What's the point of having a GP in Switzerland?

Family, Education, Health and Pets
1
Ok, it's probably pretty obvious, but I'm so confused by the health care system here.

Back home, when you fall ill, you would call your GP and make an appointment for the very same day. If it's an emergency, he/she would even come visit you at your home. And when it's something that requires a specialist, he/she would write you a prescription that enables you to go see one. (Visits to a specialist without your GP giving the thumbs up are not covered by your insurance, so everyone goes to see their GP first.)

In all the time I have been living in Switzerland, I never had a GP and this has made me quite nervous, seeing how important they are in the Netherlands. Obviously I never needed one before, but now I have something that might require immediate attention (I'm managing so far, but I need to go see a doctor if things get any worse), so I called a GP that was recommended by me.

They told me the first available spot they have is in September. What the hell? Do you have to schedule getting ill around here?!

They also told me that my illness requires a specialist, so that it's better to make an appointment with one directly.

Ok, fine by me, but what the hell do I need a GP for then? Whenever I fall ill, can I just take a wild guess what might be wrong with me and go visit a specialist of my own choosing?

2
That's why it's important to be on the books of a GP, before you need them.

Fact: new patients go to back of the queue.

If it's an urgent problem, you could consider going to Emergency at your local hospital.

Register with one, NOW, for the next time - you wont have to wait so long, for an appointment, then.

3
I needed to go to the Dr when working in Geneva 18 months ago, there was a surgery in Le Lignon, I walked in told them I wanted to see a Dr & waited could not have been easier. There are group practices throughout CH it's really not that difficult.

4
So but what would be a 'normal' waiting period? If you register before, do you get to see one the very same day?

I already went to a clinic twice (once for me and once for my boyfriend). They helped us the very same day, but made us wait forever. I hoped having a GP would eliminate waiting all together. (Thanks to being able to schedule an appointment.)

5
I understand- have been living in two other countries where you can get an appointment on the day if it is an emergency. For non-urgent ones, you'll get an appointment within 48-72 hours.

For anything that is immediate, go to the urgence/polyclinique. It is covered by your insurance.

It depends on your insurance model. In mine, I am required to consult my family doctor first who will refer me to a specialist. If I don't, my costs will not be reimbursed. Perhaps you have one that allows more freedom?

I am actually trying to get an appointment with a specialist- and the earliest is also in September.

6
See my second post. Under normal circumstances, this would be fine.

But when you are really ill, you don't really want to wait a whole lot. You just want to go somewhere, see a doctor within 10 minutes, get a pill or potion and gtfo.

7
Depends on the doctor. I have consulted two GPs so far: both of them have always seen me on the day if I need to see them urgently. For matters that aren't that time-dependent, the earliest has been an appointment in 2 days and the latest in 3 weeks.

8
In NL the GP is so important because she is the gatekeeper to all specialist health care. Here this is only the case if you are health insured by a GP model (this will lower your premiums). If you go to a group practice where several GPs work you are more likely to be able to get an urgent appointment as a new patient.

9
I believe it varies as to the urgency of the problem.

Doctors will see walk-ins, for urgent problems, providing they're registered with them (or their practice), and sometimes leave free slots between the other bookings, for emergencies.

When I needed a doctor, when I was growing up in the UK, you went to the surgery and everyone already there was before you, and those that came in behind, were after you - simple.

10
That's funny, I think it's actually easier to make an appointment with the specialist I need. (Mainly because I know one that has treated me before.)

11
Step 1. Try to see if you can get an appointment with the GP.

Step 2. If GP is unavailable, you go to the urgence (tip: go to one at a smaller clinic/hospital instead of a big university hospital where you might have to wait for a min of an hour; tip 2: convey very strongly that you need to see a doctor asap)

12
I am registered with a group practice in Bern, they are open weekdays 8am to 6pm, after that you may call the practice first, and they give you advice.

One evening I cracked my head in the wash-room and needed 6 stitches. I called the practice around 7pm, and I was being sewn up at 7:50pm.

Last Friday evening my leg became swollen and red. At 9 am on Saturday I was waiting for the practice to open, & at 9:30 I was seeing a doctor, a damaged toe was cleaned and bandaged. At 10:30 I had the results of 2 blood tests, then I was given antibiotics, with an appointment today at 16:30.

You could continue to go straight to the specialists in Geneva. You pay a lot more, and often have to wait in a queue as bigger emergencies arrive. Or you could now register with a group practice GP. Ask your insurance company, they might have lower insurance premiums for group organisations, Visana and Helsana do.

https://fr.comparis.ch/krankenkassen...spartipps.aspx

13
Is this the same as going to a private 'clinique'? And if not, does anyone know something like this in Geneva?

The one time I went to the clinic, they helped me pretty fast, because I could barely walk and sit up straight and I was puking all over the place. But then they made me wait forever on the bill, because the physician that had to sign off on it was nowhere to be found and I had to pay right then and there, since I wasn't a Swiss resident yet.

