MegaSack DRAW - This year's winner is user - rgwb
We will be in touch
I'm trying to work out what purpose GPs, and the long waiting times that they come with, serve in the NHS. My experience of GPs is that you wait ages and then have a 30 sec conversation during which they do nothing useful except refer you on (and sell your details to BUPA, Experian and Google).
For anything non-trivial you need a hospital specialist (e.g. heart conditions, cancers, orthopedics) or a physiotherapist.
For diagnosis you need a nurse and a lab (e.g. blood tests), or hospital equipment and a specialist (e.g. X-ray or NMR).
Nurses can handle routine stuff like bandaging, chronic pain management, diabetes and antenatal.
So that leaves reassuring parents that their kid is fine and trying to balance the drug cocktail for old people. And, of course, failing to diagnose meningitis. Which could be done by health visitors.
I can't help feeling that we could replace GPs with a decent phone book and remove the bottleneck between patients and the care that they need.
Gate to the specialists - Imagine the queue if everyone with a cough ended up seeing a a specialist
Deal with ongoing health problems -Diabetes and other stuff
Mental Health
they do nothing useful except refer you on (and sell your details to BUPA, Experian and Google).
I'll let a GP or 2 come along and bash you for that cheap shot but seriously have a think about it.
The GP is the front line in Health Care, keeping people out of hospital and in good stable health is vital to a continuing health service.
Change GP's then.
Once you get past the receptionists, ours are really good.
I'm trying to work out what purpose GPs, and the long waiting times that they come with, serve in the NHS. My experience of GPs is that you wait ages and then have a 30 sec conversation during which they do nothing useful except refer you on (and sell your details to BUPA, Experian and Google).
They mustn't like you (or see you so frequently for minor problems that thye have you down as a time waster). The times I speak to my GP are generally lengthy affairs (10 mins or more) and very productive.
It must be you.
I knew someone who booked appointments on a fornightly basis just in case, but never went or cancelled last minute if she wasn't [i]ill[/i] that particular week.
For anything non-trivial you need a hospital specialist (e.g. heart conditions, cancers, orthopedics)
Shame on GPs for not being able to cure cancer.
My GP has been wonderful while I've been dealing with mental health problems. Quick and prompt referrals, loads of links to non NHS and on line support, listened properly for as long as it took while I went through the problems and symptoms, understood my reluctance to go down the drug route due to the impact the side effects may have on my cycling till she came up with a drug and dosage that has helped.
All while 3 of the 6 GPs in the practice were off sick with skiing injuries and/or stress.
I genuinely don't know where I would be without her.
She's not bad for a Cervelo riding roadie.
I can't help feeling that we could replace GPs with a decent phone book and remove the bottleneck between patients and the care that they need.
Move the bottle neck up the system. GPs filter people out who don't need a specialist and make sure that they get to the correct one.
Under your system an orthapaedic surgeon would spend all day seeing people saying actually you need a physio, actually you just need to rest and take ibuprofen, actually you needed a rheumoloigist.
Why would that be better?
Deal with ongoing health problems -Diabetes and other stuff
Mental Health
Nurses.
And GPs for mental health - seriously? MCTD's experience aside, Mind did a survey a few years ago which discovered that the majority of GPs were of the "pull yourself together" school.
(or see you so frequently for minor problems
I've need my GP three times in the last 15 years.
Gate to the specialists
Two of those I turned up with a letter from a hospital consultant advising a course of action. What does your average GP add to the party when you've got Prof X, leading cardiac specialist advising that their patient gets checked for hedititory disease of the heart Y? Absolutely nothing except delay.
So your experience of 3 visits in 15 years makes you an expert??
Seriously, I assume you don't see the people they actually help, the stuff that they deal with that nurses don't have the skills or training to do, the detailed knowledge and experiences etc.
Health delivery is a multi level process, it's got different needs and requirements and the GP is one of them, there should be more matching of need to speciality and experience of the provider but sometimes a GP being a broadly qualified and experienced person is the right one to see the mass of people and lift out the urgent etc. to the next level and when happy allow nursing staff etc. to deliver where they can.
GPs are a filter. It's first point of contact for most. They are not specialists, they know enough to assess, give advice, reassurance, prescribe a few drugs, and maybe refer.
A lot of people have nothing wrong with them or a condition that will self treat and really they would be better off going to a pharmacy who can advise. In a lot of cases nothing is required other than rest.
