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Original poster

If I make a complaint about my GP refusing to prescribe medication

283 replies

Sconesandgravy · 09/04/2024 18:32

My neurologist asked the GP to prescribe a medication to help with a medical condition. The medication is one can cause birth defects. I spoke to the pharmacist this morning who called to say she was putting the request through to the GP. The pharmacist messaged that afternoon to say the GP has refused to prescribe unless I go on hormonal contraception or the copper coil. He has claimed that guidelines say he can't prescribe if I refuse the above types of contraception.

I want to complain about this for several reasons:

  • My husband is completely infertile. He had multiple samples of testicular tissue biopsied and it was confirmed he has a condition that means his sperm count will always be 0. The only way I'm getting pregnant is with a sperm donor. I obviously can't do this by accident. The pharmacist made the GP aware of this because she called me this morning and said contraception is recommended, so I said I'm not on contraception and disclosed about my husband.
  • I checked the guidelines myself. NICE guidelines state the need for effective contraception must be expressed. The BNF says effective contraception must be advised. On gov.uk there is a 2022 safety review of the medication that states health care practitioners "should fully inform the patients of the risks and advise them of the need to use highly effective contraception". Nowhere specifies what contraception should be used, and none of the above bodies specify that medication should not be prescribed if long term contraception is refused. The only thing I can find is that alternative medications can be offered if the medication is long term and the patient doesn't want to use any form of contraception.
  • Condoms and abstinence are also effective forms of contraception. If I were a man these would be recommended as they're the only available form of effective male contraception. It seems discriminatory to suddenly decide they're not considered effective contraception just because I have a vagina.
  • I'm an adult with full capacity. I have the right to make an informed decision about what I put into my body.

In all honesty it just feels a bit like the GP has refused my prescription and intentionally given me misinformation about the guidelines to try and coerce me into going onto a contraceptive that he deems the most effective, rather than allowing me to make an informed decision based on my own personal circumstances. I know this is dramatic and I won't put that in my complaint but I just needed to get that thought out of my system

AIBU if I complain?

OP posts:
Original poster
Sconesandgravy · 09/04/2024 19:54

Icannotbudget · 09/04/2024 19:03

OP if its sodium valproate the guidelines have recently been hugely tightened and any Doctor prescribing has to personally be as sure as its possible to be that pregnancy will not occur whilst the Woman is on the medication. They are personally accountable for their own prescribing decisions and leave themselves liable to being sued if a child with a birth defect is born- it’s taken as seriously as thalidomide which is still prescribed for certain conditions. They cannot take your Husband’s infertility as reassurance unfortunately as of course theoretically you can still get pregnant with someone else. The issue of you capacity is largely irrelevant in this situation as its the potential unborn child who is being protected and not you.

It's not sodium valporate, it's topiramate.

I don't know if you've seen but I've explained further down that my husband has spina bifida and my daughter has a congenital heart defect, so I'm well aware of the impact of birth defects, and really wouldn't do anything to risk it.
I know the GP isn't obligated to believe me, but please know I happily be abstinent for the rest of my life if it meant preventing another child going through the things my daughter and husband have been through.

FWIW my daughters heart defect wasn't caused by medication. It was bad luck.

OP posts:
PrimalLass · 09/04/2024 19:54

Just get prescribed the pill and don't take it

Citrusandginger · 09/04/2024 19:53

Blistory · 09/04/2024 19:20

No GP is personally responsible for a patients pregnancy unless he inseminated her himself.

It's the GP's role to outline the risks and to obtain a disclaimer if they wish. It's is barbaric to refuse a female patient medication for her current health on the basis that it's risky to an as yet, non existent and may never be conceived, foetus.

Women should not be treated as 'pre-pregnant' or as if their capacity for pregnancy outweighs their health needs. Her interests always come first and as long as she is fully informed, she has the right to make her own decision on the risks she is prepared to take and whether she wishes to use contraception.

This. Women really are still seen as mere baby carriers at times.

Shall we imagine for a moment a scenario where a man cannot be prescribed a medication for his health because it might cause defects in a child he were to impregnate a baby carrier?

Anotherdayanotherdollar · 09/04/2024 19:52

DetOliviaBenson · 09/04/2024 19:37

But she's already stated she can't get pregnant because her husband is infertile! So she doesn't need the pill.

Show quote history

I didn't say she needed the pill! The OP said

"Condoms and abstinence are also effective forms of contraception. If I were a man these would be recommended as they're the only available form of effective male contraception. It seems discriminatory to suddenly decide they're not considered effective contraception just because I have a vagina".

My point was that if a woman is taking a particular drug for let's say 10 years, that's 10 years in which her eggs are being exposed to the drug. Sperm only lives for a few days. If a man is taking the same drug for 10 years, his sperm will only have a few days exposure to the drug. So sometimes things just aren't the same for men and women!

