G.Ps Paid a bonus if they don't send people to hospital

[Mosh 10]

According to The Mail on Sunday this scheme is being introduced in Oxfordshire and 80 out 82 practices have signed up for it.

 

They will be given a target and if they meet this they will get a further bonus

[Heyesey 11]

Yay. More stupid targets and bonuses that encourage people to do their jobs wrongly just so that they reach the target.

[melthebell 862]

yeah saw that

 

whatever happened to customer service? seeing people, talking to people, treating people right

rather than treating them like cattle and ignoring people just to hit some government target

 

[mr contrite 10]

At first glance i felt the same way, but upon explanation, i can see the merits, apparently many doctors are referring patients to specialists for illnesses that the GP could treat at the surgery without the need for specialist treatment, maybe the GPs are fearful of failing to spot a serious illness, and pass the buck by sending the patient further up the medical ladder, although my own recent experience of the GPs referring me to a consultant leads me to believe that the GPs are already reluctant to refer a patient, and it was only after 3 weeks and 4 different GP visits did i get the referral i needed to see a consultant and get an MRI scan, which resulted in surgery.

[Heyesey 11]

At first glance i felt the same way, but upon explanation, i can see the merits, apparently many doctors are referring patients to specialists for illnesses that the GP could treat at the surgery without the need for specialist treatment

 

 

I can understand there being some concern over this issue, but it won't be resolved by paying GPs to not refer patients. It will only be resolved by paying them to make the right decision. Sometimes, not referring them won't be the right decision; but hey, we get money for it, so that's what we'll do.

[melthebell 862]

and surely its better to send somebody than the gp mess up their treatment?

[Heyesey 11]

and surely its better to send somebody than the gp mess up their treatment?

 

No. If GPs sent, for instance, every potential brain tumour patient to the hospital, the hospital would be buried under an avalanche of people with nothing but a headache, and it would have to turn away other people who would die for missing treatment.

 

Part of a GP's job - an important part - is to weigh the risks involved and make a judgment call. If they're to be instructed to send every "potential" hospital case to the hospital, we don't need GPs at all.

[Mathom 10]

I wonder how they will handle suspected cancer cases? GPs at the moment are encouarged not to mess about and get people referred ASAP as the sooner the better with most cancers.

[mr contrite 10]

I wonder how they will handle suspected cancer cases? GPs at the moment are encouarged not to mess about and get people referred ASAP as the sooner the better with most cancers.

 

The situation must have changed over the last decade or so because when my dad was finally referred, after 8 months of being told he had IBS, it was too late, and the cancer had spread, the secondary cancer was what killed him.

 

Difficult call for GPs, and 2 personal incidents should lead me to oppose the paying of GPs for not referring, but maybe (and impossible to prove) if the scheme had been in place back then, my dads cancer may have been detected sooner, based on his symptons, and he might still be here today.

[nick2 10]

Our GP's won't be cashing in then, they send you to the hospital at the drop of a hat.

[AGB1 10]

The situation must have changed over the last decade or so because when my dad was finally referred, after 8 months of being told he had IBS, it was too late, and the cancer had spread, the secondary cancer was what killed him.

 

Sorry to hear that Contrite.

I hope you'll find that it's precisely because of cases like this that things have drastically improved. The 2 week wait system has revolutionised cancer detection and early treatment and thus survival rates.

 

On the point of GP referrals to hospital.

Oh god you should see some of the garbage that get's referred to the surgical wards from GPs. Everyone with abdominal pain is appendicitis and everyone who hasn't pooed for a few days has bowel obstruction.

I'm not sure if it's got anything to do with how GPs train now, or maybe it's the constant fear of litigation - if there's something you're not sure about, then it's much easier to pass the problem onto the hospital, let them do a whole host of expensive tests and prove that there's nothing wrong, rather than take the chance of getting it wrong and getting sued.

 

Hopefully this scheme will mean that some GPs have more confidence in themselves and their diagnostic skills and not send as much guff to hospital!

[Heyesey 11]

rather than take the chance of getting it wrong and getting sued.

 

 

Zigackly.

 

 

If 10,000 people go see a doctor with a headache, 9,999 of them will just have a headache and one will have a small brain tumour. The only way to catch the brain tumour patient is to send all ten thousand for brain scans; but if the GP doesn't spot him, he risks a law suit for negligence.

 

We need to remember that negligence doesn't mean "not spotting something," it means "not taking reasonable care to look."