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.

GPs can’t win.
I recall a specific example of a patient who had an X-ray, which showed arthritis , so I send a letter asking her to make an appointment to discuss her X-ray. When she saw me a couple of weeks later, I told her she had arthritis, and she was angry. She said “why didn’t you tell me it was just arthritis , I’ve been worrying about all sorts of other things”.
Why is this a gps can't win situation? A phone call to a patient asking them to come in as opposed to a letter and a wait,? Of course a patient is worrying!!

No I wasn't thinking bout rheumatoid arthritis. but I was thinking of osteo-porosis!

That said, osteo-arthr is described as progressive.
And that same link mentions drugs to delay progression.
Tolerability of the drugs might depend on one's age.
So don't think what I said makes no sense.

Advice for young people dealing with osteo-arthritis.

I think I was told I probably have some at age 48, but that's not young anyway. The wear in my joints was visible in Xray but didn't meet the threshold for getting treatment. I know someone had a knee replacement age 25, so just grateful that wasn't me.

No, you shouldn't be told like that, clearly any diagnosis with ongoing implications warrants a phonecall. Our health service is crap, not the fault of individual staff, just systemic failings caused by long term underfunding.

You're lucky to have got a test! I don't mean you should be grateful, we all deserve way better, but it is buckling before our eyes and some people can't even get seen.

It was already bad before Covid, but now the Conservative government and those who vote for them have a convenient excuse.

That’s not on at all, YANBU OP. Good luck going forward, hopefully they can offer some kind of treatment/pain relief to help.

@Marsis

I would just want to know too tbh, OP has history of osteoarthritis so they perhaps incorrectly assumed you know the treatment options are limited to weight loss, exercise and pain relief. I think perhaps they should discuss prior ‘I think it’s probably X or Y very unlikely to be Z, if the result is X or Y are you happy to be told by text and you can arrange and appointment if you want to discuss.’

Well, since the treatment options are NOT limited to weight loss, exercise and pain relief, perhaps the OP was being totally unreasonable expecting some actual medical advice and not a text from the GP and incorrect advice from strangers on the internet?

People are not machines. Text messages as reminders for appointments or routine things, if the patient has agreed to that, is one thing. Sending diagnoses by phone really isn't, and apart from being poor clinical practice, leaves it open for someone other than the patient to see the information. And nobody can predict how a patient might receive that information - just because one person may not mind doesn't mean another may not be devastated.

It would have been a matter of relative ease to send a text saying that the results are back and could the OP phone in for a telephone appointment (or via the digital face to face app if they have it - a lot of the NHS now does). And subsequently suggesting that paracetamol is the only or even the best option suggests a serious lack of clinical consideration. It smacks of "it's just arthritis and you are wasting my time".

@Porridgeoat

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

Disagree. Low iron levels could be a sign of something serious. I don't think any abnormal results should be given out by text.

I literally posted upthread how I was very happy & impressed to be speedily informed of my low iron levels via text! Everyone is different - the key here should be prior agreement of how information should be sent to you. Some of us are completely happy with texts as quicker than waiting for both parties to be available for a phone call.

You can’t judge this response by comparing it with normal times, GPS are massively busy at the moment and considering everything are doing pretty well. I’m sure the diagnosis was a terrible shock, but it would have been a shock however it was delivered. You have the option of talking to them on the phone and I am sure they will then make an urgent onward referral. I would encourage you to ring them ASAP. I am sure they will ring you back today. Take care.

@frumpety

have you ?

Yes. Hence why I said 'we have been'

• 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 ?

Here is a screenshot regarding NHS Tayside and their self referral.

You probably know but just in case you don't you have to click the picture to see it all. Not being sarcastic here, not everyone does know.

@Thomasina79

You can’t judge this response by comparing it with normal times, GPS are massively busy at the moment and considering everything are doing pretty well. I’m sure the diagnosis was a terrible shock, but it would have been a shock however it was delivered. You have the option of talking to them on the phone and I am sure they will then make an urgent onward referral. I would encourage you to ring them ASAP. I am sure they will ring you back today. Take care.

