Can your GP really diagnose in 10 minutes?

Now I appreciate that we are lucky to have the NHS.  I also appreciate that many of my medical ailments are comparatively minor and that many GPs are working all the hours God sends (albeit for what could be considered a very generous salary) and do their best to help us.

An apple a day doesn’t always keep the doctor away

But, here’s the thing.

In my local surgery we are allocated 10 minutes per appointment and I fail to see how a comprehensive diagnosis can possibly be made in that time.  I spend more time waiting to see I doctor than I do in front of them. Ignoring the logistical problem of keeping everybody happy and ensuring medical emergencies get priority treatment, let me give you an example of what I’m talking about.

I have been variously diagnosed with TMJ (Temporomandibular Joint syndrome), Bruxism (teeth grinding), bleeding gums, Early Onset Hearing Loss and Vulvodynia.  Add to the mix lower back pain and anxiety. My life is occasionally a series of trips to the doctors – each generally futile because a GP will treat the symptoms you present at the time without considering the overall picture.

For example, go to the doctors with gynaecological problems and I can guarantee you will be treated for i) thrush, ii) water infection or if you are my age iii) vaginal dryness.  It’s as if there are literally only 3 choices.  Now it may well be that, for most women, these are likely to be the main contenders but what if they’re not?

And that, to me is the crux of the matter.

I have been reading about Fibromyalgia lately – happening to come across some excellent blog posts on the topic and it’s curious that every single one of my symptoms could be the result of this.

Fibromyalgia is a long term condition that causes pain all over the body. The NHS says that “the exact cause of fibromyalgia is unknown, but it’s thought to be related to abnormal levels of certain chemicals in the brain and changes in the way the central nervous system (brain, spinal cord and nerves) processes pain messages carried around the body.
It’s also suggested that some people are more likely to develop fibromyalgia because of genes inherited from their parents.”

But I know that unless I go to my GP and directly ask the question “could I have Fibromyalgia”, there is practically zero chance that anybody would make the link between my symptoms and start to address the potential cause.

Constantly treating the symptoms without addressing the cause must be costing the NHS millions, not least in the amount of antibiotics and antidepressants that are dished out.  Is it any wonder so many of us are turning to Dr Google?  There is obviously a lot of incorrect and potentially dangerous medical information online, but as our obsession for googling all things medical grows, we are reaching a place where the patients consider themselves much better informed than their doctors – which must make a doctor’s life even more difficult and may be putting some of us at risk.

There is no obvious answer to this problem.  We need a root and branch change to the way we think about medicine and its place our health.  We surely cannot go on with a situation where the sum total of a doctor’s advice is “put a bit of cream on it” (oh yes, I’ve heard that one a few times).

I suspect that the future of medical care in the UK may well involve compulsory medical insurance and private medical care.

But perhaps a rethink about how we manage doctors appointments is in order.  And some division of labour so that there are medical specialists in particular areas in each practice – my first suggestion would be paediatrics, closely followed by gynaecology! Let’s staff up practices to cover practical appointment times e.g. up to 7 pm at night.

Having spent 20 years in Law I can say that law firms have had to look at their business models and many have had to drag themselves kicking and screaming into the 21st century.  Better communication (both internally and with clients), a clearer understanding of the needs of their clients and designing services to anticipate and meet those needs have been critical for those firms who have survived.

It’s time for our doctors’ surgeries to start thinking the same way.

If more comprehensive and accurate diagnoses are not made at an early stage, then all that will happen is that chronic conditions will need to be treated at greater time and expense in our hospitals. Get the diagnosis right in the first place (or earlier on) and the number of appointments requested will probably decrease, freeing up time for treating more medical emergencies or offering more specialist care.

Otherwise, we’ll all just carry on diagnosing ourselves and putting up with aches and pains that maybe, just maybe, could have been dispensed with months, even years ago.

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11 Comments

  1. June 17, 2015 / 10:38 am

    I've just moved, but my last doctor had an email service. I really liked being able to write about 300 words, describing exactly what was wrong and sometimes suggesting what might be the issue. He would never give a full diagnosis on the basis of the email but, he would suggest how urgently I might need to come in and then when I did arrive he had a better understanding of my issue.

    • June 17, 2015 / 10:41 am

      That's a brilliant idea. This is what I'm talking about – just a bit of thinking outside the box.

    • June 17, 2015 / 8:36 pm

      Wow, I love the sound of the email service. What a great idea. It is difficult for doctors as they are so time-pressed and often under-staffed – but I agree that it's not exactly the best system. I often end up waiting an hour or two for an appointment as our surgery has a drop-in clinic system. I always feel rushed because I and they know how many other people are waiting. I know that people may tell them about a main symptom, but not about lesser symptoms, which may be unrelated. If doctors had more time to ask questions, it might lead to a quicker and better diagnosis. Hope you're okay, by the way and can get to the bottom of it. x

  2. June 17, 2015 / 11:52 am

    Totally agree with you! Worst thing they ever did was allow GP to renegotiate their contracts many moons ago.

  3. June 17, 2015 / 8:51 pm

    I hate the GP's. I work as an operating department practitioner in theatres so I have a bit of medical knowledge and more often than not find myself challenging the gp and becoming frustrated. They don't have time to listen as they are under so much pressure. The email service sounds great. Hope you get some answers soon and that you feel better x

  4. June 17, 2015 / 9:12 pm

    The email service sounds great, especially as at my GP they can only see you for 10 minutes which I don't really think is long enough.

    Emily #UKBloggers

  5. June 17, 2015 / 10:47 pm

    It's almost impossible to get an appointment at my GP. I live in a little town with a high elderly population, 10 minutes is almost a dream with the GP!

  6. June 18, 2015 / 10:20 am

    I've recently changed my GP. With the one i used to go to I was tired of not being able to get an appointment. I thought their booking system was stupid. They refused to let you book in advance, I had to try and phone in at 8.30am, which was impossible as the line was always busy. When i did manage to get through 10 minutes later all appointments had gone and i simply asked if i could book for tomorrow or a week later. They told me it wasn't possible and my only option of trying to be seen was to walk all the way down to the surgery for 8.30 the next day with no guarantee of being seen either. So i ended up going to a different surgery that has a much more sensible booking system. If they have no appointments that day they allow you to book in advance. x

  7. June 19, 2015 / 8:52 am

    Definitely agree with this! I'm constantly in the doctors lately with my little boy, and they still haven't gave me a proper diagnosis! Its been everything from glandular fever to tonsillitis to an allergy. Maybe the government needs to focus on sorting the NHS out rather than all the other crap they seem to be changing xx

  8. Tilly A
    June 19, 2015 / 10:53 am

    I really relate to this post. I suffer a lot of aches and pains, and since my symptoms aren't visible, I haven't been able to diagnose the problem (if there is one). The appointments are far too short to explain my situation, and I often don't feel listened to. I've accepted that I may just have to live like this. I hope you find your answers!

  9. June 30, 2015 / 6:11 pm

    luckily we have a great doctors surgery where we live 10 mins don't really seem long enough but that's pressure for targets set for them any good ideas which help ease the situation and help people more is always a good idea some may catch on too

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