To make a complaint about my GP? *trigger warning*

[wictional]

This is my first thread, although I’ve commented on a few.

I’m just wondering whether you ladies think that I have reasonable grounds for a complaint or whether I’m just cashing in on the ‘sue them!’ culture. To clarify, I’m just wanting to complain, not sue!

Basically, I’ve been seeing a GP for clinical depression and social/generalised anxiety disorder. He’s not my usual doctor, but due to severe anxiety I’d not made an appointment for so long that I’d forgotten my usual GP’s name

Anway, after I’d told him that neither citralopram nor fluoxetine were working, he put me on sertraline 50mg.

At my four week checkup, I asked for it to be raised because I still wasn’t doing well. He refused. I asked him if I could be tested for autism because it’s something I suspected I had. He told me that I ‘seemed like an educated young lady (I have an MA) and could articulate my problems (as a result of previous therapy)’ so he saw no reason that I should be either autistic or depressed.

After my eight week checkup, I got the courage to go back to therapy. The therapist immediately signed me up for intense CBT and an autism test.

At my twelve week checkup, my GP dismissed my depressive thoughts as being due to work stress, told me that 50mg was still enough, and said that I didn’t need to see him again.

A week later (last Friday) I was so low that I considered ending my life. I didn’t. This Tuesday, my therapist rang up and said that the preliminary test had concluded that I’m in the bracket to be diagnosed with autism.

I’m so angry with the way the GP continually dismissed me. AIBU to make a complaint, or is it just down to the fact he only has five minutes with me at a time and so missed stuff?

To give an alternate view:
My area has one neurobehavioural clinic, appointments take approximately 18 months to recieve. Very few people recieve follow up support so it would be a one off diagnosis.
For a majority of people a diagnosis doesnt change much. For example if you are already holding down employment without reasonable adjustments, other than giving you an explanation of some things (importance of which shouldnt be under rated), theres not much the service can offer. Strategies can be used in the absence of a diagnosis and theres not an obviously a medication that will help

Appointments have to be prioritised to those who are severely impacted eg. Unable to work or a function on a very basic level so some services are very difficult to access if you are not going to recieve the maximum benefit.

For a majority of people a diagnosis doesnt change much. For example if you are already holding down employment without reasonable adjustments, other than giving you an explanation of some things (importance of which shouldnt be under rated), theres not much the service can offer. Strategies can be used in the absence of a diagnosis and theres not an obviously a medication that will help

An explanation of certain things was what I was after from a diagnosis of autism. I don’t want to use it as an excuse or anything!! I just wanted to understand the reasons behind some of my traits.

YANBU. İf he knew anything about autism.
He'd know people with autism are usually extremely intelligent and knowledgable.
Not only but the fact that he didn't even discuss the reason why he wasn't going to up your dosage. He just dismissed you with a big fat 'no'. Had you done something. He could have very well found himself serious deep water.
I too battle with depression and anxiety. Im on Sertreline 200 and Propranal 70mg. My GP had no qualms about highering my dosage. Fluoxitin just didnt agree me. They basically turned me into a zombie.
Just to let you know you aren't alone.

He may well be managing expectations. As Fallofrain explains, waiting lists for adult autism assessment are in years, and that's only for those that get accepted onto the list. In my area you'll only be accepted if your symptoms are severely impacting your life, for instance you're not able to hold down employment.

The medication is a clinical judgment. If you've a history of not responding to anti depressants then he may feel there is no value to increasing the dosage. Anti depressants are not the answer for everyone.

If you make a complaint, what outcome are you looking for?

YANBU. İf he knew anything about autism. He'd know people with autism are usually extremely intelligent and knowledgable.

If you knew anything about autism, you would know that it is a spectrum and many of those affected are not extremely intelligent. That's a terribly ignorant thing to say.

What are you hoping to achieve?

YANBU to make a complaint. Just be clear in your own mind about what you hope to get out of it.

FWIW my friend was recently diagnosed with autism as an adult and found it very helpful. It has given him answers and made him feel better about himself.

Is your therapist private?

I think you've got two separate issues here. Other people more knowledgeable than me have commented on your request for autism assessment. But I'm quite shocked that he wouldn't discuss your medication - for starters, that's a low dose of Sertraline.

Also, he could have discussed other options with you, discussed whether you'd been on it long enough for it to kick in, whether you wanted to try a higher dose or what. Point is, there are lots of ways that conversation could have gone and an outright no should not have been one of them if you were asking for help.

Personally, I have found GPs really variable when it comes to MH issues. At the risk of making sweeping generalisations, some get it and some just don't.

I know it's hard but could you face trying to see a different GP?

YANBU. I think the GP sounds unhelpful and it is worth complaining. Being able to articulate your problems does not mean you can't have depression / anxiety.
Sertraline at 50mg is a low dose and it could have been helpful to increase it.
Not sure about the autism - I know it is incredibly hard for adults to get a diagnosis. Perhaps your GP was making a fair judgment.
Worth complaining IMO.
Your anger may be slightly out of proportion. Hopefully making a reasoned complaint and discussing your feelings in therapy can help you move on.

