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?

Is your therapist a private one OP, or NHS?

I would suggest YANBU unreasonable to complain.

Being articulate, having a job and an MA does not exclude you from having autism. Actually having severe anxiety makes it more likely. If the GP had tried to manage your expectations - such as length of waiting list, wouldn't get you any treatment as you are v high functioning, that's fine - but having the diagnosis itself can be v meaningful in terms of making sense of yourself and longterm mental health problems.

Sertraline - the blunt no wasn't helpful. Clearly some safety netting was going on as there were still check-ups. However something has been missed, you are having suicidal thoughts and you still need to see a GP. I'd think it was worth complaining - and after 6 weeks, it's long enough to see a response and 50mg is a low dose for an adult.

He does sound crap. He should have asked you all sorts of questions rather than making a superficial judgement based on how you were presenting to him - as if people who can string a sentence together couldn't be depressed!! Ridiculous. He needs more training, if that was really how it happened.

Sounds like any other gp to me

That's a very low dose of sertraline. Average is around 100-150. If you are obviously going downhill and he refuses to increase it without justifying why, and you did something, I would say he's breached his Duty of Care: which is for your wellbeing and safety. I'd put my concerns in writing to Practice Manager, and cc the Quality of Care Commission. If you have an ongoing or long term condition he's also legally required to (preferably monthly) , review you and your meds: not say he doesn't need to see you again.

also want to know if your therapist is private.

It sounds to me as if you want to punish the GP for not giving you what you want. Is that really constructive? Is it going to help you?

I’d go and get yourself a second opinion from a different doctor - perhaps find out which in your town specialise in MH and register with them. Ask for a referral to the Psychiatry services (I think you’ll find it’s a long wait - better to go private for an assessment if you can afford it). I think it would be worth it for you.

I think your GP may also have heard that you are having therapy already and known what this is a damn sight more than you will get on the NHS.

The dismissal of your depression was poor and worth a follow up. Not so sure about the autism

It sounds to me as if you want to punish the GP for not giving you what you want

Op wanted help.

50mg of Sertraline is v low dose OP. 100-150 is average acc to my GP. If you are going downhill & he didnt explain his refusal to increase and you did something, he'd have breached his Duty of Care for you wellbeing and safety. Legally, if you have an ongoing or long term illness he is required to regularly review you and your level of meds, not tell you there's no need to see him again. Write to the Practice Manager and copy in the Quality of Care Commission who will route to area Inspector.

I think his attitude to the possibility of autism sounds par for the course for GPs, who are mostly very ignorant about how autism presents in high functioning adults, particularly women. Not that that is good enough, just that in terms of assessing whether he has been negligent, what other GPs would do is relevant.

As far as your depression is concerned, I think his attitude is very worrying and needs flagging up to the practice as a learning point. If he really 'could see no reason why you would be depressed' then why was he happy to prescribe an antidepressant at all in the first place? Antidepressants are not without side effects and if he imagined you might appreciate the placebo effect of having your original symptoms prescribed for, then that is entirely wrong. On the other hand, if he accepted that you were indeed depressed, then he must also accept responsibility for monitoring how you're responding to what he prescribed. With depression a large part of that monitoring relies on self-reported symptoms. If he isn't prepared to listen to those then he has no business prescribing psychoactive substances.

I would complain, expressing it as constructive feedback and including a factual description of your suicidal episode. And see a different GP if you can, this one sounds awful.

I hope you start feeling better soon.

Thing is, GPs are just that generalists, some better than others for mental health. i thin you are taking it personally, you got your diagnosis and support / therapy so that is the main thing. I'm not sure what it would achieve complaining, maybe you want to mention you did actually get the autism test / diagnosis if you want to be 'right' and put him straight

I would also suggest giving it as constructive feedback as think might go down better,

I would consider a complain.

Because he dismissed every single issue you brought up.
That’s nitbte same than saying the services are under pressure. Even when they are, there are ways to tell people they won’t get anything in the NHS but may want to investigate privately what they can do.

The depression is appalling. If he told you you were ‘fine’ and then less than a week after, you were contemplating suicide, then he made a massive misjudgement and a mistake in his diagnosis. What if you HAD tried to commit suicide??

First thing I would do though is to ask to see another GP!!

It sounds to me as if you want to punish the GP for not giving you what you want

If by what you want you mean an accurate diagnosis and treatment (which was clearly out of line if te OP was considering suicide vs been told she was just fine and not depressed as such) the yes, that makes total sense imo!

I agree about the fact he failed his duty of care there. And it needs to be tackle. What if he does that to another patient and that patient decides to actually take their life because he will have wrongly again decided the person ‘is fine’??

