Dr. has left the practice!

Ciarabear

I've just called to schedule a visit to my combined care GP and to my utmost shock, have just been informed by the secretary that my GP has left the practice!

The same GP who confirmed my pregnancy, arranged my hospital referral and encouraged me to see him under the combined care scheme for the rest of my pregnancy.

The secretary's response was that I could "see somebody else". To say I feel duped would be an understatement -has anybody else encountered anything like this or is the pleasure all mine?

nikpmup

Ciarabear wrote: »

I've just called to schedule a visit to my combined care GP and to my utmost shock, have just been informed by the secretary that my GP has left the practice!

The same GP who confirmed my pregnancy, arranged my hospital referral and encouraged me to see him under the combined care scheme for the rest of my pregnancy.

The secretary's response was that I could "see somebody else". To say I feel duped would be an understatement -has anybody else encountered anything like this or is the pleasure all mine?

I'm under combined care, and I've only seen my own GP for one appointment so far apart from having my pregnancy confirmed. It doesn't bother me TBH - all I've had in my GP appointments is pee in a pot, check BP and have a listen with the Doppler and she asks if I've any concerns. I'm sure the other GP in the practice is as proficient as my own at doing these things!

Chattastrophe!

I get the impression that with combined care, as mentioned above, all that happens at the GP visits are the basic checks - any issues that arise are dealt with by the hospital. I know that with my own GP, she confirmed the pregnancy, but for most of the rest of the visits I'll be seeing the clinic midwife rather than the doctor herself - which is fine with me.

I wouldn't worry too much about it, if I were you. I think it's far more important that you're happy with the hospital you chose, that's what will really matter, in my opinion.

Moonbeam

They do so little i don't think it makes much of a difference.
They check your urine,take your blood pressure,feel your bump and that is it.

Ciarabear

Thanks for the feedback guys. It's not so much about an alternative doctor's ability to do basic checks but finding it a bit cheeky of them to not even inform me that my GP was leaving.

Technically, all doctors are qualified but we consistently see our chosen GP because they know our personal history, we feel comfortable talking to and being examined by them and because we've established a rapport with them

I wouldn't expect to see the same face at a hospital every time and chose combined care on the basis that I would.

I just think it's basic manners of any GP to inform his/her patients if they're leaving, rather than have people be told by a secretary when they call to make an appointment.

Hello Lady!

Ciarabear wrote: »

Thanks for the feedback guys. It's not so much about an alternative doctor's ability to do basic checks but finding it a bit cheeky of them to not even inform me that my GP was leaving.

Technically, all doctors are qualified but we consistently see our chosen GP because they know our personal history, we feel comfortable talking to and being examined by them and because we've established a rapport with them

I wouldn't expect to see the same face at a hospital every time and chose combined care on the basis that I would.

I just think it's basic manners of any GP to inform his/her patients if they're leaving, rather than have people be told by a secretary when they call to make an appointment.

Possibly they weren't permitted to advise patients of their departure as the clinic probably wanted to hold on to the patients, rather than risk them going with the doctor to their next practice.

As others have said, the level of care offered by the GP is so minimal it makes no difference who is attending to you.

I am personally questioning the whole combined care approach, as the actual active assistance many GPs give to pregnant women is negligble. A nurse could just as easily check BP and urine. My GP wouldn't even renew a prescription the hospital doctor gave me and told me to phone back to my hospital and get an appointment. So I ended up struggling with my MS for 4 days until I could get squeezed into the maternity clinic. The clinic doctor was really annoyed that the GP wouldn't renew a script that she had issued, and said if there had been any issue they could have just phoned and confirmed rather than sending me in unneccessarily. So personally, I am finding the combined care about as much benefit as an ashtray on a motorbike at the moment. My only saving grace is that because we're having twins, I do get seen very regularly at the hospital (every 4 weeks), so my need for the GP is small.

lazygal

I don't think combined care is that great, judging on what I've heard. I'm going private and see my consultant at every visit for the usual checks and a scan.


I know of women who were fobbed off with a nurse during the GP combined care. I understood the HSE are paying the doctors for this service, so why would a nurse take over? I know nurses are excellent but if the care is supposed to be provided by a doctor, it should be provided by a doctor.

