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!

The receptionist has no right to ask what the appointment is for - its non of her business. Just say its personal and book the appointment.
At our Doctor's you can't get the blood test until the Doctor orders it.

I think it's perfectly reasonable for the doctor to actually want to see the problem. Yabu, sorry.

try gengigel - I have lots of mouth ulcers and this helps to heal them up.
It never occurred to me to think there was anything sinister about them as they always cleared up - until the next one that is.

I agree with Cath2907- phone and book an appointment for back pain, migraine or depression. Then have DH explain from the outset of the appointment that he is there for ulcers and would like a blood test.

YANBU.

If you're worried about B vitamin deficiency, any good doctor will want to take a full history, potentially examine your DH and do some routine bloods. Receptionists won't necessarily know this and you don't have to disclose the nature of the problem when you book an appt. Would persevere and firmly ask for an appointment.

It wasn't the receptionist that said no, it was the nurse who called me back! I willingly told the receptionist what is was for though when she asked, more fool me clearly.

Just rang back, refused to say what the appointment was for this time ..... and got a routine appointment for the day and time we wanted in two and a half weeks time with our own GP.

That's what I get for trying to be helpful. Obviously what being a bit more obstructive and bolshy does for you!

Also I don't think you're being unreasonable at all.

Using an emergency appointment means:

1. Someone with a real emergency won't get seen

1. Wasting a day off work for no reason

1. Allowing your husband to come into contact with other patients with contagious illnesses on the day as lots of patients will take emergency appointments for contagious conditions (e.g. strep throat infection, stomach bugs etc).

I'm sure the GP doesn't actually need to see the mouth ulcers to order a blood test.

Well done OP- it's not obstructive and bolshy- just assertive.

If you ever have a family member in hospital you're likely to have to be very assertive in order to get them proper treatment so this is good practice!

Some of the responses here are utterly ridiculous. So a woman with suspected endometriosis can only see a GP during her period? Someone with recurrent hypoglycaemia can only get help if they’re low when seen? What a load of shit.

Of course he needs a blood test - his reporting of his symptoms should be sufficient. You can do blood tests via finger prick at home with companies like medichecks - I just recently tested a whole load of things and it cost £79, plus I didn’t have to waste anyone’s time including mine. Showed up severe vit D and folate deficiency so I took it to the GP to get treatment.

Recurrent mouth ulcers plus deficiency in Vitamins B9 (aka Folic Acid) and/or B12 suggest coeliac disease.

From NICE

"Recognition of coeliac disease

Offer serological testing for coeliac disease to:

people with any of the following:

persistent unexplained abdominal or gastrointestinal symptoms

faltering growth

prolonged fatigue

unexpected weight loss

severe or persistent mouth ulcers

unexplained iron, vitamin B12 or folate deficiency

type 1 diabetes, at diagnosis

autoimmune thyroid disease, at diagnosis

irritable bowel syndrome (in adults)"

Sounds like he ticks at least two of those.

That's a load of nonsense about needing an ulcer to be seen - it's fairly obvious that the question is about the chronicity of it.

I'm glad you got it sorted but I would advise your DH to mention what's happened with the nurse.

If he's been taking any supplements don't get bloods done!!
It will skew the results if he's been supplementing he needs to be off them for about 4 months.
Dd is B12 and folate and iron deficient, after her injection her results would be very high but she's still B12 deficient.
Even with pernicious anaemia where he won't be absorbing the B12 supplements can still raise his levels even though he won't be able to use the B12.

Surprised at the responses suggesting you lie about the reason for needing an appointment. I am a GP and 1. Yes we can see the reason for booking in 2. Yes we will therefore know if it's different to what patients say the actual problem is and 3. It is rarely a good way to start an appointment, it gives a poor impression. Just be honest as you have been!

Given his symptoms and family history there is absolutely no need to wait until he gets one! They should be ordering blood tests anyway!

I understand what you’re saying why, but people wouldn’t feel the need to lie if other staff didn’t block them from getting appointments they legitimately need!

Why do you need to explain to anyone what he wants to see the doctor about beforehand? It's between him and the doctor. Just call the receiptionist and make an appointment with no explanation of why you're calling not him or what the issue is. The receptionst at my previous doc surgery started to ask this and I simply said "It's personal". To me there seems to be a potential underlying reason for the mouth ulcers and it's important he sees a doctor about it (bearing in mind family history).

@WhyBird2k I haven't lied don't worry. I wouldn't. When I rang back and she asked why the appointment was needed I just said I'd rather not say.

Although I can see why people do it!

@BlueJava They always, without fail, ask why you need to see the doctor at our surgery. The nurse I can understand, when I book to see the nurse for me I'm always asked if it's for bloods or a smear, or if it's for DD and the nurse I've always been asked if its for vaccines. I assume when it's for the nurse it's to make sure you see the 'right' person.

It’s symptomatic of coeliac disease too, so worth being checked by gp

This is why nurses and receptionists shouldn’t really make these decisions.

Your DH absolutely needs to be seen by a GP and bloods taken, no matter if he has an ulcer or not.

Lot of nonsense being spouted here

YANBU

Hmm, he's pretty good on the food front. He eats everything and has no history of allergies at all. The only thing he cannot eat is batter (like fish from the chippy). If he eats batter, he is without fail sick a few hours later no matter where we get it from. So he doesn't eat it anymore.

But he eats other stuff with gluten in. all the time. Like bread, daily, in his lunchbox for sandwiches and weetabix for breakfast. If he was coeliac surely he'd be poorly?

Of course the GP needs to see the ulcer. Not all ulcers are the same. I used to suffer from recurrent Aphthous Ulcers, the GP will need to see it to determine what type it is as there could be a underlying condition causing it that he needs to be referred for.

op. well done on getting an appointment, if i was you or dh, i would take photos and also keep a diary of when the mouth ulcers break out etc

There are other things that can cause mouth ulcers so yes it would be useful to see them. Common things being common, it's probably the same thing the rest of the family have but it'd be pretty stupid to just assume that & miss something else treatable. I'd take their advice & book when he has something to see.

WhyBird2k surely you can see why patients might do this. In this case the receptionist and nurse were being obstructive.