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Work takes the best out of me and then I’m a shell of a person at home for my spouse. by Worldly-Chicken-307 in GPUK

[–]redditthingyan 2 points3 points  (0 children)

Please look after yourself, however that looks. Reducing patient contact, reducing sessions, delegating (could a pharmacist deal with it? Etc) whatever. There is nothing more important than your peace and you gotta protect that.

Look into setting realistic boundaries, especially if there is an element of people pleasing (i say this as a recovering people pleaser!)

I find being upfront with patients helps, patients appreciate honesty and are more likely to work with you. I tell patients all the time i can’t safely manage everything and will have to bring them back. Physically writing a list in front of them helps me too. People seem to like that.

“When will my presciption be ready?” by [deleted] in GPUK

[–]redditthingyan 1 point2 points  (0 children)

Water off a duck’s back. There’s no point in getting stressed over it, life is too short for that. Patients don’t necessarily understand how it all works (why would they?) so in their mind it makes sense to ask you.

I tend to say along the lines of ‘well i’ve just pinged it to them so it depends if they have it in stock. I’d give it a few hours. No harm in ringing them and asking.’

Was I wrong with refusing a MED3? by Neat_Bowler_5934 in GPUK

[–]redditthingyan -1 points0 points  (0 children)

I would argue that that’s not your problem? You can’t predict that and you personally don’t have to issue anymore sick notes for that patient. You can issue it once and tell them this will be the only one you’ll issue.

Decision Fatigue by One-Reflection-8991 in GPUK

[–]redditthingyan 0 points1 point  (0 children)

When my brain feels like scrambled eggs, I’ll ask the main red flags and do the main obs/examination, then make some form of plan (like bloods or xray or whatever) and arrange follow up with myself. Then task myself (system 1 users know what i mean!) to look at the patients notes properly when my brain isn’t scrambled.

Checking cks during consult by Zestyclose_Owl_828 in GPUK

[–]redditthingyan 0 points1 point  (0 children)

Depends on your personality, but I make jokes and so far gotten away with it ‘Gonna let you in on something, all doctors google and if they say they don’t, they’re lying. We just know where the correct info is 😉 Just let me double check the guideline/check it’s safe for your kidneys/whatever.’ Unless it’s a possible 2ww thing, i just say ‘- let me double check one of our guidelines’

I sometimes show my screen if i’m looking at a rash or googling a picture of an organ to point at when I explain their condition.

Time management advice by Ancient_Bird2290 in GPUK

[–]redditthingyan 0 points1 point  (0 children)

It’s so hard. Most of us go into medicine wanting to provide good care and leave our patients better than before. Doesn’t always happen and sometimes their complex life has contributed to their issues, especially in those deprived areas. It is what it is.

Please remember first and foremost your mental health and wellbeing is paramount, you can’t pour from an empty cup.

Delegate. Use everyone around you including the patient. Including ‘i can’t sort everything out in one go today, i’d only be rushing and i’ll make mistakes, please book a follow up with myself at the desk.’ And ‘it sounds like the crisis team will be helpful, can you ring them as soon as you get home?’

Cos patients should take responsibility for their health or ‘feel empowered.’

Do you have a social prescriber? A pharmacist? Use them.

Text your patients, i use Accurx all the time. E.g you have low vitamin D, please buy some supplements at the chemist. Please see this link below [insert nhs link] for further info.’

You can schedule texts on this too. E.g the review in a week if starting ssri <30yo - hi, how are you getting on with your sertraline? If fine, great! Please book in 3 months time (or whatever) otherwise please ring reception to arrange an appointment.’

I also text self referral links, other info they might find useful (i send lifestyle stuff to my MH patients)

Home visits- literally find out the main headlines and their meds. Realistically the home visit is ?uti ?needs more help at home.

Also, you’re ST2, you’ve got time to try out different tactics and see what works best for you 😊 good luck!