Some may need a prescription, or more likely are demanding one and GPs will prescribe them just to get them out the door. Hence the problem with too many antibiotics prescribed.
Anything potentially serious or needing referral is done on a repeat appearance basis. i.e. You go initially with a concern, they say it's probably nothing or it will probably go away. In most cases it self heals. In some cases it doesn't so the patient comes back. Then the GP might treat it more seriously.
Main problems I see is too many people going to GPs for stuff the pharmacy could deal with, or even things they could get a nurse to treat or walk in centre. Then there's a problem of not being able to see the same GP on each appointment so you get the initial diagnosis each time. Appointment slots are also filled up with the worried well, the hypochondriacs and people who fail to turn up.
My GP is excellent
OP you sound like a typical whinger who goes in to see their GP with an attitude thanks to the guff you've been reading in the Daily Heil. Is it any wonder they don't feel particularly enamoured towards you
jam bo - Member
Change GP's then.Once you get past the receptionists, ours are really good.
Other way round down here.
2 of the 3 in the practice I'm with are absolutely useless and have over 250 complaints between them at the last count!
Rude, ignorant, dismissive, etc.
One refused a repeat prescription for drugs on my chronic list.
Without even looking at the form.
The same one refused a prescription that was on the hospital TTO saying it wasn't necessary.
The other repeatedly refused to prescribe the full amount of a drug despite the pharmacists asking for it, the practice manager asking for it and another GP telling them it was necessary.
Ergo requiring me to submit a repeat every 12 days instead of once a month.
Like EVERY other drug on that particular list.
Just happened to be the main pain relief drug too!
F'ing idiot.
Add in the Nurse Practitioner stating that I needed a referral as nerve impingement was worsening on four occasions yet the idiot above put in writing that there was no need.
Same Nurse Practitioner then was at my house a week later when my legs stopped working needing an ambulance.
Nurses can handle routine stuff like bandaging, chronic pain management, diabetes and antenatal.
Routine diabetes and antenatal. 😆
Two of those I turned up with a letter from a hospital consultant advising a course of action. What does your average GP add to the party when you've got Prof X, leading cardiac specialist advising that their patient gets checked for hedititory disease of the heart Y? Absolutely nothing except delay.
You went to the consultant before consulting your gp and are complaing about people buggering up the system?
What Houns said.
Two of those I turned up with a letter from a hospital consultant advising a course of action. What does your average GP add to the party when you've got Prof X, leading cardiac specialist advising that their patient gets checked for hedititory disease of the heart Y? Absolutely nothing except delay.
You have that problem where you know how the world works for you so you assume that because the world works that way for you it works the same way for everyone.
What the GP added for you was clearing a space for you with the specialist. As I said before if I could just phone Professor X and get an appointment he might be a bit busy?
I've need my GP three times in the last 15 years.
Thus proving that at this point in your life you are atypical. One day you might have prostate cancer, depression and diabetes. At that point a local professional who can try and manage this complex medical mess might be handy.
You do know that the NHS generally will spend most of the money it spends on you in the last 6 months of your life
So your experience of 3 visits in 15 years makes you an expert??
Not just me [url= https://www.amazon.com/Blood-Sweat-Tea-Adventures-Inner-City/dp/0740771191 ]ambulance drivers too[/url]
and lift out the urgent
How can you lift out the urgent when your waiting time is in the weeks?
If you don't have the capacity to respond quickly, don't put yourself in the way. "Either help or do no harm".
Not just me ambulance drivers too
No such thing.
How can you lift out the urgent when your waiting time is in the weeks?If you don't have the capacity to respond quickly, don't put yourself in the way. "Either help or do no harm".
Here is a problem, your ortho specialist probably won't be spot on for your cardio problems so who you going to call? Batman isn't an option.
Urgent is not always time based, it's a needs based service, most surgerys will have on the day appointments. An oversubscribed service doesn't make it bad, funding it and resourcing it properly is the key.
Sounds like your just one of those grumpy people looking for a bit of sky to shout at today.
You went to the consultant before consulting your gp and are complaing about people buggering up the system?
Come on, you're on a bike forum, and you can't think of a scenario when you'd go to hospital before a GP? Think blue flashing lights and a helicopter.
