What makes a good consultation with the GP?: young people’s views and experiences

Here, people talk about their views and experiences of a good consultation (appointment) with the GP. This includes their views on:

information
discussing treatment options together
time to talk
seeing the same GP every appointment
getting tests and referrals done quickly
a GP that listens, speaks directly to the patient, and takes concerns seriously
a GP that’s relaxed and informal

There were some very positive experiences, and some young people said they’d never had a bad experience of a GP appointment. A good consultation involved having a doctor that they found understanding, approachable and knowledgeable. The topics below were also important.

Peter feels that GPs and the health service are very good’, though they sometimes get bad publicity.

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Is there anything else that you’d like to add at all, anything that I haven’t asked you about?

Just that I think that, in general, GPs are very good and the health service is very good, even though they sometimes, you feel that they get quite bad reports in like the papers and the media. I feel that it is better than they’re oftenthan it feels that they are, you know, theyit getsthey get presented as being quite bad. But I think that they generally do a very good job really.

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Information

The people we spoke to valued having the information they needed from their GP in an easy to understand way, including information on why a medication was being prescribed, possible side effects and, when relevant, leaflets or website addresses. Shane was happy with the information his GP gave him about mental health and local counselling services, which included leaflets and web addresses. Isaac felt that the information his doctor gave him when he needed a mole on his arm removed was ‘enough…the facts were there’. Lara recalled that her appointments had usually been good and she’d always got the information she needed in the ten minute consultations.

Aaron’s family doctor, who has now retired, always explained what medication she was prescribing, how it worked, and how often to take it.

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Was it always the same doctor that you saw?

Yeah, yeah, I’m pretty sure. Unless one maybe here and there, she might not have been well or something, but yeah I’m pretty sure it was the same one all the time.

And often you said you also went for sports injuries.

Yeah.

And can you remember any of those appointments, like what happened at the appointment or, you know, did she ever refer you to anywhere else or?

Yeah. So I had, she’d do like loads of tests on me and I would have knee problems and my dad would, as I said my dad was in before and he really had problems with his knees. So I had one referral to somebody who worked as a consultant but they told me not to worry about it, and did a couple of scans.

Was that reassuring?

Yeah, yeah, it was good. So I guess, cos then I, we had the GP but then I’d see the specialist as well so…

Thinking about this GP who has now retired, how would you describe her in terms of her being a GP, you were comfortable with her?

Really approachable. She had a good, cos since then I’ve had other GP’s and they are reading about you while you’re almost in the room, whereas she had everything ready. She was yeah really friendly and just really good at going through the whole process, explaining what you would be given and how it works and how often, rather than you having to look at what you get from the chemist.

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Discussing treatment options together

Paula praised the support she had from her GP who talked to her about various different options for acne. Her decision to try a cream instead of more antibiotics was made together with the doctor. Shane was also pleased when he and his GP looked at treatment options on the computer screen together and talked about them. Siobhan and Sarah both felt that GPs should give patients all the available options when it comes to medication and talking therapies (e.g. counselling) for depression.

Paula felt that her GP was really helpful and talkative. He gave her lots of options and explained what each one was.

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From what I know like he [GP] was really helpful. And he gave a lot of options. And very talkative as well. So I think he was really good.

And you mentioned that he gives you a lot of options.

Yeah.

And can you just tell me a little bit more about what you mean by that?

So I went because of my acne. And I’ve been taking antibiotics, which have stopped working. So he gave me lots of different other options we could try. And he helped me pick the best one.

Okay, so he kind of talks to you and talks you through your treatment?

Yeah.

Okay. Have you been back for your acne? Sorry, Suman [researcher’s name], do you want to?

I was just going to say, you picked the best treatment for you. How did you decide that? Talking with your doctor and thinking about what was important to you, how did you come to the decision, Yes, this is the right one for me?

Well, I guess he just gave me all the options and then explained what each one was. And then asked me if I wanted to, say for example, apply a cream or take them orally. And cos I had already been trying antibiotics, which had stopped working, he suggested that I use the creams instead.

Did he ever explain to you why the antibiotics might have stopped working?

No, but just cos I guess the bacteria gained resistance to the antibiotics.

And do you ever look up online, for example, for any treatments for any skin conditions? Or would it be your GP that you would speak to?