ActualCannibalShiaLeBeouf · 09/04/2024 19:50

Notthatcatagain · 09/04/2024 18:53

I cared for a lady who became pregnant while taking drugs with a very high risk of birth defects, sadly her pregnancy was terminated. The doctor who had prescribed them was beside himself over it. From then on he was incredibly strict about all his patients being on contraception before he would prescribe, no exceptions, ever.

How do you know so much about what someone else's doctor prescribed and who to?

ThePure · 09/04/2024 19:49

I really do not think your GP wants to force you to take contraception and obviously they cannot but they are required (legally in the case of valproate and tretinion) to get a signed disclaimer to say that you understand the risks, were offered contraception and declined and you accept any consequences. It really isn't too much to ask. The new MHRA valproate guidance came into force on 1st Jan this year only so possibly whatever NICE guidance you read could be out of date.

Everydayimhuffling · 09/04/2024 19:48

Though, yes, you could accept an accompanying prescription for the pill and then just not take it. However, that's only worthwhile if the GP is willing to prescribe both together without seeing you for an appointment.

Original poster
Sconesandgravy · 09/04/2024 19:47

twitternotx · 09/04/2024 19:36

oh yes - and why aren't you angry with your neurologist? Because of course it is a contractual obligation that they give you enough medication until your GP has agreed to take over. Which s/he didn't do.

Oh believe me I am angry with the neurologist. For many many reasons.

I did ask him to prescribe the first month of medication. He refused and said it's the GPs responsibility.

In fact, the neurologist has been an absolute nightmare from day one. Last year he didn't tell me about an abnormal brain MRI nor that I needed an urgent lumbar puncture within 4-6 weeks. I found out about both four months after my MRI when my husband told me there's a new app where you can access hospital records. There was a half written report stating all of this. When the lumbar puncture came back clear, he refused all requests from the GP to expedite my next follow up claiming it was trapped nerves and that lots of women get them. It took me emailing videos and threatening PALs to get him to see me.

He saw the videos I sent and said I needed to be seen the next day because he was concerned. I had other episodes and the GP requested he do a spine MRI. Neuro rejected it. I was rushed to hospital last week due to a medical episode and a registrar contacted him to request a spine and neck MRI as he's in charge of those and she figured he'd accept from her. He's also refused those because he disagrees with both the registrar and the GP about the cause of the issues, even though they both agree it's the same thing despite not having communicated with each other and having seen me weeks apart.

I will be requesting a referral elsewhere once I can actually speak to a GP, but that will still potentially leave me without meds because the waiting list is over a year where I am (which is why I didn't ask sooner).

OP posts:
TheSnowyOwl · 09/04/2024 19:47

So you wait three weeks and get the appointment or else you go back to your neurologist’s PA and ask for a prescription that way.

Regardless, complaining is something you should be doing once you’ve properly attempted to speak with the two doctors concerned and even then, you GP is well within their rights to refuse.

Everydayimhuffling · 09/04/2024 19:45

I would certainly ask to see another GP or the practice manager to discuss it with them. I wouldn't frame it as a complaint unless I was unable to speak to anyone at the surgery.

romdowa · 09/04/2024 19:44

Sconesandgravy · 09/04/2024 19:09

In response to everyone saying enter into dialogue with the GP - I would if I could but I have no way to.
The practice only sends one way messages via text with no way to reply, I asked the receptionist if I could book an appointment or get a message to him, he isn't available for 3 weeks.

GP also stated on my records that I've had a conversation with the pharmacist about my reasons to decline contraception and he's decided it's inappropriate to prescribe until I agree to a contraceptive. So I'm really not sure what else I can do other than complain.

Agree to a prescription for a contraceptive and then just don't take it ? It's the easiest thing to do all around really. The gp will never know and you'll get the other medication

DetOliviaBenson · 09/04/2024 19:44

twitternotx · 09/04/2024 19:40

um, there are other men in the world.

Show quote history

Oh, right ok. So what you're saying is all women are slags and can't be trusted to not shag any man out there.

DetOliviaBenson · 09/04/2024 19:43

twitternotx · 09/04/2024 19:40

If you are wanting a doctor to put their registration at risk by prescribing you a teratogenic drug which has strict legal conditions, then yes, you need to be on a contraceptive. That's the law.

Show quote history

The law says women need to be forced to take a hormonal contraceptive in order to access the medication they need, really? Can you link to the wording of this law? Because I find it hard to believe that in the UK in the 21st century the law requires a woman to be forced to medicate herself against her will in order to access the treatment she needs!

Notellinganyone · 09/04/2024 19:43

Medicine is notoriously patriarchal in so many ways. This is one of them. If I were the OP I would ask GP again in writing citing NICE guidelines- if he still refuses take it further.

