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?

Having said all that, I do agree with the OPs original question. All healthcare professionals are expected to work within their competence and confidence. GPs are generalists and, if they are not up to speed with something, they should admit it and make it a priority to learn.

I have a fairly rare and chronic condition. If I go to see the doctor about something that may be related, I always say at the start, "I have X, it causes Y and Z. Obviously you may not be familiar with it but ABC is a good resource on the internet."
I have to say, I have never had a GP pretend to know about it when they didn't. If they are unfamiliar, they thank me and fess up immediately.

But talking about generalist medics; my DD was referred to an absolutely useless paediatrician when she had horrendous IBS style problems. Horrid woman more or less said that DD was making it up to get out of school. We saw her about 4 times and she was honestly less use, and less informed, than a quick google.
Finally insisted to GP that DD be referred to a proper gastro specialist and she has been helped tremendously.

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I do find it useful to be able to explain to GPs about the condition I have (Factor V Leiden thrombophilia) as many of them can't even spell it and have no clue what it is. It's been called Factor V deficiency (it isn't), Factor V lieden deficiency (still isn't and now it's spelled wrong) and a couple of other things I can't remember off the top of my head but they were still wrong in terms of what the condition is. I don't expect GPs to be expert haematologists, but I DO expect them to know that it is a genetic mutation, not a deficiency; and since approx 1 in 20 people are likely to have it, it's NOT an uncommon one! So it would make sense for them to learn up about it. IMO.

I have to say that the first GP who knew about it was excellent - understood all the implications and so on - but then he'd had me tested and got my test results back before I saw them, so he could have just brushed up on it from the internet before he saw me again. :) Since then, it's been interesting to see how uninformed some medics are (and a bit worrying, tbh, since it IS so common).

I think the UK system is part of the problem - it does seem to lead to a certain sense of entitlement from a lot of people.

I am living in Australia and they work on a kind of mixed public/private system here. So you pay your GP privately but you can claim back some of the money from the NHS equivalent. I think it makes a massive difference to how it works. I much prefer the system as although I have to pay for it (just accept it is part of our budget) I am definitely treated more like a "client" - and GPs don't have the same gate keeping responsibilities so aren't limited as they are in the NHS.

Because you aren't entitled to a "free service" you can obviously choose whatever GP you like and there are no catchment areas at all.

Children are usually "bulk billed" which means you don't pay for them up front and the GPs just claim the consultation fee directly from the government - which I think is good as it means people don't refrain from taking a child to the GP due to financial worries. But you still get the same treatment (i.e. listening, understanding, respect).

I also can't believe all the people complaining about failure to prescribe various types of formula . Here prescriptions are not free for kids and they are not subsidised for adults (there is means tested support with this - i.e. free prescriptions.) - so people needing particular formula go and buy what they need. I think where piscivorus works has the right idea on this. Surely if your child needs a certain formula you would go and buy it even if it is more expensive?

On a final note - I'm not slamming the NHS - have always had great experiences with it myself (and for my kids) in my 35 years in the UK but I do think people expect what can't be provided on a massive "free at point of entry" scale. If your child needs something additional and you aren't getting it FGS go private - I did on one occasion as my DS needed an op and there was an issue with the timing. I borrowed money to fund this and was worth every penny.

It's £30 a tub mutley and that's the cheaper ones. Do and I were both working and could afford a new baby and were more than prepared to pay for everything obviously. We didn't even get tax credits at the time.

But that's a lot for people to afford through no fault if their own.

PS landrover I am really sorry to hear what happened to your DC - in what I am saying I would never mean that you should have "put up or gone private" in that sort of situation. A serious mistake was clearly made with awful consequences and I wouldn't ever suggest anyone should/could defend the practitioner who made that mistake.

giles I accept that's expensive but formula is a lot more expensive here than in the UK anyway so I suppose I just now see that as a fact of life. Obviously when doing a budget you have to put whatever you need to feed your baby top of the list and then cut out other things that may not be so essential.

To some extent I think parents just need to accept that babies don't come with a budget limit and that is part of our responsibility. Yes that formula is expensive but they are only on it for [what 2 years max?] - and there are other major costs associated with differing needs of children that could easily outweigh that over the years.If you have a child that wets the bed or wears daytime nappies much longer than his/her peers then you have significant additional costs of washing/nappies - possibly not the best example but the best I can come up with off the top of my head - is getting late here

Regular formular is £9-10 a tub. Plenty would budget for that. We did. But neocate if you read back is £53 a tub. That's five times the price for a tub half the size.

Trust me I'd have loved nothing more than to go to the shop and buy my baby formula. I wasn't interested in freebies I paid for my babies formula first time round and was going to second time around.

And three yeas ago you couldn't buy it. It was prescription only

Oh and I guess the through no fault of their own is what I am referring to when I think people are entitled. Many things cost me money that are no fault of my own (my car breaks down and I can't get to work, my handbag gets stolen and money gets taken from my account, I get taken ill and can't work) - unfortunately life is not fair and equal and one baby might cost more than another.

