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!

well I would really really object whatever the circumstances to having a receptionist give me that spiel when I rang up to make an appointment just because I was a woman . If a practice has a doctor like that, just let him see men - problem solved.

And I would never want to see a GP with those beliefs even for an in growing toenail. Men who think they have a God given right to dictate what women do with their bodies are beyond contempt and especially when they are supposed to be health care professionals - yes funny word that, professionals.

My view has and always will be - If you cannot do all parts of a job that job is not for you. (Unless you are physically unable to do it)

If you do not agree with abortion or contraception or is leaves you with an uneasy feeling do not take a job where that is a major part of your role.

GPs are General practitioners. The clue is in the name. Its general medicine meaning you will come across all kinds of health needs. Especially family planning.

Would this same GP refuse to provide aftercare for a woman who had an abortion?

Although I remember a case where two midwives refused to aid in the care of women who had terminations

www.bbc.co.uk/news/uk-scotland-glasgow-west-30514054

but honestly. As a midwife you know your duties will involve the care of any pregnant woman including those who have terminations. So why sign up?

to finish I had to go to my family planning clinic to have my coil removed because My on GP refused to even remove it and gave no reason why just 'we don't do that here' previous one was fitted and removed by a trained GP at my old practice.

The female Dr at the family planning said she was seeing it more and more. GPs refusing to prescribe fundamental medicines to women and young girls that protect them and maintain their health. (It was a long appointment.) She was astonished at the number of GPs who wouldn't prescribe the pill for ladies in agony and heavy bleeding due to endometriosis. It wasn't even for contraceptive use but medical. The same with ladies to regulate their cycles or kick start them again. She was an awesome doctor though. We need more like her who will call out other GPs for being twits.

Actually, bourdic, that would solve the problem. Duh, never thought of that.

That's a really interesting link sweetnhappy. Thanks for that.

Another GP here. I prescribe all contraception. In our area, we do not refer for termination; the local system allows us to give the necessary information to the patient and she then self-refers. This avoids any problem with doctors' personal views.

However, while I think the service OP received was poor in that she had a 45 minute wait, she was not actually denied contraception. The system worked (albeit with a delay). I suspect the practice was unaware that the locum had this personal issue with contraception, but if they were aware then this should have been made clear to all the patients seeing that locum.

I absolutely agree that doctors should have the right to opt out of providing termination; even gynaecologists can do this. The result has been that these services are largely removed from general hospitals now, and are provided by specialist services. The imperative, however, is that this must not result in a delay in treatment for women requiring the service.

NB The doctor signing a prescription, no matter who wrote the prescription, is legally responsible for it. Thus as independent practitioners, doctors have every right to refuse to sign any prescription if, for example, they do not believe that it is the right drug for the patient, or if they do not have sufficient experience with that drug to be able to take full legal responsibility for it. This is true of all drugs, and contraception is no exception. Also GPs do not have to provide contraceptive services at all (it is not part of the core contract), although most practices choose to do so.

The doctor signing a prescription, no matter who wrote the prescription, is legally responsible for it.

Good thing contraception and abortions aren't illegal then, isn't it? No one's objecting on legal grounds, it's all on "ethical grounds".

The system worked (albeit with a delay)
Why should patients be delayed because of outdated and sexists PERSONAL beliefs. Why should a GP that passes the buck get paid as much as one who doesn't?

The imperative, however, is that this must not result in a delay in treatment for women requiring the service.
Except in the real world, it does result in a delay, as we've seen on this thread.

That is my point, Ten; there should not be a delay. It is perfectly possible to design systems so that there is not. This is why referral for termination in my area has been changed to self-referral by the patient to the service which the NHS funds locally. This means there is no delay in the system at all. The personal beliefs of the doctor are removed from the equation altogether.

Re GP pay; GPs are not employed by the NHS. Surgeries could individually agree within their own practice that GPs who do not provide certain services will be paid less, if the other doctors find it is having an impact on their workload. Most do not do this but it is entirely up to them and nothing to do with NHS funding.

there should not be a delay

How can there not be? Patient sees doctors whose delicate sensitivities are upset by the pill, gives history, is then referred to another doctor who being (as you say) personally liable for the prescription has to take the history all over again. Two appointments. Twice as long. You're not suggesting that one doctor who is (as you say) personally liable would just sign a prescription on the say so of another doctor, of course.

How can there not be?

When the appointment is made all the receptionist needs to say is the Dr whatever doesn't deal with contraception or terminations, are you still happy to see them or would you like to see someone else?

Re GP pay; GPs are not employed by the NHS. Surgeries could individually agree within their own practice that GPs who do not provide certain services will be paid less, if the other doctors find it is having an impact on their workload. Most do not do this but it is entirely up to them and nothing to do with NHS funding.

