not less.

Edit2: I forgot to mention that your anesthesiologist argument is a pretty shitty example. Because we now know more about anesthesia, we now know more about what works, and what doesn't. This has allowed us to protocol steps that used to take a medical degree to understand. Now nurses (CRNAs) can administer anesthesia. It's a growing field. You don't have to be an anesthesiologist, or a doctor period, to administer anesthesia. Try again.

[ElectricBlue187]

I have a GP who won't tell you your blood test results unless you come in. So I go in and he tells me the results are clean and there's nothing wrong with me. $75 for that little piece of thirty second insight. Motherfucker.

Same here except it costs me like $200 because its an Oncologist. Fucking legalized robbery.

[Buttchin]

But, you know what we have a lot of in america? Psychiatrists, so it's ok.

Most of the country has a shortage of them... Hell in Columbus, Ohio (a major metropolitan area by pretty much anyones standards) the wait time to see a psychiatrist is 4-6 months unless you have been recently admitted to a inpatient then its closer to 2 months because they emergently squeeze them into their schedules. Only certain cities have excess psychiatrists (think NYC LA) but those psychiatrists as still busy taking care of the people willing to travel to find one cause none are in their area.

[Buttchin]

Hockeypuck makes the best arguments for why more doctors willing to do primary care is whats needed in medicine and not more specialists. Dammit mant to edit my post not create another... sorry

[RevDM]

What? You're blaming HIPAA for Scullibundo's justified complaint? You can totally give test results over the phone, especially negative ones that can save time and money for the patient. I and every other frickin' resident in this country do this ALL THE TIME. As long as we're comfortable with believing that the person on the other end of the line is who they say they are, then we're fully capable in our right to discuss test results. Hell, I can even do a simple follow-up visit over the phone and the patient doesn't even need to come to clinic to get a simple bandage removed. Poor effort on trying to blame HIPAA on this one, since HIPAA is actually a good rule and actually gives the patient more rights and offers more privacy protection.

You would totally get that question wrong on the boards.

[Zoe]

You would totally get that question wrong on the boards.

http://www.hhs.gov/ocr/privacy/hipaa...identalu&d.pdf

Q: Can health care providers engage in confidential conversations with other providers or with patients, even if there is a possibility that they could be overheard? A: Yes. The HIPAA Privacy Rule is not intended to prohibit providers from talking to each other and to their patients. Provisions of this Rule requiring covered entities to implement reasonable safeguards that reflect their particular circumstances and exempting treatment disclosures from certain requirements are intended to ensure that providers’ primary consideration is the appropriate treatment of their patients. The Privacy Rule recognizes that oral communications often must occur freely and quickly in treatment settings. Thus, covered entities are free to engage in communications as required for quick, effective, and high quality health care. The Privacy Rule also recognizes that overheard communications in these settings may be unavoidable and allows for these incidental disclosures. For example, the following practices are permissible under the Privacy Rule, if reasonable precautions are taken to minimize the chance of incidental disclosures to others who may be nearby: ... Nurses or other health care professionals may discuss a patient’s condition over the phone with the patient, a provider, or a family member

[idwl]

My GP is awesome and when I go to see him, the dude only sits down when he's in the examination room talking to a patient. Rumor has it that GPs are the bottom of the graduating class of doctors but that's why the good ones will say "yeah I'm not touching that, call this specialist" if they're stumped.

I don't know I'm currently in 2nd year of med school. I went in wanting to be a GP when I finish mostly cause I want normal work hours , and money :p

[Dynamite Shikoku]

OP, your fault for buying into the medicopharmaceutical bunkum. You should have gone to your local naturopath or homeopath instead. I'm sure you would have gotten better care and would have gotten a sick note. The years of medical school and residency the so-called medical "professionals" (who are GPs) are nothing but scam-filled years designed to provide cheap labor for most hospitals, which is tantamount to white-collar slavery. After all, a quick Google search is far more illuminating and informative than any visit to such a medical quack would be.

lol

[AdventureRacing]

Well i think some people are going to be in for a rude shock as GP shortages continue to get worse. Who wants to go into a field where you are overworked underpaid and everyone thinks you do a shit job (when really they have no idea what they are talking about).

No doubt there are shitty GP's out there (i work with some every day) but in general most of them are quite good and play a vital role in the medical system.

Also just at the above poster, more specialisation is the last thing we need. More and more the medical industry is moving away from this and that's why nurses are being given extra responsibilities.

[animlboogy]

I spent months trying to get a referral to an orthopedic doctor and I just ended up with appointment after appointment with GPs sending me to physical therapy, which aggravated my condition, then putting me on muscle relaxants that made it impossible for me to work, then back to physical therapy. I didn't get a referal until I was stooped over, limping from all the exercises.

Turns out I have a massive hernia and two slipped discs. If they would have given me an MRI months ago I could have dealt with this then. My neurosurgeon is kinda furious about what happened here.

