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Seeing the GP: Advice and tips for young people

Young people’s advice to GPs

The young people we talked to offered many different types of advice based on their experiences of health services, healthcare, and seeing the GP. Here are some of their suggestions.

•    good communication really helps – it’s better to speak less formally to young people than to adults, and to explain things in a way that’s easy to understand
•    it’s helpful when GPs use plain English rather than medical terms or acronyms
•    it’s important to include young person in the consultation and talk to them directly when they’re with a parent or guardian
 

For younger patients, it’s better to talk in an easy to understand way. As Simon got older he started learning more about his condition and understood more complex words.

For younger patients, it’s better to talk in an easy to understand way. As Simon got older he started learning more about his condition and understood more complex words.

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So if they’re with the parent, it’s good to include them, but talk to the young person. It’s their appointment. It’s also good to try and think, you know, we’re helping young people and, you know, all the doctors that have been people without a training in medicine. 

So it’s good to try and think, ‘Right, instead of coming out with all these fancy words and acronyms, let’s just take a step back and just, you know, don’t dampen it down too much where it’s, you know, too young an audience. But you’ve got to look, you know, if you’re talking to a seven year old, you’ve got to talk differently to a fourteen year old or perhaps a twenty year old. It’s about the way that your approach a conversation and just think about, you know, making it age appropriate, which is what, you know, it’s an ability to be able to do. 

But I think that should be brought more into the training process to, how to talk to patients perhaps without lots of fancy words and just, you know, get the message across. But don’t make it too complicated.

Have your own GPs been good in that way?  Your GPs over the last, you know, since you were three?

Yeah, so as younger, younger person, they used to talk to me in a nice easy to understand way. Sometimes you know they’d say, “Oh we need to be an ESR and a CRP. And when I was ten, that meant nothing really.” [laughs]. If it was, you know, “We did the blood test, it shows if your arthritis active.’’ I would have understood that. 

But as I was growing up into teenagers, it was me saying, “Are you going to do my complements. Because I do science anyway and naturally engaged into the condition and I would ask questions and they would realise. ‘Oh, he understands this and we can talk a little bit more complex perhaps to him.’ So it’s looking at your patient and thinking, ‘How can I get this across to them so that they’ll understand?’  
 

It’s good when GPs direct their questions to the young person and not their parent. Young people can explain what’s wrong with them.

It’s good when GPs direct their questions to the young person and not their parent. Young people can explain what’s wrong with them.

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Is there any message that you would like to give to health professionals – GPs let's say – that…from young people, anything that they could improve?

Kind of treat us on our own, not kind of with parents, so kind of ask us the questions. Don’t ask parents and always kind of ask…like try and be confidential and stuff like that; just try and trust in the young person that is telling exactly what is wrong with them because they are the person who's ill, so not the parent.
•    be honest about doubts and when you don’t know about something
•    it’s important to listen to the patient
 

People can have a positive experience of a consultation if they feel that the GP has listened and empathised, even when the appointment is quite short.

People can have a positive experience of a consultation if they feel that the GP has listened and empathised, even when the appointment is quite short.

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I think people feel that when they come into the room, patients feel that energy, they feel like that, they’re only there for a second and that they almost are being passed off. Once that energy is removed and people feel like they are being listened to, I think it would really greatly improve the service of GPs.

Yeah. So it’s more, is it do you think about how they come across rather than the time of the appointment?

I think it is, I think even

Should the appointment times be longer?

Even in the time, the appointment they have, feasibly I think the time they have is probably the most feasible. But even in that time, if they can use that time to make that person feel more like they’re being listened to, and they sympathise with that individual, I think the person is more likely to have a positive experience in there. And it’s more likely to help, you know, rather than just sort of being so indifferent to it or being reserved from it.
 

It’s important to respect the knowledge patients with complex needs often have about their own health and care.

It’s important to respect the knowledge patients with complex needs often have about their own health and care.

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I'd say for children and my age sort of thing – teenagers, a bit older, I think you’ve really got to listen to the patient. Don’t, you know what I mean, actually listen to them. Let them say what they want to say and actually go from there, and use that because quite often we don’t get like – that’s the thing with the Voice of a Child that we're doing, is we're trying to get children's voices heard. Because, you know everyone, like it's always been a thing that oh adults are superior than children in a way because, you know, I mean they're older, they're more wiser. But actually, I'm sorry but if it's their own health, they know. 

Like, and there's things that I've been through that I think, 'Oh, I think they could have done it this way.' And it would have been a different story basically. I think they, I think any professional in health could learn from someone like me just to be like, 'OK and show me the way you do it,' and then be like, 'OK, what if you did it this way?' And then they'd realise yeah OK whatever.
•    being patient and caring can help young people feel less nervous – it can be embarrassing or daunting going to see the GP
•    it’s good to get to know your patients as people. It can help a young person feel more comfortable when a doctor asks about them as a person (e.g. about school, sports, etc)
•    young people often feel uncomfortable in formal environments. It can be helpful when the GP comes across as relaxed and informal. Hazzan said, ‘Try and make it as casual as possible’. This could involve introducing yourself and asking a young person how they are
 

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.

