What makes a good GP?: young people’s views and experiences
Good GPs are experienced and knowledgeable
- Lara is at school, and lives with her mum and sister. Ethnic background / nationality: Argentinian.
What are the qualities of a good doctor?
Well, experience. Cos the more experience you have, you clearly know more, and you see more and stuff like that. Like having, like understanding and listening to the patient and not trying to like, I don’t know, like butt in, if you know what I mean, like, yeah. And also I guess just like good like social qualities, like being able to talk and not being nervous. Like being able to give all the information that you need and knowing all the information that you need.
Do you think that doctors are good at speaking to younger people?
I guess they have to learn to get better at speaking to young people. But I guess when they start they’re a bit like, cos they’re old they’re more used to speaking to older people. And cos they speak really formally cos, and like most medical words are pretty long. And you have quite a lot of different needs and different symptoms and stuff like that. You have to learn how to explain those things to children that don’t know what that means. Especially like, well, I guess not young children, cos they’ll be with their parents. But like teenagers still want to know what they have. So you have to be able to explain it to them.
- Simon is a university student. He lives at home with his parents. Ethnic background / nationality: White British.
Did your parents or you occasionally leave a letter and then he would get back in touch?
Yeah, so I had to take, I went on holiday to France with a charity when I was about ten, and I needed authorisation to take the medication on the plane. So my mum did that, wrote that letter and dropped it in, and straight away, within a couple of days, he’d wrote a letter. He rang us up and he said, you know, “This is what you need to do with it. You need to show it to such when you get to the airport.” And he said, “It’s in reception ready for you to collect.”
So he was just really, really supportive and he just went that extra mile to help, and he still does now. Just to help, anything that I’ve got any problems with even if I can’t see him in clinic.
And can you talk a bit about this ‘extra mile’? The little things that he’s done that you feel that he’s really gone the extra mile to help.
Yes, quite a few occasions really. When I was having a really bad stage with Crohn’s and arthritis. Well, it wasn’t, I didn’t know it was Crohn’s. So he used to, kept pushing, because I kept going back to him saying, “Something’s not right here.” So he referred me to the gastroenterologist at the children’s hospital and he kept pushing and sending them letters to say, “Can we speed it up a little bit?” And he kept ringing me back up in the evenings to say, “How did you get on at the clinic today? Is there anything that I can do to help the process, to help in any way?”
And it’s the same with medication, the repeat prescription, and he would automatically, when the allowance had run out for how many times you could have the medication, he would renew it automatically without having to go in to have a review. You know it was just a lot of different things. Being available to contact him. I used to go into his clinic and speaking to him. It was that continuity of care and two way communication, and open communication that was really helpful.
The importance of a friendly, welcoming approach and good communication skills was a very common theme. Young people said good GPs:
• explain things in an easy to understand way – they don’t use a lot of medical jargon
• are patient and understanding (not ‘patronising’ or ‘condescending’)
• treat young people like an adult
• are friendly, empathetic and easy to talk to
• are calm, reassuring and come across as if they care
• ask about you as a person (e.g. about school or hobbies)
Tagbo recalled that his GP knew the whole family and always asked about their lives. He felt that good doctors are in touch with their patients, comforting and polite.
- Peter is at school and lives with his parents and older sister. Ethnic background / nationality: White British.
Have you got one doctor or do you see lots of doctors?
I think it's a husband and wife who do it, so we normally …and they sort of share patients. And I've been to see both of them, and they're both very nice and you know. They put you quite at ease. I think the woman's quite, sort of a bit nicer, but they both sort of…you feel that they're definitely qualified and they know what they're doing when you're with them. And so that’s very reassuring when you're there sort of to feel…that it's all, you're in safe hands. And they're very nice, you know, they're, they do their job quite well.
Yeah. And you mentioned that the female doctor is a bit nicer than the male doctor. What's the difference; you know what makes her nicer?
