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To think this letter from gp was really rude?

(134 Posts)
ariane5 Sun 10-Mar-13 09:09:57

Dd2 has a lot of health conditions and is frequently very unwell.

Last sat (2nd) she was terribly poorly and our gps were shut so we took her to the ooh walk in and she was prescribed antibiotics.

On monday she was worse and woke up at 3am in the morning extremely ill and with high blood ketones (she is diabetic) so dh took her to a+e, she was let out the following morning.

Yesterday I received a letter from our gp and the more I read it the ruder it sounds.

"I noticed you took dd2 to a walk in centre on monday. I am concerned and disturbed by this. We have her records here and can provide better continuing care. I am worried as to why you felt it necessary to take her immediately to a walk in centre"

"Please make time to explain this to us, make an appointment or telephone as this issue needs to be discussed"

For a start dd2 went to a+e not walk in early tues morn-surely if information has got through to gp then it would have stated the time date and reason?

I don't understand why they had to write a letter like that, would have been much easier to phone me and clear it up.
It has made me really annoyed.I feel like phoning tomorrow and telling them to check their facts before writing a letter of that tone.

AIBU?

careergirl Sun 10-Mar-13 19:29:39

I'm understanding this a bit better now and, dare I say, this may not be a bad thing. In this case A & E, OOH's was entirely appropriate and the only option, but it may educate people that there are other options than A & E e.g minor ailments clinic at the GP, minor injuries unit etc etc. Also it can enable the GP's to work out where there are gaps in service provision or if there are issues in respect of access to services e.g. lack of appts and so on?

terrierist Sun 10-Mar-13 18:16:29

ariane - regardless of the reasons behind it the letter you received was rude, complain loudly.

Imagine - I had no idea this was how it works now, thank you for highlighting it. I vaguely remember news items at various times about changes in how the NHS is organised/funded - I should have paid more attention.

Those blaming GPs - imho most of them will be working as we'll as they can within the system they've been stuck with and I would rather my GP's main concern was for patient care than for a campaign to change the way the NHS is run. WE foot the bill for the NHS, the person we should be shouting at is the person paid to represent our views when these decisions are made - our MP.

ariane5 Sun 10-Mar-13 17:58:22

Yes that is a direct copy except I left out dd2s name and the walk in centre name.

I didn't think it was particularly well written-it sounded like it was done in a hurry (or in a bad mood).

dayshiftdoris Sun 10-Mar-13 17:33:51

I wonder (sorry if someone has said it) if the report from OOH / A&E said 'Diabetic care & advice' or some other nonsense...

It's not wrong but it doesn't say why you needed the help with her diabetes (because she was ill) and so they have read it as you attending A&E for routine diabetes advice (because clearly you nothing better to do at 3am).

Make an appointment to see the practice manager and ask for that letter to either be removed or your response (write one & take it) to be added to the original (most systems allow this)

clam Sun 10-Mar-13 17:06:23

Poorly worded, yes. Not sure I'd go so far as to say it's rude, however. You could interpret it as them being concerned and disturbed that she'd felt it necessary to look for another source of medical care when they understood it to have been whilst they were open. It seems that they've got their wires crossed, so all that needs to happen is for the OP to explain the real course of events, at which point the surgery will probably say, "OK, so sorry to have worried you."

Can't help thinking that all this is a bit of an over-reaction.

Dahlialover Sun 10-Mar-13 16:47:10

What Ballonslayer says

The whys and wherefores of structural changes of the NHS are irrelevant.

That letter is rude and bears no relation to what actually happened so is factually incorrect. I would be shocked to get something so unprofessional from my GP.

The surgery needs to know this

clam Sun 10-Mar-13 16:12:59

All these posters jumping up and down and suggesting "demanding" an apology! What the hell good is that going to do? Likewise, changing GP. From what ImagineJL says, its the same for all practices.

And I am beginning to see why surgeries and hospital receptions have those signs up saying they will not tolerate ause of their staff. The way ImagineJL was addressed, given that she was attempting to explain the system she is having to work with, was appalling.

Another bad day for MN.

DazzleII Sun 10-Mar-13 16:03:29

Gallifrey: "My friend is a doctors receptionist and apparently the surgery get charged about £250 every time someone goes to A&E.

That's why if you need an emergency appt just say you are going to A&E and they will fir you in straight away!"

Thanks, Gallifrey, that is a v useful tip.

