Waste of GP appointment?

[blacklister]

I have called our surgery today to book an appointment for my DH (he would do it himself but he's away for a fortnight abroad with work and in a different time zone) and have been told by the nurse that they won't book one.

I spoke to Reception, happily explained what the appointment is for and she said she'd get a nurse to call me. The issue is recurrent mouth ulcers. DH has had them on and off for years, but the last three months or so it's been every other week. They're very painful, large and unpleasant. Bonjela, that igloo stuff, none of it helps much. He doesn't smoke, drink heavily or eat a lot of spicy foods (all irritants) and is generally in good health.

He's been to a pharmacist who recommended a multivitamin as they can be caused by a lack of B vitamins and Corsodyl when one appears (he often has 3/4 at once).

After mentioning it in passing to his parents, turns out his Grandad, Dad and Brother all have the same issue. Grandad had a problem with retaining a specific B vitamin before he died and needed injections a few times a year.

So I explained all this when I called. Said no need for an emergency appointment obviously just a routine one when they can get him in over the next few weeks. The Nurse basically said it's a waste of the GPs time because there's nothing they can do for something that's 'intermittent' and unless he has one (or more) at the time there's no point in him coming in! They'd rather he called on the day when one comes up and take an emergency appointment.

AIBU to call back and insist on a routine appointment? Seems ridiculous to me, to take up an emergency appointment for a non-emergency!

I think you should do as you've been advised and he makes an appointment when he has them

I can see where they're coming from. It's potentially more of a waste of an appt if he turns up and there's nothing for the GP to see.

Would a dentist not be a better option than a doctor?

It sounds perfectly sensible to me.

The GP won't have much to do if you take him when he's healthy. An emergency appointment when he has the problem makes much more sense.

Could you request a phone appt with GP so he can order blood tests.

Can't believe I made the assumption GP was a man

I would say he needs to be seen, they can be caused by B vitamin deficiency and the GP would need to do a blood test for it.
My DH and elder DD have this.
There doesn't need to be an ulcer to perform the test.
Can he have a phone consultation with the doctor?
If the surgery refuse I would consider moving to a different practice

The test is particularly pertinent given his family history

So his family have pernicious anaemia or B12 deficiency? Either way bloods can be taken by the nurse before seeing the Gp.

If you think he might be B12 deficient, why doesn’t your husband just call, explain family history and see if GP will authorise a blood test? This is surely the main concern, not the mouth ulcers.

A dentist might be a good idea actually @kitkatsky.

Also, yes a phone appointment @TumbleTussocks could be the answer.

Problem is with an emergency appointment is he won't be able to see our GP, he'll need to arrange to work from home that day in advance to go (ulcers don't stop him being able to go to or do work) which he can't do if we need to wait and see and it's a 'sit and wait' clinic so you can be there hours and hours for what will be a routine thing. Emergency appointments are like gold dust on the day, you have to ring when they open, get triaged on the phone and then go and wait only if they decide your ill enough. I can bet that he'll ring and they'll say mouth ulcers aren't an emergency matter.

We'll have to give it a go and see what happens. GPs don't need to 'see' everything to help - if I've got painful periods that's explained by discussing not having to have a look at it.

Its also worth bearing in mind, if his family have autoimmune diseases in them then he's at increased risk of developing one so bloods should be checked.

Please get his blood tested. This is not to be taken lightly.

If you have the spare cash, then what about your DH sees a private GP service where he works, and get the simple blood tests done to rule in/out a Vit B deficiency? If he needs medication then this can be continued by the NHS GP practice.

Why not make a routine appointment (which is reasonable IMHO, I wouldn't have thought this inappropriate when I worked as a GP) and take a photo of the ulcers to show the doctor?

This is ridiculous, the GP doesn't need to study the mouth ulcers to consider what action should be taken. It is absolutely appropriate for him to see a GP about this. Ring the surgery back and tell them he wants a routine appointment for erectile dysfunction. (Or maybe they'll want evidence that he can't get it up before he can talk to the doctor about it!)

Do as they advise.

Good luck.

PS has he had any treatment for this?

I am sure you know this but just in case....

Vitamin B12 or folate deficiency anaemia

Our GP surgery keeps changing its approach to appointments, but at one time you couldn't even book a routine appointment (apart from if you had one appointment and the GP asked you to then book another one), you had to book on the day for everything, so maybe that is what they do. (They soon stopped that, presumably because it made it even more impossible to get through on the phone first thing in the morning).

It sounds like it could be B12 deficiency. This is serious. Make and keep to the appointment. It can lead to pernicious anaemia or stomach cancer.

Thanks for the info. No spare cash for a private GP, I'm a SAHM so we're on one income.

They definitely do still routine appointments, they just said he couldn't have one because there might not be 'anything to see' by the time the appointment comes round. Normally around a two week wait, but that's fine.

Personally I'd make a routine appointment to discuss his "back ache". He can then turn up and talk about his mouth ulcers - the Dr. won't know why he made the appointment in the first place!

I sort of get why the doctor would want to actually see the mouth ulcer, if only to check it actually IS a mouth ulcer. GPs tend to assume we're all idiots who have absolutely no knowledge of our bodies and ailments. So, annoying though it is, I'd go with their request once he's back.

Hi Op, i had an infected mouth ulcer I went to the gp for (was causing me terrible pain and I couldn’t eat) and they said it was more a dentist area. They did prescribe this orabase paste though, not like bonjela as such as it had the consistency of porridge/paint - tasted disgusting but really helped soothe my pain.

I know slightly different as your husband’s may have an underlying reason but if he can get his hands on orabase when he has a bad one it may help.

I'd book an appointment with his dentist. The dentist can then ring/write to the GP to organise the required blood tests (giving the GP practice no excuse to refuse), or can in fact bypass the GP and refer directly to Oral Medicine who will be able to look at all the possible underlying causes of ulcers and are also the best at providing the full range of symptomatic treatments if no cause is actually found.

If there is history of B12 deficiency in the family, go to discuss it. There are tests and things that can be done, that could save his life. Not being over-dramatic or anything, but best to get it checked.