I think she's almost a bit more motherly you know, sort of that kind of figure, and so you feel a bit…especially when you're younger, you feel a bit safer almost with her, whereas the man's slightly more, slightly more brisk. And so when you're older he's sort of…he's fine, but as a younger child you sometimes feel that the woman's a bit nice…you know you feel more comforted by her.
And do you usually see the female doctor or the male doctor or you’ve seen them about the same time?
I think we normally see the female one because I think she does more appointments I think than the man; I'm not sure why, I think…I think he only works some days, I don’t know why. But I have seen the man a few times.
And what would you say makes a good doctor because you’ve mentioned she's had some good qualities, and he's had some, but you know sometimes you’ve felt more comfortable with her – what qualities would you say make a good GP?
To be, to give the impression that they know what they're doing and you know, that you're in safe hands; to feel that they're definitely qualified because it's your health and you can be quite nervous. And also to, you know, just to feel that they’re doing something that they actually care about, why you’ve gone to see them. To give that impression, it helps you quite a bit. And to just sort of, you know, calm you down slightly you know and just make you feel that it's all fine, that kind of thing.
- Simon is a university student. He lives at home with his parents. Ethnic background / nationality: White British.
What are the kind of qualities that he’s got, or other GPs who you’d consider good, what are the kinds of qualities...
So, somebody who’s approachable. Somebody who understands the condition and understands you as a person. Somebody who communicates really well. So makes sure all your letters are up to date. Keeps you up to date with blood results, and then somebody who when you go to the appointment, doesn’t try to rush you.
And I know, you know, they are restricted by the times but, some GPs I’ve been, I’ve been in two minutes because they just wanted to give me a prescription and then go straight out. Whereas he talked to me, said, you know, “What’s been wrong? Let’s do these tests and let’s see what they’re like and then come back and we’ll take it from there.”
So he was very sort of nice and didn’t worry you. So it’s like, you know, “We’ll take things one step at a time.” And just that reassurance as well, that’s really important. Instead of worrying the patient. He thought about what he said, which is really important. I think that’s a really good quality for any GP.
And you mentioned a couple of times that he’s been, he’s gone the extra mile and he’s been proactive hasn’t he?
Suggesting things you’d never thought about.
Yeah. And, you know, going to him saying, “I’m not feeling quite right.” And him saying, “Have you ever had this test?” And I said to him, “I don’t think so.” So he would go and look. So he’s, “Let’s do it and let’s see, what’s wrong.” And most doctors say, “Ring back up in a week when the blood results are back.” But within a couple, it was two or three days, I’d get a call and it would be him saying, “I just got your blood results and this is not quite right.” So I was low on Vitamin D at one point. So he said, “There’s a, you know, there’s a prescription for Vitamin D at reception. Pick it up and you can collect the tablets.” So it was that, without me having to go back for him to tell me that. So that was really helpful.
And he understood I was at College as well so there wasn’t much time to having to keep missing, you know, because I had to catch up in College. Where I could just go after College, or get my mum and dad to pick up the prescription for me. So he just thought about, you know, ‘Let’s make it a little bit easier for this person really.’
So he was proactive in terms of all the tests and medications but you mentioned he was also proactive in telling you about things that you could, like the compensation thing that you mentioned at University or at School if you’ve got exams and…?
Yeah, so you know, he was really good at seeing me and I explained that I wasn’t doing so well and he said, “Oh, you have exams.” And it was like, he made sure that he conversed with me what I did outside of having the illness. And he said, you know, “How was you doing your exams?” And I said, “Oh, I wasn’t that great, and you know, I was not feeling well at all.” And he said, “Oh you can get this, because I’ve done it with another patient. Will you be happy for me to write to your College to explain that?” So there was that openness and actually asking, “You know is it okay with me?” And he says, “I’ll do it all. I’ll write everything for you and I’ll send it off and if you have had a bad day and you might not have done as well as you’re capable of doing, that shouldn’t impact on your grades.”
