What problems can a GP help with?
• what can a GP help with?
• physical health problems
• mental and emotional health problems
• raising awareness of the GP’s role
What can a GP help with?
GPs deal with a broad range of physical, mental and emotional problems. As well as finding out what’s causing a person’s symptoms and treating them, they provide health education, offer advice on smoking, diet, sexual health and contraception, give vaccinations (injections), and may carry out simple surgery. In some cases the GP may need to refer (pass on) the patient to a hospital or another healthcare service (for example, physiotherapy, podiatry or counselling) for tests, treatment, or to see someone with specialist knowledge. GPs usually work in practices (surgeries or health centres) as part of a team, which includes nurses, healthcare assistants, practice managers, receptionists and other staff. Practices also work closely with other health professionals, such as midwives, health visitors, mental health services and social care services.
Physical health problems
Young people went to see the GP for all sorts of reasons. The doctor was often the first person they saw if they had a health problem that they were worried about. Examples of minor health problems include ear, eye or chest infections, rashes and other skin conditions, periods, and ongoing pain. Simon, Emma, Caitlin and Jalé were living with long-term health problems so saw the doctor whenever they were worried about these. Long-term health problems include asthma, diabetes and arthritis. Other people went to the GP surgery about sexual health, whether that was for contraception, cervical screening or STI tests (tests for sexually transmitted infections).
- Lara is at school, and lives with her mum and sister. Ethnic background / nationality: Argentinian.
I don’t get very ill normally, like ill enough to have to go [to the GP]. But one time I had like a rash all over my arms and my chest. And so my mum took me to the doctors’ to see if there was like anything wrong. And they were like, “It might just, it will go away.” And it went away. But normally we just go for like check-ups or anything like that. But we don’t go normally, if we’re really ill....
How often do you go for check-ups?
Probably maybe once a year, maybe not even once a year. It’s not very often, but, yeah.
Can you just talk me through what would normally happen in a typical check-up?
Of what I can remember, we would go there. They would ask us questions. They would like check our body, our what’s it called? Like our body temperature. Check our heart rate, and just make sure everything’s okay. And then that’s it.
And who would normally do these check-ups? Was it the nurse or was it the doctor?
Very few of the people we talked to knew that they could speak to the GP about mental and emotional health problems. These include ongoing stress, feeling low, depression and anxiety, and emotional problems at school such as bullying or exam stress.
Lara and Paula thought that GPs only helped with physical problems, and Kyle and Simon said they were more likely to speak to friends than the GP about emotional issues.
- Jake is at school and lives with his parents and younger sister. Ethnic background / nationality: White Irish.
Do you think people go to see the doctor for the issues that aren't completely health related?
What like personal problems?
Well I suppose that sort of like…there's another job for like…there's someone else you go to for that isn't there, you won't go through a doctor, like seeking personal advice.
Is there any…who would you…if someone…a friend of yours was asking, "Who can I see about personal advice?" who would you tell them that they could see?
Well I…like professionally, maybe like a counsellor or something. Something along those lines, not a…not…well I suppose it depends on your relationship with your doctor, cos if you're quite close to them and you get on with them well then maybe it could sort of be arranged. But that wouldn’t be my first choice anyway.
So, in your case, what would your first choice be – to see a counsellor or to talk to a friend or?
Oh I would go to a friend before I went to anyone else, like I wouldn’t go straight to a professional, no.
So, say you were having lots of stress before an exam or something like that, would you prefer to talk to a friend or go to see a doctor or talk to parents?
I would…I would just go to my friends really.
- Kyle is at school. He lives with his dad, grandmother, brother and sister. Ethnic background / nationality: Black Caribbean.
Do you think people like around your age, teenagers, do you think they feel maybe a bit nervous going to the doctor, or self-conscious or anything like that?
Well, for things like injuries, no. But if it's like about maybe stress or they're depressed or something, then they might feel a bit…also it depends on them really.
So sometimes people go to the doctors about physical problems, injuries and things like that.
Sometimes people go for more kind of emotional or mental health reasons like you’ve just mentioned.
Do you know that you can go to the doctor for these things or is it something you haven’t got a lot of information about?
Well I've never really gone for emotional reasons, it's more physical. But if I were to have emotional reasons, I probably wouldn’t go to the doctors, I'd probably go to like a psychiatrist or something.
Would you talk to friends at all about it, or family?
Well, I'd try to find someone like in my year that’s going through a similar thing, and like I'd confide in them, yeah. Probably not my family.
So someone in your year with the same… would you find that more, easier or better than talking to family?
Yeah, yeah it's just…it's like talking to someone with a common interest as you; you sort of…you can trust, you can trust them.
And would you use the internet at all?
