AIBU to make a complaint about my partner's GP or will it just make things worse?

[Theloftmonster]

I really don't know what to do for the best.

My partner has been under the same GP for years. To start with DP thought the GP was great, he was young, enthusiastic and DP felt he was really listened to. Years have passed and the GP is now one of the partners at the surgery.

DP had a motorbike accident in his early 20s. He broke many bones in his body including his knee. He has suffered pain in his knee ever since and, with age, this has become much worse. Around 15 years ago the GP started prescribing Co-codamol for the pain, DP has been taking it ever since. DP also suffers from anxiety and depression, he has been on the same antidepressants for years also.

A couple of years ago DP went to the GP with a bulge in his lower abdomen, he was in a fair bit of pain. The GP said that he couldn't feel anything but finally agreed to refer DP to the local hospital. When DP was seen at the hospital the consultant was concerned enough to mark his case as urgent because the hernia was so progressed he was worried about strangulation. DP was operated on within three weeks.

A while later DP complained of pain in one of his legs. The GP again was dismissive but DP was finally diagnosed (by a different GP in the surgery) as having cellulitis and was prescribed antibiotics, the pain was still there and so he was given a second course. DP still felt pain but again the GP was dismissive.

DP struggled on but after about a year his hip became very painful. He again went to the GP who reluctantly sent him to the cottage hospital. The x-rays showed that there was an issue with the hip and DP started on cortisone injections in the hip. The first injection worked fantastically but the relief was shortlived. The second injection did nothing to help. DP again went to the GP and had an appointment where a young female trainee doctor sat in. DP came back from the appointment in absolute pieces. DP says that the doctor basically said that DP was a pain-killer addict and DP felt humiliated. His mental health nosedived, it was awful seeing him in that state, he could barely motivate himself to get out of bed for weeks. His mood slowly improved, he went back to work, even though he was in significant pain. He refused to go back to the GP because of the way the last appointment had made him feel.

Finally I persuaded DP to see a female doctor at the surgery that I had found particularly empathetic, she referred DP to the hospital. The pain continued to increase, by now DP needed crutches to walk. He reluctantly went back to the doctor and they agreed to write to the hospital to see if it could be expedited. Nothing happened. DP rang the doctors every month or so, finally an appointment came through. By now DP was more or less bedridden because the pain was excruciating. DP was finally diagnosed stronger pain relief (the surgery wouldn't send anyone out to see him but then prescribed oramorph and later on tramadol over the phone). Each time he needs a repeat prescription he has to ring the surgery and is made to feel like an addict trying to get free drugs.

At the hospital they x-rayed the hip again. As the doctor looked at the x-ray, called in a colleague for a second opinion and said that the difference between the x-ray at the cottage hospital and the x-ray they had just taken showed a massive deterioration which should not have happened in that time frame. The doctor referred DP for urgent tests and said that the consultant would do the hip replacement himself. We got a phone call on the way home for the hospital to book the CT scan. Over the next month DP had blood tests, bone density scan and a MRI scan. Every one we saw commented on how much pain DP was obviously in and were very sympathetic. Still the GP surgery have refused to put his painkillers on repeat so he needs to ring up each time and plead his case. This has massively affected his mental health as he feels like he is marked as an addict and not believed.

We got the results about a couple of weeks ago. DP has been diagnosed with Avascular Necrosis. The blood supply to his hip had been cut off some how and the bone has basically died. His hip joint has crumbled, he is now mostly bedridden, occupational health has given him a wheelchair, crutches, a raised toilet seat etc. DP is having his first operation this week where they are taking samples to see if there is an infection that has caused the necrosis and to clean out the socket. After that, assuming there is no infection to treat, he needs at the very minimum, a full hip replacement. The muscles in his legs have withered away, he has been told he is going to need a shedload of physio after the operations to be able to walk again, let alone do anything else. DP is 51.

DP still has to ring the surgery each time he needs more painkillers and it really affects his mood, his depression and anxiety has worsened considerably.

It really feels that DP's GP has made a judgement that DP is some sort of addict when all he is doing is trying to control the pain he is in. I feel that the GP has allowed his opinion of DP to cloud his judgement and this has meant that DP didn't get the treatment he needed until things got to breaking point both physically and mentally and, even now, DP is still having to constantly justify himself.

DP is worried that if we complain about the GPs attitude that it will only get worse, I think that something needs to be said. DP is the shell of the person he used to be. I am willing to do the complaining for him so he doesn't have that extra stress. WIBU to complain? If so is it the practice manager we speak to? To complicate things I think the GP is the head guy.

Sorry it is so long!!

Please complain.

Bloody hell, what a terrible time for you all

I would encourage you and your dh to complain to the practice manager. Obviously no guarantees of what will happen but After working in nhs back offices, people who complain are not generally earmarked as trouble makers and their care affected. If anything they generally get better care, although there may be grumbling behind the scenes, people don’t want to be scrutinised further so go out of their way to make sure things are done right.

