GP diagnosis by text

[BeingAMumIsHardWorm]

I received the following diagnosis by text message with a footnote saying call if you want to discuss.

AIBU to be annoyed to have got this by text.

"Dear Mrs so and so

Your X-ray results have come back and show that you have severe osteoarthritis. Call the surgery if you want to discuss this "

I am relatively young to have severe osteoarthritis and am feeling quite upset by this diagnosis but am annoyed that they sent me the diagnosis in such a flippant way.

Why couldn't they call? The options are not just text or an appointment in two weeks' time.

What were you expecting the result to be?

That's an appalling level of care. I'm shocked. That GP should be put on a warning.

@BeingAMumIsHardWorm

Thanks all for taking the time to reply. I knew I had arthritis in one of my knees but have been told that I have severe arthritis in both my knees and degenerative arthritis in my hands and other joints in my body. Only found out the latter as I did ring to discuss. Makes me wonder if they wouldn't have bothered if I didn't ring. I also had to extract the information from the GP. She sounded surprised I was ringing. Wasn't offered any advice other than to take paracetamol and refer myself to physio. But again was offered this advice when I asked what I can do to help.

Don't you get some sort of medication for this? Surely not just pain killers?

Why don’t you just ring them as they suggest ?.

A phone call would have been much more appropriate.

It is annoying. I had a text to say my blood test had shown something significant and to ring the gp ASAP. As I work till 6.30pm, it had shut and it was a Friday night so had to wait till Monday. I had a horrific weekend of anxiety so I wasn’t impressed.

I must admit though they tried to ring me and I missed the call as I was really busy.

The Doctor told you to self refer yourself to NHS physio's ? Are you already known to them ? or did they mean get in touch with a private physio for advice ?

Bloody hell. I can see that there’s a place for some texting “Your blood test results are in and normal” or even “Your blood test results are in and you are borderline anaemic, please call to arrange a prescription” but bad news? Certainly not. I’m sorry that happened to you

[quote BeingAMumIsHardWorm]@Moondust001 the wording on the text definitely said severe and that is all the treatment she offered. Some of my joints are very very painful.
What alternatives are there? I am definitely going to ring back tomorrow and speak to someone else. [/quote]
I am not a specialist (but medically trained, just no longer working in medical practice) but I have obviously picked up a lot from personal experience. Options are huge and varied - and often depends on the individual reaction. Some things work on some people and not on others! One thing I should say - the amount of pain you have and the severity of arthritis are not linked! I know that sounds perverse, but the bodies way of creating pain is also highly individual - so you could actually have mild arthritis and loads of pain. I have really severe arthritis in the right hip and no pain! And my spinal "pain" is neuropathy - numbness rather than pain (and I would rather have pain!). So there is no secret fix - everyone has to experiment - which is why there are specialists.

But in general yes, you need pain relief and also anti-inflammatories are normally prescribed. There are some treatments though that sound "off the wall" - for example some drugs that are actually antidepressants in higher doses, in lower doses can help certain manifestations of arthritis.

There are a range of alternatives too to consider although you'd have to pay for them. CBD oil, obviously, although the stuff you can easily get at many stores isn't potent enough if it's bad, and obtaining certain medical grade supplies can be "interesting". There is research that shows that avocado soybean unsaponifiables can help people - it's widely used medically in parts of Europe and elsewhere. Not in the UK although a lot of specialists advise trying it.

In the end it is a bit hit and miss until you find something that helps you. But I would suggest asking to be referred to a muscular skeletal specialist - people often aren't told about them but they are a normal part of NHS provision and it is a right to be referred. It tends to be a bit chicken and egg - the GP's most informed about arthritis tend to refer automatically and those who aren't don't!

@frumpety

The Doctor told you to self refer yourself to NHS physio's ? Are you already known to them ? or did they mean get in touch with a private physio for advice ?