No, I would never. I would always consult with the GP.

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Time to talk

Not feeling rushed during the consultation helped people feel that they were being listened to and given the time to talk, and then they could leave with the information they needed. Emma found it frustrating when consultations felt rushed and the doctors came across as if they were ‘counting down the seconds until you get out’. Auberon, who often saw the GP about mental health, said that some doctors rushed the appointment but the doctor that he liked, and did his best to see every appointment, booked him in for double appointments.

The GP spent 20 minute with Auberon, which gave them time to talk. The appointments with other doctors weren’t so good and lasted 5 minutes.

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And you mentioned that the good GP listened. Did you feel that you were given the time to talk?

Yes. This GP that I always see normally the appointments are like ten minutes a session, but she always used to book double appointments for me to have time to talk to her and stuff. So she always used to give me twenty minutes a session so it gives us time just to talk about it and stuff.

Yeah, and you felt that she listened. So you felt that you could talk about what was on your mind?

Yes, yes.

She took you seriously?

Yes.

And have you noticed any changes like from sixteen to nineteen in terms of how the GP has talked to you, or has it always been the same?

It’s always been the same really because I used tobecause I’ve seen them by myself, so yeah.

And you feel confident enough to go and see them by yourself?

Yeah.

So that GP that you mentioned is good. She listened, and you made double appointments and you didn’t feel rushed at all?

No.

How about with the ones who weren’t so good?

The ones that weren’t so good only used to give me a single ten minute appointments, and some didn’t even used to be ten minutes. It used to be like five minutes. I would walk into a room and start explaining my mental health, and they would justused to tell me to speak to my psychiatrist, so I just left.

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Shane also saw his GP regularly about mental health and said that consultations with his preferred GP often lasted around 20 minutes, which was enough time to talk and not feel rushed. Sarah, who saw the GP about anxiety and depression, praised the doctor for always making time for patients. He had ‘a reputation’ for running over time but was worth waiting to see.

Appointments with Sarah’s GP lasted as long as she needed. He really explored what was wrong and then talked about the different options available.

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He’s very good. He always asks you how you are at the start of every appointment in a way that’s not, it’s a How are you? Rather than, What is wrong with you? And I think there’s a very big difference in that question. It’s not, You’ve come here for a purpose and I want to know what it is. It’s, How are you doing and how is your health? And I think that for mental health situations is quite an important distinction.

And the doctors at Uni, what was there kind of introduction when you came in?

It would be, So how can I help you today? That kind of line they always say.

With this doctor did you feel rushed at all or sometimes or not…

No. So he’s got a bit of a reputation for taking like 45 minutes per patient so you can wait for a really long time with him. But it’s worth waiting. And I’d rather wait than not wait, like you might be waiting at the surgery for two hours but you know that, when you’re seen, you’re actually spoken to and he doesn’t just talk to you about one problem, it’s about everything.

Yeah. So you didn’t mind having to you know to wait even if your

No.

appointment was 10 o’clock but by now it was half eleven, or something.

No, that was fine. I always expect. It would be expected in the doctors, but yeah.

But you don’t mind because you feel that he gives you all the time you need.

Yeah. Yeah, it was worth waiting.

You mentioned that with this doctor he often had an appointment like for 45 minutes if you needed it.

Yeah.

Can you remember any of the appointments you had with him that were much longer than some

It would have been long, yeah, it would have been long. One of, the first one was long, second one would probably have been normal-ish length. But yeah the first one was like, I was clearly not okay I think and he was like, Okay, you’re not leaving here until we’ve got a solution that you’re happy with for now. And we’ll keep coming back until… Yeah he was really good.

So can you remember the time at all, or it’s hard to remember?

It would have been about 45 minutes because that’s kind of how long his appointments always seem to last.

So that’s, you know, that’s quite long for a doctor’s appointment isn’t it?

Very long, yeah, it is long. But people keep coming to see him…

And so the first appointment was about 45 minutes and he really wanted to help find a solution and you were saying that you really felt like he did care?

Yeah. I think it was more that he wouldn’t, because with another doctor, I’m feeling like this. They would say, Okay it sounds like you’re experiencing symptoms that might be connected to X. Whereas he’d be more like, Okay, can you chat to me more about that. What do you mean when you’re feeling like that? What other reasons or what other, what’s triggering that other particular feelings within that? Like he’d really push it. And then talk to you about the different options and things.