You have a number of issues that if you had the answers/explanations for would make your lives a lot less stressful and ultimately that’s a good thing.

Don’t forget your GP doesn’t operate in isolation, they’re answerable to the CCG, GMC and CQC (even involving an MP is a consideration) but you have to follow the official steps. If you don’t feel you’re being taken seriously or are unsatisfied with an answer you can escalate.

I completely understand if you and your dh feel overwhelmed at this point. It’s a scandal that our system is set up to put so much onus on individuals to fight (and hard) through bureaucracy precisely at times they feel they are being failed and are vulnerable. My feeling is though, you have to weigh up how much longer the status quo can continue. It sounds like both you and your DH are going to be needing close GP involvement for some time. If you’re current complaints could be resolved then surely this would be easier long term?

I think I would change GP too personally. This shouldn’t affect your continued care under specialisms provided they’re all in the same Trust. its so important to have trust in your doctor and I’m not sure I could have that it your shoes. It would probably be helpful to get your DH’s orthopaedic consultant to put plainly in a letter how much pain relief is appropriate for your DH’s condition.

As a chronic pain sufferer with a fabulous GP I sympathise so much. Life should not be made harder than it needs to be.

I would write to the practice manager asking for an urgent review of your DH’s medication protocol and request that his meds are put onto repeat without the need for this pitiful farce each time he needs them.

If he hasn’t already had a Pain management referral I would consider requesting this too. The consultant can make recommendations. They cannot prescribe long term as some PPs suggest, it has to come from your GP. However, if the consultant has recommended x medication it’s less likely to be dismissed.

Just write a succinct letter requesting this and get your DH to sign it. As much as some of your DH’s medical history is awful most isn’t directly relevant to this issue now.

Very best wishes for his treatment. As someone with hip pain and a steroid injection not long ago I’m now a bit concerned.

Hi I work in a surgery admin role you cant complain on his behalf unless your partner consented to that happening no one can discuss anything with you. The painkiller issue you could definitely ask to see practice policy about this but the doctor may have flagged that he has addiction issues on his record he could request to see his records to see if this is the case. If he has any outstanding referrals I wouldn't change surgery yet but if he is under the consultant now and no further referrals it's easy enough just to change surgeries.

tillytrotter1 Your post is a bit unfeeling really. It’s not that uncommon for partners to advocate on behalf of someone who is ill, especially when there are mental health issues as well. It clearly is her business as she’s dealing with the implications every day.

If your DP has taken an opiate based painkiller for more than 3 days his body is physically reliant.

That's just scaremongering. Taking it for more than three days does not create automatic addiction. I took it for months often for more than three days at a time and had no physical symptoms at all when I stopped.

The painkiller addiction thing is getting very silly. Yes you can be addicted, but that doesn't mean that you aren't in pain and don't need them!

If you have a problem it's not going to magically go away if it can't be fixed.

Are you one of those women, usually quite elderly, who actually accompany their OHs into doctor's appointments? I've always found that funny.

Why is it funny? Many people take someone with them to help them a) remember what was said. b) for moral support

@LightsInOtherPeoplesHouses your anecdotal story is important- however the body can develop dependence within three days. Especially at prescribed level doses that is just a simple fact. I didn't say he should stop taking the meds or he didn't need them. I am pointing out why is is so common for GPS to have such policies in place.

Opiates are not even very effective for chronic pain, they cause rebound pain and there are far more useful medical options.

Call Dr Singh at the London Pain clinic and get him to prescribe privately
The last thing he needs is judgment
The poor soul

also what a caring wife you are xxxx

@tillytrotter1 Do you have experience with anyone with anxiety and depression? In an ideal world he would be managing this all by himself. Unfortunately at the moment he can't because he can't get to medical appointments by himself. He can barely walk, he can't dress and undress, he certainly can't drive, so yes I do have to go to appointments with him. I didn't previously as you can see from me explaining what my DP said the GP's reaction was like, I wasn't there to witness it because at that point he could manage a bit better physically.

Being in constant pain screws with your head. He never manages to sleep more than a couple of hours in a row. He is going absolutely stir crazy being unable to move, stuck at home all day by himself. He has too much time to think and dwell on things. He lost a parent in difficult circumstances fairly recently. He is coming to terms with the fact that he is unlikely to get full mobility back. He is 51 and using a raised bloody toilet seat and a wheelchair. So yes, he is suffering quite considerably mentally, that isnt exactly surprising though in the circumstances.

Tilly, you sounds like a genuinely awful person. OP, please complain, you sound like you’re at the end of your rope and dealing with a lot. It needs looking into seriously by someone who obviously cares more than this GP does.

I just read Tilly’s comment again and I am quite convinced she’s a giant dick.