I want him to realise that there’s more to depression than meets the eye. I want him to stop dismissing people.

He said I looked fine to him and didn’t need to see him again, then a week later I phoned an ambulance because I couldn’t see a way out.

I want him to think about that. He’s a medical professional.

I think you'd be unreasonable to complain, sorry. As Bombadier and fallofrain have explained, autism can be a difficult diagnosis to make, the diagnostic process can be lengthy, and services are under-resourced. If you're functioning well, and just seeking a diagnosis to help you understand yourself, then you have less clinical need for the autism service, and might be triaged low on the priority list, if the referral were accepted at all.

If you're keen to have a diagnosis, perhaps you could pursue it privately?

You are not unreasonable to be disappointed in how your depression is responding to treatment. If you're not happy with that GP's approach to your management, why not see another GP in the practice?

Frankly I’d just see someone else. Some doctors don’t have any interest in mental health.

My friend had a similar experience when her son was struggling massively. GP started talking about his own son . Turned out her son did have Aspergers and the diagnosis helped them as a family very much.

But why are you keen to get a diagnosis?

Thank you to those who understand my concern about my medication.

My therapist has forwarded my test results to get me formally diagnosed, although I understand that it’s a long and arduous process. Again, it’s helped me understand a lot about myself, which is what I wanted to get out of it.

As people have said, it’s the stark ‘no’ that’s really riled me. I felt so stupid, like I was making a big deal out of nothing when I said I was considering crashing into oncoming lorries on the way home.
But apparently that meant I was fine

"He said I looked fine to him and didn’t need to see him again, then a week later I phoned an ambulance because I couldn’t see a way out.

I want him to think about that. He’s a medical professional."

I'm sorry, but this sounds manipulative to me.

By all means, push for referral to a general adult psychiatrist if you're not responding to antidepressants and you're calling ambulances due to morbid thoughts, but you may end up with a diagnosis other than autism.

I would complain (actually I wouldn’t but I think you should), maybe the next person he dismisses will attemp suicide

Sertraline 50mg is a very standard adult dose, and can take up to 6 weeks to take full effect.
I’m sorry but I don’t think the GP was being dismissive. Complain by all means, it’s your right, but I can’t see you getting very far tbh.
I’m not entirely sure why you were so keen to get a diagnosis of autism?
It sounds like your issues are with depression and anxiety, I’m sorry it can’t be easy for you, but I would suggest you focus on your main problems rather than worrying about whether the GP offended you

Sertraline 50mg is a very standard adult dose, and can take up to 6 weeks to take full effect

I understand this. But my requests at 8 and 12 weeks were also dismissed.

I don’t understand how it’s manipulative to say that he was wrong about my diagnosis and that he should take mh issues seriously?

I wanted to know if I was autistic because I have many traits that indicated that I was. My therapist has confirmed that my test results show that I am. This has explained a lot of my behaviour, and made me realise that I’m not just awkward and stupid, like my GP made me feel.

I think you'd be unreasonable to complain, sorry. As Bombadier and fallofrain have explained, autism can be a difficult diagnosis to make, the diagnostic process can be lengthy, and services are under-resourced. If you're functioning well, and just seeking a diagnosis to help you understand yourself, then you have less clinical need for the autism service, and might be triaged low on the priority list, if the referral were accepted at all

And he couldn’t possibly have been expected to explain that to her rather than practically patting her on the head and telling her to go away?

YANBU to complain. He should not be so dismissive of patients’ legitimate concerns.

Leliana how is it "manipulative" to think a GP who sends away suicidal patients and tells them they're not depressed and don't need higher doses of antidepressants needs some form of correction? Yes she's using herself as an example, because she has nothing else to use. I doubt she's the only person he's done this to, but even if she were, it's still not on.

You can't be too articulate to be depressed or autistic, what an idiot he is.

Tbf to the OP, Fallofrain’ long waiting list and lack of support excuse only really works if the GP explained that.

It should be completely unacceptable to lie to patients/service users or fob them off just to make up for short comings in local provision. Apart from anything else it does lead to both a lack of confidence and trust.

Is there another GP in the practice that you could see about the depression.

Who did this preliminary test?

"But apparently that meant I was fine" but he doesn't think you are fine as he has put you on an antidepressant.

If he said he doesn't need to see you again, that doesn't mean don't come back, it just means he has no specific date for you to re attend. Does he know you see a therapist? Did you tell him you had suicidal thoughts?

Maybe you should just go back and see another GP.

@wictional and @rinabean - telling healthcare professionals that you're suicidal because of something they've done or not done is widely recognised as manipulative behaviour amongst healthcare professionals. Obviously, expressing suicidal feelings in itself is NOT manipulative, and I didn't mean to suggest it was, but saying "I wanted to kill myself because you didn't do what I wanted" comes across as if you're emotionally blackmailing your GP.