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 very…well 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 be…they should relax themselves, should be relaxed. They should interact, they should …because if you, if you just…if you tone it down…if you tone down your, if you tone down the professionalism to some extent and to more of a social…to more of a…to more of an informal sort of stance, then it would definitely have… it will definitely…you’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 more…to be a bit more chilled.
•    it’s important to give a bit more reassurance to young people who live on their own with little support, including information
 

Amy’s GP was reassuring. She gave her a leaflet and told her about websites she could look at when she had a breast lump.

Amy’s GP was reassuring. She gave her a leaflet and told her about websites she could look at when she had a breast lump.

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And you mentioned that you live on your own now, don’t you?

Yeah.

How, when did you start living on your own? Can you remember how old you were?

I moved, I got my flat on my 16th.

And you mentioned that sometimes you, like you, I think you said earlier that you didn’t have a lot of support around you. So it was really important - 

Yeah.

- that the health professionals give you that kind of support?

Yeah.

Do you think it’s more important when people are living on their own, young people around the age of 16, 17, 18 living on their own, that they do need to have more maybe questions answered than- 

I would say -

Or any other kind of support?

I would say that everyone deserves the same amount of support. But I think, given the fact of when somebody, you know that they haven’t got a lot of reassurance around them, that it’s important to give them the answers that they are seeking. Because it can have an effect on so many different things. 

I think that even being, pointing them to websites. Just so it, you can go on to websites and, okay, so, you know, ‘I feel for this, if it feels like this. Is there any odd shape or what’...It can make you aware of the things. So this is what the doctor did for me also. He said, “All right, look at this.” He gave me a leaflet and it showed you how you should press, how you should feel, what you should be looking out for. Is there a change? And made me focus on that. 

So then I would say, “All right, there hasn’t been a change. The [breast] lump doesn’t feel like this. It’s okay like. It could just be me panicking.” And it sort of, it like, it rested, like put it to bed for that little bit. And then when I had my results back it sort of, it just took it out, it sort of washed it away. So...
•    offer young people a range of treatment options and involve them in decision making
•    ask young people if they’d like to speak to you on their own if they’ve come to the appointment with a parent/guardian
•    it’s important to take mental health seriously and help raise awareness of it
 

GPs shouldn’t be afraid of asking people about mental health and self-harm. It’s hard for young people to talk about everything but there’s usually ‘more to it’.

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GPs shouldn’t be afraid of asking people about mental health and self-harm. It’s hard for young people to talk about everything but there’s usually ‘more to it’.

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I would just say like don’t be afraid to talk about it [mental health and self-harm] because I think a lot of the time doctors can be scared to say the wrong thing or whatever. But it's just like, just sort of like…it's just you don’t have to be afraid to talk about it because it might be a bit daunting asking someone, "Have you hurt yourself; how do you feel?" But if the person isn't comfortable talking about it, then they just won't and it's fine. It's better that they just ignore it. 

Like my advice would just be to just never ever ignore anything. If you're ever worried then go for it; just tell someone, like never ignore anything because that could be really dangerous. And I'd just say like always assume that there's more to what they're telling you because people are never going to be able to tell everyone their whole life story in a few minutes that they get with you, so just assume there's more to it. And just do what you can. Like, yeah just do what you can.

So when a young person is saying to their GP that they're hurting themselves, should the GP assume that there's much more behind that, and they're maybe hurting themselves more than what they're telling the GP?

Yeah, I think so. Like, or just be… assume that there is more to it. Like don’t just take what they're saying at face value. Like there's always going to be more to it. Like cos I mean if you was going to a GP you can't tell them everything in ten minutes, it's just not possible. So maybe if they gave you an hour or something, then you would…then you could take what they're saying and not assume there's more to it. I don’t know, like…but always just like think what else is there that I can help with. What else are they experiencing that I could potentially give them some support with like…yeah.
 

Talking about mental health is hard. It would be good if GPs acknowledged this at the start of the appointment and then discussed the options and plan.

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Talking about mental health is hard. It would be good if GPs acknowledged this at the start of the appointment and then discussed the options and plan.

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I think initially saying that you understand this [depression] is difficult to talk about, and stating straight up that I accept that this is a problem and I believe you. And I want you to talk to me about these, if possible, so that I can show you a range of options available. So it’s talking, saying what you’re going to do before you then do it. So saying that these are the, you know okay, this sounds like you might have this, what they do, I’d like you to talk to me more about how you’re whatever doing about it, and then we’re going to discuss what options and you can pick one. 

So then it gives them, gives people the ability to take control of what they want to do and reassure them that going forward, you know, this will be followed up. We’ll take this together going forward. And I think it’s really, really important that you see the same GP. I don’t think you should move around GPs.

And you mentioned being given the options, like the very first time that you went you weren’t really given…

No.

…any options. So....

I think giving options is really important because it’s your health but it’s also you’re more aware of how you work than anyone who you meet is gonna be able to judge in a short space of time.

I think the key would be, I think like I said earlier, to see people as more than a health problem. And to see them as more complex than a particular line of treatment can sort out most of the time. But I do also think that listening, being friendly, being approachable, but all these are skills that are really dependent upon the situation that you’re in.
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