To not expect dh's dr to threaten to stop prescribing his meds?(143 Posts)
DH has received 2 letters from doctors surgery, one dated 2 weeks ago and one dated last week. First one from nurse asking him to contact nurse as he missed his INR check/blood test, saying she'd left messages asking him to call. She didn't call our home number, only his mobile. She didn't leave number for him to call her back. DH, being a man, doesn't have the surgery phone number stored on his mobile. I asked him to call surgery after receiving first letter but he forgot - he's been working long hours and away from home (hence missing his appointment).
In second letter, from our dr, dr says he's writing because they've tried to contact him several times. Dr says he remembers dh telling him he often works away from home through the week. He goes on to say he will stop prescribing his medication if he does not make an appointment within the next month as its not safe for him (dr) to prescribe the meds (warfarin). INR clinic is once a week, between 9-5. DH leaves for work at 730, home at 7pm.
(We have recently moved & changed drs. Previous surgery tested dh every 6 weeks, sometimes dh couldn't make the appointment so there were times over past few years where he wasn't tested for 2, maybe 3 months. It was never a problem as his INR is pretty regular now.)
AIBU to think this is a bit out of order (stopping dh's meds)? Yes, i appreciate that the surgery tried to contact dh, but they didn't try our home number - in which case I would have explained and this situation could easily have been avoided.
No it's not out of order.
It could kill him, cause a stroke etc if the INR is not checked.
Your GP would be negligent if he continued to prescribe without getting this checked.
The correct thing to do is discuss your difficulties regarding opening hours and see if he can get his INR checked another way. Would the GP let him do his own in between GP check. You can buy machines yourself?
Warfarin has to be closely monitored, my dad had to go ever week, for years, and the dose changed ever time by a few grams.
Your DH has to take leave to see the doctor. It's either that or be dead.
I think YABU too, I'm afraid.
I am on meds that are not available on repeat prescription & that have to be reviewed periodically. It's a pita but that's the way it is. If I need & want the meds, I have to make arrangements to attend a clinic.
So he's at less risk from becoming ill without his meds than with them? His last appt was just over a month ago when his levels were fine/well within range :&
Are you his mother? All this "oh he's a man so he doesn't know the phone number" and "he's got to work long hours" is bull. Men are able to use google to find out a phone number surely? Maybe if you stop babying him, he can start taking responsibility for his own health? He'll probably know his diary better than you to decide when he can best take some time off to have these tests done?
The doctor is acting responsibly.
Unfortunately the surgery cannot speak to you due to patient confidentiality likewise many surgeries will not leave messages.
Holly, dh's levels have rarely changed over the last 3 years he's been on it. As I said earlier, he's gone max 3 months without check and still been on same dosage. Admittedly that's only happened once ...
Cabbage, dh has thought about buying one of those machines. Will be calling surgery to find out if he can be tested somewhere else or at other times of day.
Your husband needs to grow up and take responsibility for his own health.
he needs to make an appointment to have his blood test done as soon as possible.
The GP is right not to prescribe without knowing everything is right first
What else can the doctor do if your husband is too lazy/entitled to make a simple phone call and get his appt sorted. These are strong and potentially dangerous drugs.
Nobody is "too busy" to do this.
No not necessarily less dangerous to stop the meds but maybe but there is a big difference in who takes responsibility. He maybe needs to book appt with GP take in his book and discuss his problems with appointments. The Dr can explain the risks of irregular monitoring and maybe they can come up with a solution with dh taking responsibility for his actions
Widow. DH is not allowed to use Internet at work nor does he have it on his phone. I'm not babying him so please stop accusing me of such.
I'm happy to accept IABU, I'm just surprised a doctor would threaten to stop prescribing warfarin. Why has he been taking it if dr feels he can stop prescribing it?
YABU!! His doctor would be irresponsible if he kept prescribing without knowing his INR levels. Life is busy but it's NOT difficult to arrange a doctors appt
YABU, but I see your point.
You (and your husband) know that your DH's INR has been stable for years.
Your knew Dr may not.
He is acting responsibly, but pointing out he may have to stop his meds unless an up to date INR is available to him.
He did not just stop anything at all.
And yes, your DH needs to take his own health on as his problem. It is not difficult to store the surgery's number on his phone .
Oh gawd, your new dr, sorry - no coffee yet
Ok. I KNOW dh needs to make an appt. he knows this too. He's not lazy or entitled AF, he's working very hard long hours ATM which is far from ideal but that's how it is. Your comments are rude & unhelpful, but if it makes you feel better to be abusive towards my dh, fill yer boots!
Thanks for the input.
The GP doesn't want to stop it. However if his patients won't undertake the required monitoring needed to know its safe then the GP has no choice but to stop it.
If he carried on giving it knowing he hasn't been correctly monitored then if something happens then it is on the GPs head.
If he stops it then it is clearly on record that your husband has been contacted on numerous occasions and he was warned in advance and still didn't do anything therefore protecting the GP who is only doing what he has to given the fact the patient isn't willing to take responsibility for themselves
The doctor can't keep prescribing it without your DH having regular checks. That would be dangerous and negligent.
I am looking at it from the POV of the doctor's surgery
He has already wasted their time with an appt he failed to attend. That slot could have been given to someone else, and he didn't cancel it did he ?
He is wasting NHS time and money. I don't make excuses for that. The organisation is on it's knees and one of the reasons is because people take it for granted and abuse the system. Every phone call to chase/letter they send you is the end of a time consuming process. That is what your H is doing when he is "too busy" to sort a simple appointment out.
He has been taking it to reduce his risk of DVT/PTE/stroke or whatever. That risk is reduced IF his INR is between 2-3 or whatever level is appropriate for his condition (can be up to 4.5 for certain things).
This means his blood takes 2-3 times the amount of time to clot than the next person's.
If his INR is too low, he is at risk or whatever he is taking it for in the first place. If it is too high, he is at risk of bleeding including brain haemorrhage.
It is the doctor's responsibility to ensure appropriate monitoring. If a pt does not have their INR monitored, something bad happens, the prescribing dr (the person who has signed the relevant prescription) is accountable.
With both phone call and letter being used as a reminder, and as doctors' numbers are published and readily available, then DH has no reason for not contacting thr surgery to make his appointment.
If he does not give this enough attention/priority to use/store the phone number, then that's his business, not the fault of the surgery.
YABVU. If the INR is not checked then the warfarin should not be prescribed. How would you feel if he had a massive bleed because the INR was too high, or a stroke because it was too low? Would you still be happy then that the GP had prescribed, just because it's been stable in the past? I don't think so. GPs should never give in to unreasonable demands when they know it's not safe, if it all goes wrong you can bet the patient won't be defending the doctor to the GMC saying they were only trying to help and make things more convenient. No they'll be suing them and writing into the Mail. He has a month to get the INR checked, thats plenty of notice and unfortunately if you're on warfarin then your health needs to be prioritised.
And how much chasing do you expect the surgery to do? You've had 2 letters, a call to his mobile and yet you're not happy they didn't call your home phone!! And how hard is it to google the surgery number? The GP shouldn't have to keep chasing you, your husband needs to take some responsibility for himself. And if he knew he was working away why did he 'miss' the appointment? Surely he should have cancelled it? There are lots of areas where patients are able to check their own INR at home though, so you could enquire about that.
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