If I was public I would ask for other options besides combined care. I have a great GP but I prefer to see someone who specializes in pregnancy during pregnancy.

notlongleft

It would not be feasible for the practice to ring everyone and tell them that the GP is leaving - how long do you think that would take and how many people would they have to tell? Also imagine the practice rang you to tell you this and you had suffered a miscarriage or something that could really upset you so that wouldn't be pleasant either.

I do completely understand your frustration that your GP is gone as you have been attending him/her for a long time but I do not think it is reasonable to expect the GP office to have notified you.

Hello Lady!

The vast majority of care packages incorporate the combined care element - even fully private. They usually suggest that you attend your GP between every hospital visit, just for the basic checks.

Which is fine, but I think rather than paying a doctor for this, the HSE should pay a lower rate to the nurses, because as you say, it is something they are more than qualified to do. The GP's don't usually do much more than the minimum. There are the occasional one or two who are more pro-active, but myown personal experience is anything outside of urine and BP and their immediate advice is go to A&E or phone your clinic midwife.

I totally agree with you regarding the specialist care needed during pregnancy.

For example, a while back I had a bad cold which I couldn't shift for over a week. I went to my GP, naively thinking there might be something they could give. The doctor I saw is one I have seen before when not pregnant, and previously I would have said she is excellent. However, when I mentioned to her that I was having some pain and discomfort and asked could it be streching pains she said, I doubt it, its too early. I pressed it, asking even with twins and the fact I am obviously already quite big, are you sure, and she said no it couldn't be stretching.

So she then got the doppler to check the heart beat. It was the first time I had had a doppler. And she then says, I can only hear one heart beat, so I think you should go to A&E. I was a bit freaked out to say the least. She also said, that really the GP was no use to me if I have any pain/sickness/discomfort as they are not equipped or experienced enough to deal with my high risk twin IVF pregnancy so she suggested that I do not even bother attending the GP if I am unwell and instead go straight to A&E.

When I got to the hospital the doctor there was absolutely flabbergasted that a trained doctor would even attempt to use a doppler on a twin pregnancy less than 14 weeks. He explained that my babies are sitting one in front of the other, so the one behind can't be heard on a doppler. A doppler is known to be of no use to check twin pregnancies so early on.

Thank god all was well and both babies were happy as larry jumping around in there. But rather than get reassurance from my GP I was stressed out and in a panic. I was afraid to drive myself to the hospital, so phoned my husband who left work early to bring me. I also had to wait 4 hours in A&E only to be told, well yes, that is stretching, and yes it is earlier than a normal pregnancy, but you are having twins! So it was all fuss for nothing.

When I told my consultant what happened she too was amazed and said that a trained GP should be more than capable of dealing with a twin pregnancy, and that unless I am bleeding, in severe pain or are instructed by a midwife, there is no need to head to A&E, and again a GP should be able to help with minor ailments of pregnancy. However, given my experience she has told me only to go to them for BP and urine checks and if I get ill contact the hospital midwife who will advise me and if needed will phone my own GP to liaise with them.

So my experience of combined care is that it has been a waste of taxpayers money, I have been sent to A&E unneccessarily and have had no benefit other than BP and urine checked. So again I wonder, can a practice nurse not offer the same service at less cost??

Hello Lady!

notlongleft wrote: »

Also imagine the practice rang you to tell you this and you had suffered a miscarriage or something that could really upset you so that wouldn't be pleasant either.

Your GP would know you have had a miscarriage as every visit to a hospital, expecially via A&E would be reported to them. Even a visit to the doctor on call service is reported to your GP clinic.

notlongleft

Well thats good to know Hello Lady, I didnt realise everything was reported back as at my last combined care appointment my GP had no idea of a small complication that I have which was discovered at the hospital.

Hello Lady!

No they won't report everything back from your chart at the clinic, but A&E admissions or 'emergency' care (which is what the out of hours doctor is classed as) will be reported to them. So in the unfortunate case where you experienced a miscarriage, your GP would be notified of this by a communication from the A&E dept.

