To think doctors, specifically GP's need to change their approach to patients

[GlasswareisOverated]

We live in the technological age. We have access to information at our fingertips, that someone fifty years ago, hell even twenty years ago would not have been able to comprehend.
Am I being unreasonable to think that drs need to lose the 'we know best about everything medical' attitude.

Obviously I won't be performing brain surgery any time soon or stripping legs of vascular veins to be used in cardiac surgery but I can read a laboratory report and understand what it means and I can get the gist of most medical studies.

"Half of what you are taught in medical school will be wrong in 10 years’ time. The trouble is, none of your teachers know which half"
Former dean of Harvard medical school, Sydney Burwell.

I agree. The idea that GPs are good at managing chronic diseases is a joke.

My OH has cancer and will need to be on a sackful of prescription drugs for the rest of his life.

The GPs havn't a sodding clue about how to deal with all the complications and side effects that come with that.

The oncologist will only deal with the cancer itself and keeps referring everything else back to the GP surgery, such as vitamin deficiencies, high blood pressure, heart palpitations, general pains, etc. When OH goes to the GP to get treatment/meds for these things, they're hopeless. The GP surgery won't even agree to doing his blood tests, and just send him to the hospital for them. Latest saga is a Vit D deficiency, highlighted by both the oncologist and an orthopeadic consultant over a year ago. OH got himself the strongest possible OTT Vit D from the pharmacy, but levels are still falling. Oncologist and Ortho consultant both told DH to get stronger Vit D on prescription from his GP. Six months later, after several phone consultations and 2 more blood tests (GP wanted his own doing instead of relying on the oncology ones!), still no bloody prescription and the latest was a message from the GP telling OH to get the strongest OTT vit D from the pharmacist - clearly hasn't listened to a word OH has said nor read the notes of previous consultations.

Some GPs are absolutely hopeless. It's no wonder they think they're busy when they can't do the simple things at first attempt and patients need multiple subsequent consultations for the same thing because the GP won't bloody listen!

I'm pretty sure that no-one goes to a GP with an "antagonistic" attitude. You go when you're absolutely desperate and in pain or feeling otherwise unwell and you're hoping that they'll help. However, if you're constantly being fobbed off and your extensive googling has suggested something to you which hasn't even been considered, you'd be forgiven for feeling frustrated!

@JetTail

And that is why patients could never simply refer themselves to consultants.

But that doesn't apply for simpler things. People "refer themselves" for NHS dental and optician appointments, but can't do that for NHS hearing aids, nor podiatry, nor physiotherapy for example. I knew I needed hearing aids, but it took 3 months to get the GP to do the referral to audiology. My son had an ingrown toe nail which the GP surgery kept fobbing him off for, until they finally did a referral to podiatry, after a few months of severe pain, being unable to do sports, etc., completely unnecessarily.

Referrals for the "big things", then yes, of course, but so much of what they do really is simple and obvious enough for self-referral. I really don't see any difference between self referral NHS dentistry as opposed to hearing aids. In both cases, an initial consultation would flag up if the patient was in the wrong place or if there were signs of something more serious needing referral elsewhere.

The oncologist will only deal with the cancer itself and keeps referring everything else back to the GP surgery,

and this is part of the problem. Consultants and their teams should be able to deal with things which are issues related to a condition that they understand better.

Ds has a number of chronic conditions and the ones which are best to manage are the ones where the team at the hospital are contactable and act quickly. I contacted the endocrine team last week and got back to me in hours suggesting a change to make

That's not comparable! Dentists and opticians are not consultants! You know you need one but you don't know what treatment you might need. It's like doctors. You know you need a doctor, but you might not know which speciality within the 'doctor' sphere. You're comparing apples and oranges. You might as well have said that referring yourself to a consultant doctor was comparable to realising that your car needed some assistance and you 'self refer' to a mechanic!

Trouble is that when you've already experienced multiple instances of mistakes and fobbing off, you become conditioned to expect the worst.

It took me multiple appointments to get put onto HRT. I saw many GPs of both sexes re different conditions all pertaining to the menopause, but no one cared - just basically told "it's how it is". Ironically, it was an appointment with an "old" male GP where there was a breakthrough who actually listened properly to what I was saying and set me up on HRT patches which have worked a treat.

