To raise a concern about this GP?

[Thistledew]

My MIL is a retired nurse. Last week she phoned her GP and said that she was concerned that she was suffering from a subarachnoid haemorrhage (a bleed on the brain caused by a burst blood vessel). She had a headache, stiff neck and nausea. She has a family history of this problem as it caused her mother's death.

Her GP said that he would not call an ambulance for her as they would be likely to be too busy but that she should drive herself to the hospital and go to A&E for a scan. MIL fortunately took a taxi to A&E, where she was assessed as having a muscle spasm in her neck, which was causing the headache. There was no bleed on her brain.

It seems utterly alarming that a GP would advise someone suspected of having an active bleed on the brain to get in a car and drive. I'm considering contacting the practice manager and raising this as a concern for investigation.

On the other hand, what I suspect but cannot prove is that the GP has diagnosed MIL as having nothing more than health anxiety and thought that although there was no realistic likelihood of her suffering from a haemorrhage at that time that it was the only way to resolve her anxiety.

But if I'm wrong about that, then should I take it at face value and raise a concern?

Yes of course you should raise a concern if you are indeed concerned, what’s the worst that can come from it?

@goodforyounoonecares

Yes of course you should raise a concern if you are indeed concerned, what’s the worst that can come from it?

The worst is that it creates an unnecessary issue for the GP who was just trying to manage a difficult patient.

But the GP isn't the right person to call about a possible brain bleed. The GP has less access to ambulances than the public dialling 999. And the GP was right that she didn't have a brain bleed.

@Thistledew

How is MIL a difficult patient? I didn’t get that from your OP.

Could you MIL have mis-interpreted what the GP said? Eg was he meaning someone to drive her (eg neighbour).
Does she in fact have health anxiety?
Did you listen to both sides of the phone call?

If she is prone to self diagnosis that has proved to be wrong then it might be the GP thought she was wasting his time.
If her phoning and diagnosing herself wrongly is unusual for her then I would complain about his advice.

I'm considering contacting the practice manager and raising this as a concern for investigation.

Why? Your MIL is a grown woman and if she wants to make a complaint, she can do it herself.

Presumably she would've called an ambulance herself if she thought it was an emergency anyway, why did she expect her GP to do it?

If your MiL is a retired nurse who thinks she has a subarachnoid hemorrhage, wtf did she call the gp rather than 999?

Tbh you’re posting on a forum where there aren’t that many medically trained professionals and where no one has listened to the call in it’s entirety.

Forums such as these tend to be biased against GPs as lazy and greedy, amongst other complaints.

If you genuinely have a concern about clinical negligence, it is your responsibility to raise a complaint to fully investigate this.

She suspected she had an active bleed on her brain. It sounds like the doctor didn't. Why did she call the doctor? If I thought my brain was bleeding I would call an ambulance.

*its not it’s

Why would your MIL call the GP for a subarachnoid haemorrhage? As a nurse she would likely know who to call in an emergency?

Does she have capacity to raise a concern herself?

Were you there for the consultation with the GP? Since his assessment was correct and it was a muscle spasm, is there something else which makes you unsettled?

You have no idea what conversation was had between them. GPs don’t just have a yes/no flow chart - they use clinical nuance. If after taking a history over the phone they were confident that your MIL wasn’t having a haemorrhage, they also wouldn’t be able to justify phoning an ambulance. Safety netting your MIL and telling her to present to ED if she was still concerned was the right thing to do. It’s a massive leap to just assume the GP wrote off your MIL as someone suffering from anxiety.

I would say...She phoned up and gave the qualified GP her symptoms and the GP assessed she was not seriously ill, but should attend A and E to be checked. She attended A and E and and it was confirmed she didn’t have a serious problem. I am not sure what the issue is here. She did not have the symptoms of sub arachnoid haemorrhage as if she did she would be so unwell she would have struggled to hold a conversation with the GP.

Surprised that as a retired nurse, your mum thought the GP was an appropriate person to call.

If your MIL had any actual insight into subarachnoid haemorrhage she would not have called the GP! Also, nobody in the throes of a subarachnoid haemorrhage would be capable of making a phone call and chatting about their symptoms. The GP’s course of action appears to have been correct. Why would you want to make their life difficult by making a complaint about a non-issue?

I suspect the doctor knew your MILs anxiety was driving her presentation...and did not suspect a subarachnoid hemorrhage.

I'm confused.
If she wanted an ambulance, why did she ring the GP? It's faster to ring for an ambulance yourself

I suppose that actually what I want to achieve is (as usual for MN) a solution to a DH problem rather than a MIL one.

I don't think the GP actually did anything wrong, apart from affirm MIL's belief that she needed a scan.

I do think that MIL has health anxiety. This is the second serious illness that she has 'diagnosed' herself with in the last year. The last one was cancer. She didn't have cancer, she had a urine infection. This seems to be an escalation of odd behaviours around health.

DH is reluctant to question his mother on medical matters because of her former training, but I can see him getting worried about how his mother describes her health problems. I just wish there was a way that he could hear it from a medical practitioner that her problems are anxiety based, not physical.

Health anxiety is awful. I've been there, done that. Diagnosed myself with three deadly diseases in a week once. I didn't believe the doctor and convinced myself I was dying.

The best thing for me was doing CBT, I don't suffer from it that much anymore and if I do start getting concerned I control it and forget about it a few hours later.

I don't think the GP actually did anything wrong

You have answered your own question then

It does seem an odd thing to do. Anyone capable of diagnosing an SAH wouldn’t mess about with the GP, they’d know it’s A and E, pronto. They very fact that did phone the GP suggests that she wasn’t capable of making the assessment, ex-nurse or not, so I’d think that was really odd. No health professional is an expert in every area.

It's fairly shitty for DH to get a call from his mother in the middle of his working day to say that she is on her way to the hospital for a scan for the thing that killed her mother, when in fact no reasonable medical practitioner actually thinks there is a realistic likelihood that she has that thing.