To think the gps at my surgery shouldnt advise patients on things they know nothing about?

[Koothrapanties]

Dd has bad reflux and cows milk protein allergy.

It took months to get her a diagnosis and this was only once she was so ill she was admitted to hospital with blood in her poo and every other symptom on the list. She was in a very bad way. I had gone to the gp again and again, but had been dismissed as a hysterical first time mother.

She was put on domperidone, gaviscon and nutramigen (special milk) by her paediatrician and has been thriving ever since, still very sicky, but much better.

We had to go to the gp to get her medications on repeat prescription and were told by the gp to get her off of domperidone because it was an antipsychotic and very dangerous for her. We tried to wean her down on it but she started projectile vomiting again and was losing most of her feeds. Spoke to the paediatrician who was very cross that the gp had meddled and explained that what she had said was rubbish, and explained any side effects domperidone can cause.

I saw another gp for myself today and quickly asked him how to arrange dd's change to the next stage of nutramigen at 6 months. He told me to give her cows milk because nutramigen is not nutritious enough apparently?! I told him that the paediatrician had said not to even try to introduce it until after 12 months as she had such a bad reaction, and The gp didn't seem best pleased.

The last gp I saw for my pelvis problem also told me I have a problem with my ICG joint, which my physio has told me doesn't even exist! They were all laughing at the letter she had sent to them which made no sense apparently.

This isn't good enough surely? I understand GPs aren't experts in every area, but they shouldn't be giving out dangerous advice like they have for my dd! If they don't know, then surely they should leave it to the specialist dealing with the problem? Aibu?

YANBU, we had the same palarva with our Ds. We have a friend who is an orthopaedic surgeon and he says that GPs are just Jack of all Trades, so for anything more complex than the absolute basics you should just view them as a referral service to a dr who knows that area of medicine.I've had a mixed experience with fantastic GPs who are quick to identify symptoms, provide support and press for referrals and hopeless ones. The worst spent the entire appointment telling me off for being 3 minutes late and that he couldn't possibly look at my baby. Ds was on my knee screaming in pain and vomiting!

I agree that it's only a minority who are crap, but GPs need not to take this so personally! I'm a civil servant and we get bashed in the media and on here, but since I know I do a good job I don't see those comments as being aimed at me.

And I know there are crap civil servants as I have met them! Why do other professions seem to want to turn a blind eye to bad practice in their colleagues?

I also agree that being a GP is not harder than the other professions.

I work in a hospital specialty and so deal with GPs a lot. I think the problem is that it's a really bloody difficult job to do well but actually a very easy job to do badly and get away with. Because of the recent changes in training doctors contracts, pay and training in hospital a lot of people are now choosing to be GPs for the lifestyle rather than because they care about it and will be good at it I would love to do it for the weekends off no nights and easier childcare but I'd be crap at it . They do 18months training in 3 hospital specialties and then 18m in a GP practice and in this time are expected to know everything about everything as opposed to in hospital specialty training where you train for 7/8 years minimum to learn only about your area. Being a good GP needs a shit load of work, knowledge, compassion, patience and extra work done and the ones that are good are worth their weight in gold.

Lots of the problems listed come from mixture of ignorance and arrogance. Nobody expects a GP to know everything but if they don't they should be honest and tell the patient that and find out rather than using half knowledge and guesses passed off as treatment.

I think if, as in the OP, a doctor is handing out dangerous advice then complaining is absolutely the right thing to do. Most good doctors would much rather know they were wrong about something, apologise and change it to prevent potentially harming someone else than carry on regardless but without a complaint.

Being a doctor is a bloody hard job and currently made harder by the press, bad attitudes, suspicion of patients and often no support from senior management and employers. It isn't made any easier by bad doctors causing us all to be tarred by their brush.

I meant to add that having worked as a GP receptionist I know how easy some of them have it. One of them was an alcoholic who couldn't work in the afternoon. Everyone knew but no one did anything about it.

