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Old 22-11-2011, 03:04 PM
truthseeker truthseeker is offline
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Default Not happy with service provided by GP practice

Just reminded of this from another thread here about GPs.

Im not happy with the service from my GPs practice. I like the GP on a personal level, but over a few years, and increasingly in the past 2 years I have become unhappy with aspects of the service. The reason I hadnt changed GP in the past was mostly because Ive had the same GP for 20 odd years and it seemed like a lot of hassle to change. A recent nasty experience with the practice has persuaded me that I should change.

But Id like peoples opinions, perhaps Im being unreasonable in my expectations?

There are 2 GPs in the practice, Im not confident of one of them due to more than one misdiagnosis, therefore I always only use the other, meaning I can really only see a GP half of the time.

One GP costs a tenner more than the other for no reason I can see. Unfortunately its the one I prefer who is more expensive!

One GP refuses to accept medical card holders or indeed to sign up to any scheme (like combined care for pregnant women) at all - in other words, private patients only, at a tenner a pop more than the other GP. I just feel, for a caring profession, that this is a bit money grabbery and it doesnt sit well with me.

There is absolutely no service offered outside of a straightforward appointment, ie, if you phone afterwards with a query about your appointment, with a query about instructions given, with an update such as your condition has worsened - the receptionists will not entertain you at all. To the point of rudeness actually. They behave as though they are the gatekeepers to Valhalla. I know that this is coming from their employers so they are not directly to blame, but I object to paying for a 20 minute appointment at 10am and then having a simple question at 1pm and an absolute refusal for it to be dealt with. I have on occasion had to pay for a second appointment to ask a question regarding the first!! The only way to speak to or get a message to the doctor is to pay for an appointment. If you leave a message you never ever get a call back.

One GP refuses to computerise the system, meaning you can never have a receipt re-issued which is annoying if you lose one.

Sometimes they dont write things in the notes and if, god forbid, you end up back because of some issue to do with an earlier appointment and you happen not to see the same person (a locum covers holidays for example), there is confusion because nothing was written up.

If you have to make a return visit with the same complaint in a matter of days, you are charged full whack again.

The locum GP (and the locum receptionist for that matter) always behave in a totally different way and offer help beyond what is normally available leading me to believe that the practice is actually not helpful compared to others - of course, Ive no experience of other practices so dont really know!

So I suppose the question here is this - is the above a normal way for most GP practices to behave?
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  #2  
Old 22-11-2011, 03:20 PM
micmclo micmclo is offline
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Don't you know?
Some doctors have a God complex

Just on the medical cards, it's their choice realy. If they have a good reputation and enough private patients then they don't need the extra workload. Nothing uncaring about it.
Maybe they've had bad experiences with many locals with medical cards or possibly have hassle getting paid by the department.

People often don't respect what they get for free so maybe they stopped dealing with medical cards due to timewasters. And while you are not a timewaster, if they take your call they'll take fifty more during the day from everyone else
It's a business and a business decision was made, nothing to do with money grubbing
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  #3  
Old 22-11-2011, 03:22 PM
horusd horusd is offline
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Sorry truthseeker, nothing to add to your comment, but the secretaries acting'... as though they are the gatekeepers to Valhalla.' is brilliant.
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Old 22-11-2011, 03:52 PM
Purple Purple is offline
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Like any business (and it is a business) there are different practices offering different levels of care at different price points.
Just because you pay at the higher end of the scale it doesn’t mean that you’ll get high-end service. Shop around; ask friends and family to recommend a GP and move.

On the issue of medical card patients not all GP’s can get a medial card list. Most of them would like them but it’s a closed shop. The average payment per patient consult per GMS patient is €65 whereas the average charge for a private patient is €50. That’s another bug-bear of mine; why is the state paying a 30% premium to doctors who have a guaranteed income?
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Old 22-11-2011, 04:14 PM
truthseeker truthseeker is offline
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Quote:
Originally Posted by micmclo View Post
It's a business and a business decision was made, nothing to do with money grubbing
Yes, I appreciate its a business decision, but it irks me nonetheless.

Quote:
Originally Posted by Purple View Post
On the issue of medical card patients not all GPís can get a medial card list. Most of them would like them but itís a closed shop. The average payment per patient consult per GMS patient is Ä65 whereas the average charge for a private patient is Ä50.
What do you mean by this Purple? Whats a closed shop mean?

As a patient of the practice I can ask for an appointment with either doc, but one doesnt accept medical cards - so in reality just one of them deals with any medical card patients. Would the medical card list not apply to the practice as opposed to the individual doctors in the practice? The locum who covers holidays accepts any patient of either GP, medical card or not.

On the rest of it - yes, Ive spoken to family and friends (some of which are with the same practice and are also considering a move), and will definitely be moving. It can be difficult to find a practice open to new patients actually - never realised that before.
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Old 22-11-2011, 04:15 PM
Firefly Firefly is offline
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Quote:
Originally Posted by Purple View Post
Thatís another bug-bear of mine; why is the state paying a 30% premium to doctors who have a guaranteed income?
I can never figure this out...surely with such a guaranteed income it should cost the government 30% less?
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  #7  
Old 22-11-2011, 04:23 PM
Sunny Sunny is online now
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Quote:
Originally Posted by Purple View Post
On the issue of medical card patients not all GPís can get a medial card list. Most of them would like them but itís a closed shop. The average payment per patient consult per GMS patient is Ä65 whereas the average charge for a private patient is Ä50. Thatís another bug-bear of mine; why is the state paying a 30% premium to doctors who have a guaranteed income?
I did not know that. Surely there are large savings right there.
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Old 22-11-2011, 05:29 PM
Purple Purple is offline
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Quote:
Originally Posted by truthseeker View Post
What do you mean by this Purple? Whats a closed shop mean?
Only vocationally trained GP's ca have a medical card list. The number of doctors that can be vocationally trained is restricted.
Many GPís have the required experience (time spent working in various sectors of medicine etc) but didnít do so under the umbrella of the vocational training scheme and so canít get a medical card list.
If one doctor in a practice has a GMS list then all of the doctors in that practice can see patients from that one doctors list. In fact the GMS doctor may never see their own patients. They still get paid for them though, still get the pension, still get the grants for equipment and still get their receptionist, secretary and practice nurse paid for by the state (if they have enough patients on their list). Itís all those extras that make up the Ä65 average. GPís saying that they ďonlyĒ get X per patient is like Gardai quoting their basic pay and leaving off the allowances and extras they get.