I don't give a flying fig where the money comes from, it's still going into the GP's pocket. I'm not being precious about my tax money here, I'm outraged that a GP who creates more work for their colleagues (and their patients) takes home the same pay as one who just does their job. You're just talking around the problem.

PurpleDaisies we've already covered why this isn't ideal / might even be upsetting to some patients.

When the appointment is made all the receptionist needs to say is the Dr whatever doesn't deal with contraception or terminations

And it's guaranteed that the doctors that do have as many free appointments?

How can it be ethical, when you consider all of the advances that the contraceptive pill has made to women's health all over the world, in terms of life expectancy, quality of health and so on, to refuse to prescribe it? How can it be compatible with the Hypocratic Oath? Do such doctors also refuse to vaccinate, in case it causes harm? Or refuse certain medication to women, in case it hampers their fertility? The mind boggles.

And why not make it a condition of entry to a medical degree in the first place that such strong old fashioned religious beliefs won't stand in the way of the normal, standard duties of a doctor? I mean you have the CAT test or whatever its called, which would-be doctors have to pass with a very high mark to be considered.

This is the thin-end of the wedge starting with opt-outs being allowed for abortion-related procedures, and it now seems to have become fashionable amongst a few recently qualified and non-EU qualified doctors to flag up all sorts of religious beliefs that permit them to selectively do their job and at the same time discriminate against women

ElkeDagMeisje standing ovation

I was in a situation where I was working in a small hospital and the two surgeons had stopped doing abortions due to religious reasons and one of medics in A&E wouldn't give the morning after pill or fit the coil for the same reason. The nearest hospital that could deal with the result was 120 miles away :( Needless to say there was an extremely high teenage pregnancy rate :(

I was in a situation where I was working in a small hospital and the two surgeons had stopped doing abortions due to religious reasons and one of medics in A&E wouldn't give the morning after pill or fit the coil for the same reason. The nearest hospital that could deal with the result was 120 miles away

I'm sure the doctors on this thread will say that the need to pay for a 240 mile round trip is perfectly reasonable, and patients should just put up with it, so that doctors can maintain their religious observances. If the women didn't want to have a few days off work and buy expensive train tickets, they shouldn't have had sex, should they?

Whilst I acknowledge that conscientious objection is currently a legal right of HCP it is one I am very uncomfortable with. HCP are also obliged to practice non-judgementally and I feel the 2 are incompatible. I am against abortion, I would not have one myself but I chose to become a HCP and I cannot impose my personal beliefs on a patient. It is not for me to judge.

As for Dr Ethics - I'd love him to square the following with his conscience - as a locus GP he is either paid directly by the practice or via an agency which is then paid by the practice. The practice receives tax payers money including extra money for providing contraception services. He is therefore being paid out of money some of which is for contraception services [shocked]. Evil tainted money - he should be ashamed. Or does the practice pay him less because he's only offering a partial service? Elke - brilliant post

Locum - sigh

I'm sorry Iwantanotherbaby No GP refers for termination in YOUR AREA? Am I reading that right? There is a whole area in the UK who won't refer women for terminations?

This is such a mind-fuck. I'm not too sure where I stand on the general conscientious objection issue. Good arguments have been made for both sides on this thread. Abortion and (possible future) end-of-life questions in particular are such a minefield.

I think it's despicable, however, that a doctor should choose not to prescribe contraception. I understand the rationale(s), but I still think it's despicable if you consider the alternatives that you're forcing patients into. This kind of misogynistic paternalism has no place in our society, and I think practices should be avoiding doctors and locums with these kind of belief like the plague.

I don't feel I should ever be told that a doctor doesn't prescribe contraception. I never have and I hope I never do. The implied judgement is horrific. If any practice is stupid enough to hire someone who doesn't prescribe contraception, then I don't want to know about it, ever. If I find out, I will change practice immediately, even if it's less convenient to me. It seems to me that boycott of the entire practice (with a letter explaining why) is the only way to deal with this.

PearHead the implied judgement about terminations is also horrific. Why is it different. Your upset because it's been applied to contraception but not because it's can be applied to what (occasionally) is a contraceptive fail.

That last paragraph is a bit of a mess. What I mean is that no practice should hire someone who doesn't prescribe contraception and, if they do, they should be ashamed of it and keep their dirty little secret under fucking wraps as best they can. I don't want to read signs saying "Dr X doesn't prescribe contraception". Nor do I want to be told so over the phone. They should deal with it. Hide it. Make the doctor see only men and see how well their career turns out. Our kids should never be given the message that there is anything wrong with contraception. This is making me so ANGRY!!!

Typing under my desk has led to massive grammar fail. Sorry.