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Seeing the same GP every appointment

Paula and Louis, who rarely went to the doctor’s, didn’t mind which GP they saw, though Louis felt that seeing the same one does help build ‘more of a relationship’. Hannah was happy to see any available doctor because she felt they were all professional. She preferred seeing the doctor she’d seen throughout her life, though, because he knew the whole family and she trusted his expertise. Fran also liked seeing the GP who’d known her since she was a child, and knew her medical history and the medications she takes for psychosis.

Most of the GPs at Louis’ local surgery are very good. He’s seen the same ones for many years.

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So is there anything else you’d like to say about your GP or the nurses or the local surgery at all?

I think they do a pretty good job and you usually don’t have to wait too long for a wait. And most of the GPs there are really good and I kind of know them all, well kind of very loosely but no, they always seem to be very nice and good doctors.

So if someone moved into the area quite new, would you recommend that surgery?

Yeah definitely, definitely.

And if they’re saying, “I’m thinking of registering with a GP,” would you actually mention the oneyour family doctor or would you?

I think I would mention my family doctor because they’re very good, so I probably would mention that, kind of recommend to see, well you know I’ve had her for so many years and it’s always kind ofthey’ve been always been really good. So I probably would recommend that one, yeah my doctor, my GP.

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People who wanted to talk to the doctor about mental health often liked seeing the same doctor every time too, someone who knew them slightly and who they felt comfortable with. Simon and Jal‚àö¬©, who were living with long-term conditions, felt that seeing the same GP as often as possible saved them having to explain their story again to different doctors. Emma, who has type 1 diabetes, didn’t mind seeing different GPs because ‘they’re all doctors’ but still tried to get appointments with her preferred GP who she felt more at ease with.

Rowan saw lots of GPs when he was having severe stomach pains. It would have been helpful to see just two who knew about his tests and hospital appointments.

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So, you mentioned that you saw lots of different doctors?

Yeah.

Maybe up to about ten. Did you ever see the same one twice during that time?

I’d say probably a couple of times I saw the same one twice. But even then because sometimes they were at large intervals when they couldn’t always remember because obviously they see lots of different patients every day.

So would it have been helpful at all to have seen the same on every time?

I think it really would have been. Or maybe, because of course you sometimes need the second opinion, then maybe a couple, but just someone who knew what was going on. And, because of course it was quite complicated the places I was going, and the different reasons why and everything, it would have been good to have something like a plan drawn up of what their aims were.

Yeah. And you mentioned you kept the notes?

Yeah.

Were you able to get the notes from the GP or your mum and dad were able to get them, how did that work?

The notes were justafter they had done their appointment, then I just asked forif they happened to be typing away at the time or something, then I’d ask just for a print-out of what they’d written or something, and they were more than happy to give that to me.

So you asked yourself did you?

Yeah. And it really helped because then you could give that to the other doctors, and they could have a quick scan through and see what they thought.
And I think within the practice, though, they’re quite good at looking through people’s kind of recent appointments and things. But the appointment system happened to be all changing at the time, and so it was always good to have a hard copy to hand.

So you always asked every time, “Could I have a copy of that?”

Yeah.

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Simon saw the same GP as much as possible and preferred to wait to get an appointment with that doctor whenever he could. Emma and Jal‚àö¬© believed that they’d have to wait longer if they wanted to see their preferred doctor every time, so sometimes saw a different one if they needed an appointment quickly. Jal‚àö¬© also felt that it could be worrying having the same GP every time if the doctor didn’t listen. In these cases, she thought it would be good to see another doctor and have a second opinion.

Getting tests and referrals done quickly

Simon and Aphra felt that seeing a GP who knew them also helped when it came to getting tests done quickly if something was wrong, getting referred if necessary, and making sure they got their results.

The GP told Isaac that the mole on his arm would have to be removed in hospital later that week. He phoned Isaac at home with the appointment details.

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He [GP] had a look at it and heard what I’d said, and to my stress said, “You’re going to have to go to hospital and get that removed like almost immediately.” And within the week I was in hospital having it removed, so I was. Yeah, immediately when he was like, “Oh you’re going to have to go to hospital”, I was like ah, so it’s a bit more serious. He’s like, “But you’re fine, this is why we take you there, it’s fine.” But when you get told you need to go to hospital, you don’t immediately start going, “Oh, I’m fine, that’s yeah.”