- Tagbo is at school. He lives with his parents and brother. Ethnic background / nationality: Black African.
And with the doctor you mentioned that she's …you’ve had the same doctor for a long time?
So when you go to see her does she recognise you?
Yeah, me and my parents and like the family, yeah definitely.
You all go to the same one?
And when you see the doctor, does she ask you about you or maybe about the health, the problem; does she ever ask questions about you – "How's school?" or anything like that?
Yeah, she does, yeah definitely. Same with my parents when they go there; again, "How are you, how's the family?" etc etc so...
So do you feel…?
Yeah, it's very comforting, it's very like almost like as a friend, so yeah.
That’s nice, that’s really interesting – do you want to expand on that?
Yeah, because it's nice because we've had this doctor, we've had our GP for years, a long time, like so it's almost like as a family friend. And it's someone that we can rely on as a family. And it's nice having and nice knowing that we have someone like that.
That’s brilliant really, that.
So that’s the sort of GP then you would like to stay with, you know for years wherever you're…while you're staying there you'd like to stay with that GP?
And if somebody new moved to the area and they were looking for a doctor, would you recommend her?
• explain the logic behind their decision, why they’re doing examinations, and the next steps
• really listen to what the person is saying
- Auberon is a student and lives at home with his parents. Ethnic background / nationality: White British.
And in terms of seeing your GP, maybe talking about the anxiety and depression and things, have you found the GP to be helpful?
I have, yes. Some…I am…depends what GP you see really because some of them are really lovely and stuff, but some don’t even know what mental health illnesses are and just like think it's all a big joke and stuff. But I don’t…yeah so I try to see the GPs who understand me, but some…it's like pick n' mix really.
So, how would…is it quite…when you say hit and miss – different GPs every time you go or?
I can request a GP, but it depends on if they're working that day or something, or I might need to wait till a day that they are working to make an appointment with them on a day that they are working, so yeah.
And the GP that you like to make an appointment with most, can you talk a little bit about that GP – what's that GP like; what makes that GP good?
They are very supportive; they are very …they're very supportive, they are very …they understand me in terms of what I'm saying, and they are good listeners and that they try to go the extra mile in terms of how they can help. Because this GP will phone me whilst, when I was having a bad patch with my current, my old adult psychiatrist now, now she was trying to switch me to a different one, and so now that’s been put in place now so I've got a different psychiatrist, so yeah.
So the GP that you like to see most, is that a male or female GP?
It's a female.
Female. And how long have you known her?
I have known her since I joined the… well not really because she joined…about a year, about a year.
And you said she's a good listener?
Understanding and she goes the extra mile?
Can you talk about that? What kind of things make a…when people say that she's gone the extra mile, what kind of things has she actually…do you feel she's done more than any of the others?
Yes, like I said, she referred me, she referred me to this…to another psychiatrist, and she was also trying to refer me as I didn’t get on with my…also my old care co-ordinator at the time. She was trying to switch me to a different team altogether, to the [place name] team, which is [place name] way, so it's not that far. So yeah, so she…as she used to work there in [place name], so she was trying to switch me to see if it would be the correct one for me.
- Jalé is an ‘A’ level student and lives at home with her parents. Ethnic background / nationality: Mixed Race (White British and Black Caribbean).
What would you say makes a good GP, what are the qualities of a good GP?
For me, having seen most of the GPs at my clinic now, I think that it's the ones that will listen to what you're saying, because I know on some occasions I feel that they will kind of jump on something you said before, you’ve kind of finished, and I find that quite difficult because you kind of forget what you were going to say. But they will listen to what you're saying; will give you advice on what to do whilst you're waiting [for test results or hospital appointments], because waiting is always so long whatever you're doing. So, you know, whether it be just try and eat something or de de de. And will just, you know, will make you feel as though you're not just another number, sitting in their chair and to get out as soon as they possibly can.