I do think for patients there ought to be some form of information to us about changes in govt policy which result in GPs being v v angry with us when we are just expecting what in the past we have been told to expect. I got into a big ruck for wanting to get my ears syringed by the nurse, and when she refused, I booked an apptment with the GP. He was really rude and said I could wait for over a week for syringing just like everybody else. I was going mad with itching in my ears, so went private and was found to have an advanced and nasty ear infection, which the GP in his fury had failed to notice in spite of examining my ears. Fgs.

SolomanDaisy Sun 10-Mar-13 16:00:19

Is that really a direct copy of the letter? The English is quite poor.

careergirl Sun 10-Mar-13 15:56:49

I always thought I was helping the GP by going to the walk in centre! For example there is one absolutely opposite my work so if I am struggling with what I call a minor ailment like earache I will nip in to see them. No bothering the GP no time or little time out of work for an appt. What a bizarre situation!

BalloonSlayer Sun 10-Mar-13 15:46:42

I am not sure what some of the posts on this thread are getting at.

As has been explained, GPs have to pay for/account for visits by their patients to OOH/A&E.

If the GP has been led to believe - as the GP's letter implies - that the OP took her DD to out of hours when the GP's surgery was actually open, ie chose the OOH service over a visit to the GP, then the GP:

a) if going to have to fund the visit
b) may be having to answer questions as to why the OP couldn't get an appointment for her child at the surgery during normal opening hours
c) may be having to answer questions as to why the OP had no confidence in the GP and went straight to OOH
d) is genuinely bewildered as to why the OP went straight to OOH as they have previously had a good relationship regarding her DD's care (this does come over in the letter)

The answer to all the above questions, is this - The GP's information is incorrect. It didn't happen.

The OP is NBU being offended by the letter, as it is rude.

But some questions being asked by the GP is justified given the information that the GP was led to believe.

I think it is certainly fair to be concerned that someone confused or vulnerable, or with poor literary skills could receive a letter like this and believe that they are being told off for going to A&E at three o'clock in the morning. After all, quite a lot of mumsnetters on here are leaping to that exact same conclusion.

The OP needs to draw this to her GP's attention, and stress that a phone call with the opening gambit: "Did you take you DD to out of hours at nine o'clock on Monday morning?" would have been far more appropriate way of handling this, and the matter would have been cleared up at once.

Which is, er, exactly what the OP was suggesting when she started the thread.

I think you should respond with honesty, say you understand the practice is liable for costs whenever you attend ooh and a and e, which is why you have never used either as a first option. However the tone of the letter you received makes the patient/doctor relationship an uneasier one.

School nurse paediatrician & GP this week. As well as 3 phone calls to the specialist A&E dept so we took a whole to get there!

Gosh don't pick on imagine. I have been doing various bits of work (sort of) with GP's recently. They're, on the whole, a decent caring bunch who have every area of their work interfered with. If for example they don't want to prescribe you statins because they think the evidence is limited and they may do harm they will be penalised financially for not doing so. This is the same.

Blame the succession of govts who have treated patients as tins on beans to be traded with. The rot set in when people like McKinsey were paid millions to improve efficiency within the NHS - whilst failing to understand that patients are not homogenous beings and they come with different degrees of complexity.

I'm just back from the hospital with ds1 - so will probably get sent one of these this week. This started with a misdx via a telephone triage (another favourite in the new NHS) - which means he has probably spread it all every where as well. He also now has a shed load of medication that he prob wouldn't have needed if treated earlier. (He did also see a sch

puds11isNAUGHTYnotNAICE Sun 10-Mar-13 14:24:02

The letter doesn't sound very professional. I cannot imagine a professional writing in such a dramatic style as to say they were concerned and disturbed and worried as to why you sought medical attention.

Would their first port of call not be to follow it up with the OOH surgery rather than send an insulting letter to a patient?

If I was you Ari I would be changing GP's.

Cooroo Sun 10-Mar-13 14:23:29

Thank you ImagineJL for coming and sharing your experiences. I'm fortunate that me and my family currently have little call on the NHS, but your account of what is going on is deeply disturbing. You always imagine they will be there for you when you need them (my father was a GP many, many years ago and put his patients' welfare above everything). I know in the abstract that this government is damaging everything that was good about this country, but your post was really interesting.

Sorry you got abused for it.

