Was this a bit unethical for my GP to suggest this?

[TheWholeShackShimmies]

Last month I went to see a GP as I am totally and utterly worn down with everything in my life.

I am 51 and in the depths of perimenopause, I have some decades long health issues (including poor mental health) which have gone crazy over the last few years, I care my my mum who suffers from Alzheimer's and cancer, I work part time as a carer and on top of that I have the normal life stuff such as helping my teens navigate the world, trying to train our previously abused and very anxious rescue dog and finding time to enjoy some fragments of my life with dh. I am frazzled, feel awful every day and have had enough.

Wasn't expecting much from the consultation, we all know we can only get so much across in a 10 min GP consultation and our surgery does have a "one consultation, one problem" policy.

Anyhow, I ended up seeing a new GP and I can honestly say that I thought she was fantastic. She gave me 45 mins of her time which was unbelievable. I got upset whilst explaining everything and she was so kind and gentle and started explaining that in her opinion the NHS is pretty poor at seeing the whole picture when it comes to health issues and as a result she is very much into a holistic approach. This all sounded great until she started telling me all about a natural health clinic in our local city which she is working at and suggested to me that I go to them, she gave me the details of one of the practitioners and said I really should go see her as she will be able to help with all my health issues). I was so bamboozled by it all tbh, it was left it at that and no other help via the NHS was offered.

In my naivety (and desperation) I believed this place was somehow connected to the NHS because she was involved in it but upon further investigations it is an 'alternative' health clinic, the lady she recommended is a nutritionist and not a state register dietician. She also charges £300 for an initial consultation. Tbh, I have spent a small fortune over the years going to see people like this and am still struggling with the same chronic health problems so can't say they have been much help.

I can't help but feel this is wrong. I feel bad saying this because, as I say, this GP was absolutely lovely but I am kind of back to square one now and will have to make another appointment with a gp which will be a least 4 weeks wait.

I get that a doctor may suggested other avenues when someone is looking to treat various conditions but should NHS doctors really be actively promoting places outside of the NHS especially if they have a vested interested in the place they are apparently promoting.

I am not sure what to think tbh but I no that I am in the same position with my physical and mental health right now and nothing has changed so back to square one.

I would love to but simply cannot afford, I had told her that I am currently only working very part time hours due to my health issues but I realise she was just so excited to talk about this place that may have fallen on deaf ears.

I just don't feel I can complain because she was so kind and genuinely seemed lovely. I will see if I can make another appointment with her and explain again that I simply can not afford to visit this private clinic and will hope she could refer me onto the menopause clinic at my hospital and at least try to tackle this issue.

My long term goal would be to feel a little better so I can return to working longer hours and then, perhaps, I could try this place out that she recommends?

She is a registered GP.

She may be being lovely because she's trying to persuade you to sign up to an expensive service she has an interest in!
Or maybe there is an innocent explanation in which case it won't do any harm to tell the practice manager that you're confused and worried about what happened because it doesn't seem to be the usual way GPs behave. They may say: 'Don't worry, the innocent explanation is...' and you'll be happy. Or else they won't, because there isn't an innocent explanation!
Either way I wouldn't go back to that doctor now. Ask to see another GP about your symptoms, and search for reviews for this private clinic or whatever it is. If you're able and willing to spend the money, you might research other alternatives too.

OP don't go back to her! Why not go to a different GP, and go stsight in with the referral request. Sometimes they don't know what you are really after. Maybe (giving her the benefit of the doubt) she thought you wanted to avoid conventional HRT and so were in the market for the clinic she would benefit from

Kerstina I was shocked to see I had been in there with her for 45 mins, I have never experienced that in my 51 years. I have tried various antidepressants for many years but they have all made my gut issues so much worse, I have recently weaned myself off one. I need to try hrt but I have recently been diagnosed with endometriosis and adenomyosis and mum has just been diagnosed with breast cancer. I also suffer from a failed uterine ablation from 2 years ago which causes labour type pains when I bleed so am obviously not keen on taking anything which could raise the risk of bleeding, the GP was hesitant to suggest one which would help me due to these reasons. These are the hoops I am currently going through with the NHS. The gynae department have put me on a year long wait for a laparoscopy and no advice about hrt from the gynae. I am going round in circles.

I didn't mention that I wanted anything 'alternative'. I did agree with her that the NHS will not view a patient as a whole being and will just treat each area without connecting the possible dots (for example my endo gynae refuses to agree that my digestive issues could be related to my endometriosis yet so many endo sufferers have gut issues also).

I mentioned to her that I am at the end of my rope with peri symptoms and this was when she said that she was hesitant to suggest hrt as it isn't her speciality and due to my complications she was unsure what would work best and it was then when she started talking about the private clinic and how this nutritionist lady would be great to go an consult with.

Sadly, it is very difficult to get to see a GP at our surgery. 2 have left and there are only now 3 GPs in an extremely busy surgery. It takes over an hour just to get through to them on the phone and there is a 6 week wait for a routine appointment ( but I imagine this is the norm for most surgeries these days).

The clinic has only recently opened which is why she has been asked to come onboard, I believe.
It only has 6 reviews at present, although they are all 5 star rated.

In an ideal world, if I had money to burn, I would try the place as it may help me but it's a bit of a moot point as I simply do not have the money.

Looks as though I will have to try to get an appointment with the only GP who specialises in female health, which will probably be another 6-8 week wait.