Did he ask any questions to assess your risk of suicide?
I ask because having suicidal thoughts are not that uncommon and does not always mean you need more help than you are getting. But this is very different from being at real risk of suicide. The usual thing to do is assess which patients fall into by asking some questions.

You can make a complaint but absolutely nothing will come of it.

50mg is really the minimum dose for zoloft. That's where patients usually start and go up from there. The only reason not to increase it if the starting dose isn't effective would be if you were showing signs of serotonin syndrome, which you don't see to be.

If it were me I'd probably just find another doc, but I don't think it's unreasonable for you to express your concerns formally.

Just to clarify, did OP make it clear to GP that she was suicidal?

Did he ask why you thought you might have an ASD, OP? I supported a client to get a referral for assessment. I thought the GP would dismiss it out of hand, but when I explained some of the behaviours he displayed that could be consistent with an ASD, the GP was more than happy to refer.

The process is a long one though. He's been through 2 initial assessments and now has to spend 2 days being assessed, and it has taken nearly 2 years to get this far.

I totally get why you want to know, but I think it might be helpful to consider how you feel if you get the referral, and you turn out to be neurotypical. It might be an idea to consider how that might affect your mental health.

Maybe try and see a different GP at the practice next time you go. Some GPs are just a bit crap at MH, and some are excellent.

Also, I beg to differ re Sertraline. 50mg IS the standard dose, it may even be started at a lower dose. 200mg is the maximum

You're under the care of a therapist. So, no need for a referral to one, right?
Your therapist needs to liaise with your GP more, OP. Is there a reason this isn't happening? What type of therapist are you seeing?
As far as the GP is concerned, he's following protocol and managing your medication appropriately. He is actively treating your for depression and it takes time to get the meds/dosage right. It's not a one-size-fits-all approach. If you have the medication from the GP and the therapist on board, what more do you wish for from the GP with regards to your depression?
With regards to the autism, your therapist carried out the testing and should be sharing this data with your GP. If you wish to move forward with this, I'd advise you to ask your therapist to start writing letters to your GP. Your GP can act on the advice given to him by the therapist.
Why aren't these two healthcare professionals communicating?

YANBU.

The next time he dismisses some one it could cost their life. Yes the NHS is massively overwhelmed but it’s the GP job to make sure that people like OP don’t slip through the net.

She kept asking for help. He wasn’t listening

Even if your therapist is private, OP, letters need to be written. IMO this is in the therapist's hands to guide your GP.

Hi Wictional,
I’m so sorry to hear how depressed you are feeling at the moment. It must have been really difficult if you thought that taking your own life was the only solution. I’m glad you didn’t.

Your GP has been very ignorant and shouldn’t have dis issued you so lightly and his facts regarding ASD are very mislead.
At this point, it might be worth you posting on the SN Chat board as I think you might get more support from an ASD point of view....especially as many people there have either had diagnoses as adults or are parents (me) of children who have.

Check out some info on the ‘Triad of Impairment’ as this is the criteria that is used when assessing (social communication and language, imagination and flexibility of thought & social and emotional interaction).

When your GP so carelessly poofed you away without much consideration, he obviously didn’t realise how girls and women can present very differently to men and boys; in that they are better at masking their difficulties socially. Masking however, is knackering and by the end of a day, melt downs and shut downs are common as the person with ASD has spent their day hiding their usual behaviour, so as to appear neurologically atypical.

Perhaps you could call your surgery and ask if they have a gp who has experience or an interest in mental health or autism and if yes, book a double, 20 minute appointment with them to discuss what you’d like.
If there isn’t anyone there with a specific interest I need mH/Asd, ask to see another gp.

Maybe before you go, if having read the ASD criteria yo still think it’s relevant, print it off and note down the parts that you match so you can show them.

If you ever want to offload, please feel free to pm me. I can either help with ASD stuff or just ‘listen’ if you just want some support.

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

Which is a legitimate reason to complain and totally reasonable.

Calling somebody manipulative for describing finding themselves suicidal after being left without adequate help or support, despite asking for it - as we are all so regularly implored to do - is shitty, abusive behaviour.

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

Only by the really unprofessional, poorly trained, inadequately experienced, negligent ones who hail from toxic workplaces where the idea of "manipulative" SUs still gets bandied about as if it's still 1950. The ones who end up at inquests saying things like "I thought she was just attention seeking".

It's not viewed that way by the responsible, competent professionals who view the people they're tasked with supporting as human beings with unmet needs and potentially difficulties in communicating those needs. These would be the ones who consider it abhorrent to write people off as "manipulative" or "attention seeking".

It's sad that there are any professionals remaining who sit in the former category. They shouldn't be allowed anywhere near SUs.