RedToothBrush Bosnia-Herzegovina Sun 10-Mar-13 14:19:05

Doctors are SUPPOSED to be the advocate for ill and vulnerable patients in a socialised health service like the NHS.

If they are more concerned about their jobs and their own necks then are failing in their duty under a socialised system.

I am realistic about things. I am realistic that whistleblowing and collective opposition to proposals are effective. IF the people concerned and know and are in the system are prepared to take action.

Its whether they have that will to do that, that is the issue, not whether it is a realistic way of changing the system.

Welovegrapes Sun 10-Mar-13 14:16:52

Not sympathetic to you, imagine, sorry, because gps negotiated a hugely favourable new contract when labour was in power which left gps highly paid and with the ability to contract out ooh care.

That letter is very threatening in tone - 'disturbed'??? Demanding to be seen to discuss it?

If you think that is just inappropriate/confrontational then you have lost sight of what the hypocratic oath was all about.

It is unkind, accusatory, rude and a waste of public funds. Wasteful because the GP could be seeing patients instead of writing the letter and instead of having the rediculous meeting with the patient about it.

A&E themselves should be asked to flag flagrantly inappropriate attendance - eg ingrowing toenail, headache and that should be sent to gp. GP could then write an appropriate letter saying A&E flagged that on x date we could have helped you with xx issue and we would like to remind you of opening hours, contact details and how to get an emergency appointment. Attached is a leaflet on when to go to A&E:

Rosa Sun 10-Mar-13 14:11:51

Agree the letter is not using the nicest of terms and could have been phrased much better. but good for the GP showing concern for a paitent....
I would yes contact them , explain why you went ( erm your dd was getting worse and you needed medical advice there and then)and I expect they will probably apologise .. I could be wrong but why would the gp have bothered writing to you if he / she wasn't showing some concern for your daughter?

Tee2072 Sun 10-Mar-13 14:08:21

"Seeing as an enormous number of GPs can afford to work part time, it's hard to be completely sympathetic to their claims as a collective professional group of overwork. Sorry GPs."

This.

And, imgaine if your unions are ineffective, get rid of them. And don't say 'but I don't have time' whinge whinge whinge. Someone, who knows what is actually going on, because they are in the thick of it, needs to take a stand. Or we all lose out. The average NHS user can't. We aren't told enough. Not even in posts like yours.

I'm tired of the whinging and the 'not my problem/can't do anything' attitude all over the world.

What if Ghandi, or Martin Luther King, or Rosa Parks had had that attitude? Where would be today?

BoffinMum Sun 10-Mar-13 14:05:33

Seeing as an enormous number of GPs can afford to work part time, it's hard to be completely sympathetic to their claims as a collective professional group of overwork. Sorry GPs.

twentythirteen Sun 10-Mar-13 14:01:19

That's one paranoid GP!

ponyandpotatopie Sun 10-Mar-13 13:58:26

thanks for answering imagineJL
I had no idea this happening.

ImagineJL Sun 10-Mar-13 13:56:32

Red please be realistic about what individuals can achieve.

Some organisations have unions. They pay union fees, which fund the people who run the union. Their jobs are to look at working conditions and "rally the troups" if something needs to be protested against. It's a big job for many people. Getting a large group of people to reach an agreed decision on a plan of action involves a huge amount of time and liasion and discussion to reach a consensus. Those at the coal face simply don't have time to coordinate such a response. This isn't an excuse, it's a statement of fact, and applies across the board in all institutions.

Our unions (BMA and RCGP) put up a bit of a fight but not a huge amount. They fight a bit, and sometimes they win a bit, as with the recent stalling of private bidding plans. But the government are determined, and they have power.

I am as sad and worried about the NHS as anyone. I work in it so I see first hand how the cuts are affecting people, as well as seeing my own family affected by service reduction.

But please don't attack me for the state of the NHS. I don't make the rules, I just try and see patients and do the best I can for them, within the constraints imposed on me by politicians and their tiny cheque books.

OP if you're still reading, I don't think any GP would argue with what you did given the circumstances, and the wording of that letter was very wrong. They need to be taken to task for that.

I don't think I'll post again because I do find the very angry posts quite upsetting.

foxache Sun 10-Mar-13 13:27:27

Imagine has provided solid, inside information about the situation and also suggested something we can do about it, why is she being attacked? The posts were interesting and gave some insight into why the OP received such an upsetting letter.

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