As a paediatric nurse married to a GP I absolutely agree with Betty's post above.

It was that sort of attitude that has led us to be registered also with a private GP. If we think the NHS will fob us off, we go there. They are AMAZING - look things up if they're not sure, will phone a specialist and ask if that doesn't give an answer. They listen carefully to what you tell them, and credit you with a brain of your own! Repeat prescriptions are a doddle too - phone up on the day and pick them up later!

I agree they obviously won't know everything and no one expects them to. Allergies, intolerences, eczema, asthma, though are regular childhood problems. And so serious to get wrong. Leaving adults permanantly damages internally from missing it/dismissing it.

I do think that perhaps extra training on these things would be a good idea. People end up with SS involved after frequent hospitalisations as a result of these things going undiagnosed.

Betty it must be very frustrating knowing you are doing a good job, but others aren't, causing more distrust towards doctors.

Zirca I wish we could go private, but it's completely unachievable for us :(

Giles I worry now that if I take dd to the drs for anything they will see I have taken her so many times and get ss involved. I read on here about a woman being investigated because she took her dc to the doctors too often and it has stuck in my mind. It's not my fault it took them all that time to diagnose!

I'd have thought that eventually it would save the nhs money. I know the formular a are expensive but so is a hospital stay, constant appointments, wasted unneeded medication, anti Ds for the distraught parents etc. Better to spend the money on them young while the body heals quicker and changes so much that there is more hope of these things being grown out of (not all obviously some are life long) but if children grew up healthier or would cost less in long run. People loose jobs through bad attendance, child care won't take poorly children as allergy based or not vomiting child is off for the 48 hours after.

It happened to a friend of mine too. Luckily one visit and it was over they saw no reason to be concerened but I realise how easily that could have been me depending on how dd did if I hadn't begged for the formula.

It's so unfair on parents who are innocent of any wrong doing but can't get a dr to listen.

for everyone on this thread who have suffered so much more than I did. :(

One thing that reassures me is that my hv is awesome. I know they sometimes get a raw deal on here, but mine has been a fantastic support. I know if ss were to ever get involved she would stand up for me until the end of time. She has told me repeatedly what a fantastic job I'm doing with dd and how happy and healthy she is now she's better. I can't sing her praises enough, she is amazing at her job.

"Why do other professions seem to want to turn a blind eye to bad practice in their colleagues?" In my experience there are very very few professions where that is the case. The medical profession is the most salient example, where that attitude is universal, it seems.

:) glad to hear that krooth

Consultants also don't know everything as well as GP's we sadly found out to our detriment.

Medicine has a lot to learn, and from what I can see even when there are breakthrough idea's it is a two pronged problem, very difficult to get that information out there and even harder to get other's to accept they have been mistreating patients and they have to change their practices.

Lots of the problems listed come from mixture of ignorance and arrogance. Nobody expects a GP to know everything but if they don't they should be honest and tell the patient that and find out rather than using half knowledge and guesses passed off as treatment.

^ This is so very true. I respect those who admit they don't know enough about our condition rather than those who have no clue and pretend they do. It has become a running joke now in our family, will they admit it or not. We find half lie. They fumble their way through the appointment getting all manner of things wrong, we give each other knowing smiles. They obviously go off and learn and the next time you see them they know what they are talking about. I have no trust or respect for that type and avoid them like the plague. The one's I trust will always be the one's who admit they don't know what they are dealing with and go off and learn, they are honest people and they are less dangerous.

Khloe I agree. I would much rather a doctor said to me that they didnt know much about a certain condition but would look it up. I would respect them far more than them giving wrong and potentially dangerous advice.

I agree with tht too. People never stop learning and this is the beauty of the internet. Use it. Use it to diagnose or look into new drugs , trials etc.

some one closed to the idea of things out side their knowledge is dangerous. What's the point in research if no ones going to look at the break throughs or options available.