Even if they can't do anything for you that day, or even if it is, they're not concerned about it, to actually have…take the times you know, "This is what's going on; you're absolutely fine." Or, "This is the next step." Just because you don’t want to feel like another number because it always, whatever the result is, you do kind of feel like you’ve just been brushed out. And obviously they see, I don’t know how many hundreds they see a day, but you know that’s the kind of job you’ve taken on. So I feel it is important that you take every patient as a patient. And they're not there because they want to be there. They're there because they're not well.
• have read your notes before they see you, they don’t read them in front of you
• are honest even if they’re unsure what the problem is
• are welcoming and professional
• respect patients’ boundaries
• are supportive
- Siobhan is doing her A Levels, and voluntary work in her free time. She lives with her parents. Ethnic background / nationality: White British.
Were you seeing the same one [GP]?
Yeah, the first time round. But the more recent time I’ve been, it’s been a different doctor every time. So the time before I had the same doctor, but she went on maternity and never came back.
Oh right. And that’s the one you liked?
What was nice about her?
She were just always, like, if I were having like a crap day, she’d just be dead smiley and happy. And like she’ll just do, like the doctor, the male doctor I’ve seen in there, he just sort of looks at his keyboard when I say summat rather than looking at me. So she like always kept her eyes on me and made notes after I’d left.
So you feel that she listened more --
-- and gave you the attention that she’s listening and, you know, all of that?
What would you say make, are the qualities that make a good doctor? So a few things you’ve mentioned....
I think like empathy with people, like especially with like mental health difficulties. Cos it’s difficult to talk about that kind of stuff for the first time, especially as a young person. And if you’re all on your own as well, be like, realise that that’s probably really scary for you to go on your own and talk about everything that’s going on. And just to be happy and not grumpy.
- Kyle is at school. He lives with his dad, grandmother, brother and sister. Ethnic background / nationality: Black Caribbean.
What was his [GP] attitude like?
He was quite full of himself, you know, he thought he knew what he was talking about, but he didn’t yeah, but I didn’t really like him.
But who's your usual doctor?
Well, I used to go to one that was my friend's mum, well it was just a coincidence that it was my friend's mum, and yeah she was pretty good. And then yeah, then there's one other, so there's usually two usual ones but they're…they’ve been doing it a long time.
And you said that this other doctor that you saw, she was quite good. What was she like, what was good about her?
The physio or the doctor?
The doctor, you know the one…your friend's mum.
Oh yeah, yeah sorry. Yeah, well she sort of understood…I can't remember what I was in for, but then she understood where I’m coming from and she didn’t like make me uncomfortable. Well the other one didn’t because they're professional, but I sort of felt more comfortable around her.
So what would you say are the qualities that make a good GP, a good doctor?
Have a think – what kind of…how would you describe a good doctor? What kind of words, like caring or approachable or welcoming – what kind of things do you think make a really good doctor?
They have to be welcoming and also have to be professional because that makes you more comfortable. Cos sometimes I used to get a bit nervous going because I didn’t want to like, like show them what's wrong with me. So if it was my toe for example, but when they're…when they just like take no notice of it…well they do take notice of it but they don’t go, "Eurgh disgusting," you know. They just, because they’ve seen it before and that sort of makes it easier to talk to them.
Yeah. That’s a good answer. And you mentioned the other one who you did see when you had the ingrowing toenail. What was his attitude like when you went to the appointment that maybe made you not so comfortable?
Well he did say, "Oh that’s nasty." So I didn’t really like that, yeah. Made you feel a bit self-conscious. And then…then he started…he's the same one that said I had the groin strain so yeah, he's pretty cocky.
Good GPs also:
• ask how you are instead of what the problem is
• are caring and want to help
- Sarah is a PhD student and lives with her partner. Ethnic background / nationality: White British.
He’s [GP] 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 wait even if your…
…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.
Yeah so you, you talk to him quite a bit.