Gee_G

Ciarabear wrote: »

I've just called to schedule a visit to my combined care GP and to my utmost shock, have just been informed by the secretary that my GP has left the practice!

The same GP who confirmed my pregnancy, arranged my hospital referral and encouraged me to see him under the combined care scheme for the rest of my pregnancy.

The secretary's response was that I could "see somebody else". To say I feel duped would be an understatement -has anybody else encountered anything like this or is the pleasure all mine?

If you are happy and comfortable with the gp that has left, why not ask at reception where they are gone and move with them?
My Gp left the practice when I was 7months pregnant and I followed her

Ciarabear

notlongleft wrote: »

It would not be feasible for the practice to ring everyone and tell them that the GP is leaving - how long do you think that would take and how many people would they have to tell? Also imagine the practice rang you to tell you this and you had suffered a miscarriage

If I was unfortunate enough to suffer a miscarriage, my doctor would know about it. I don't expect a personal phone call, I expected to be told as a matter of basic courtesy by the doctor during an appointment.

Lazygal, I see no issue with the combined care scheme. Pregnancy is not an illness and unless there are complications, don't require medical intervention beyond basic routine checks which any doctor can implement.

Also, paying for private care does not ensure your doctor has superior knowledge or ability

Suucee

My recently moved to a new practice and had never seen my new gp but when she moved to a new practice I got a letter to inform me and the new address and phone number. I didn't want to go with her as had never even met her so went to the practice to tell them I was staying. But considering I, who had never even seen that gp got a letter to inform me of the move. I do think the OP should of at least got a letter.

Re the combined care. I went to gp last week to confirm my pregnancy and get things started. As I said was first time attending new practice. GP decided to scan me but couldn't find anything. I was so worried, I had done 4 tests and he done another all positive but couldn't find anything. I thought it was way too early and hadn't been expecting a scan at all. He was worried it was ectopic so reffered me to EPU, that was wens and I had to wait until fri to go to EPU.
Things went grand in EPU as done an internal scan. Even they said it was early but still need to go back tomorrow again to keep an eye. I still think it was a lot of needless worry and tbh im still worried.
Now im kind of thinking I should attend one of the other gps in the practice but then again he apparently scans each time so like that idea too .
Also that bloody HSE GRRRRR. They had a staffing issue in EPU and decided to make a point and close the EPU, ended up having to register in EPU then go and register in A&E then give history and details, then be admitted and go up to ante natal ward waiting area, then go back down to xray for scan, then wait hours before being seen and told everything was ok and come back next week. 6 Hours we were there.

I don't know whether to be mad at the gp (maybe he was just being safe I suppose) or the bloody HSE.

They f**ked up with my SIL last year who unfortunately suffered a miscarriage and got her first hospital booking in appointment out in the post nearly a week after having a D&C.

Hello Lady!

when you say a scan do you mean an ultrasound or a doppler?

If its an ultrasound then you are lucky that your practice has this equipment. If mine had I wouldn't mind so much visiting them as at least they could see the babies and heartbeats, but with a doppler it is no use with twins. I actually think that in order to participate in the combined care scheme they should have scanning facilities.

I totally accept that pregnancy is not an illness, but you can get ill when pregnant, and I just think that GP's should be more able to treat minor illness and injury for pregnant women rather than fob them off to an already overstretched A&E system for every little thing outside of checking BP and urine. They can't have it both ways - either 'treat' pregnant women or let nursing staff 'check' pregnant women. But don't get paid for 'treating' when all you do is a urine and BP check.

Suucee

Hello Lady! wrote: »

when you say a scan do you mean an ultrasound or a doppler?

If its an ultrasound then you are lucky that your practice has this equipment. If mine had I wouldn't mind so much visiting them as at least they could see the babies and heartbeats, but with a doppler it is no use with twins. I actually think that in order to participate in the combined care scheme they should have scanning facilities.

I totally accept that pregnancy is not an illness, but you can get ill when pregnant, and I just think that GP's should be more able to treat minor illness and injury for pregnant women rather than fob them off to an already overstretched A&E system for every little thing outside of checking BP and urine. They can't have it both ways - either 'treat' pregnant women or let nursing staff 'check' pregnant women. But don't get paid for 'treating' when all you do is a urine and BP check.