She did spend 45 minutes with you which is great in the NHS. It may be that the consultation was going round in circles, she realised the NHS wouldn't provide the kind of care you were seeking, so she recommended the private clinic and mistakenly thought you were interested in private treatment.

Alternatively she may have just been plugging her private side gig.... But I think that's less likely as it was mentioned towards the end of a long consultation, rather than her mentioning it sooner.

Personally I'd book another appointment with her, say you hadn't realised the clinic was private and you can't afford it, and you are interested in what can be offered by the NHS such as menopause clinic referral or things the GP can prescribe.

I wouldn't complain at this stage as if she made the recommendation in good faith having misunderstood what you wanted, next time a similar patient comes in she will just do a standard 10 minute consult and send them on their way. If she continues to suggest the private clinic after you've said you don't want that then I would raise it.

"She did spend 45 minutes with you which is great in the NHS."
Not if you were the poor person sitting outside waiting to go in next for your own appointment!

Sorry, I am not sure if I didn't explain it fully in my op but she started to mention the private clinic quite early on in the consultation and the majority of the 45 mins was talk about this clinic and how it was being set up, her involvement in it and the various clinicians who were being invited to get onboard with this place.

In all honesty I really wouldn't want to complain about her especially as she is new to the surgery and was just so damn nice, I have never met a GP like her before and would like to see her again and I fully explain that this clinic is out of the equation for me and hope she may be able to refer me on to the menopause clinic at the hospital.

This did concern me and I did say to her that I was sorry for taking up so much time but she said the following patient hadn't shown so not to worry but I imagine the others must have had a long wait too!

Is there a conflict of interest? Does she actually have a financial interest in the centre or just work as an employee there or have a private practice there? Is it a even a company or are they just consulting rooms that practitioners can hire? The natural health clinic near where I live is a charity. If she doesn’t actually gain from the referral, it isn’t unethical.

Is what she’s suggested doing/seeing evidence based for your health condition or is it a load of twaddle? Agree she shouldn’t be promoting her own business interests/friends.

I just came on to say I hope you find something to help and there are probably many of us that hear you ❤️

I went to the GP on Monday with the same issue 5 mins later I was sent away with an app to help me sleep 🙄and an underlying message of perimenopause is normal get on with it. I do think your Dr was unethical but it must be a difficult balance for you as she was kind and listened. Perhaps some of what she said can be implemented without spending hundreds? I have been trying to look at vitamins to see if any of them actually do help but separating the fact from the fiction is quite difficult - I have no advice but just take care of yourself x

A few have mentioned hrt but I should have mentioned in my OP that I have endometriosis and adenomyosis. I also suffer from the effects of a failed uterine ablation so any bleeding now causes me a lot of pain. My mum also has breast cancer. My gynae has told me hrt will probably exacerbate most of my current issues, so hrt may be a bit of an issue atm unless I can get to consult with a hrt specialist.

As far as I am aware from googling it, it is a private clinic, they charge quite a bit for consultations and treatments so I can't see that it is running as a charity. I really don't know if the GP has any financial investments in the place?

I do wish there was a charitable run natural health clinic near to me though.

I am in the depths of perimenopause, I suffer from awful gut daily issues (have had endless tests for these), have endometriosis, adenomyosis and a failed uterine ablation. She was suggesting I see a nutritionist and perhaps going on to have reflexology/acupunture etc, that type of thing. Standard alternative health stuff.

if she is making money from it in any way she should not be suggesting it.

Thank you so much ❤. I am sorry you are struggling too. I know it is so hard for health professionals at times but it does feel as though we are banging our heads against the wall all the time doesn't it?

I do try to take a holistic approach to everything with healthy eating, drinking only water, sleeping as well as I can, exercising etc. I need to look into some supplements, I think I am low on some minerals.

My understanding is that the NHS were starting to embrace homeopathic medicine for certain conditions.

45 minutes is FIVE appointments worth so I kinda think you should have covered traditional medicine routes and maybe there weren’t any for you? I mean I think after than long your doctor would have a full grasp of the situation.
Maybe those weren’t right for you or wouldn’t have helped you?

I get it’s standard alternative stuff…..but are there scientific papers saying what she’s recommending works for those conditions? Dd has endometriosis, I’m not really sure how a different diet could help but maybe I’m wrong. I’d hate to think she’s tak8ng advantage of peoples desperation to get fixed. And if there is evidence saying stop eating x foods shouldn’t she be telling you this?

sounds like she’d be better off referring you to a gynae consultant to discuss options.

www.worcsacute.nhs.uk/documents/documents/patient-information-leaflets-a-z/diet-and-endometriosis-2/ www.worcsacute.nhs.uk/documents/documents/patient-information-leaflets-a-z/diet-and-endometriosis-2/]]]]

so Worcester hospital trust have a leaflet on diet, did the GP give you any such advice or tell you to pay £300 for this advice?

She wasn't promoting homeopathy (NICE doesn't recommend this btw). It is one of those health clinics with several different practitioners offering various treatments so a nutritionist, a reflexologist, acupuncture, b12 injections, food allergy testing etc.

Nothing stated on the NHS website, they say these things may help alongside standard medicine but they don't promote it.
I saying that, it does interest me as I follow quite a few endo sufferers and several have been trying the anti-inflammatory diet and are seeing improvements in their pain.

I am already under the gynae department but stuck on a year long wait for a laparoscopy. The gynae there can not recommend any particular hrt because he isn't an expert.