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.

No GP or any gynae including my new endo gynae have suggested any kind of diet or have given me any leaflets. I do follow me own diet from stuff I have gleaned from the internet, in the hope of eliminating the pain etc.

Thank you for the leaflet.

I would be so grateful to a GP who listened and suggested alternatives. I have never had any advice from MHS doctors other than to stick with the (nonexistent) care they offer. Our doctor told my 14 year old son that the physio offered on the NHS would be just as good as anything we could find privately and there was no use paying a lot of money. The physio offered by our GP practice was a pathetic joke, and the private physio solved my son's problem.

If the doctor had said right away- we can't offer much, but it is worth paying for a sports physio, we would have got help a year earlier.

Utterly unethical and should be complained about? Was she Indian by any chance? The last two Indian HCPs I have seen started to go down this route, before I gave them short shrift. My friend with Indian parents says that approach is common there, with there being no NHS.

NHS Director here. The GP was promoting her private practice. This is not allowed and she's breaching policies and codes of practice. She needs referring to the GMC which can be done online.

The NHS is free at point of entry and treats everyone the same. By signposting you to private clinics and ones she works at creates a two tier system - the ones who can afford to access and those who can't = unethical. Secondly she's promoting here private company for pers9nal gain - profit. Thirdly people are vulnerable when they are ill and could be more easily parted with money than when they were in full health.

Please report her to GMC and let them sort it out. She knows she isn't allowed to do this, its the basis of her NHS practice. I've dealt with this before - its very straight forward because the rules are very clear.

But sadly, not everyone can afford to go anywhere for private healthcare, I can't.

Although I agree with you. My son has a problem with his knee, he received one NHS physio appointment and was told there wasn't a lot they could do for him. He went to see a private physio who has helped him so much he is no longer taking pain relief and no longer wears his knee brace.

Having previously been a NHS employee I agree with everything you say but I really feel hesitant to do this, she was so nice and I have never had anyone on the NHS offer me the time that she did. I am hoping it was a one off maybe?

I would like to make another appointment with her to clarify the fact that the clinic is off limits for me due to lack of funds and hope that she may be able to refer me to see a hrt specialist.

Many years ago my go suggested acupuncture for my migraines. I thought he meant privately and would have been concerned but he was offering it as my nhs gp.If your gap believes this nutrition will help you , she should be advising in her nhs session. My acupuncture did help with the migraines short term.

I know that not everyone can afford to pay, but everyone should be offered the information that paying might get you more personal care or better care in certain cases. Telling people: 'there is no better care available' because not everyone can afford it, or because of guidance from the NHS is really awful, in my opinion.

My neurologist recommended I tried a daith piercing, acupuncture around my neck and ears and Botox for my migraines.

Basically the NHS meds he gave me made me suicidal & “extreme low mood” was one of the main side effects! It was horrible. And he genuinely wanted to help me feel better (once those meds were in the bin!!)

He knew I was struggling at work and he had booked me in for an MRI but suggested the things above while I waited.

I can honestly say he improved my daily life so much. Everything suggested helped a bit and collectively changed my life. I’ll be forever grateful for his open mindedness.

however, if he was to receive personal financial gain from it I would have been a bit suss.

I’m not sure OP but I feel it’s a bit naughty to sell your services to someone who may be a little vulnerable! And that doesn’t sit right with me at all.

No problem. If diet is helpful I’m sure there’s stuff you can look up without paying £300 for an appointment. Dd’s gastro consultant btw says allergy testing is a waste of time. We’d paid about £300 for a private test! Dd has her laparoscopy next week for endo.

The thing which we only just found out about and wish we’d known earlier was that our local hospital isn’t a specialist hospital for endometriosis (I didn’t know some were) and any gynaecologist there will just do a bit of laser removal if they see anything. But excision surgery is gold standard and you have more chance at a specialist hospital of stuff not being missed. I wish we’d known a year ago so she could have asked to be referred to a specialist hospital.

Could it be part of their social prescribing network?

There is so much about endo which they just do not inform the patients about. My hospital is a BSGE accredited endo centre but I can't say they are that great tbh.

That was exactly what my post said! If she is making money from the referral or gains in another way, it would be unethical. If there is no financial or other benefit to her, it is not unethical.

OP, are you sure that the centre is not just consulting rooms that are rented out to practitioners? I wouldn’t assume the GP has any financial interest in referring you. There is a big difference between promoting her private practice and recommending a professional (for genuine reasons) who just happens to rent rooms in the same building.

I don't think so. My mum is with the same surgery and has a social prescriber, the GPs tend not to get involved with that and will pass everything over to her. I have not been offered an appointment with her.

That could well be the case, I am not sure tbh. She was telling me about the clinic which was then opening and how she has been asked to come on board but didn't really go into depths about her actual involvement.

Our GP recommended private councelling for our DS at £200/hour!!

Different situation as he was trying NHS and getting a terrible service plus the GP was not connected in any way to the private councelling (she had other patients that rated the place highly)

That was the price 15 yrs ago too so heaven knows what it is up to now!

I would say "asked to come on board" would be enough to mean that she shouldn't be suggesting it to someone who is registered at the practice. Its not quite a "financial interest" but blooming close.

I would love it if GP’s could refer us to private clinics and the NHS paid. Think it would help everyone. I have recently been diagnosed with inflammatory arthritis and on,y treatment long term seems to be s drug called Methoxetrate? I wish I could have acupuncture or referrral to a specialist dietician .

Surely that's unethical and a conflict of interest?!
She's basically saying the nhs can't help but I can if you pay £300
Nutritionists aren't registered
Dieticians are and can be referred to on nhs if there is clinical need
I would personally research supplements that MAY help and try
She sounds very kind, but actually spent beyond allotted time in your appointment. Imagine the build up in the waiting room!
I'm not sure I'd report to the practice, but I certainly would not see her privately.

So she refused you the NHS standard care you're entitled to in favour of making the clinic she works at hundreds of pounds?

I think she was probably trying to help you. Don't get me wrong, I'm not really a believer of alternative therapy but it does work for some people.

I worked in with a charity were we would offer alternative therapies as a relaxed mind can make a massive difference for some chronic illnesses and help some as much as the medication. I wouldn't dismiss the the GPs advice completely or think it was wrong, I genuinely feel she's trying to help you and not extort money from you.

People describe holistic treatment as a bit woo but do you just want to treat the disease or tackle what might be contributing to dis ease in your body ?

I'm not sure. I do however like it when gps are honest about what is available through the nhs and suggest other routes to try. I have discussed alternative therapies and private only treatments with my GP and really appreciated the 'off the record' advice. I think they need to be careful how they say it but I don't think it's necessarily a terrible thing to do.

Why are you wasting time and energy on this?

Surely you need to focus on your health and not if it's ethical or not.

It's your health that's more important isn't it?

People are always lovely when they want you to spend a fair amount of coin.

Go back, tell her you want to be referred to a menopause specialist with a view of getting your peri under control. There's no point in going just to offload everything that's going on. It just muddies the water a bit.