Yeah that’s probably what I'd do first, yeah.
- Simon is a university student. He lives at home with his parents. Ethnic background / nationality: White British.
And you’ve talked about going to the GP because of the long term conditions. Would you consider going to your GP, for example, if you were feeling stressed about the condition, or feeling stressed about work or exams or things like that?
I must admit it’s something I’ve not done. And I’ve got stressed and you, sometimes you just think, ‘Well, I’ll get over it.’ And sometimes you think I’m too busy to think about stress, which makes you more stressed.
Would you be more likely to talk to friends about that sort of thing than to talk to a GP?
Probably to closer friends, I’d say, you know, I’m more stressed and I have mentioned to the GP a few times that I’m really fatigued. But the problem, you know I’ve just had the response back, “Well there’s nothing we can do about that, unfortunately.” Which is, just adds to the stress because you’re so tired, and you’re told well do less, do less things. But, you know, I’m still a young person and I should be able to do all the things a young person without this condition could do.
But sometimes it is, it’s a funny thing to talk about stress, and I think we need to get better at talking about it and realising, you know, it can affect our lives and our health.
Sometimes if GPs perhaps asked, “How are your stress levels? How are you feeling?” You know, do you think you might need any support or you need to talk about things? And sometimes that GP, or, you know, somebody talking to a patient about that will just help them to open up a little bit better.
So you think GPs could be better at asking people, young people or people of all ages?
People of all ages, but particularly young people. And, you know, people who have a condition as well, to actually not think about, you know, the stress and the psychological side because it can really get pushed under the carpet. But if they are more likely to show some signs of, you know, sharing, you know, thoughts of how they do feel. And it is, it’s a hard subject to talk about. I think if that conversation’s started it will help.
And you, you feel the conversation should be started by the GP by asking the question, “How are your stress levels?”
Yeah I think, I think it would be good. Some people may go into their GP surgery and say, “I’m feeling really stressed.” But not everybody does have that the confidence to do it. And just by the GP put it subtlety into the conversation, you know, ‘how are you feeling? Are you feeling stressed at all?’ So they don’t feel it’s something they should be ashamed about. They shouldn’t feel guilty about it. And that’s important the way that the GP approaches that question really.
- Ambeya is a student and cares for her mum, who has mental health problems. She lives at home with her parents and two brothers. Ethnic background / nationality: British Bangladeshi.
Have you ever been to your GP for any stress related things or anything that’s not necessarily physical, whether it’s mental health or…?
I haven’t gone…I don’t think I've ever attended the GP for like anything to do with stress.
Do you think it's appropriate to see your GP for issues around stress or any kind of behavioural problems at all?
I would like to, but then again I think, from like previous experience and stuff, I think when it comes to stress or anything stress related, it's better to have someone permanent rather than being moved around doctor to doctor. So I'd rather…with anything related to stress, I'd rather see a counsellor who will give me ongoing support rather than a doctor who I'll only see like once every five months.
What sort of problems do you think that, in a young people's clinic…what sort of problems do you think a lot of young people have in common that they would be going for?
I think mainly it…I think mainly it would be to do with mental health, definitely. It's definitely mental health, and I think that’s one of the…that’s…I think that’s why I'm so passionate about the NHS because it's mental health that is more worrying than physical health.
And do you think young people know that they can see their GPs for mental health issues?
No. Because I don’t think I could have…I still don’t think I can go to my GP and talk about mental health and stuff.
What could be done to improve awareness do you think?
I think there's so much that can be done. But it's just the fact that mental health is mainly aimed towards like adults, it's not aimed towards young people at all. So it's just the fact that knowing that young people can access mental health services would be so much easier. Because, so far, I know only adults get emphasised about mental health.
So where should it all start, telling young people. If someone was saying, "We'll start telling all young people that they can go and see the GP for mental health issues", where should they take the information first?
It would have to be school, definitely school, because, like I said, school is the most time spent during the whole week, and that’s the only time they’ll be able to get information like this.
It was only when Vinay went to university to study psychology that he learnt that patients could speak to the GP about mental as well as physical health. But he felt that GPs were perhaps not the best professionals to talk to. He would prefer talking to a counsellor and did eventually speak to the mental health advisor at university:
- Vinay is a postgraduate student and lives in a shared house. Ethnic background / nationality: British Indian.
Did you know that you could see the GP about things that weren’t physical pain?
I think genuinely I didn’t know that until I did my degree. I knew that the first point of call was a GP if you’re going through mental health issues, or psychological pain. But I didn’t know that until I’d done my degree. I didn’t know that was the first point of call.
Yeah, for all those issues.
Yeah, so one organisation has made this flyer to make people aware of all the different issues that you…
…could see, go and see a GP about. Did you know about any of these? Or is it quite new information?