It was an ultrasound. Im new to that gp and didnt know they even had ultrasounds. So its very good really . I will probably get a scan at each visit.

Hello Lady!

That's great. I wish it was standard practice for a GP to have an ultrasound scanner. I mean, most physio's have them now, so its not asking too much for a GP to have one!

lazygal

I'm fully aware being pregnant isn't an illness, but it isn't a walk in the park. I've posted on other areas of boards about women I'm in a mums to be group with who aren't getting any anomaly scans at all, only a scan to check fluid levels and position at 34 weeks. I had some issues present at 20 and 34 weeks in my last pregnancy and again this time, and my consultant whom I see at every visit and who scans me every time was on top of everything. My GPs surgery doesn't have a scanner, so potentially serious issues can go undiagnosed, as they can with other forms of combined care where scanning isn't routine.

If I had cancer, I'd want to be seen by an oncologist. If I had a skin disorder, I'd want to be seen by a dermatologist. When I'm pregnant, I want to be seen by an OBGYN, and given that our maternity services are constantly trumpeted by certain sectors of society as the safest in the world, I don't think that's too much to ask. I know I got better care in the private system this time and last than other mums I know. It's not PC to say it and its seen as snobbery to say that private is better, but equally I am very, very thankful we have the means to go private because I would not be happy with the level of care I see others getting in the public system. If others are happy with not being scanned or don't think the expertise of an OBGYN is for them, that's their call. But I feel more confident about my care and that of my children when I've a doctor who's expertise is in what I'm dealing with right now.

My GP is excellent and has been for many years. I'm happy to be under general care for general medical problems. But for me pregnancy is a specific medical condition and I like having expert care during it.

Ciarabear

lazygal wrote: »

I'm fully aware being pregnant isn't an illness, but it isn't a walk in the park. I've posted on other areas of boards about women I'm in a mums to be group with who aren't getting any anomaly scans at all, only a scan to check fluid levels and position at 34 weeks. I had some issues present at 20 and 34 weeks in my last pregnancy and again this time, and my consultant whom I see at every visit and who scans me every time was on top of everything. My GPs surgery doesn't have a scanner, so potentially serious issues can go undiagnosed, as they can with other forms of combined care where scanning isn't routine.

If I had cancer, I'd want to be seen by an oncologist. If I had a skin disorder, I'd want to be seen by a dermatologist. When I'm pregnant, I want to be seen by an OBGYN, and given that our maternity services are constantly trumpeted by certain sectors of society as the safest in the world, I don't think that's too much to ask. I know I got better care in the private system this time and last than other mums I know. It's not PC to say it and its seen as snobbery to say that private is better, but equally I am very, very thankful we have the means to go private because I would not be happy with the level of care I see others getting in the public system. If others are happy with not being scanned or don't think the expertise of an OBGYN is for them, that's their call. But I feel more confident about my care and that of my children when I've a doctor who's expertise is in what I'm dealing with right now.

My GP is excellent and has been for many years. I'm happy to be under general care for general medical problems. But for me pregnancy is a specific medical condition and I like having expert care during it.

I'm quite sure the consultants at public maternity hospitals are expert obstetricians and gynaecologists too

lazygal

Ciarabear wrote: »

I'm quite sure the consultants at public maternity hospitals are expert obstetricians and gynaecologists too

They are, and I see one at every appointment because I'm going private. I'd have a very different experience doing combined care, as some women don't see an OBGYN unless an issue arises. I shouldn't have to go private to get consultant led care and scans and set appointment times, but I do. Every woman should get the level of care I do, not just those who can afford it. Other women are happy with midwife led or combined care, but you should have a choice, it shouldn't be based solely on ability to pay.

Ciarabear

lazygal wrote: »

They are, and I see one at every appointment because I'm going private. I'd have a very different experience doing combined care, as some women don't see an OBGYN unless an issue arises. I shouldn't have to go private to get consultant led care and scans and set appointment times, but I do. Every woman should get the level of care I do, not just those who can afford it. Other women are happy with midwife led or combined care, but you should have a choice, it shouldn't be based solely on ability to pay.

