To want to angrily complain to my GP for giving DD the wrong dose of medicine

[agirlhasnonameX]

I very well could be, I have medical related anxiety and haven't slept, so perhaps I'm blowing out of proportion.

DD3yrs had scarletina (scarlet fever) a few weeks ago and was given a 7 day course of antibiotics. I researched it and found everywhere that a 10 day course is the treatment for it. If not treated properly, it can come back, cause liver and heart problems later in life and pneumonia. I phoned the Dr and asked them if they'd given the correct course as I'd found otherwise and they assured me that 7 days was fine.
She has been at hospital last night with a rash 10x worse and the Dr thinks it's possibly scarletina again (although could also be MC) and now she has been given the correct ten day course to treat it.

I'm not sure if it's a money issue or if they have her less to prevent becoming immune to antibiotics should she ever really need them, although if the latter it seems silly that she will now be taking almost double what she would have if she'd had the correct course to begin with.

AIBU to call my Dr out on this and complain?

DD was given 10 days of penacillin when she had SF (twice!!) We had to pick up more on day 5 as they won't give more than 5 days worth as it's premixed and has to be kept refrigerated.

Sorry your DC is poorly, can you seek a second opinion on the first course? It should all be in her not

Yes. YABU. Presumably they are fully aware of the recommendations and used professional judgment to adapt the recommendations to the patient.

Definitely not BU. Complain.
They are supposed to follow the GP notebook guidelines, and they have not, i.e.:

"The treatment of choice is penicillin and this leads to the rapid resolution of symptoms in about 24 hours. A ten day course of treatment is necessary to eradicate the streptococci (1)."

www.gpnotebook.co.uk/simplepage.cfm?ID=-1912209389&linkID=6492&cook=no

Yabu. What would an angry complaint achieve. Just inform them.

Presumably they are fully aware of the recommendations and used professional judgment to adapt the recommendations to the patient.

I wouldn't necessarily presume that at all! I've been given the wrong dosage of antibiotics twice. Some doctors don't take enough care with researching dosages.

10 days is standard for penicillin class antibiotics, 5 days for azithromycin.

YABU. Presumably they are fully aware of the recommendations and used professional judgment to adapt the recommendations to the patient.

This. They may be using local guidelines rather than the ones on Dr Google.

They may be using local guidelines rather than the ones on Dr Google.

Nonsense. A GP doesn't have the expertise to override NHS rules and procedures.

I've been prescribed penicillin by a GP in the past even though my notes say I'm allergic to it in big red letters. Luckily the pharmacist was on the ball and asked me if I had any allergies!

Nonsense. A GP doesn't have the expertise to override NHS rules and procedures.

Yabu. What would an angry complaint achieve. Just inform them.

Complain so the matter is properly investigated. If the doctor has been negligent or incompetent then the practice needs to know about it and take action.

"Informing" them will have no effect whatsoever.

Some of you seem to think that GPs are infallible!

Nonsense. A GP doesn't have the expertise to override NHS rules and procedures.
One of the Drs she saw printed me off several pages of NHS information which also stated a ten day course is required.
We where given the 7 day course in one go, but her second prescription is in two halves.

missugirl

Local guidelines ARE NHS.

I wouldn't be angrily complaining about anything until I asked for the rationale behind it.

And I'm angry because my DD could have ended up extremely unwell. Scarlet fever left untreated can still be fatal.

The recommendation to prescribe a 10-day course of penicillin V as first line treatment is based on expert opinion in the PHE letter to all healthcare professionals issued in response to increased incidence of scarlet fever [PHE, 2015b], the US clinical guideline Clinical practice guideline for the diagnosis and management of Group A streptococcal pharyngitis: 2012 update by the Infectious Disease Society of America [Shulman et al, 2012], the British National Formulary (BNF) [BNF 70, 2015], and the manufacturer's Summary of Product Characteristics (SPC).

So no, a GP does not have the expertise to ignore the guidelines.

I would ask the question politely and firmly request an answer, giving the rationale that you would like practice to be improved if necessary due to your daughters experience.

If you have a dh or dw who would pursue this matter it might help it not be viewed through the lens of the practice knowing you have health anxiety, even though that sucks.

The above is taken from the NICE guidelines, which dictate NHS treatment.
cks.nice.org.uk/scarlet-fever#!scenario

I dont know about an 'angry' complaint, but it sounds as though it should be raised as a concern/complaint.

I would start by contacting PALS or the practice manager at the surgery.

I'd suggest you don't raise it as an 'angry' complaint because generally these don't get you what you want.

What would be a good outcome of your complaint? I would suggest that the GP, and the practice as a whole, learn about current guidelines about prescribing for scarlet fever.

So I would suggest you raise this as a factual complaint stating the dates and times etc. along the lines of:
My daughter saw Dr B on X date and was diagnosed with scarlet fever. He/she prescribed a 7 day course of penicillin.

I double-checked with Dr B on Y date, having found information that the correct course was 10 days. Dr B reassured me that 7 days would be fine.

My daughter then relapsed on Z date and was admitted to hospital. She was diagnosed with Scarlet fever and was then given a 10 day course of penicillin in accordance with NHS guidelines (include the link here)

I would like you to investigate this as a complaint and to bring it up as a critical incident at the practice, especially as we discussed the need for 10 days on Y date. Please inform me of your findings and any action taken by the practice.

So not an angry complaint - but clear and achievable by the practice.

To be fair though, the guideline is just that, a GUIDEline and not a protocol, and to be fair, in this case, is based on the lowest quality level of evidence available which is 'expert opinion' otherwise known as a group of clinicians sitting around a table and deciding 'that sounds like a plan...'

If you are concerned then why not raise the concern with the GP surgery and be open minded to the possibility that as professional, qualified doctors they may have an insight into your child's particular case that google does not. Going straight in with an "angry complaint" doesn't seem particularly measured.

If the doctor has made a mistake then you are well within your right to complain. Good luck with it all. I have recently made a complaint about something wrong my GP did. I had to put it in writing to the practice manager

Is it definite she had scarlet fever and not glandular fever? Some of the symptoms are similar and antibiotics can give a rash with glandular fever.

Thanks for the replies.
She definitely had scarlet fever.
When I say angrily complain I don't mean I'm intending to storm in shouting and swearing or anything. I should have said firmly complain (I'm not great at being assertive in situations such as these) although it comes from a place of anger in honesty. I suppose I should see what they have to say first.
Thank you to the pp who wrote out a template of a good way to word a complaint letter too.