Could he have said that in a better way or were there not many ways to?

There aren’t many ways to say to someone you need to get something cut off your arm in a hospital. And I suppose you need to be told, and once you’re told you just sort of have to deal with the slight stress it causes and get it done, yeah.

And did he saygive you much informationwhat is it, what’s going on there?

He didn’t really. He just sort of said, “Well, you have got a mole that is slightly abnormal; you are going to have to have it removed; we will have to get you to a hospital.” And that was really the information I had. But at the time I’m like, “OK so get itget offget it riddenget rid of it,” you know. At the time I didn’t really need more information than, “Right, when am I going?” like you know, because if it needs to go, let’s get it done, that was more my frame of thinking than, yeah.

So you wanted to get rid of it and that’s what he said.

Yeah, once the doctor said, “Well it needs to go.” I’m like, “Well, get it done then, it’syeah.”

Would you have liked any information or do you think he gave you enough?

I think he gave me enough and I suppose ityeah I think the information I needed was given, and the facts were there that I had something, it wasn’t right, it needed to be gone. I’m quite a straight forward sort of person. It’s like, well if it needsthis needs to happen, get it done, let’s you know get it over with, that’s more ofyeah.

Did he say how long it would take? Did you know that it would happen that quickly, within the week?

No, they rang up my house a few hours later when I got home, and they stated that’s where my appointment was, that’s where I was to go, and yeah, so yeah.

So that was quite quick.

It was, yes.

Did you expect them to ring that day?

Considering the doctor’s reaction to the mole, I was expecting it to be rather quick. I was expecting the reaction to be rather quick considering his reaction to seeing it and hearing what I said was rather quick of, “We’re getting rid of that, you’re going to hospital”, so yeah.

Did that worry you at all or did you just think, well at least I’m getting it seen to or….

At least I’m getting it seen to; at least it’s going to be gone, it’s notand he did reassure me because I did mention seeing the poster in the waiting room. He did assure me, “You haven’t got cancer, it just needs to be gone to make sure nothing happens.” So that was fine, yeah.

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When Sarah had bad stomach cramps and diarrhoea for around a week, she went to see the GP. When tests showed she had campylobacter, the most common cause of food poisoning in the UK, the doctor acted quickly.

The GP was really good. After Sarah got home from hospital, he phoned every few days to ask how she was getting on.

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So were you given the antibiotics almost straightaway then?

Almost straightaway.

They took a sample?

They took a sample, it got processed like a high priority, and then within two days the doctor came over,

To your house?

To my house and then they took me in an ambulance to the hospital. And I was on a drip for, I wasn’t in overnight, they just put me on a drip for an afternoon, which was amazing. Everything a lot better and then I went back home, back to my house in [place name].

So when the doctor came to the house you got a phone call saying,

Saying, Your tests have come back as campylobacter, can a doctor come round, like when is a good time?

Did you have much information about that at the time or?

I googled it. They put, so they gave me antibiotics at the hospital. And I got the antibiotics prescription at the hospital. So I started taking them then.

So you stayed there about a day?

Yeah.

And then?

Came back. And the doctor would ring not every day but every couple of days to check in.

Right. That,

Yeah.

Did you feel –

Supported? Yeah, they were really good. As soon as they were like, This is what it is they were really alarmed because, I think because and I worked out afterwards there had been an outbreak from this restaurant. If children get it or if elderly people get it, it’s really bad and if you’re pregnant and you get it it’s really, really bad.

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Amy usually sees the same GP now, who’s helpful, proactive and reassuring. She sent Amy for blood tests and referred her to a dietician.

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Do you see different doctors every time or do you usually see the same one?

Yeah, I usually see the same person.

And what do you think of that doctor? Have you got any views on what that doctor’s like? Do you feel comfortable or…

I had a previous doctor there and she moved. And I didn’t feel like, that she didn’t benefit and give me the answers that I needed. And when I see this doctor and I explained everything to them, they were like, No, this is not right. You know, we need to refer you to hospital. We need to have the blood tests done. We need to check your blood. We need to do this, do that, do this. You can go to see a dietician and sort out your thyroids. So it was quite proactive from when I’ve had this doctor.