And did you feel that he was a better doctor than the ones that you saw at university?
I think it depends how you define better. Better for me, yeah. It doesn’t mean he was a better doctor ‘cos it would be different for everyone, but for me, yeah.
Can you tell me a bit about his qualities? What made him better for you? The kind of qualities, so friendly or kind or understanding, good listener? What kind of qualities?
Yes, a good listener. He was definitely a good listener and asked questions that were not clearly questions that you’re meant to ask. So, and would remember things between appointments that you’d said that he probably hadn’t written on your notes. And like just other things, like my sister has been very ill and he has like, whenever she walks into the doctor’s surgery now, even if she doesn’t have an appointment, he will make time to see her between patients if he needs to. And that’s something he doesn’t have to do. And because he knows, I know he does things like that for people, I know that he cares.
And he’s there till late at night because he’s overrun on all the appointments and he’s, you know, I think he’s a really good doctor. And he listens and takes you seriously, but isn’t patronising which I think is quite a difficult skill.
- Caitlin lives at home with her parents. Ethnic background / nationality: White British.
Caitlin: They [GPs] need to be like caring and that they actually want to help, which hopefully most of them do but you never know. And like I'd say they would – I don’t know like – oh I've gone blank. Ah it's coming, coming -
Caitlin’s mum: The thing that Dr [name] does is he listens to what you're saying and -
Caitlin: Yeah, he doesn’t like just go -
Caitlin’s mum: They dismiss her because -
Caitlin: I'm mostly right. In my feeling, like if I say, "Oh, I don’t feel right." But then Mum might look at me, see my sats and stuff, and it's actually alright. But actually I'm not, do you know what I mean. And I actually I'm the best judge of that I think. And he actually gets, he actually accepts that actually I, the people are the better judge so they have to be, you know what I mean....
Caitlin’s mum: Caitlin doesn’t cry wolf, so she doesn’t, she may be saying and then Dr [name] will come out and said, "I can't find anything wrong with you." And then three hours later she starts throwing up, which she couldn’t have known, you know, but Caitlin knows her body very well.
Yeah, so you can tell how you're feeling even if the, even if everything else is at a certain level, you can tell how you're feeling and you can tell him and he listens?
Caitlin: Yes, because like with other, I don’t know if it's just GPs, but other people like nurses or whatever, you just want someone that doesn’t like – say if like you're doing something wrong or something, they don’t just go and say, "No, you can't do that." They’ll either just -they should like make a way round it, like be like, "Oh just be -" I don’t know, willing to negotiate...not negotiate but you know what I mean, just try and like be subtle and just be like, "OK let's do this-" or-
Caitlin’s mum: But you do negotiate with your doctors Caitlin that is, because Caitlin's got such, usually got a very personal relationship with them. So she will negotiate and say, "Look, well this antibiotic..." She's so aware of what medication she has, you know. "This is how I feel, this is what worked in the past." And they will really listen to her.
Caitlin: Yeah I mean, it's the same for GPs, it's good if they do and, just great, a lot of people just – I just like people who are nice. Who actually and they're wanting to be there for you, and that actually – well, one, know their stuff, you know. They need to know what they're doing and not be saying things that aren’t right. And actually I think as well, understand the family situation because it might be that someone might not take something as easily as someone else, do you know what I mean, like news and stuff might not be good for...
Does the gender and age of a GP matter?
For a lot of people the gender of a GP only mattered when it came to sexual health, and some even then felt that all doctors are professional and it didn’t make a difference.
- Age at interview:
- No personal details given
How was the doctor at the sexual health clinic? Were they easy to speak to, approachable, friendly?
Yeah, she was really nice actually. I think personally from that point of view, if it was a male, I wouldn’t have felt the same. And, yeah, because I had to get quite, quite personal with her. But, no, she was really nice. And like, you know, she, I think sometimes you get doctors where, especially in the sexual health clinic, where they almost are quite, what’s the word? Nervous about saying certain words [laughs]. And I think when that happens it makes you a little bit nervous about saying certain words and describing certain things with your genitals and your relationships and stuff like that.