14
As soon as we moved here, we went to see the local GP- just to meet him, introduce ourselves and make him aware we are here, and tell him of pre-existing conditions. I can't remember if he charged us for this- but even if he had, it would have been worth it. That meant that when we did need him, his receptionist and staff knew who we were and so did he. We can see him at 1 day's notice if we are prepared to wait in the waiting room, which maybe a while... and he will do home visits if we are really unable to go ourselves (although this has never happened).

In the UK, it is the norm these days to have to wait a few days before being seen- certainly in some areas- and home visits at night are nowadays almost unheard of (unlike Ye Goode Old Days when OH worked very long hours and did 1 night in 3 or 4, and 1 weekend in 3 or 4).

15
My wife doesn't have a GP. She goes and sees whichever specialist she thinks is appropriate. It's not that difficult to determine which specialist is the one you probably need. It's never happened that it's not been obvious; if it were, she'd find a GP (she doesn't like mine). But thankfully in Basel it's easy to see a doc at short notice, even if you're not registered already.

16
Switzerland is facing a crisis in primary care - there are simply not enough GPs to go around - and it's only going to get worse as the older generation of doctors retire.

This is especially critical, as the GP still functions - officially or unofficially, insurance model dependent - as the gatekeeper to specialist treatment. While one's insurance might allow you to see a specialist on your own, many specialists here only see patients on a GP referral.

Urban areas are by and large not as badly hit as rural ones, but the problem is growing in cities too.

It took me several years to find a GP willing to accept new patients, and several more before I found another who was actually a decent doctor willing to accept new patients.

I usually have a weeks' wait for an appointment if I have an illness, often 2-3 weeks for something less acute. A routine appointment will take a few months. The GP usually can slot in a truly urgent case in the same day - but it had better really be an emergency. Try pulling that for a less than urgent case and you will never be listened to again.

For care that cannot wait, the options are the hospital emergency room - but again, this is only for life-and-death situations - and in the greater ZH area is the Permanence walk-in clinic at the HB. There is usually a wait of an hour or two, first come first serve, but you will be seen. I think there is a newish practice - Aerzthaus maybe - that also take walk-ins.

Surely there must be a similar walk in clinic in Geneva - hopefully the Geneva contingent will come along soon with info...

I'm sitting here suffering from 'something' while my GP appointment is still two weeks away. I could go to the Permanence, but that means an hour train ride into the city and I don't think it wise to expose my fellow passengers to whatever it is that I have. So I wait, and try OTC remedies. If I get to the point where my life begins to flash before my eyes I'll call the GP and ask for an emergency appointment.

That's the unfortunate reality of primary care in my area today - and likely to become more common throughout Switzerland as the GP crisis grows.

Hope you find someone to see you, and that you feel better soon.

An when you do find someone, be very clear what your symptoms and concerns are. The Praxis Assistant taking the call assesses urgency, this is the person who can help you get a same-day emergency appointment if it is needed.

17
I live in Geneva and have never bothered with a GP. The few times i needed a doctor, i called a medical center and got an appointment for a few days later. One time i really had an emergency, i just walked in and was seen an hour later

18
That's probably the right thing to do, but as I hardly ever need a doctor, I wasn't really looking for someone to establish a close personal relationship with. I just need a guy (or woman) who will see me when it's absolutely necessary and prescibe me something that will fix me right up. For me, GPs are like hairdressers; pretty much anyone will do until I find the one I absolutely love and then I'll stick with 'em.

But yeah, having a little one now, I guess it's more or less necessary to have a good relationship with a GP, especially if this means you get to skip the line. But I won't be scheduling an appointment to bond with a GP anytime soon... I'm much too ill for that...

Yeah I'm probably able to figure out what kind of medication I need as well, but sadly, it doesn't work like that.

Wow that sucks. In the Netherlands, we have the same problems with dentists.

And yeah, I feel miserable right now, but not quite miserable enough to rush to the hospital. (But too miserable to be arsed to find a GP that is willing to see ill people on the same day.)

Guess I will wait one more day and if it gets any worse, I will try to find a walk-in clinic.

19
I'm in the "no GP" camp too. I just use Medix Toujours and walk in as needed. They're open until about 22:00, 365 days a year.

You can make an appointment if you prefer, but as a walk-in I've only once had to wait more than about 40 minutes to see a doctor, and then they booked me in and suggested I nip to the coffee shop and come back in half an hour.

OK, they won't look after chronic diseases, but I have a specialist guy for that.

20
In ticino there's a cantonal number you can call for a home visit by the on-duty doctor for your region also at night (organized by the cantonal doctor organization), otherwise you can just go to the ER, there's people going to the ER because they have a cough that doesn't let them sleep, the suggestion to go to a smaller private clinic is a good one.

For Geneva i see there are several services of doctors 24h/24h and also telephonic consultation: http://www.ge.ch/urgences/welcome.html

You may also want to consider the TelMed insurance model if you want to call you insurer to ask what to do.

Anyway the good thing about the swiss system is that you are covered but can do whatever you want, go to whatever doctor/hospital you want, private or public. I remember in italy everything went through an underpaid public GP, if you wanna change it you have to go to an office, paperwork, etc. boooring.