How is this doctor better than the one that you didn’t feel so comfortable about?

I feel like the reassurance. Cos I guess in, sometimes especially even in the society that we live in today, things might not always be what it seems. So, I don’t know, we could, like with the lump for example, it might have been in my head that there’s something wrong. But you should have helped me to get that problem away and forget about the problem rather than just not sorting it out.

And with this doctor, they’ve been able to help me. So my overactive sweat glands, I knew I didn’t have thyroid problems, but they have to check anyway. So the doctor sent me, figured out, Okay, there are no thyroid problems. So it is the case of having overactive sweat glands. So I now know that I can have Botox now to remove like the sweat from the sweat glands, so I don’t sweat. So for me that was an accomplishment.

With the IBS, I used to be quite a big girl, I wouldn’t say big but I had meat on me. And I lost a lot of weight since the IBS. And that’s something that’s affected my confidence. Now this doctor said, Okay, we’re gonna go and see a dietician. So we can start – even if it’s just certain things to snack on that you know, that’s gonna be good for you and it’s gonna make you add weight. So for me it’s an accomplishment. Because now, not only is it just finding out what I can eat, but I’m gaining more weight now, so I can put the weight back on. So I felt like it’s just, even it’s just helping, you’re actually helping somebody.

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A GP that listens, speaks directly to the patient, and takes concerns seriously

For Aphra a good consultation involved being listened to. When she went to see the university GP, she told her about symptoms that she thought could be a chest infection. The GP felt it was a cold and then asked her if she wanted contraception. Aphra felt that the GP was making assumptions about what she wanted.

Aphra prefers her current GP and surgery. They listen to what you say, and they give health and lifestyle advice without shaming’ you.

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So I think I’ve actually been quite lucky with the surgery that I’m at. It’s been the surgery that I’ve had since childhood and then I went away for university. Went to a different surgery for three years and came back. And I find that my local surgery actually really listens to me, which I know can be a real difference. And I’ve had some friends go to the same surgery and go, “That doctor’s absolutely useless; they never pay attention.” But I don’t know if it’s partly because I never went very often as a child, so I think when I went in the last year or so I’ve started going, “Oh I’ve really got something wrong with me.” They immediately went, she’s probably telling the truth, we never see her.

And I do think that this surgery is a lot better than the one I was at when I was at university in Wales, just because I remember the first time I went to the one in Wales. I’d got a terrible chest infection, and the doctor didn’t listen to me. She was going, “Oh it’s probably just Fresher’s flu, you’ll be absolutely fine.” And then she just went, “Are you sure you don’t want to go on the pill, or do you want to get some condoms?” I was going, “I’m not here and lying about having a chest infection for sexual health stuff. If I needed condoms I’d just come in and tell you.”

But you don’t get anything like that at the surgery I’m at now. It’s a lot more about they trust you to go in and go for the complaint that you’ve actually got, or from you know, if you need to go on the pill they’ll just go, “Yeah, you go and see this doctor and see this nurse.”

And I like the fact as well that when I’ve been and it’s been the general kind of health check-ups, and they go, “Get on the weighing scales.” They don’t just go, “Ooh you need to lose weight straight away.” They just go, “Oh lose a bit, but at the same time who doesn’t need to lose a bit?” There’s no kind of shaming there. And every health problem you have doesn’t come back to, “Oh just lose some weight, or go get some exercise.” There’s a lot more of, “Actually we’ll give you a blood test and we’ll see what’s really going on there.”

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Tagbo also felt that a good consultation involved having a GP that listened and explained information in a clear and concise way. Feeling respected and taken seriously was also important, and being spoken to directly. When Isaac was younger, he’d had appointments that had left him feeling annoyed because the GP had spoken to the adult that went with him instead of to him. He was happier with the appointment he’d had most recently when he was around 16 or 17 and went on his own.

The GP was friendly and kind. When Isaac had been younger, he felt they blank you and speak to the adult.

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They were friendly, they were nice, tried to make me stop looking so petrified in the fact I had a mole that needed medical attention as that can be slightly worrying. But, yes, they were kind. They were nice andbut that was when I was more sixteen/seventeen. I went in on my own and such so, with only me in the room, they spoke to me and such, and it was easier. They have very littleI don’t want to say respect for younger people, that’s the wrong word. It’s when you are in a room with an adult as well, they blank you and speak to the adult. I don’t quite know the word for that but they do just sort of ignore you and speak to the adult yeah, yes so.