And why would you want to see an OBGYN unless an issue arises? I'm doing Combined Care and had been seeing my doctor. An issue arose and I saw my OBGYN then when I needed to. There is absolutely no need to see a consultant at every appointment throughout your pregnancy or to be scanned either and I'm not sure why you insist there is

lazygal

Ciarabear wrote: »

And why would you want to see an OBGYN unless an issue arises? I'm doing Combined Care and had been seeing my doctor. An issue arose and I saw my OBGYN then when I needed to. There is absolutely no need to see a consultant at every appointment throughout your pregnancy or to be scanned either and I'm not sure why you insist there is

My point is women should have the option, not everyone, like you, wants consultant led care but it should at least be offered.

Ciarabear

lazygal wrote: »

My point is women should have the option, not everyone, like you, wants consultant led care but it should at least be offered.

Why?

icescreamqueen

I'm nearing the end of my pregnancy now and having experienced consultants and midwives, I honestly believe midwives are so underpaid and overworked. Consultants are at the opposite end of the spectrum, they are ridiculously underworked and overpaid. Many have no interest in their job and only care about the €€€. It's really annoyed me seeing this in hospitals. I was under the care of a particular consultant and I met him once! A friend of mine told me he goes back home to South Africa on holiday at least 5-6 times per year. The 10 midwives I had care from between one thing and another were unbelievably professional and really cared about their work and patients. They don't have the power about certain things like consultants do yet have the expertise. Anyway rant over.

lazygal

Ciarabear wrote: »

Why?

Because they might want to. Not everyone wants midwife led or combined care.

Ciarabear

lazygal wrote: »

Because they might want to. Not everyone wants midwife led or combined care.

And you expect the taxpayer to fork out for every pregnant woman's personal wants?

There's a huge difference between wanting to see a consultant at every appointment for your entire pregnancy and needing to.

If you need to see a consultant as a public patient, you will. It's just ridiculous to expect to see to a consultant for free at every visit for no reason

pwurple

lazygal wrote: »

My point is women should have the option, not everyone, like you, wants consultant led care but it should at least be offered.

It is, you just have to pay for it.

Hello Lady!

Ciarabear wrote: »

And you expect the taxpayer to fork out for every pregnant woman's personal wants?

There's a huge difference between wanting to see a consultant at every appointment for your entire pregnancy and needing to.

If you need to see a consultant as a public patient, you will. It's just ridiculous to expect to see to a consultant for free at every visit for no reason

I don't think lazygal is suggesting that you waste a consultant's time if you don't need to see him/her. But I have had a similar experience to her in that my GP is pants at providing any care at all. Checking BP and urine is the sum total of the care I get from my GP. I agree with lazygal that this is not a very effective use of resources. GP's either need to step up and be more proactive in treating pregnant women, or consultant led care needs to be offered. At the moment, the system falls between two stools. Pregnant women do get sick with minor ailments, but for many of us if you go to your GP you get told to go to the hospital or try to get your hospital to move your appointment forward. They get paid their allowance for this visit, despite not actually 'treating' you. That is madness, and the taxpayer is footing the bill for that. They then foot the bill for your attendance at the A&E too. So double cost to the tax payer.
I was sent to A&E because my GP didn't use a doppler properly FFS! Total waste of resources that are already overstretched.


My own personal opinion is that GP's who wish to sign up for the combined care system need to be more trained in OBGYN treatment. They should be obliged to have scanning facilities. That way, if you need a doctor, you go to your GP. You only need to go to the hospital or see a consultant if your GP feels it absolutely necessary.

If this is not done, then they should amend combined care so that it is not GP led, but nurse/midwife led, as the nurses are more than capable of taking BP and urine and the occasional blood test.

I am going semi-private and to be honest, since my experience of combined care I am glad I am. If I could rely on more pro-active GP treatment I wouldn't need to. I think this is the point lazygal is making - if you want to have guaranteed pregnancy care you cannot rely on a GP, and it should not be a case that you only get this care if you can pay for it. I agree with her there. there are some serious deficiencies in the GP led combined care model as it currently stands.