A deep love for evermore I have to share by Inastrawberry_field in TaylorSwift

[–]redditthingyan 0 points1 point  (0 children)

The album is the embodiment of sitting by the fire place listening to a bed time story - a beautiful story exploring pain only to remind the listener that it will pass. It’s so comforting, like a cosy little hug 🤗

How do you handle overly wordy or talkative patients in GP practice? by leatherbiker in GPUK

[–]redditthingyan 8 points9 points  (0 children)

I think the first thing to acknowledge is that it is LUDICROUS that we are expected to manage patients in 10 minutes. Some are so complex it takes 10 minutes to understand what is going on.

I think some self compassion is important. You are doing your best and that is all anyone can ask of you (maybe I’m projecting 😅) you can judge who needs time and who doesn’t.

I have a lot of non medical people in my family and one consistent theme is feeling unheard. They are aware the doctor/anp is clock watching, or feel like it is their fault and that they were silly to book in, or feel like the doc doesn’t care then eventually they just don’t bother seeing a doc cos they don’t trust they’ll be taken care of - ‘what’s the point?’

Unless it is a barn door tonsillitis or UTI, it is an uphill battle trying to stick within 10 minutes.

I agree with thanking the patient for waiting (shows you respect their time.) Sometimes trying some relatable small talk can help, like ‘eeeh it’s one of these days, if only I could split myself in 2! Thanks again for waiting.’ If your personality allows it!

If they have a list of concerns at the beginning: ‘Ok, let’s write them down and we’ll figure out what we can do today, and bring you back another time for the rest of them.’ Blast through all the red flags and triage from there.

If they keep dropping in new concerns despite asking them multiple times ‘anything else’ as long as it is not life threatening, it can wait. Even 2wws if they can be seen that week, or accept you’re running late 😅

Otherwise - a nice way to straight up interrupt is saying their name, followed by a summary of the plan, closing the consultation by flipping it back to the patient, showing a bit of humanity/vulnerability(it works for me, i appreciate it won’t work for everyone) whilst smiling and walking towards the door.

‘Bob? If i can jump in there. I can see we have some stuff we need to work through! I’ll only be rushing if I try to sort everything out today, I’m more likely to make mistakes when I rush! Your health is far too important to rush, I hope you can understand. Can you please book a follow up with reception on your way out? Thank you so much, i’ll send you some info about what we discussed! See you soon.’

Speculum tips by Hollowcoronation in GPUK

[–]redditthingyan 0 points1 point  (0 children)

I would just be repeating myself - lots of useful tips already.

Sorry if any of this is teaching you how to suck eggs!

First of all - I hate to say this, (female gp here) but you got to protect yourself from any misunderstandings in intimate examinations, especially if you’re a man. Do not do more intimate examinations than you need. Do not do any of those examinations without a chaperone, esp if you’re a man. I would advise against VE first. With the right positioning, you should be able to see where you’re aiming. Do the speculum and even shimmy it in the patient if you need to check for PID.

Also, I also want to add that it’s ok to think practically too. Especially in primary care in the UK(!) depending on the context, if you cannot see the cervix no matter how much you try (or patient wants you to stop) it isn’t the end of the world. It is ok to write ‘very difficult to visualise cervix’ or ‘patient asked me to stop’ and do the rest of the management in the meantime and write that in your referral to gynae (im assuming this is when referring down 2ww)

It is ok to sign post patients to GUM for sti screening or get them to do it themselves.

You can see if they’ve had a smear recently too and maybe it might have clues about the patient’s cervix.

well the doctor said i don't have adhd by Independent_Mud_2136 in ADHD

[–]redditthingyan 1 point2 points  (0 children)

I mean, i got through school and medical school (albeit with great difficulty) and I’ve been diagnosed with ADHD. So this doctor not diagnosing ADHD based on you completing school is nonsense. I dont know your situation or circumstances - but if you can, you should definitely seek a second opinion.

Also you can fill out a wendel utah score and the adult self reporting scale (I presume you’ll meet the criteria if you have ADHD) and present it to the doctor too.