Please complain.

tillytrotter1, what a vile excuse for a human being you are. I accompany my DH to some appointments and I'm certainly not elderly, I do it if he wants moral support or if he thinks he might not be able to hear properly (he's partially deaf). I suggest you keep your fucking opinions to yourself.

OP, when my DM was alive she signed a letter authorising me to speak to her GP on her behalf. This meant she didn't have the worry of speaking to them herself.

Good luck to you and your DH.

I am so sorry that your dh has had such an appalling experience with his gp. Contacting the practise manager is your first port of call. Can he dictate an email for you to type?
I guess if you have no joy then take it further, and there have been some suggestions by pp on what to do there.

I will say I don't understand why he has to ask for his meds every time. My dd has been on Tramadol for approx 7 years for CRPS and has hers on repeat prescription. Once a year in her review she gets a bit worried they might say she needs to stop, but so far they haven't. I really don't know how she would cope if she was taken off them. Actually, I can guess, and ot wouldn't be good.

All the best for you and your dh. You do need to look after your health too, otherwise you might not be able to look after everyone like you do. I wonder if you can get some help in whilst you have the procedures you need to have done?

Do opiates stop working if someone is on them for yrs? Don't they stop being effective for pain relief with high levels of use?

OP you can complain with a signed agreement from your DP that you are acting on his behalf. You address it to the practice manager. You will revive a letter telling you the timescale for a formal reply and may be invited in to discuss.

But be clear what it is you want to achieve and make those points.

If it is negligence in the diagnosis being missed in your opinion than that is one issue which would be dealt with through the usual channels and you would need a solicitor to progress this on your behalf.

If it is to address the issue about prescriptions and how you feel that is linked to the GP being dismissive of the level of pain your DP is in then that can definitely be dealt with at practice level.

State that you feel-
The GP dismissed your DP in a consultation as being a drug addict when talking to a colleague and your DP felt belittled and humiliated and it led to him not seeking help when his pain escalated and affected his mental health.
That you feel the GPs judgement of yourDP as someone simply addicted to analgesia has affected their professional relationship and clouded his clinical assessment negatively.
That due to all this your DP becomes extremely anxious when he has to phone for a repeat prescription and you want to discuss alternatives ways to have access ongoing repeats of his medications (which he clearly needs) eg can be done electronically to pharmacy each month etc. (So long as your DP is sticking to the prescribed amounts and not using over this and requesting early then he shouldn’t need to speak to someone every month. If he is asking for them before the time is up then yes he would have to else he could easily take far too many and the GP would be criticised for providing them). So it’s a two way street that his request must be at the appropriate and agreed timescale.

You can also ask for him to be registered with a different GP at the same practice but it isn’t usually possible for them to guarantee he might to have to see the original GP in an emergency.

It sounds like the issue is resolvable and is one of how your DP has been made to feel rather than any clear negligence or missed diagnosis. The times have changed when it comes to opioid prescriptions and your DP has fallen foul of either end of the spectrum.

If he is still in pain despite the cocodamol whilst awaiting surgery then he should ask to explore alternative medications.

I wish him and you well.

lljkk they might be less effective at the same dose once you’ve been on them a while, yes, which is why most people are started off on a low dose and then titrated up as their tolerance grows until they’re on a dose that provides the most amount of relief with the least side effects (a therapeutic dose for someone who’s been on them for a couple of years would likely knock out somebody who is opiate naive).

But no, they don’t ‘stop working’, that’s a misconception.

Opiates are not even very effective for chronic pain, they cause rebound pain and there are far more useful medical options

You are the perfect example of somebody who knows a little and then mistakenly believes they know a lot (and worse, tries to pass their limited understanding off as fact, applied across the board apparently to everybody regardless of their medical history and situation). I hope there aren’t people reading the thread who are naive enough to take any of it without a great pinch of salt/talking to their doctor.

@tillytrotter1 i honestly can't believe you have come onto this post to verbally attack this OP when she is asking for advice on such a sensitive subject for her family!! think the saying "if you have nothing nice to say dont say anything at all!!" applies to you!!

my partner or even when needed my father comes to my appointments for with me for moral support and to enforce the reason i am there! i live with a chronic pain condition and have done since i was 11, among other conditions and my doctor has been happy to put me on morphine patches as she calls them but not look into why i was in so much pain. Sometimes it takes someone to be there with you to have your back and provide support!! something you obviously cannot do for another person!

Thanks for your feedback @StripeyTopRedLips actually I have a chronic long term pain condition and medical training so I do know a fair bit on this subject but keep on bitchin' 👍🏼

Hello fellow chronic pain patient!

Then you really ought to know better if what you say is true than to present your opinion as global facts. I’m glad for you there are other better options. For many people, there simply aren’t, opiates are effective and not everyone experiences rebound pain. Your experience (and mine) isn’t applicable to everybody.