About this GP

[slightlyconfused85]

Now before I start I generally think Gps are amazing people, I'm not dissing the profession. Today, however, I booked an appointment to get the contraceptive pill after the birth of my 2nd child. I was given an appointment with a locum who explained my options to me, then said he didn't prescribe contraception for ethical reasons. I then had to wait 45 minutes for another gp to be able to fit me in to prescribe this for me. Aibu to think that if the gp surgery is going to have locums that won't do this then they could have let me know on the phone when I booked? I know the receptionist didn't know what I wanted but they could say if it's an appointment to discuss contraception then say and we will find a different GP. Had loads of time wasted today and feeling (probably irrationally) irritable about it!

Hence my point that I would allow existing staff the right to refuse, whilst requiring compliance from New staff.

I think that would be reasonable.

But in the case of contraception, it has never been illegal in this country, and doctors who started training before abortion was legalised are all now past retirement age.

Yep... unfortunately, we've allowed current staff to have their right to object, probably because no one wanted to tackle the fall out of not doing at the time, and because no one foresaw the societal changes that have occurred in the last 50 years.

There's little to nothing that can be done about that, much as I agree it's wrong, and so the solution is to change it for all incoming New staff.

I suppose you could announce a requirement for compliance in, say, 5 years to allow objecting staff to be retrained and employed in other roles, but it may be simpler just to continuously recruit new doctors without objections and change things bottom up, as it were.

It's far from all staff, in any case, and I just can't see another way round it. New staff should never have been allowed to object to the distasteful bits, but they were.

'Christian' GP practices fill me with cold, hard dread, btw.... but I don't like faith schools either.

Tiggy you're saying what I did, things change, sometimes dramatically, and its not as simple as 'this is the law now, comfy or else!'

Existing staff should be allowed to object to anything which is brought in after they sign their contracts, so current medics would have the right to object to the legalization of assisted dying. I can't see any other way of being fair.

Medics starting after the law changed, however, would be aware of the fact that they could be asked and would be accepting that along with the job.

They, in turn would be exempt from any subsequent relaxation in the rules.

OP - apart from anything else, if it turns out this is "allowed" - surely the receptionists should be briefed to say "dr xx doesn't deal with appointments around x subject" - thereby saving everyone a lot of time.

I'm not sure where it ends though...ethical objections...we could be there forever on that one!

Existing staff should be allowed to object to anything which is brought in after they sign their contracts

Sorry, but why? Other businesses don't get to object when company policies change, why are doctors a special case? "Ethics" can pop up anywhere, not just when dealing with health / life and death.

Existing staff should be allowed to object to anything which is brought in after they sign their contracts,

Should people who started as firemen on the railways in 1950s working on steam be entitled to demand steam locomotives to stoke for the rest of their working days?

This is not an entirely idle comparison. One of the (many) things that completely fucked BR's finances through the 70s and 80s was the continued presence of a "secondman" in the cab of all diesel and electric locomotives, who was the former fireman (or, later, the post occupied by now-retired former firemen) who had been needed on the footplate of steam locomotives, but whose abolition was something that the government wouldn't back BR in doing for fear of provoking a national rail strike.

Honestly, apart from "doctors are people too" and "they're entitled to their personal beliefs" and "human rights", no one can give me a concrete answer about why they should be allowed to object and trample over other people's human rights, while still getting paid the same salaries as doctors who don't create more work for their colleagues.

So, I have PCOS which means the progesterone pill will help regulate my irregular periods (currently down to about 4 periods a year) therefore reducing my cancer risk. By a GP could conceivably refuse to prescribe me this on ethical grounds? How is increasing my risk of cancer ethical!

Other businesses do have the right, and they exercise it.

The firemen, as in any whole class role no longer needed, should have been supported into alternative roles where available, or made redundant.

This isn't a discussion about small changes, where reasonable adjustment criteria would apply. The point I've been responding to, was that gps should be required to do everything in the role without being able to object on religious/ethical grounds.

Quite apart from the fact that that ignores UK 'reasonable adjustment' rules (and I agree that it should, medics being a special case), it's not actually fair to say 'we told you you wouldn't have to do that when you took the job 15 years ago.... but we've changed our minds.'

Every job has a job description, a list of things that you will and won't have to do, and doctors are no different. So, the objection clause should be removed from all new contracts, because it is ridiculous, but doctors and nurses can only be held to agreeing to the role as it was when they started in it, and must be given, as every UK employee is given, the right to resist changes to that contract after the fact.

New staff would therefore now be required to perform and prescribe as is the current legal and medical advice and could no longer object on religious or ethical grounds. They would not, and reasonably, cannot be expected to give automatic consent to any future major changes.

Existing staff could be asked to sign New contracts abolishing their right to object.... but I doubt that many would, even the ones who actually don't.

I don't agree that they should be able to, but they can, and I don't know what else you could do yo resolve that fact.