It just sucks because I kept asking over and over for an MRI and a referal because the pain was so awful but they kept saying, "no, you're young, just keep up with the therapy." and now I've been unemployed since February because of all the delays. I walk around like a limping hunchback and want to faint from the pain after three minutes. And it's been this bad for months. But no, just plug away at PT. That'll fix you right up!

[RevDM]

http://www.hhs.gov/ocr/privacy/hipaa...identalu&d.pdf

That's interesting because that one specifically popped up in one of the ethics questions.

[Zoe]

That's interesting because that one specifically popped up in one of the ethics questions.

Now many practices do implement their own policies which are more stringent, but HIPAA itself only requires reasonable precautions for just about everything.

[Bagels]

Fuck GPs. However, I have far more respect for actual physicians who work in a hospital, as they are real Doctors. Now they truly help patients. Not some asshole who suits behind a desk in a suit. To be frank, I probably have more medical knowledge than a GP.

The FIRST thing you learn in hospital internal medicine is that it's not your job to actually "heal" people. Your job is to focus on the problems that will get them out of the hospital so their GP can figure out how to fix them.

Not every GP is fantastic (we call them Family Practitioners - GP is the older term in the US. More recently, I've started to see PCP - Primary Care Provider. I did a double take the first time I read that we were "discharging patient to his PCP"), but I've met more good ones than bad. Those people are saints.

[ronito]

I like GPs and I LOVE my kid's pediatricians.
But I do find it sorta funny how some people believe that Doctors or the whole medical profession for some reason is beyond greed and that people should get into it solely for altruism.

[Hari Seldon]

You gotta just try a bunch and find one that is good. The quality varies wildly. Had to do the same for my kid's pediatrician.

[nib95]

I've nearly always had awesome GP's tbh. Have a few friends/family who are GP's too and I can tell you, a lot of it really is because they want to help people or because it's morally rewarding. Trust me, it's not an easy job. Crazy hours, insane stress, work load, risks, responsibility and all sorts. It's not a job I could personally do. Much easier and quicker ways/jobs to make the same sort of money.

[Bagels]

I like GPs and I LOVE my kid's pediatricians. But I do find it sorta funny how some people believe that Doctors or the whole medical profession for some reason is beyond greed and that people should get into it solely for altruism.

The flip side is that no one seems to believe that people go into medicine for any reason other than the pay. And, frankly, while the pay is fairly attractive, you can make a lot more money with way less time in training, shorter hours, and little to no exposure to bodily fluids.

The reasons that people choose medicine are as complex as the reasons they choose any other career. The obvious exception is lawyers. Bunch of greedy sleazebags. I kid, I kid.

Please don't sue me.

[mre]

The flip side is that no one seems to believe that people go into medicine for any reason other than the pay. And, frankly, while the pay is fairly attractive, you can make a lot more money with way less time in training, shorter hours, and little to no exposure to bodily fluids. The reasons that people choose medicine are as complex as the reasons they choose any other career. The obvious exception is lawyers. Bunch of greedy sleazebags. I kid, I kid. Please don't sue me.

Don't backpedal when you're right.

[Beef]

Since you don't know how medicine works, I'll explain it to you another way. There is this patient. She is a 50 year-old widow. She has high blood pressure, hypothyroidism, and acid reflux for her medical problems. Her husband died a year ago and she is still feeling a little depressed about it, and this includes difficulty sleeping. This can easily describe a million people in the U.S. right now. I'm making her medical problem list short on purpose. Since you want more specialists, she will have to see: 1) A cardiologist to manage the blood pressure, and also checking lipid levels 2) An endocrinologist to check her thyroid function tests. 3) A gastroenterologist to manage her acid reflux and screening colonoscopy. 4) A psychiatrist for her depressive symptoms 5) A neurologist to manage her insomnia 6) A surgeon for breast cancer screening with mammograms 7) A gynecologist for her screening Pap smear. That's seven specialists you want her to see when a GP is more than capable of managing every single one of those issues except for the screening colonoscopy. (Edit: A GP didn't come up with these medical innovations. Specialists did. But it all coalesced into being managed by a single GP, not a team of specialists. That's evidence directly contradicting your prediction) That's also potentially seven different doctors giving her prescriptions. A GP serves as the point person who knows the patient as a whole, as specialists only treat a piece of the pie. Also, do you think specialists actually want to manage these primary care issues? Do you think overworked surgeons have extra time to now take care of screening mammograms? LMFAO. Of course, as knowledge expands, specialization increases. But that makes the point person more important, not less. Edit2: I forgot to mention that your anesthesiologist argument is a pretty shitty example. Because we now know more about anesthesia, we now know more about what works, and what doesn't. This has allowed us to protocol steps that used to take a medical degree to understand. Now nurses (CRNAs) can administer anesthesia. It's a growing field. You don't have to be an anesthesiologist, or a doctor period, to administer anesthesia. Try again.

Excellent post, well said.