I didn’t, I didn’t. Yeah some of these I, in my degree they said that the doctors would see. But the thing is, is I think I’m a bit dubious whether it would work because I think there’s certain professions that would probably be better equipped like a psychologist or therapist or counsellors. Because I think the doctors are so back logged with all these other problems they, some of these might be a bit too… it would be a complete different direction and maybe not of their speciality.
Yeah. Are you more likely to go to the doctor for physical pain?
And if you were having any other issues, maybe some that are on this list or other ones, you wouldn’t go to the GP?
Well I had, I’ve had a few obviously psychological issues as well. But I’ve been to see, I went to see the Uni mental health advisor for that because I felt that she had a psychological background. She kind of had a speciality and it was something that the Uni provided for me. So I thought it was just the most fitting,
Yeah, and that was completely separate to the GPs, it’s completely independent,
Yeah, so a lot of GP’s surgeries do offer counselling and things, had you heard about that, you know they could, they can refer you to a counsellor. Had you heard about any of these services?
I think it had been mentioned, but I think with my experience of the kidney problems I didn’t want to be, especially when it’s mental health, I didn’t want to be placed on somebody else’s hands, and then somebody else’s. I thought it would be just easier to go to see one person straight away.
- Susan is a medical student and lives in a shared house. Ethnic background / nationality: White British.
I ended up getting counselling because I was feeling very stressed, and there was a lot of work for me to catch up with, yeah.
And was that through the university, through the [name of] Division?
I went online and I found, yeah it was via the university. So I didn’t actually see my GP, maybe because I didn’t have someone that knew me. But I still…I felt very embarrassed that I was anxious, and I've always bottled that up. And I didn’t…I think part of it as well I didn’t want another healthcare professional to see me being like that as well. So I'd…but for some reason it was OK to see a counsellor [laughs].
Through the university?
Through the university, yeah.
Yeah, a few people have mentioned something similar. So you would have preferred …because it feels more anonymous?
Yeah and just…especially being a medic, I felt uncomfortable seeing a doctor. I think there is a bit of a culture of denial of mental health problems at medical school. And yeah, I guess I didn’t even give the GP a chance. And maybe if I had I would have been surprised. But yeah I wanted to just stay out of that.
Yeah. Did you know that you could have seen the GP?
I think so but actually, before I did all the reading on the internet, and before I actually did my GP placement, I wouldn’t have considered it as my first point of call. I'd always seen the GP more as physical problems – the kind of quick fix prescriptions like my fungal infection, just go in, get the drug, or go in and get a referral. I didn’t…because I'd never had that much continuity of care, I didn’t see them as someone who would be well placed to see me over time and treat anxiety sort of thing yeah.
Raising awareness of the GP’s role
Like many young people, Ambeya felt that there should be more information about GPs being able to help with mental health problems, and that this should be made available in schools. Nikki also felt that mental health education should be taught in schools and included in the National Curriculum. When she needed help at a young age, she had ‘no idea’ she could speak to the GP. When she did finally go to the doctors’, she felt that the first few GPs she saw were unhelpful but she later found one that she liked.
- Nikki is a student and lives with her parents. Ethnic background / nationality: White British.
I've always gotten ill a lot because I think it's because my immune system is quite weak. I've always gotten ill, like I always get colds and stuff so I was always going to the GP to get like antibiotics or whatever. Yeah so I did, I've always gone to the doctors quite a lot. I just don’t…no one's really interested in the other side of it when it comes to mental health; it's just physical health they care about mainly.
Do you think many young people know as well that they can talk to the GP about these things, or do they often think, 'Oh the GP's not going to be interested, it's not a physical problem.'
Yeah, I don’t think people have any idea. I mean I didn’t have a clue that I could talk to my GP. But then even when I did…someone told me that I could, like GPs they're often quite… not sensitive about it. So I'd just be like, "Oh OK you can go for a walk or you can take this medication, what do you want?" Like, it's just ridiculous. So I think, even though people have no idea, so they need to know that they can, but then at the same time GPs aren't very good at it.
So when you were going to see the GP for physical problems – coughs, colds, or any other things like that – were you usually going with your mum?
Yeah, I was going with like my mum or my dad or whoever, but yeah.
And what did you think about the GP at that point – just someone you see for physical problems, a short appointment, that kind of thing?
Yeah, I had no idea that their role was to deal with any issues; like I had no idea about that. I just thought they was there only if you had an infection, and that’s it. And they just give you some…they just check that you actually have it so that you don’t like…so that people don’t just lie to get medication; then they give you some medication, then you leave. I didn’t even know it was about other physical health issues; I just thought it was just for like infections and stuff.