The IMF boys are not happy with this set-up and have insisted that it be changed.
The more competition the better in my view. A cut of 20% for all services that the state pays for would not go amiss. That includes all the prenatal care etc that is covered for all patients, medical card or not.

My wife disagrees with me on this (obviously ) but while it would impact severely on our household income I still think it is the right thing to do (a bit like taxing the childrenís allowance and introducing property tax).
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Old 22-11-2011, 05:41 PM
micmclo micmclo is offline
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Quote:
Originally Posted by Sunny View Post
I did not know that. Surely there are large savings right there.
I seem to remember Mary Harney tried to make savings but a huge fuss was kicked up and I don't think anything was done in the end

Minister for Health must be the toughest job in the country, all you do is face down vested interests. Sometimes you win and sometimes you lose
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Old 22-11-2011, 06:21 PM
vandriver vandriver is offline
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Do you have any link to back up your claim that it costs e65 per visit on average for medical card patients?
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  #11  
Old 22-11-2011, 06:30 PM
truthseeker truthseeker is offline
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Purple, thank you for that most informative post.
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  #12  
Old 22-11-2011, 07:24 PM
ajapale ajapale is offline
 
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Quote:
Originally Posted by Purple View Post
The more competition the better in my view.
Im not so sure about this! There are a lot of factors which influence your initial and subsequent choice of GP and am willing to bet that price is way down the list of those factors.
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Old 23-11-2011, 08:33 AM
Purple Purple is offline
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Quote:
Originally Posted by ajapale View Post
Im not so sure about this! There are a lot of factors which influence your initial and subsequent choice of GP and am willing to bet that price is way down the list of those factors.
There are other forms of competition besides price competition.
Service providers should compete on service, competence, price, facilities and ease of access (location, opening hours, parking etc).
Doctors are no different from any other service provider in this regard. The patient (their customer) should also feel that they are valued, that the doctor knows that they have chosen to spend their money with him or her. I always find it strange that so many people thank their doctor after a consultation but so few doctors than their patient for the custom.
At the end of the day you are buying something from them. They should be grateful for that.
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  #14  
Old 23-11-2011, 08:44 AM
Purple Purple is offline
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Quote:
Originally Posted by vandriver View Post
Do you have any link to back up your claim that it costs e65 per visit on average for medical card patients?
.Here
They give a figure of €64 in 2008.
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  #15  
Old 23-11-2011, 08:45 AM
Protocol Protocol is offline
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http://www.hse.ie/eng/Staff/PCRS/Con...e_of_Fees1.pdf

Link to HSE PCRS document on payments to doctors.
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  #16  
Old 23-11-2011, 09:34 AM
Vanilla Vanilla is offline
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Wouldn't mind a bit of competition in our area. Our GP moved and his patient files were left with another GP in the town. There are only two GP practices now left in the town. I didn't want to go to the GP that the files were moved to and tried to move to the other GP with my family- but we were told there was a 'waiting list' !
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  #17  
Old 23-11-2011, 10:23 AM
Firefly Firefly is offline
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Quote:
Originally Posted by Purple View Post
...still get the pension, still get the grants for equipment and still get their receptionist, secretary and practice nurse paid for by the state (if they have enough patients on their list).
I didn't know these things were paid for by the state...that's a complete joke. A good friend of mine is a GP and I always wondered how he could afford a practice nurse and a receptionist. Next time he complains about medical card patients wasting his time by coming in every day I'll ask him how his pension is doing!

This needs an overhaul. Something simple like going to the dole office for a GP voucher if you need to see a doctor. The doctor then gets refunded after the visit by the state for an agreed amount. No pension, no practice nurse or any of the other benefits...
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Old 24-11-2011, 11:51 AM
Complainer Complainer is offline
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Quote:
Originally Posted by vandriver View Post
Do you have any link to back up your claim that it costs e65 per visit on average for medical card patients?
I'm pretty sure that the capitation fee mentioned in http://www.hse.ie/eng/Staff/PCRS/Con...e_of_Fees1.pdf is a fixed annual fee per patient, not a fee per visit.
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Old 24-11-2011, 12:59 PM
Purple Purple is offline
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Quote:
Originally Posted by Complainer View Post
I'm pretty sure that the capitation fee mentioned in http://www.hse.ie/eng/Staff/PCRS/Con...e_of_Fees1.pdf is a fixed annual fee per patient, not a fee per visit.
Now if I wasn't on Complainers "Ignore" list then he would have seen the link I posted.
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  #20  
Old 25-11-2011, 08:49 PM
johnwilliams johnwilliams is offline
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can a doctor (a) who has a patient with a medical card stop another doctor (b) from taking on said patient, a neighbour of mine wanted to change to a different doctor ,but new doctor was not able to take neighbour on, no reason given ,a lot of people have been leaving doctor (a) for other doctors lately ,and think doctor (a) may have put a stop to it. doctor (a) is not as good as the other doctors in the area
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