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The good GPs Aphra saw were friendly and listened. The bad ones went through her notes during the appointment, didn’t listen very well, and were less experienced.

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So you mentioned that some of the GPs there at the university, they were fantastic all the locals wanted those same GPs. What made them fantastic, can you remember the kind of qualities that?

They really knew what they were talking about and they were a lot more patient. They’d invite you to come in. They’d quite often meet you at the door and kind of shake your hand and say hi to you. And they’d sit down and listen to what you had to say for a few minutes. They won’t be fiddling, they won’t be reading your notes, they’d be listening. And then they might check the notes and ask you a couple of questions before they kind of started trying to do an examination.

And the bad doctors were normally going through your notes while you were talking to them, or they’d be listening kind of but you’d see them fiddling with some jewellery or something like that. With flicking a pen around, kind of that obvious I’m bored and I’ve seen so many people today.

And they justthey didn’t give that impression that they knew what they were talking about. They didn’t seem that confident in themselves, whereas I think some of the older doctors were the better ones. They’d, you know, spent ten years as a GP and so they knew exactly what you were going through and they were really sympathetic at the right moments. And they were really going, “I know what’s best to do here.”

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Some GPs Isaac saw were better than others. The good ones spoke to him and not to the computer screen.

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Some [GPs] were better than others. Some were kinder and more talking to you as a person, asking you questions. Some were more just get on the computer, don’t even look at you, just sort of ask questions to anyone in the room who will answer. And just type it all down and a bit like the one that just, “Well here’s your prescription, go.” So, yes theI’ve seen a few different types of doctors, yes.

And if we were going to feed back to doctors from talking to young people, what qualities make a good doctor? What would you say are the things that make a good?

Qualities to make a good doctor. Talking to a person rather than them justI understand they see a lot of people but talking to them like they are people and there, and not just blankly asking questions and then typing and then, you know, I understand it’s there’s a lot to do. But being talked to rather than just them talking to a computer screen and expecting answers, it is generally better, yeah.

And when you’ve seen the doctors, you said they didn’t really talk to you. Did they?

No. Whenever I went with a parent, they always would just talk to my parent rather than me.

Did they ever ask you about you how’s school or anything like that?

A few did, which is the difference between the few doctors. Some of them would ask me questions such as that while waiting for something to happen, or a printer to work or something, they would ask questions. Some would just ignore me and hand me the thing when it had been done. But some of them did ask questions and were nice and started a conversation, yes.

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A GP that’s relaxed and informal

Shane’s preferred GP introduced herself to him by her first name, which immediately helped him feel more at ease. Sarah also recalled how the GP in the village she’d lived in introduced himself and asked how she was rather than what was wrong. Being relaxed and comfortable with a GP was important to Shane, Nikki, Sophie and other people who wanted to talk about mental health. Siobhan felt a bit uncomfortable talking to GPs and said, ‘I find it difficult to talk in face-to-face situations. And doctors are always in a suit and tie. And that’s quite daunting I think. I feel like it’s going to a teacher sometimes.’ A few other people, like Tagbo and Hazzan, also felt that it was helpful when the GP came across as relaxed, informal and ‘try and make it as casual as possible’.

Teenagers don’t like formality. It would be helpful if GPs came across as relaxed and informal, even though they have a very stressful job.

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What I think they should do they should, they should be relaxed. I know being a doctor’s really stressful and it’s verywell I don’t know that, I don’t know why I’m saying that. But I know it can be stressful because of having a job like that is stressful. But I feel like they should bethey should relax themselves, should be relaxed. They should interact, they should because if you, if you justif you tone it downif you tone down your, if you tone down the professionalism to some extent and to more of a socialto more of ato more of an informal sort of stance, then it would definitely have it will definitelyyou’ll definitely engage with teenagers that way. Because teenagers don’t like formality, and I feel like it’s important to engage with teenagers and so it’ll be a bit moreto be a bit more chilled.

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Bad experiences of a GP consultation

Although people told us about many positive experiences of good GP care, some also talked about disappointing appointments when things didn't go so well. Problems...