To consider complaining to the GP practice(39 Posts)
DH was feeling very sick last week. He went to the GP, explained his symptoms, stomach ache, vomiting, loose watery motions, light headed, clammy skin. He said he had not eaten for 36 hours.
She took his blood pressure, it was quite low. She did not examine his stomach.
She said it was a virus. Told him to drink plenty of fluids and come back if not better in 7 days.
DH lived on painkillers and water. He wasn’t sleeping or eating and getting worse each day. I must say he has a very high pain threshold. He waited the seven days, returned to the practice and saw a different GP who examined him, asked for a urine test and sent him straight to hospital.
DH was diagnosed with a ruptured appendix and had surgery at 1 am this morning.
Should the first GP have examined him? Should she have felt his stomach?
Should we complain?
I can’t help but think an examination could have indicated an issue with his appendix?
I don’t think so, sometimes these things cannot be found. I saw a GP one day and she missed a serious infection. I was in intensive care on a ventilator 24 hours later. I didn’t consider complaining. I’ve also had a family member who was having emergency surgery 12 hours after a GP missed something. I said “missed” but I think we forget they are general practioners, not miracle workers. All that said, giving feedback to the surgery is a whole different ballgame.
Sorry, should have added that I hope your DH makes a speedy recovery.
Yes she should definitely have done a physical examination, however didn’t she tell him to come back if his symptoms got worse? And why didn’t he go back?
Perhaps the first gp should have examined him but at that stage nothing may have come of an exam and his symptoms sound very much like those of a virus. It's the go to diagnosis these days but the reason for that is that they are so common. Quite honestly if as you say he got worse and worse each day, I would have encouraged him to see the gp well before the 7 days. The gp was giving that advice based on a virus and saying if he wasn't better after 7 days return, suggesting the illness would improve over time. I am sorry your husband is so poorly and it is hard not to feel annoyed but I would concentrate on helping your husband get better at this time. A physical examination should have been done but I would perhaps ask why this wasn't the case and have a discussion to highlight this for the future in the first instance. I am sure the GP will be feeling terrible about it.
Oh my goodness. How horrible. Yes, the GP should have examined his abdomen and checked for the Rovsing's sign. I am not a GP but I am married to one and our son had appendicitis. I remember that even DH got it wrong in the first few hours, but as it progressed, appendicitis became more likely and his examinations of our son at home led us straight to A&E
Early diagnosis of appendicitis can be difficult. And in the GP's defense, it is stomach flu season, so given your DH's symptoms, this would be the obvious conclusion.
What exact symptoms did he present to the GP the first time around? Did he have acute pain at that point?
I think you need too speak to a doctor (someone independent) to find out whether it is reasonable for the first doctor to have not identified it. You're (I assume) not a medic so you can't really decide whether they made a mistake or not.
No, she told him to come back if not better in 7 days. He didn’t get worse, he didn’t get better, he felt as bad on day 7.
He is feeling much better now, Sunny. Thanks.
We’ve all had a terrifying glimpse of our mortality.
In your initial post you said he was getting worse each day, so he should have went back before the 7 days really.
That aside, the issue is that you can't say that even if the first GP examined him on the first visit that they would have diagnosed it correctly, as the symptoms and clinical signs at the second visit would have been different (more severe/pronounced).
It does raise the question though - why don't GPs routinely perform clinical exams? As a vet it is imperative that we do full clinical exams for every patient regardless of symptom. I know it's very different to human medicine but I can't even remember the last time a doctor took a stethoscope to my chest, never mind anything else.
Sorry, he did get worse but took more painkillers so the overall feeling was maintained at a constant level.
I did try to get him to go back before the seven days, but he wouldn’t listen to me.
I don’t want to get the first GP into trouble but I was concerned that she didn’t feel his stomach.
If he was taking more painkillers surely he knew he was feeling worse?!