So how could that be improved for younger people especially?
Well, if mental health was on the National Curriculum then they could say it through there, like you can tell them that they can go to their GP if it was on the National Curriculum I think.
So, in those lessons, just more awareness that people go to see the GP not just for physical problems, but all sorts of emotional problems?
- Auberon is a student and lives at home with his parents. Ethnic background / nationality: White British.
If young people are feeling anxious or depressed, do you think they know that they can go to see the GP? Do a lot of the young people know that you can see the GP for…?
I don’t think they do. And I think that message needs to be getting out there in terms of mental health because I felt like this before. I knew my GP was available, but there was no-one I could talk to. And I feel like that’s how young people are feeling; that there's no-one that they can talk to, and I think the message needs to get out there that young people can go and see their GP and their GP is there to help them.
Yeah, so they can… apart from physical problems, they can see their GP about mental health issues, emotional problems?
So, even to the extent, I think you had a leaflet or something; I don’t think I've got it here now. For example, other problems that they might be having, to do with bullying or stress with exams, or anything like that, should it be made available this sort of information; all the different reasons that you can see the GP?
Yes, because I think bullying… because bullying can lead into mental health, and also physical health, illnesses, and so can stress with exams and stuff. I think they need to see their GP before they get into a mental… before it starts to need to… under the mental health road. And so it just can break it off there and they can sort it out there before it starts to get more serious.
- Hazzan is at school and lives with his parents, sister and brother. Ethnic background / nationality: Black African.
I didn’t really think that you'd be able to talk to a GP about bullying because I thought it was like strictly health related things that you could speak about. And like, yeah, like stress and self-harm – I didn’t think those were things that you could speak about. But I don’t think the rest of it [the RCGP leaflet] surprises me as much as I would expect.
So this leaflet has been made so that people, younger people especially, cos it's for young people, can know that these are all the different reasons that you could see a GP.
As a lot of people, you know, might not have heard of all of these reasons. Do you think this kind of leaflet would be good either in the surgery or given to young people or put up at school or anything like that?
I think if there was – yeah I think that they'd be useful if they were given out in like registration one morning at school, so then everybody would have the chance to look at, look through it. And then the teacher would be able to explain it to the students so then they would know that the GP isn’t just, ‘Oh I've hurt my leg’ or ‘Oh I need to get an injection’ lemme check that, down to the GP. They can actually be something that they look forward to doing because they're able to express themself.
And in terms of, you know talking with your friends at school, is health a kind of subject that comes up much or not really or, you know is it a subject that you talk about at school or not so much?
With friends it usually just comes up in conversation. But I think most of the things that happen are like sexual health or like sport and stuff. Or like mental health because those are the things that concern us the most. But I think in school we will have sex education lessons like now and then. But with teachers it's mostly like, ‘Eat healthy, like have your five a day and do sport’ and that’s it, like then your life is perfect.
When asked about the issues that most young people are concerned about, Paula said ‘anxiety and stress and dealing with school and friendships’. Tagbo mentioned sex, drugs and alcohol as major concerns and Louis talked about exam stress, depression, and drug abuse. Ongoing anxiety caused by bullying was another worry that Nikki and Auberon felt people rarely discussed with the GP.
- Louis is at school and lives with his parents and brother. Ethnic background / nationality: White British.
I think definitely stress to do with exams, maybe depression kind of to do with exams as well. Definitely like smoking and alcohol, kind of drug abuse as well and the effects of that; and relationships too would be, I think would be useful.
Would you say they…those were the top issues that young people are…?
Yeah, and mental health as well I think are the top issues that kind of young people are concerned about.
And some of these issues, like stress before exams or stress about a relationship or something, would you think young people would go to see the GP about that sort of stress? Do they know that they can or not?
I don’t think…I think they think they're time wasting if they’ve just got stress over exams cos they think everyone, you know, is already stressed. I think they won't go unless they’ve got really serious kind of, really stressed and got an issue, but I don’t think they would otherwise.
So we could have some information like that on the website. What other ways can we get young people to know what reasons they can see the GP? How is it best to get to young people?
Probably on social media, probably maybe social media campaign about what you can go and see a doctor about. Leaflets in… the doctor's surgery as well I think…or maybe just kind of GPs telling them when they see them that they can speak to them about it if they ever need to, that would be helpful.
And if GPs…say a young person went to see a GP and the GP gave them a leaflet about that sort of thing, would that be helpful at all?
I think definitely after like maybe they’ve seen an unrelated issue, maybe even if they don’t think that the person's stressed out or needs help like that; it might just be helpful just, in the future; if they do need it and they can kind of relate back to the leaflet and think, oh yeah, I can go and see the doctor about that.