To loose my shit at my GP?

So a totally different scenario to the OP?

I also guess different areas may have different rules regarding whether it’s the responsibility of the gp or the consultant, or even what the condition is/what oversight is needed might make a difference.

Dh is on steroids for a rare autoimmune disorder, literally 2 in a million people worldwide get it. All his care is at the hospital, regular appts, blood tests, the consultant prescribes the steroids. Which are a licensed/recommended treatment for the condition. But the GP will have never seen it before, he won’t be the best person to manage dh. A friend is on the same steroids for a different condition, much more run of the mill and the same GP prescribes them and oversees care.

Not comparable as Viagra is not an off-licence drug when prescribed for erectile dysfunction.

Losing your shit is the best way of being without a gp.
They shouldn’t have to tolerate abuse.
Why don’t you lose your shit with your consultant?

I think you should have contacted the GP to say why you weren't doing it and to educate them.

Yes & Sometimes general uselessness in numerous other concerns too💚😥

I know one of my local practices has started doing this as well. Won't take over private prescriptions (for hormonal treatments or for mental health even if very normal) and won't even do shared care with NHS consultants. I don't even know how the latter is lawful.

My DH has eye drops that were originally prescribed by the hospital. According to a lot of people on this thread (and the other local surgery, thankfully not ours) the GP should not prescribe them because they are not eye experts. That seems bonkers to me. I can't see why a GP can't follow the instructions of a specialist unless they actually think it would be actively harmful to the patient, in which case they should contact the said specialist and talk to them and then decide whether to prescribe.

It's honestly not worth pursuing. The consultant needs to prescribe it for you if they feel it is the right medication.

I was a physio, and would get various requests from doctors that I perform certain procedures that I did not agree with because of the dangers or lack of evidence. I was therefore obliged to not do them.

Had I 'followed instructions', as you want your GP to do, and thus caused harm to the patient, then I would have been held responsible. More so than the requesting doctor, because as a physio, I should have known the problems with the procedure.

Your GP is in the same position, hence the letter.

I wouldn't sign my name to something or expect someone else to that didn't feel comfortable doing so.

Randomised clinical trials of testosterone to date have not demonstrated the beneficial effects of testosterone therapy for cognition, mood, energy, and musculoskeletal health.

This is correct but they haven’t added that at present the nhs can only prescribe testosterone as HRT for loss of libido. So asking for any other reason won’t be accepted.

The GP argument about not being trained to prescribe hold no water, you have been assessed by a menopause specialist who thinks you may benefit. GPs could never have specialist trading in every medication. That’s why a specialist makes the decision and asks the GP to prescribe and monitor.

If you want to pursue this with your current practice then I would write to the practice manager in the vein that of course you understand that the GP may have not been trained but the gynaecologist has and is recommending it so how best might we move this forward? Within any practice there will be one or two doctors who are more willing and interested.

If they absolutely refuse it might be easiest to go privately or move practice (ask around).

But remember you want it in order to improve your libido, nothing else.

The gp's letter seems fine to me. Their argument seems reasonable.
I guess you need to contact the hospital and ask them what they will do now.

You would be massively unreasonable to “lose your shit” at your GP. That’s never appropriate. There are lots of medications GPs don’t prescribe. You need to understand how much they are responsible for their own prescriptions and the consequences for them if it goes wrong. If you can’t get it through the GP, then you’ll need to keep getting it through whoever prescribed it to you first.

As if there haven’t been enough scandals about poor care, massaged figures and dramatically increased costs of privatisation 😔 It’s the PPE scandal in plain sight

The shingles vaccine is available privately in Scotland and England. I paid for it recently. Shingles can be very painful and recent studies suggests that those vaccinated may have lower dementia risk.

I'm with the GP on this ours haven't the time to monitor.

Doesn’t a GP have a personal liability for prescribing? So they have the right to refuse. Which they have. I don’t see it as dismissing women’s issues.

I take an off licence medication, specialist did the initial prescribing/supervision and my GP now prescribes it but won’t make any changes without further instruction from the specialist. It’s the way it works.

please don’t “lose your shit” at your GP (unless you want to have no GP).

Agree with this

You said the testosterone had been prescribed by the specialist - but it’s not clear from the rest of the message if that is actually the case?
Specialists ought to be initiating pretty much all medications that they advise - including titrating to optimum dose, monitoring for side effects. Once stable some GPs would be happy to take over prescribing of testosterone, some would ask the specialist to continue as it’s off licence.
The majority of GPs will have had no training in testosterone as menopausal HRT - if it were me I would definitely prefer to have a specialist overseeing the initiation and dose titration.

It’s a request. Not an instruction. As an independent practitioner accountable for their practice they are well within their right to say no. More dumping of work into primary care.

You are within your rights to be frustrated, but losing your shit at your GP is not the right response.

I do believe you should be taking this up with your gynae, who like others have said, should be the ones prescribing.

I absolutely agree with your GPs letter, and any time I have been prescribed something by a specialist, they kept me on their books until they knew I was getting on well with the prescription before referring me back to my GP to prescribe.

Your GP is showing care for your health and wellbeing, this is agood quality.

Hang on in there.

Occupational hazards and all that!

I think that’s a fair response. For some people it can have permanent side effects such as a low voice.

It’s about accountability, who are you coming after if these SE appear ? Then they won’t be covered by their indemnity and pay personally out of pocket.

Blame the litigious society we live in.

If you went to a private menopause specialist could you not just self fund ?

Not to mention if the OP had actually ‘loosed’ her shit (to quote exactly) - which would literally mean crapping all over the GP surgery floor…

We're in Wales can't get the shingles vaccine until 70. Asked my GP if I could have it privately. Apparently not.

And what else do we need to become experts in?? This is specialist treatment and off licence so the specialist should prescribe. The clue is in the "G" of GP "general" ie run of the mill stuff not specialists treatment. In 34 years as a GP the amount of stuff transferred into general practice is exponential. We can't be experts on everything, we aren't insured if something goes wrong with these off licence prescriptions. Instead of getting cross with the GP why not get cross with the specialists who just want us to be their dogs bodies on prescribing without any consideration to our job, training or responsibilities.
General practice sees far more patients than secondary care and in Scotland the budget for general practice has more than halved in the last 10 years. We cannot be experts in everything.

I’ve recently been prescribed testosterone by my GP post bloods showing suboptimal levels but they can only prescribe it for loss of libido according to her. I have blood tests every 3 months.