I moved GP surgery for that very reason. I put a suggestion in the suggestion box in the reception area. My suggestion was for one GP at the practice to go on a one day training course in our condition. There are several of us in the family with it, and it is through to be very under diagnosed, so other patients would benefit. I was apparently very insulting for asking them to have more training, I was told they would treat symptoms in the standard way and patted on the hand that they will look after us.

It was the leading expert in this country that warned people with our condition about that behaviour, they called it lazy medicine. I left that surgery.

Khloe what a joke! That's terrible and so patronising! I would have moved too. I hope you are getting better care now.

The policy in my old practice was not to refer it seemed. Even when presenting with three red flag bowel cancer symptoms. The delays and cost associated with that failure in care is causing me problems 3 years on.

Consultants aren't immune to perverse advice either. When I finally got the drugs I needed 12 months after a letter had been sent advising my gp to prescribe them a specialist gastroenterologist told me to take them with another drug which was completely off the scale in terms of prescribing advice. I believe disciplinary action has been taken although I didn't complain.

I just wonder if there are enough cross checks and peer reviews throughout the system.

No we are not getting good care from the standard NHS HCP's. We are getting excellent most up to date care via specialist NHS HCP's and via specialist private HCP's. It has been a massive struggle to get where we are, it took a lot of hard work from me to ensure the children have been seen where they have and are finally getting the tests and care they needed for so long, including an operation. It seems to much easier for HCP's to make a guess and write people off as mentally ill, than to make patients well it seems.

Giles I agree that proper supply of these formulas is essential and it would save money on referrals, hospitals, etc in the long run if formula was only requested where parents had a genuine concern for their child's health. Sadly, in our area, we are facing a lot of requests from people who are misinformed or who can't or don't want to pay for it and see a chance to get milk free of charge. The fact that this guidance has been produced from our CCG and 2 neighbouring CCGs suggests it is a more widespread problem too

Khloe That attitude is shocking. At our practice we have a clinical meeting weekly where doctors, nurses, pharmacists and trainees can discuss anything in our week that is worth sharing with our colleagues. That would come up as "Does everybody know we have several patients with xyz?" so everybody was aware and could then learn and share expertise

It is sad that so many people have had bad experiences. I work with GPs who are excellent, knowledgeable and caring; they spend a lot of time training for themselves, other professionals and training younger doctors to be (hopefully!) the good GPs of the future

Wow! wouldbemedic has said it all for me:

"there is a culture of feeling put upon. If they spent as much time thinking creatively as they seem to do feeling peeved, and if they employed their powerful capacity for self-pity in the cause of compassion for patients, we'd have a stronger medical profession and one we could feel proud of."

(was your pelvic prob spd by chance? if so, I had a very similar experience)

I must be working with very different GPs to the average ones then as I have never seen a culture of feeling put upon, unlike some other professions. Most GPs I know through work and socially admit to feeling stress in the workplace and frustrations at some issues of the NHS but are focussed on helping their patients and get tremendous satisfaction from doing that

There must be a way though. Maybe asking for video evidence or visiting the family at home at feed time. Or just looking at symptoms as a whole and not just jumping in with the first thing that can solve just one of the problems.

I mean with dd we had movicol

I guess the crying could be "colic"
The skin-eczema
Gunky eyes- moucusy baby
Grunting- --- whatever
Nappy rash- thrush

Every symptom could technically be explained away or treated with creams /medication and that's what some drs do.

You have to look at the WHOLE thing sometimes.

I realise many try and scam free formula but babies suffering as a result isn't right.

I do get there's a problem and wish there was a solution. But denying presriptions until the babies suffered for months and is in a right bloody state is not the answer either .

And attitude is everything. Just leaving feeling listened makes all the difference.

You can have tied hands and sympathy. You do to have to be dismissive because you cant do anything right now of that makes sense.

Oh and this post isn't meant as a dig to you pis :)