Well each time that someone posts an issue they e had with their GP, the answer is that it’s normal, you can’t ask for more because times are difficult and That was true before Covid too.

FWIW other european countries do NOT have that sort of issues. France, germany etc... people go and SEE their GP normally. They still have their routine appointments.
Yes in some areas, they’ve had to stop non urgent surgeries (Paris for example) but it want the case during the summer and early autumn. Whereas getting an appointment here, let alone actually seeing a GP in person is hard.

Now ask yourself the question as to why this is the case... Plenty of answers as for as I can see

• NHS run down in the first place
• unwillingness of the government to resume normal service so that they can then introduce Telehealth only once things have settled
• GPS not feeling safe working in those conditions etc etc

But not expecting better is sad imo.

What alternatives are there? I am definitely going to ring back tomorrow and speak to someone else

I take naproxen, without it there are times I can’t even lift a cuppa as my hands/wrists are so sore.
However, it has to be prescribed with a stomach protector which causes its own problems. I’m now anaemic as that causes absorption issues. I’m going to give it all a break and make do with the pain whilst I get my iron back up. It’s true what they say, once you start medication you need medication for the side effects of the medication!

You can’t judge this response by comparing it with normal times, GPS are massively busy at the moment and considering everything are doing pretty well.

They are no more busy down here than normal and I've been told that by one of the practice nurses that I see quite often for blood tests.

This dehumanising text definitely wasn't what the government had in mind when GP's went digital.

I'm actually quite surprised that you received this text. I recently had several blood tests and agreed rough timescales with my GP when I should organise a follow up appointment, in order to discuss blood results & treatment options.

Definitely give feedback to your GP and the practice manager, this type of text is not acceptable.

I think you’re being very precious. Whilst I understand osteoarthritis can be very painful, it’s a very common ailment and one that can be managed. I would actually appreciate receiving a text that confirmed diagnosis instead of having to wait to see the GP.

I’d appreciate diagnosis via text for speed, however I’m less impressed by the nonplussed invitation to contact to discuss if you want.

A diagnosis with an appointment date to discuss your options or a asking to please call would be fine. Not what they’ve sent as you say is really flippant.

I appreciate some people need face to face appointments and some surgeries are not doing enough of them. However I also think we should celebrate the fact that we now have the infrastructure for remote consultations. They can be much better for people working, people reluctant to attend in person (men, mental health problems etc). I can now access health care much easier and quicker before, and without any risk of infection. I think it’s a good thing we don’t all have to go to the GP at the moment, personally I think that is superior to countries that do. Needs more of a balance of types of appointments but we do t always have to be negative about everything.
This is not disputing OPs situation, she should complain of course so that they can re-evaluate processes

Bungle - I think you're right that a lot of people will appreciate the ease of remote appointments because it's difficult for people who work to get to the doctor, it can be difficult for anyone to get an appointment, but if those things weren't true and we had GP care like they have in other European countries where you can make an appointment quickly and go after work, we might not see it the same way.
For some problems you need to be examined properly.

I don't think they should have text.

Both ds and I have had tests for things during lockdown and both times the GP rang to give results.

Sorry about your diagnosis op. I think all diagnosis should be given to the patient when there is an opportunity to ask questions. It's really unfair to just send something big like that in a text.

I'd be ok with a text personally - assuming it was effectively confirmation of an expected diagnosis. I'd probably prefer 'please call to make an appointment to discuss' as the next part - I wouldn't want an "assigned" appointment because that's unlikely to be convenient - I'm fairly flexible if I can plan childcare in advance but would need to check DH has nothing immovable in his diary.

A message to call for results would definitely cause panic/overthinking!

I definitely think this approach is much better than the Drs in our area.

Both me and DH were called and told that our test results were abnormal, but a dr would call us in 3+ days.

I'm an anxious person, and I fell to pieces (am since working on resilience!) But I honestly went straight to the worst thought of what it could be.

DH also was called and told that his blood tests were out of range for several things, which then meant that he had to speak with a Dr, in 3 days time.