We have been self refer to NHS physios for about 7/8 years in our area

My biggest issue with this is that, in osteoarthritis specifically, X-ray appearances don't always correlate well with clinical symptoms, so as a rule, we are taught to use the patient's symptoms to assess severity, not X-rays. You can have an awful-looking X-ray but feel fine, or a great X-ray but struggle to move. It may be worth speaking to your GP again. The usual approach is to treat the symptoms. If painkillers and physio control your symptoms, it doesn't matter what the X-ray looks like.

@premiumhob have you ? I haven't been for a good few years , I accepted that I needed to lose a lot of weight and do the exercises they gave me and ended up doing neither , so haven't dared go back
But I know at the time I had to be referred via the GP, do you just ring up and ask for an appointment or do you need proof of a diagnosis ?

Sorry to hear this is the way you were contacted.

I'd feel the same as you, it doesn't seem appropriate at all.
I'm guessing you're going to be contacting the surgery anyway
going forwards so I'd definitely complaint as it was insensitive

This sort of text would be fine if your diagnosis was low iron levels

Your gp should have phoned you.

That's actually terrible. So curt and cold. No advice, no 'next step' given, no medication discussed. It is awful and I would complain in writing.

@Porridgeoat

This sort of text would be fine if your diagnosis was low iron levels

Exactly. What were the doctor's thinking? It is awful OP.

You sound like very hard work. Just phone your doctor and book an appointment to discuss the result like they suggested

OP that is shocking I would complain to the centre manager. I had some bloods taken last month just a routine yearly thing. My blood pressure was up too. My GP surgery rang twice but I was outside and didn’t hear the phone then they rang early afternoon and it stopped as I picked up the phone. I received a text message on the mobile to say could I please phone the surgery. The GP was concerned and the Practice Nurse said he would like to put me on some medication. So I had three attempted phone calls and a text message to ring no diagnose just could I phone them. This was the following day in a busy small city practice. That is service. It wasn’t even my GP who is fantastic. In 30 years I have only complained once and that was about a receptionist who wouldn’t let me see my GP when I had chest pains and short of breath. GP dealt with it in training.

Some of my joints are very very painful.
What alternatives are there?
I have osteoarthritis, just in its beginning stages. I have had two injections which were amazing and lasted nearly a year each. Personally I think a text as opposed to a phone call at least is a joke, no matter how busy they are and to be surprised you rang shows a huge disconnect between the doctor and their patients. Sorry op

OP, all I can say is that you will be wasting your time calling the surgery for severe osteoarthritis, as they won't be interested. I suggest you say that you have COVID instead, as that's all anyone is interested in.

If every single tickle in the throat is COVID, there's no reason why arthritis can't be COVID, too.

It sounds like this has really shaken you OP, and this wasn’t a welcome way to inform you of this diagnosis. But I do think in some contexts a quick text from the GP can be appropriate. I’m currently having tests for a variety of things. I had blood sample taken on a Friday and 7:30 on the Monday morning had a quick text from my GP saying she’d reviewed the results and most were ok but the iron is low, please start taking iron supplements, but she didn’t want to see me until we had the other tests back as well in a few weeks. In that context I was super impressed at the speed and efficiency of her communicating that with me. Her text wasn’t as perfunctory as yours though and is more part of an ongoing conversation.

It does sound though like this text is just part of what comes across as your GP’s overall disregard and lack of ongoing support and advice for you at how to manage your condition. You’ve probably already heard of them but Versus Arthritis is the UK charity for arthritis and they have a helpline might be a useful place to start www.versusarthritis.org/get-help/ - there will be a lot more than paracetamol and physiotherapy! I work with animals and with animals with arthritis we think about nutrition, supplements, exercise, hydrotherapy, different medications, joint injections, ongoing monitoring of pain management. If your symptoms could be managed with paracetamol I doubt you’d have been at the GP.... hopefully if you persist maybe they can refer you to a specialist who can help you with a more holistic approach to managing your symptoms. There’s probably online patient peer support groups that could be good as well.

YANBU OP.

I am not medically trained, but I'd hazard a guess that communicating with your patients comes pretty high up on the skill set GPs need to have.