...but in the specific example you missed the word "heritory", which kind-of implies that there might have been someone else involved.
raymeridians
Currently waiting time for an out patient appointment, referred from a GP, is about 18 weeks
Do you believe that this number would be better or worse if we stopped having Gps next week and just booked a hospital specialist directly ourselves
It sounds to me like your the drive who thinks that traffic congestion would be less if everyone else used public transport.
Come on, you're on a bike forum, and you can't think of a scenario when you'd go to hospital before a GP? Think blue flashing lights and a helicopter.
Yeah you haven't a clue have you?
...but in the specific example you missed the word "heritory", which kind-of implies that there might have been someone else involved.
That makes even less sense now.
Happy ranting, but I'd say take a chill pill if there's any hereditory heart disease or there'll be more blue flashing light. I hope you get sorted soon.
Come on, you're on a bike forum, and you can't think of a scenario when you'd go to hospital before a GP? Think blue flashing lights and a helicopter.
and when I had a lovely fungal toe nail infection the GP was the best person to deal with that.
Same as when I got ill or needed some serious travel advice and jabs at short notice for a work trip - proper risk based conversation with somebody who knew
none of those were things that should be done by people who were not the GP
When I crashed big I went straight to A&E
Sounds like your just one of those grumpy people looking for a bit of sky to shout at today.
I'm a bit grumpy 'cos the pain kept waking me up all night and I'm woried that I'm going to have a chronic problem due to delay in being seem be a specialist...
...but yes, I am venting steam.
Providing 90% of the nation's medical care for 10% of the budget.
shuffling old people off this mortal coil with a conciliatory nod from the relatives and an extra press of the morphine pump?
I'm a bit grumpy 'cos the pain kept waking me up all night and I'm woried that I'm going to have a chronic problem due to delay in being seem be a specialist...
If it was seen as urgent you'd be seen very quickly, clearly they're not concerned enough. I hope you get sorted either way though.
Perhaps the OP's GP should adopt the Doc Martin approach
"Any one here with a genuine urgent medical problem?
If not, Bugger off"
What would the OP do? Sit or stay?
In all seriousness, the workload pressure on all NHS staff at present is not really sustainable. As GP's are the primary care point, they often receive all the frustration from patients. I couldn't do their job, nor that of the reception staff. You would be appalled at some of the things that have been done and said to the receptionists at the three surgeries I Have worked for in an admin role.
Unfortunately many junior doctors are also seeing the flack that GP's are getting due to pressures that are not of their making and are not opting to train as GP's.
"I'm woried that I'm going to have a chronic problem due to delay in being seem be a specialist."
Pay for a first private consultation and then have the treatment on the NHS. (I *believe* this is possible.)
which brings us back to the part where it's the funding and support that are the problem not the system
which brings us back to the part where it's the funding and support that are the problem not the system
I genuinely think it's the system that's inefficient.
Rather than 1 GP on £100,000/yr you can have 3 nurses on £30,000/yr. You get dedicated skills and see more patients. You don't need a doctor for your fungal infection or your travel jabs, both can be done by a nurse (mine were). My referral could have been done my someone in India for peanuts because there was no clinical judgement necessary at all.
Specialist nurses are awesome value for money, whereas doctors are expensive.
No neither could actually, the toe required a good look and an honest assessment of the treatment options. The Travel jabs needed a serious conversation about the implications of getting certain jabs or not and the risks based on a number of factors.
Rather than 1 GP on £100,000/yr you can have 3 nurses on £30,000/yr. You get dedicated skills and see more patients.
Bur seriously you have no idea... what happens when the nurse misses something?
On salary costs whats the actual cost? As anyone in business knows the salary is not the main cost of employment, by the time you add the building, infrastructure, CPD and more along with ongoing management and employment costs what is the overall difference between the cost of employing a GP over a nurse?
My referral could have been done my someone in India for peanuts because there was no clinical judgement necessary at all.
Very good a tiny and trivial part of the GP's life. The process of bouncing a referral because it's not needed or the wrong thing will save an even higher paid medical professional wasting their time.
You cant make appointments in advance to see our gps and you cant necessarily see our gps because they go through a telephone triage system and it often takes an hour to get through on the phone to arrange that.
Rather than 1 GP on £100,000/yr
😆
It gets better.
My referral could have been done my someone in India for peanuts because there was no clinical judgement necessary at all.
