Make your complaints known to whoever it is that employs them. If nothing happens and you're still not happy, find another job.
I’m home from work and tired and so don’t have time tonight to write the update, but I promise I will reveal all tomorrow.
"but I promise I will reveal all tomorrow"
Are you the girl from the Big D peanut dispensing card?
Is it a new or old colleague of the Canis familiaris variety?
They never seem to fulfil their obligations, but get away with it with unfair levels of cuteness and mastering the ancient art of hang dog.
I agree that dogs are completely ****less with very little sense of responsibility, especially if they think no one is watching, but unfortunately this isn’t one of our dogs.
This person a partner?
Was my thought, from my recollection of the OP's trade. That particular 'industry sector' is rife with issues like this...and you can't just sack the buggers.
He'll have to wait for them to retire or find a way to buy them out...or just put up with it unless the quality of their work attracts the interest of the professional regulator.
Give them a chance, they’ve only been in power 8 weeks….
That's no excuse, Liz Truss managed to transform the economy in under 8 weeks.
Probably not the same sector, or issues, but i've had to deal with contractors in the past who have done very little for their money, but, it's all about the contract, and as you're list just includes more annoyance style things, i'm guessing there is no areas they've breached, and no formal route to liquidated damages being requested?
Biggest piece of advice i can give if this is the scenario is just don't try to take it personally, keep it as a works issue that is left in the workplace after you leave, it's the same issue you see across business, this time it's just resource rather than capital.
Raid the stationary cupboard/nuts and bolts store / loo roll stash/tea bag tin and blame the shirker seeing as they're getting framed for everything else
Sounds like a (the only) director.
Oasis reunion tour falling apart already?
I’ve been waiting to hear about that since the reunion was announced.
I'm probably going to sound harsh here but I think that OP is deliberately stringing us along by not divulging more info. OP has asked for advice but is being opaque in giving further information to allow us to give reasoned? suggestions.
I'm on holiday, I've had a glass of nice wine. OP you're being silly with us. Don't post clickbait unless you are prepared to interact with it properly if you wish to maintain integrity. i.e. Rule #1
As others have alluded to, I'm guessing this is a complaint about government?
Only an hour to go until the big reveal!
The main thing is... don't let them shorten your life expectancy 😉
Iron the soles of his feet and whip him with a car aerial?
@Kramer is a GP, the person he's talking about; "the contractor" is probs a partner in the practice. Each GP practice has a contract with the NHS to provide services, and the folks that own the practice are referred to sometimes as contractors. As opposed to any salaried doctors that they then employ to help them with patient load.
Under-performing partners are a bane of the industry, they're like ticks, stubborn and equally difficult to extract if they don't want to budge. It's up to the other partners to act really, but often times they're just as bad, burying their heads in the sand as their unco-operative and uncommunicative partner does less and less work and extracts the micheal more and more. I've been in this situation with a dual partnership where one was an asshole and the other partner although a good hard working GP didn't have the power to do anything about it really. I forced the issue by suggesting to a couple of the salaried GPs that they might want to start noises about becoming partners, or they'd leave. The behavior improved rapidly.
If it was me, I'd post about it on a forum and try to get some advice. But i'd keep it sufficiently vague to stoke interest and then provide a massive anticlimax when I provided the details the next day.
I AM IRONMAN
Just to keep it in context, I assume we are taking Vitamins here?
Someone I work with is behaving atrociously.
I really hope this isn't about me...
If it's a contractor just don't continue or renew contract, depending on the terms of that contract.
All our short term contractors are on a contract with clear expectations. I've called three of them over the years to explain I wasn't happy. Two changed thier ways, one we parted company with permanently.
Ok, apologies for the delay, it’s going to be a longish post so I wanted to wait until I had some time to write it.
As a few of you have already guessed, this isn’t a singular colleague, but actually repeated behaviours by a group of colleagues.
That group of colleagues are hospitals and secondary care services (services that we as GPs refer our patients into for further care). For succinctness I’m going to use “hospitals” to describe this group from now on, as they make up the majority.
It is doctors (senior and junior, NHS and private), nurses and other therapists.
What started as isolated incidents are now becoming commonplace. Not only is it causing massive problems for us as GPs, it’s causing issues for you as patients. After all if your GP surgery is busy doing the hospitals work for it, then there’s less time and resources to spend on seeing patients, which is our actual contracted job.
Some of the inappropriate things that hospitals are asking us to do are:
- Deal with their abnormal test results.
Apart from the fact that they are paid to deal with their own results, a large part of dealing with abnormal results depends on the context in which they were done, or speaking directly to another specialist to see whether any further action is needed. Both of those are better achieved within the hospital than by dumping them into the GPs lap.
- Providing sick notes for conditions that they’re treating.
Hospitals have been able to do this for decades. Part of the reason that they have is to free up appointments with GPs. Even so it is amazing how many of them refuse to do so, or if they do do them, provide them for a ridiculously short period of time and then when the patient asks for an extension refuse to issue one and fob them off by telling the patient that it’s the GP’s job.