Grannyhasthemoozles · 09/04/2024 19:42

@prescribingmum 👏🏻👏🏻👏🏻

they’d soon complain about the GP if a pregnancy was to happen which had to be terminated or baby born with severe disabilities.

this ‘stamp my feet and complain’ culture is one of the things I find most difficult in our jobs and it’s so draining!

twitternotx · 09/04/2024 19:40

DetOliviaBenson · 09/04/2024 19:37

But she's already stated she can't get pregnant because her husband is infertile! So she doesn't need the pill.

Show quote history

um, there are other men in the world.

Original poster
Sconesandgravy · 09/04/2024 19:40

Balloonhearts · 09/04/2024 19:22

I did a quick Google and what immediately came up was high risk of neural tube defects. I can see why he doesn't want to risk prescribing it without you being on contraception and he is within his rights to do so.

The husband infertility thing is a red herring, marriages do end, people do have affairs, he can't take chances and make a judgement call on the likelihood of this happening, he doesn't know you.

Neural tube defects can be horrific. Anything from a cleft lip to spina bifida or even holoprosencephaly. Google an image of a child with Cyclopia and I think you'll understand. If you are currently pregnant or don't have a strong constitution I suggest you do NOT Google cyclopia. Its not a sight you'll forget in a hurry.

Firstly my husband's infertility is actually caused by the fact he has spina bifida. He's one of the 75% of men with the condition that are infertile. I didn't mention it in the original post because only the infertility is relevent. But I am well aware of how awful neural tube defects are.

My daughter (not his obviously) has a congenital heart defect. I live with and deal with the consequences of birth defects every day.

Also as an aside. I'm a competent adult. If I were to get divorced and be in a position where I could get pregnant accidentally, I would obviously be happy to go on the relevent contraception. But I'm not divorced, and I can't fall pregnant without fertility treatment.

OP posts:
twitternotx · 09/04/2024 19:40

DetOliviaBenson · 09/04/2024 19:39

Jesus! This is like saying I should be taking the pill even though my husband had a vasectomy, you know just in case I happen to land on some random's erect penis! Fucking hell!

Show quote history

If you are wanting a doctor to put their registration at risk by prescribing you a teratogenic drug which has strict legal conditions, then yes, you need to be on a contraceptive. That's the law.

DetOliviaBenson · 09/04/2024 19:39

twitternotx · 09/04/2024 19:37

oh and BTW, blood group studies show that at least 10% of the population aren't fathered by the person that they think is their dad. so your husband's fertility is irrelevant......

Jesus! This is like saying I should be taking the pill even though my husband had a vasectomy, you know just in case I happen to land on some random's erect penis! Fucking hell!

TidyDancer · 09/04/2024 19:38

I think you're unreasonable to complain without first having spoken to the GP, which I do appreciate is difficult given your update. At the moment the GP is getting second hand information coming at him from both the neurologist and the pharmacist. He's not heard anything from his actual patient. The system is not patient friendly at all at times but I think the GP is actually acting quite responsibly in the circumstances.

DetOliviaBenson · 09/04/2024 19:37

Anotherdayanotherdollar · 09/04/2024 19:33

The pill won't protect her eggs, it will prevent her potentially defective teratogenic eggs being available for her to become pregnant

Show quote history

But she's already stated she can't get pregnant because her husband is infertile! So she doesn't need the pill.

twitternotx · 09/04/2024 19:37

oh and BTW, blood group studies show that at least 10% of the population aren't fathered by the person that they think is their dad. so your husband's fertility is irrelevant......

twitternotx · 09/04/2024 19:36

oh yes - and why aren't you angry with your neurologist? Because of course it is a contractual obligation that they give you enough medication until your GP has agreed to take over. Which s/he didn't do.

LunaTheCat · 09/04/2024 19:33

I am a GP.
You need to go in and talk to GP.
There are some medicines that I absolutely cannot prescribe to a woman who may become pregnant without signing a declaration that they have adequate contraception.
GP’s are not supermarkets.
It really gets my goat when specialists do this - ask for GP to prescribe without any discussion.
I have been told by specialists to prescribe things that are wildly inappropriate for a particular patient given their history , my knowledge of their circumstances and other medication.
GPs are often more aware of drug side effects and contraindications than a particular specialist.
Please see your GP and have a conversation— and I really hope it helps. 😁

Anotherdayanotherdollar · 09/04/2024 19:33

DetOliviaBenson · 09/04/2024 19:27

But if the medication is going to effect her eggs, surely it will effect them even if she's on contraception. How is the pill going to protect her eggs? Confused

Show quote history

The pill won't protect her eggs, it will prevent her potentially defective teratogenic eggs being available for her to become pregnant

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