So they sent you along for shits and giggles?
I've had really poor experience with GP's over the last year or two, some I've already posted on here so wont go into it again but safe to say I would have been better served with some kind of online service, preferably one where I could access and monitor my own vitals and book referals aa needed.
wilburt - there's plenty of companies who do blood testing, some you can do yourself, some at private hospitals or use a private phlebotomist.
My doc's are great and even the receptionist are friendly and helpful.
I have MS, I'm at my GP surgery reasonably often as things randomly stop working properly. They're great and always able to help, be it advice or prescribing something to assist with whatever the issue is. My initial diagnosis I presented with issues that I had no idea wtf what was causing them, I thought it might have been diabetes. The GP wound up referring me to the right place/MRI scan. If you just have specialist nurses then wtf do you do when someone presents with a range of random symptoms and no idea what's wrong.
Nurses do not have diagnostic skills. Its not part of our skill set even for specialists or practitioners.
NOt all healthcare systems use GPs as gatekeepers but its one important role for them. Stops the specialists time being wasted with people they have no need to see
I've spent ages typing a long and carefully worded answer. Then deleted it as all I really want to say is...
Sad. Sigh.
A lot of GPs actually are nurses - it was realised years ago that minimal clinical knowledge was required and so they quietly enrolled a load of other people. A lot were nurses but my mate's a GP now and he used to be a postmaster (he says it's pretty much the same job) and DrP on here has a background in pole dancing.
Course, they all still earn over 200 grand a year, otherwise everybody would catch on
Nearly has me but DrP was a stripper not a pole dancer.
I use my gps to track my rides, speed, distance etc...
Not used the maps yet.
Can't be arsed reading all this but just in case someone hasn't yet pointed it out to the op, 90% of patient contacts are in primary care, so a better question might be "what are hospital doctors for?"
A year of all you can eat general practice costs about half of one visit to hospital outpatients. Without gps costs would spiral even higher out of control.
When I call for an appointment with my GP I normally get seen the same day. Sometimes it's the next day.
That's disgusting scotroutes
Whereas my wife phoned up for an appointment recently. This was late September. No appointments in September or October, told to phone back mid October when they start taking bookings for November
Where as I can get one the same day if I meet the triage criteria.
Well one of them must be doing it wrong then
Whereas my wife phoned up for an appointment recently. This was late September. No appointments in September or October, told to phone back mid October when they start taking bookings for November
At this point I pull out the dead or cured speech. Once they realise the call is relatively serious, I get seen pretty quickly
It's clearly the existing gps fault that there aren't enough doctors wanting to be gps.
And with threads like this who can blame them....
I don't think anyone is criticising the doctors, more the system they work within.
Well I spent the day diagnosing and managing chronic disease, dealing with some emotional and psychological problems, dealing with people with muscular skeletal disorders many of whom are better kept away from hospital. Managing skin and eye and ENT problems. I can then arrange almost any test that is available other than as an inpatient. I have developed close professional relationships with a couple of thousand patients They get to speak to me or see me very quickly. Try seeing someone with any depth of experience in hospital as quickly.
I did work in a nurse led system in Canada which actually needed more doctors.
I hope OP, when you actually need a GP, politicians with attitudes like yours haven't got rid of them. But I'm not sure you deserve them 🙁
[quote=Stoatsbrother ]Well I spent the day ...
Yeah, but did you do anything useful?
Regarding appointment times, with my GP it was about 2 weeks to get a routine appointment last time I got one a few months ago - though it does appear to be steadily rising as it was closer to a week not so long ago. If you need an appointment the same day you can get one by phoning in the morning, something I have also made use of recently. The only issue I have is that I ended up using that for something where I didn't need to be seen the same day - could have waited a day or two, but not really 2 weeks, so I kind of think they need some sort of intermediate category for triage.
I've been very happy with the service I've got from my GPs - it's just a shame I've wasted so much of their time in the last year with multiple appointments due to a problem following surgery - when I got referred back I had to phone up and hassle the consultant's secretary to get avoid going back on the waiting list for months when it would have been solved with a simple follow up appointment. No, it's not GPs which are the problem.
Oh and whilst we're doing having a go at the medical profession, that was repeat surgery which wouldn't have been necessary if the first consultant at the private hospital (referred there on the NHS) had done his job properly, so it's not even the NHS I'm most unhappy with.