But I was fortunate that in that scenario she was really nice and just kind of said things how they were. Which I liked. And, you know, obviously didn’t probe for unnecessary questions. And just got on with it I think. Efficient.
So sexual health is an area you think that gender perhaps makes more of a difference?
Do you think that men would feel the same way?
Yes, I think men would feel the same way. I mean obviously I’m not male so I can’t say. But I think it’s just, it’s inbuilt in us that you can show everything to a woman, whereas showing everything to a man means something different. Which is strange. Maybe that’s just me or my upbringing. I’ve no idea. Or societal stereotypes.
But, you know, I think, I mean I, that’s coming from a place as well that I’ve never been in the scenario of having to strip down in front of a male doctor either. So, you know, if you ask me would I be open to that, I’m not, yeah, I think I would be cos they’re a doctor. Like they’re obviously there to help you be better or explore whatever it is you’re there for. But I think initially in your head, you’re kind of like, “Please be a woman, please be a woman, please be a woman.”
Do they ask you? Do you have a choice between a man or a woman? Or is it kind of just luck of the draw?
I think it depends on how quickly you want to be seen. Because I remember actually there being a box, I think there was a box that was like ‘see any doctor’ or ‘see female or male’, well, for the sexual health clinic anyway. So I did tick the female.
- Ish is a sales advisor and lives on his own. Ethnic background / nationality: White Hungarian.
Did the gender of the doctor ever make any difference for you, whether they were male or female?
To be honest, for some reason I feel, probably because of my own sexual orientation, I feel more welcomed about females. They seem a little bit more caring. But I don’t know, I feel like male doctors try to rush it through as in like, “Let’s get in. Let’s do it. Let’s move on.” Female doctors will tend, like most likely tend to like put their heart behind it. So I prefer female doctors a 100 percent, like in any area whatsoever in my life ’cos they make me feel more welcomed and it seems like they actually look like they care about what’s going on instead of like rushing through it.
So what could male doctors do better?
I’m not saying that the male doctors should be, you know, like being all over the emotion and giving me a teddy bear I go, every time I go. I’m just saying that this isn’t really like a boot camp. Like, we’re not in the army. And you just saying, “What’s wrong with you?” First of all, that’s not really how you speak to people, like actually you take your time. “Hi, how are you doing?” It’s not a hard word, not a bad phrase. You show you care a little bit. That’s it.
You know, just rushing through it, like, “What’s your symptoms?” “Why are you here?” “When did it start?” To me, that’s just like, you’re not really caring about what’s going on with me. You’re just telling me the basic things that you’re supposed to ask. So there’s nothing behind it whatsoever. So to me, it’s not really caring at all.
- Peter is at school and lives with his parents and older sister. Ethnic background / nationality: White British.
In terms of the doctor, you mentioned you’re…you usually see the female doctor. Do you have any preferences in terms of seeing a female or a male doctor, do you think it makes much difference or what are your main thoughts on that?
Sometimes it can…like now I'd probably prefer to see the male doctor because you can…you feel that you're speaking about…you understand the same things. But I think if it comes down to it, you don’t…it doesn’t make a huge difference, it's just pers…you know, when you're in there and especially if you're waiting just to see whose come in and it sort of puts you more at ease to have the male one personally. But once the appointment starts it doesn’t…like you get quite used to it I think.
Yeah. And you mentioned earlier that when you were younger, in a way you preferred the female one, but now that you're older you prefer seeing the male doctor?
Yeah, because you're more used to speaking out so you don’t feel as nervous I think, so you can say the things even if you're not quite so at ease. So in that way you don’t really need the motherly figure that sometimes the female, like, can give. But...and when you're older you prefer to have someone similar to you that you can speak to.