- Make onward referrals for the patient.
Again this is part of the job that they’re contracted to do, it is not part of a GPs job, and it takes a huge amount of our time and effort. Also when a referral is made, ideally it should be to answer a specific question, so it is best coming directly from the clinician who wants the question answered who is also best placed to forward the relevant information. More and more we’re seeing this as a tactic for hospital doctors and their teams to avoid taking clinical responsibility for their patients.
- Follow up their patients appropriately.
Again it’s part of what hospitals are contracted to do, and they’re not doing it, instead telling patients to come to us for follow up. Once again this is not generally part of our job, and actually takes us away from seeing our own patients who are ill.
- Arrange their own tests and investigations
I’m starting to sound like a broken record here, but hospitals are paid to arrange their own tests and investigations, and deal with the results. In most cases GPs are not. However hospitals often don’t, using the excuse of patient convenience as to why not. This is not credible as it’s perfectly possible for most hospitals to use the same test services that we do for our patients, they just choose not to. Tests are better arranged directly by the person who wants them done, so that they can make sure the correct test is ordered (and avoid the Chinese whispers effect) and get the result directly back to them, rather than rely on a chain to pass them on (through the GP) with the associated potential points of failure.
- Looking for spurious reasons to refuse referrals
More and more we’re seeing referrals being rejected for arbitrary and nonsensical reasons. Often to be reversed when we query it. We can only imagine that this an attempt to avoid their contracted workload.
I am going to write a further post with some examples of all these points.
What makes all this even more egregious is that when we politely raise this with our hospital colleagues we are routinely met worth BS excuses, denial and obfuscation.
Interestingly it’s not just me. Two of my good friends who are senior hospital doctors have seen the same trends of their less senior colleagues doing everything they can to avoid taking clinical responsibility for patients and so creating unnecessary workload for their colleagues.
I’ll be honest, there has always been a tendency amongst a proportion of our hospital colleagues to be arrogant, especially to their (perceived as) lowly GP colleagues, but at least in the past we used to have confidence that (mostly) they were competent. Now I’m not so sure.
Probably not the thread that most on here were hoping for. 🙂
Have you considered gluing yourself to the reception desk at your local outpatients department?
Or writing an angry letter to Pulse magazine?
Somewhere in hospitaltrackworld, docs are probably complaining about GPs and the quality of their referrals. My recent experience of the system is that none of you buggers communicate with each other or the patients/clients, whether it's GPs, secondary care, social services...
That seems totally crap. I can't imagine how it will chance, I hope it does.
This cheered me up, thank you
Have you considered gluing yourself to the reception desk at your local outpatients department?
My guess (and very much an outside look) is that they are just all flat-out firefighting and can't afford the time to do anything other than the bare minimum for whatever happens to be the top of their heap at that moment in time.
Hospital was pretty crap with FiL earlier this year, and we heard a number of similar stories from others.
I don't particularly blame the individuals, who may have been doing their best in an impossible situation. It's also possible they were a crap person (specifically one consultant seems to have been the key failure) but I don't know how much it's attributable to them personally. The nurses seemed to be doing their best but didn't have the authority or knowledge to answer most of our questions when we visited. So having gone in with only a broken elbow, he got "dealt with" until he could no longer stand up, and then discharged into a care home where he died shortly after.
Agreed. One of the problems is that you are the employer on the GP side, and the staff in secondary care are employees.
In all honesty I've tried writing to the individuals concerned (generally the same departments/names crop up all the time) and that makes no difference most of the time. I think the key is to write to the employee and copy in their manager/employer - systemic changes rather than individual are needed. Whether this will work remains to be seen of course but as you have pointed out GPs really need to free their time (and money so they can pay their staff) to do GP work, not specialist work.
I find the BMA templates useful here for a quick letter/move on strategy. We absolutely need to quickly remind secondary care that they remain responsible. Patients need to be advised that PALS are their point of contact for any hospital issues they can't resolve through first attempts eg calling the secretary. The days of GP practices chasing hospitals on behalf of patients are gone (there are exceptions if course, but very few).
There are of course many excellent secondary care colleagues, and no doubt many poor examples of GP work, but neither precludes ensuring the systems are robust and safe on each side.
My recent experience of the system is that none of you buggers communicate with each other or the patients/clients, whether it’s GPs, secondary care, social services…
I'm sorry to hear that.
Somewhere in hospitaltrackworld, docs are probably complaining about GPs and the quality of their referrals.
Interestingly, in my 20 year career as a GP, every so often a hospital doctor gets a bee in their bonnet about that, and decides to come and audit/educate us about appropriate referrals. Every time they've stopped within a day or two because they've realised just how much we actually deal with ourselves and the level of clinical risk that we carry on a daily basis.
The last consultant I worked with in the community told me that "basically you do eighty percent of what I do, in twenty percent of the time" which I think is a fundamental truth of being a GP.