I'm a bit grumpy 'cos the pain kept waking me up all night
You can ask the GP for Dihydracodeine, it's pretty effective pain relief.
So, in summary, in general:
1) GPs swamped by ridiculous demand, likely not able to meet needs of an 'entitled' population that expects excellent, universal, point of care service regardless of issue or location
2) Frustration amongst patients at inconsistent service, seemingly random and unaccountable care provision,
Solution: privatise NHS
For NHS: patients have to pay = less unneeded calls to healthcare professional as you have to pay for it (or your insurance does), including ambulance call outs
For patients: if the service is crap, go somewhere else. The crap providers get exposed pretty fast and go out of business
Win win
I'm not seeing a way out here unless patients change, and also NHS changes.
I must be lucky as I can get a Gp appointment within 24 hours if your not bothered about which one of the 5 you see. If you want a specific GP,for example one Gp manages to get me referred to see a specialist (Orthopaedics usually for me) she can get me one within a week. She does however constantly rollock me for smoking.
I have see her every 6 months for my Mot (Blood pressure check and check bloods)
Can't complain at all. Also when requiring a specialist I can choose which hospital I want (tend to avoid Blackburn)
Out of hours service is also good in the Area can most of the time fit you in, fit my missus in 20 minutes after ringing, diagnosed a middle ear infection, antibiotics and strong pain killers and she was settled for the evening.
No need to go bother Urgent care/A&E.
Oh, come on - surely you could suggest shooting the ill, or the poor, or both. Just so we [i]know[/i] you're taking the pissSolution: privatise NHS
No need to shoot them that's a waste of bullets, just let them die.
I've had no issues whatsoever with my GP, having been twice this year for the first time in a decade. First appointment resulted in a prescription and a follow up booked in four weeks after, and the second a no quibble referral to a consultant (at which point health insurance took over).
Same practice has a nurse who deals with minor injuries, no waiting around and a free lollipop for not crying when she peels off the gauze you stupidly put over a graze and is now embedded in your flesh.
It's not just health gatekeeping these days - one of the knock-ons from the massive cuts to local authority social care over the last few years is a lot more people going to their doctors with problems that are not primarily medical.
See also: A & E
See also: "Bed blocking"
Yes, I know they're going to "integrate health and social care". It won't be pretty and it won't be quick, and in the meantime the NHS is picking up the pieces of social care cuts (with the police picking up the pieces behind them - teenagers in mental health crisis sleeping in cells and police cars for example).
On the other hand, GPs aren't necessarily the best value-for-money part of the system imho.
Surely you get back the value you put, go with a genuine problem, get a genuine treatment. Go with a cold and get told to give it time to recover.
I pretty much don't go to see mine, but I'm lucky because I don't have anything significant wrong with me.
I do get colds quite a bit, but I don't expect my GP to be able to resolve that.
[quote=bwfc4eva868 ]I have see her every 6 months for my Mot (Blood pressure check and check bloods)
Your GP? 😯
Not much I agree with the OP on, but that does seem a waste of a GP's time - I saw the nurse for that recently. Also any particular reason (no need for details) for the 6 month check? I think I was told to come back in 5 years, though not paying all that much attention given no problems found and I'm fairly aware of my health (I've since lost ~1/2 a stone, having been borderline on the waist measurement - the nurse accepted my excuses for that being partly due to my other recent medical issues).
[quote=toby1 ]I pretty much don't go to see mine, but I'm lucky because I don't have anything significant wrong with me.
I hadn't been for years, but have made up for that in the last few with referrals for an MRI on my knee and hernia ops (and the aftercare mentioned above) - and also taking my mum for a few visits when she was staying here. The knee MRI was the only one where arguably going to the GP was the wrong way for the system to work, as I went with a letter from a private physio asking for the MRI when direct referral might have been more efficient (and results went back to physio after) - though it was still helpful to get somebody else looking at it, he certainly didn't give the impression I was wasting his time.
I do also try and get in and out quick - I'm conscious that the GP I prefer is always running at least an hour late and the appointment slots are only 10 minutes (I'm sure they love 30s appointments). He did once comment to me about having trouble getting rid of the patient before (and gave the distinct impression he thought they didn't really need to see a GP, whilst he has never given that impression regarding my sports related issues).
DrP on here has a background in pole dancing.