I think you have to chalk this one up to experience. He should have gone back to the GP but didn't. Appendicitis early on does present as a stomach virus. A physical exam would make very little difference.
The initial symptoms sound like a virus. It's virus season. Seven days makes a correct diagnosis much more likely. Most viruses get better after seven days. He didn't so the new doc investigated further (as the original probably would have done). Unfortunate for DP but doesn't sound like a medical 'mistake' tbh. hope he gets better soon!
I think your DH has to take some responsibility for not being proactive and going back when he wasn’t getting any better. You told him to and he didn’t, perhaps a lesson for him to learn?
However yes with abdominal pain and nausea yes an examination should have happened. Even so the diagnosis may not have been made at that point, but advice could have been given about the possibility of appendicitis.
You would be unreasonable to complain - the symptoms you describe sound very much like flu, and it's very possible that the doctor wouldn't have diagnosed appendicitis even with a physical exam.
To be honest, I think your husband is to blame for refusing to go back to the GP/A and E for 7 days when he knew he was getting worse.
Yes op I would complain. Gp should have done a thorough examination. Stomach temp ears throat blood pressure.
I agree with pp's who say DH is partly to blame for not taking your advice and going back sooner
However, perhaps the GP could have a) done a stomach examination and b) been clearer with their instructions - he'd not eaten for 3 days, surely they didn't intend for DH to go 7 more days without eating, and they should have said come back in 7 days of not completely better but if things get worse or you're still not eating come back in a day or two. It may be worth putting in a complaint as an opportunity for the GP in question to improve communication skills if nothing else. I wouldn't put in the complaint expecting anything back from the GP practice but if you don't point out where they could improve they never will.
Why are people saying it’s ops husbands fault? He was told by a professional to come back after 7 days. He was told it’s the flu. He takes meds for the pain thinking it’s the flu.
I think you have to , or in this case your husband , has to take responsibility for his own health . The Dr said to go back if he felt worse and he chose to take more pain killers instead , I doubt the original advice would have been any different if she’d done an examination with the symptoms he presented with . Hope he gets well soon .
But generally, isn't that a GPs stock answer when they don't know what the problem is? Its a virus, go away but come back if its worse in 2/3/5 or 7 days depending on whether the GP believes you about how long they have been ill already?
I think there is a step between a huge formal complaint and a polite letter that makes someone consider and reflect upon their process for the future.
My colleague was diagnosed with swine flu when it was all the rage. 48 hours later he had emergency surgery on his appendix and it took this big hulk of a man 6 months till he was back working full time. The least she could have done was feel his tummy. Mine has been felt for all sorts of reasons!
To be fair to GPs - nine times out of ten this would have been a self-limiting virus. And when patients say 'I haven't eaten anything in 3 days' nine out of ten would mean 'I've only had soup / cups of tea / dry toast. It sounds unfortunate but don't think that a complaint would help. GPs are human beings and it sounds like an innocent error rather than 'negligence'
Well if the GP had examined his stomach, she wouldn't have felt the appendix but she would have noticed him jumping 10 foot in the air when she pushed down.
I would complain. I would have thought best practice would be that if someone presented with stomach pain then it is palpated.
DD's appendicitis was missed for a similar amount of time even though I took her to the GP everyday, who insisted that she was constipated despite me saying she wasn't and constipation doesn't usually cause vomiting a fever does it? We almost lost her too from peritonitis because it had burst. Luckily I ignored the GP who told me to wait for him to refer her to a paediatrician and rushed her to A&E on day 5. He altered her notes when I complained, to say that he had told me to take her to A&E straight away but couldn't produce a letter of referral!
He was told it’s the flu.
Because it sounds like the flu. GPs can't realistically do every check possible on every patient just to be safe. OP has described the symptoms as 'stomach ache' and told us her DH has a high pain threshold. A burst appendix usually presents far more acute than her DH did. I'm amazed that after spending at least a week with a burst appendix, her DH was well enough to walk into the GP's office.
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