My guess (and very much an outside look) is that they are just all flat-out firefighting and can’t afford the time to do anything other than the bare minimum for whatever happens to be the top of their heap at that moment in time.
I used to think that, but it's actually gone beyond that now, and it doesn't explain the poor attitude when we make them aware of the issue. I'm going to post later about some actual things that have happened, where it's gone past firefighting into the realms of incompetence.
doing everything they can to avoid taking clinical responsibility for patients and so creating unnecessary workload for their colleagues.
At a recent visit to A&E my wife asked a hospital doctor's advice regarding a heart issue that she has, and the response was "Discuss with your GP". Here you are, an (admittedly junior) specialist in a hospital with all the tests you just done at your fingertips and access to all the machines that go ping, and that's your response? Pointless.
I think Trust doctors know that they can get away with it, so they do. They have way more political clout than GPs.
I left the queue for Oasis tickets for this?
The last consultant I worked with in the community told me that “basically you do eighty percent of what I do, in twenty percent of the time” which I think is a fundamental truth of being a GP.
It's a fundamental truth of being a good GP, which is what it seems you are.
It's interesting that when someone from secondary care, who has doubtless spent hours ranting about how lazy, workshy and ignorant GPs are, pops into your surgery, they get a different picture. Would your depiction of hospital doctors as lazy, workshy and ignorant survive contact with reality?
It's a broken, badly organised and under-resourced system, with a lot of individuals doing their best, and some who have probably mentally checked out and are doing as little as possible.
I can understand the frustration, though. Patients are being failed left, right and centre. I have numerous examples of excellent, and slipshod practice over the past decade involving relatives, some administrative, some via GPs, and some via secondary care.
Would your depiction of hospital doctors as lazy, workshy and ignorant survive contact with reality?
The difference between GPs and hospital doctors is that all GPs have worked in hospitals, very few of our hospital colleagues have any experience at all of General Practice, and even fewer a working understanding of what it is that we actually do.
But yes, I've had direct contact with my hospital colleagues, and whilst there's always been a few who aren't very good, IME they're getting more common. It's not so much laziness and being workshy, it's the arrogance without the competence to back it up. And my friends who are senior hospital clinicians have commented on the same phenomenon.
This was the way last time i had to lean heavily on the NHS 20+ years ago.
The GP went above and beyond at every stage, contacting other services within the NHS and (eventually) a contracted third party provider when the NHS either gave me waiting times measured in years just for an initial consultation. Or simply didn't respond.
At that point, all i needed to see him for was 20 minutes once a month for a general looksee and a renewal of my prescriptions.
I found out later that he was also dealing with the recent suicide of his son and a fairly serious illness of his own while trying to sort out my issues.
I think all we can do is simply take a stand.
Although it's tough intiially, it's the only way change occurs.
I write about 3 letters per week simply refusing to take on additional work from hospitals, and tell them, in no simple terms, it's not my job. it's theirs. Or someone elses. But whoever's job it is, THEY need to do it.
I then tell the patient.
From Private consultants asking me to refer back to THEMSELVES in teh NHS, to pre-op clinics asking me to request this, that, and the other scan. I just simply say No.
I've had paediatric clinics asking me to arrange 3 monthly ultrasound scans and review the result, and let THEM know if it's abnormal (for a cyst or whatever. "no - you want the result, you do the test".
I often get letters of annoyance back, but my mantra is "it's ok for YOU to be annoyed. I'm still not going to do it".
No-one dies because it's all slow paced out patient stuff.
Honestly, just do what we're meant to do, and tell the hospital "no".
I've given up going 'above and beyond' years ago, because, in the sad honest truth, "if you go the extra mile, you just end up a mile in the wrong direction"
DrP
True, but a lot of GPs haven't worked in a hospital setting in decades. If you're observing an attitudinal change, I'd suggest it's probably something to do with the cumulative effect of everything that's happened in the last 10-15 years affecting clinician behaviour. Also I'm pretty sure that many patients would say that their contacts with primary care feel different to 20 years ago, and not necessarily in a good way.
Sometimes it is hard to look at a vast, complex machine from a single point on the inside and get a reliable view as to where the points of failure actually are.
I'd agree that it's probably been a long time for most GP, but... we all know the basics..
- hospital DOCTORS can and SHOULD write a bloody prescription for a patient if they want them to start a drug there and them.. I've written letters to trusts and individual consultants telling them that it's a complete waste of a GP appointment for a pateint to have seen consultant X, and then the next day book to see me because "consultant X wants me to have this drug ASAp. can you do that". I promis you - if the pateint had to PAY (which i'm not saying they should, at all) for each contact with the health service, THEY would ask the consultant "erm, can YOU give me a script for this drug?"
- hospital doctors can and SHOULD give a poor scaffolder with a broken spine a bloody sick note. Why wouldn't you. They exist, and are in the hospital.
It's been years since i've been working IN a hospital, but I sure as heck know that the people in white coats with a stethoscope around their neck can and SHOULD be able to prescribe drugs and give advice on discharge..
DrP