Nearly has me but DrP was a stripper not a pole dancer.
Chuckle... is nothing kept personal anymore..!
Dr 'sexy' P
No need to shoot them that's a waste of bullets, just let them die.
Or just bring them in to hospital on a Friday, because everyone dies in hospital at the weekend.
Aracer- GP or the Nurse it doesn't really matter just they always want it checked every 3-6 months.
Again without wanting any details, do you have health problems? Because I'm sure that isn't standard.
[url= http://www.bbc.co.uk/news/uk-england-humber-37620853 ]6500 people in brid are about to find out "what gps are for"[/url]
Assuming that could become a common scenario? Just reading that GP partners at a small practice are faced with a choice of taking out significant personal loans or declaring bankruptcy to cover liabilities. The world is going mad.
In my area (waiting time of 5 weeks for appointments) a developer has kindly offered to pay for building costs to extend the current surgery. With almost 1,000 new homes planned how will these GPs magically appear?
Yes c_g I fear it is. There is a real problem in some areas that just can't attract GPs.
No one in their right mind would take on a partnership nowadays as there is so much uncertainty. So we have practices being taken on by other organisations, community interest companies, healthcare trusts and the like. They then end up being run on locums until they get ditched as they aren't financially viable. At the same time as the government keep telling us we can have a wonderful 7 day service for no extra investment. All made worse by local councils stripping back the investment in the bits of the health service that they are responsible for out of public health funds which aren't ringfenced (sexual health, alcohol services, health visitors, school nurses, etc) which adds to the workload placed on the rest of the system.
But don't worry. Jeremy keeps saying everything is fine and there is enough money.
docrobster - I don't understand how these partnerships came about, presumably thanks to the Tories and their 'market forces' mantra? 'Outsourcing' isn't the answer for healthcare, have seen reports that locums are earning the most ridiculous sums of money so that can't be sustainable surely.
Can certainly appreciate that some areas are unable to attract GP's, presumably these will be the areas of deprivation as well as those with high housing costs?
Suspect that the public doesn't know half of what's going on, certainly what you've said about local councils is news to me.
As a middle-aged person I well remember the problems of the 70's with 3 day weeks, power strikes etc. but equally we're now experiencing frightening times in the UK thanks to a Government who's so out of touch with healthcare and much else. I suspect that more and more people will have no option but to pay for their own healthcare (as I currently do). Injustice and inequality in healthcare that's completely at odds with the ethos of the NHS.
Partnership is the traditional model of general practice and came about at the birth of the NHS. Until 2001 nearly all gps were partners, we own a stake in the practice. If not the building then the capital that is invested. We take a share of the profits left over from the contract after paying all the bills. As I'm financially invested in the practice I work hard to make it a success. So much more than just seeing patients.
New contracts "apms" for practices can be given to whoever wants to run it as a business. Gps are all just employees. They come they see patients they go home. If it's a crap place to work run by people who don't understand the nature of general practice they move on. Usually these contracts are more expensive than the traditional "gms" model in terms of pounds per patient.
I've been a partner 18 years. If I left I wouldn't be a partner again.
Why go through all the stress of trying to deliver a service when the local prime ministers challenge fund pilot pays £100 an hour to see a few coughs and colds, because the successs of that particular crock of shite is a vote winner but looking after 90 year olds with umpteen chronic diseases isn't.
I would be a partner again - with the right people and in the right place and don't regret my career choice for a moment... But we are used to the demoralising effect of the DoH kicking us, the Daily Mail kicking us, and people like a few posters here with grudges or no knowledge of what we actually do, kicking us.
The APMS enterprises in my area are all in dire trouble and delivering poor services and costing hugely more. And because they are failing, our local CCG is going to screw around with the contracts of those who are delivering timely decent and good-value care... And this is greatly in danger of making a lot of us retire early... 🙄
[url= http://www.pulsetoday.co.uk/hot-topics/stop-practice-closures/vulnerable-practices-to-be-allowed-to-fail-and-wither-says-nhs-england-director/20032943.article ]Official policy. Let struggling practices fail. [/url]
Holy thread resurrection....
Was chatting to a colleague about GPs/specialists etc etc..
This table should highlight to the OP and other 'doubters' what the point/role of GPs is quite neatly..
[img] 
[/img]
DrP
Whose job is it to diagnose Trollitis?