I mean great that the NHS do fund this formula for now but actually in reality they won't be able to continue functioning on this "free to all" basis (as we can see from this thread there are so many problems arising) and the UK will be likely to be forced to adopt a more mixed system. I wonder whether people will prefer that or complain that they no longer get free prescriptions and a totally free at point of entry service.

I'm not "entitled though"

It's never occurred to me ever to get prescriptions for anything that's available to buy. I've always always always paid. Always. But needing a dr to prescribe formula that's ONLY available that way is completely different.

I think the whole prescription only would be a far less significant issue if you had to pay for it as GPs are probably largely questioning the necessity as they are gatekeeping a service that costs taxpayers a lot of money. If the patient was paying the GP wouldn't be worried about prescribing it. So the system probably would work better - as it does here!

Having been highly taken aback at no free prescriptions for kids here when I first arrived I now think it is totally reasonable. Why should the taxpayer pay for my kid's prescriptions if I can afford to pay for them myself. By no means am I rich but I can plan a budget and need to allow for those costs as part of my responsibility as a parent.

Oh and I didn't say you were entitled - I was referring to this statement you made:
But that's a lot for people to afford through no fault if their own.

How much do you have in your take home pay there in Australia to fund your private health care?

Neocate's £35 a tub, I just checked on Google. Where on earth does it cost £53 Giles?

DS used to have 4-5 tubs a week, which would have cost us £140 a week. He has a diagnosed allergy so why shouldn't it be prescribed any less than anything other allergy related medication. Should I be paying his for all his eczema creams and reflux drugs too? It's not like it's a choice.

I think GPs are being made to cutdown their referrals so are reluctant to refer. However if it's genuinely out of their knowledge base, I don't see why they don't rather than fobbing you off, only for you to go back another 5 or 10 times with the same problem.

I even remember one consultant telling us they were under pressure to discharge as many patients they could from their books to get the numbers down. So it happens everywhere.

Yes a lot of things aren't anyone's fault.

But an adult can choose to some extent what tey are prepared to live with.

No ones going to take your car away because it broke down too many times.

And your not going to die if your hand bags stolen.

You can't really compare that with a child who's being slowly malnourished to death and faces permanant damage through being unable to get the formula.

Thanks Mutley x I talk about this time and time again, that if I take my dog to the vet, he gets immediate treatment! The irony of it. The vet will always give antibiotics on a just in case basis and my dog is always believed!
Obviously I am not suggesting that antibiotics are given out for everything but it is hard when they are babies to work out what is wrong! (by the way, out of interest is there really proper evidence that you become immune to antibiotics?)

Yes but if you need your car to get to work and you therefore can't earn money to feed your children.... and so on.....

I am not disputing that you should be prescribed formula that your child needs if it is only available on prescription, but I'm saying that the system is at fault. I don't think the NHS will be able to function long term the way it is - particularly having seen first hand how a different system works. And I would be one of the biggest advocates out for free health care and free education - I suppose in my old age I am more realistic than idealistic.

khloe - the pay is higher where we live than the equivalent in the UK but the costs of living are dramatically higher overall so I don't think that is the point. Taxes aren't actually significantly lower despite less "free" public services. But people accept that there is a cost involved in their health care (and education but that's a different story) and IMO it amounts to a better respect for services - and by the same coin better respect from services to clients.

I have not actually paid privately for any health care here nor do I have private health insurance (we don't have a massive income). I have probably had 4 GP appointments since I arrived here for which my cost was $35 each (about £20)

However I did pay for a private operation for my DS in the UK (when earning UK salary), where he was entitled to it free on the NHS because I wouldn't let my principles/financial worries get in the way of what I knew was best for him. I borrowed the money and cut back on other things to pay it back.

I love that. My dog is always believed!

And my husband says dog gets instant, proper treatment because I pay for it, interesting!

I love my dog and my vet!!!!

landrover - I'm probably in the minority but I've always been keen for my kids to have anti-biotics if they need them. My DC1 had loads (probably 6 times a year on average) under the age of 5 for various chest infections etc and is now an extremely healthy 9 year old who has never had any since. My DC2 rarely had any - apart from preventatively after burst ear drum a couple of times. He is also a very healthy child now. DC3 had them for 2 days at birth IV as they were worried she had an infection - I know some people fight this as being unnecessary but I was far more reassured that they managed this conservatively and gave the anti-b's than took the risk that she died of group b strep. (They couldn't definitively say if she had an infection until the cultures from her blood test had been tested which took 2 days - once they realised she had no infection she was straight off the anti-bs). She is now a very healthy 9 months old who has had no anti-bs since.

So I am in your camp - and I'm sorry you have the reason you do to be in that camp.

And if your child is sick and hospitalised regularly you can't hold down a job to get money to feed the children or pay for petrol for the appointments landing you signed off their service....

And landrover - I agree with your husband! Hence why I think the semi-private system works better here in Australia than the free at point of entry system in UK.