Life too short to RTFT, I've done first 6 pages.

Just wanted to say, while I have no problem with conscientious objection as such - i.e. I think there are so many tasks this GP CAN do that he shouldn't be not working IN GP or as a doctor - clearly the practice needs to tighten their appointments system. Surely it would take only minutes more for the reception staff, when somebody requests and an appointment, to say something like 'We have a doctor working here who doesn't prescribe contraception or refer for terminations. If you need to see a doctor about such matter, then we'll get a different doctor to see you'. Or word to that effect.

They'd only need this spiel for women of child-bearing age, presumably. So either they'd need to get your details up before offering an apt or ask your DOB, or just say the spiel to everyone? Certainly keeping a woman waiting for 45 mins to see another GP is not acceptable, esp. as he was happy enough to talk about contraception, just not to prescribe. That feels ever so slightly hypocritical to me but maybe I'm missing something.

"Sorry, but why?"

Because they didn't agree to it in the contract.

Would you accept your rent just going up £100 per month if you'd signed a contract?

Surely it would take only minutes more for the reception staff, when somebody requests and an appointment, to say something like 'We have a doctor working here who doesn't prescribe contraception or refer for terminations. If you need to see a doctor about such matter, then we'll get a different doctor to see you'. Or word to that effect.

I don't feel that a patient should have to disclose that kind of information to the receptionists in order to avoid going through the rigmarole of an arguably useless GP appointment and then waiting another 45 minutes to see someone else, though. If that kind of service is unacceptable for patients, it shouldn't suddenly be acceptable if the patient chooses not to share sensitive information with someone who is not a health professional directly involved in their care.

Topaz, I do agree with you in principle but I'm not sure how it would work in practice. As Smillas says, it would involve some kind of disclosure to the receptionist which they may not be comfortable with.

Practise

Practice. Eugh. Long day. You know what I mean.

yanbu op

I might have mentioned on the way out something about being an environmentalist.....

There is sexism at play here. As well as ageism. Because progesterone only pills are more likely to be prescribed to women over 35 and if some GPs are refusing, that lessens the choice for the age group of women whose choices are limited already..

Lurked has a good point with the supermarket analogy A vegetarian supermarket shelf stacker wouldnt be able to refuse to stack meat in a freezer for instance...they would be out on their ear. Yet a GP can refuse because of ethics. It reeks of class.

So we have the hat trick really. Sexism ageism and classism.

The reason for this kind of approach to conscientious objection is partly historical and sociological. Socially we tend to have reached a consensus that abortion is a matter for individual choice but this was not always the case. The debates over the de-criminalisation of abortions tended to reach a stalemate because the two sides had completely incompatible moral views. The way forward in terms of legislation was to suspend judgement on these views (e.g. the moral status of the foetus, the rights of the mother) and focus on practical consequences: when abortions are illegal they still take place, endangering the life of the women and encouraging unscrupulous medical practitioners so it is better for the law to de-criminalise this practice so as to better control it. This allowed opponents of abortion to retain the idea that abortion was morally wrong but still support de-criminalisation as the lesser of two evils. In that context it was important to protect the rights of those who were morally opposed to abortion and did not want to contribute in any way to the process, hence the conscientious objection clauses.

Such clauses may appear outdated now that there is greater emphasis on patient choice, a view of doctors as skilled enablers of the patient's choices and an understanding of abortion as a personal choice that should be available in a medical context.

I agree that disclosing info to receptionists has to be a concern. They are part of the health care team though. A woman need to get her slot with an appropriate GP without having to wait 45 mins or come back another day. Every day, it would seem, patients are asked why they need n appt. It's ever happened to me!!f you phone up to request a slot what a female GP you're signifying that you are having gyne problem, possibly, or need a smear. Being given the info that one GP does not offer contraception or TOP referrals doesn't mean you have to tell reception staff which. Just that you need a different GP. And anyway who do you think types the referral letters? I agree it's a difficult one and has to be done with tact.

A note in practice booklet might work - but this guy the OP saw was locum, so that doesn't work - and not everyone will read the leaflet anyway. Having a notice on the desk isn't going to work either as the patient will arrive for her appointment before she sees it.

I imagine a locum who creates work for other GPs like this might well not be top of their list to invite back.

So I'm ringing up to make an appointment because I'm ttc, or I've recently had a miscarriage and the receptionist goes into her spiel about we have a doctor here who etc etc .WTF.

Throughout medical school, starting pretty early in first year we do modules in medical ethics and law. Soon after graduating there is a ceremony which involves us taking a modern version of the Hippocratic Oath. I think if you truly wish to produce a new generation of doctors who have no right to any conscientious objection you'd have to remove all of this from the equation.

The following link may explain it better:
patient.info/doctor/medical-ethics

Okay, bourdic, that might be hard. None of it is easy exactly. But
it's not a common situation, I'd imagine. WTF to you too.

Ref to conscientiously objecting GPs, not miscarriage.