As for general GP competence, I once had a severe case of thrush in my mouth which wasn't cleared up by the antibacterial mouth/tongue creams etc. The GP prescribed a strong antibacterial tablet which he said would clear it up within a week. The prescription was for one week's worth, i.e. 7 tablets. When I handed it to the chemist, there was a fair bit of whispering between the dispensing staff and one came over to tell me they were just going to phone the surgery to check something. After about half an hour, she came back and told me there'd been a mistake and that the tablet was a "one off" and it would have been dangerous to take it 7 times as it was so strong, the GP had made an error prescribing too much and they were waiting for a replacement prescription for just a single tablet!

So, I don't apologise for having an "attitude" with GPs as they aren't always right and patients really do need to do their own research/checking etc rather than relying on the GP being right.

So what's the difference between having toothache and going to the dentist against having an ingrown toe nail and going to the podiatry dept, or not being able to hear and going to audiology? Some things are obvious enough that patients can "sign post" themselves. As I said, dentists already check for other things during check ups etc, so if the dentist has suspicions of something more sinister (i.e. mouth cancer), then s/he will refer elsewhere, just as an audiologist will refer if their observations/tests throw up something suspicious. An awful lot of the "obvious" stuff could be taken away from the GP control and passed to self-referral.

If you can get a Vit D & K supplement, it works better. I bought some online from Amazon the year before last when covid was raging as I was told that the K works to aid absorption. Vit K though can be a dangerous one sometimes though as it can increase the clotting mechanism, so not really to be taken by a cancer patient unless you consult with at the very least, the GP.

This is the one I buy www.amazon.co.uk/gp/product/B07D3B4Q2P/ref=ppx_yo_dt_b_search_asin_image?ie=UTF8&psc=1

Also, there is another way to get Vitamin D which is one I'm not even going to write, in case some idiot takes the advice without a very large dollop of caution!!

And this article (do not take this as Gospel) states the following:
“For better absorption of vitamin D, you must include vitamin K, magnesium, and zinc in your diet. They speed up the absorption procedure and reduce your likelihood of being vitamin D deficient,” she suggests www.healthshots.com/preventive-care/self-care/6-ways-to-increase-absorption-of-vitamin-d-in-the-body/#:~:text=%E2%80%9CFor%20better%20absorption%20of%20vitamin,D%20deficient%2C%E2%80%9D%20she%20suggests.
NOTE: I HAVE NO IDEA WHAT SORT OF WEBSITE THAT IS OR INDEED WHETHER IT'S QUACKERY but it certainly does mention the Vit K.

I can see your point, but sometimes it's not actually simple. Like the cases I referred to in the last few posts this morning. Also, there would be a lot of idiotic self-referrals for consultants to have to sift through. Also, a GP should be able to treat the ingrown toenail. A consultant shouldn't be required.

Also, just to warn you - you will be bombarded now with about 50 posts saying 'cancel the cheque!' i.e. to state that thrush isn't bacterial, it's fungal. Brace yourself @Badbadbunny 😂

@JetTail

If you can get a Vit D & K supplement, it works better. I bought some online from Amazon the year before last when covid was raging as I was told that the K works to aid absorption. Vit K though can be a dangerous one sometimes though as it can increase the clotting mechanism, so not really to be taken by a cancer patient unless you consult with at the very least, the GP.

But that's exactly the problem. The GPs havn't a clue. It's why neither the oncologist nor ortho consultant will issue a VitD prescription - they say it's the GP's job to do it, but the GPs havn't a clue, hence six months since asking and still no resolution. My OH would happily make his own arrangements if he could!

That has to be frustrating as I certainly wouldn't gamble with self-prescribing while receiving treatment for cancer. I would contact the GP somehow and state 'DH is going to buy the following item online and take it, UNLESS you state otherwise'. That sort of pins them to the wall a bit as they then literally have to say either yay or nay. Well, maybe. Worth a shot!

@JetTail
Also, a GP should be able to treat the ingrown toenail. A consultant shouldn't be required.

But they didn't. That was the problem. They suggested salt baths, various creams, etc., but it just got worse. It took a referral to podiatry (not a consultant), and partial removal of the nail to solve it. GP kept saying the referral would take months, citing that as the reason for trying to "self treat". In the event, he got a podiatry appointment within a couple of weeks and they booked him in for the partial removal the week later, so no delay/wait at all, once the GP had finally done the referral. Months of pain for no reason at all. If there'd have been a way to go straight to podiatry, it would have saved several GP appointments and months of pain.

Has either consultant written to the GP suggesting prescribing Vit D? Or have they just told you? A lot of it can be that the consultants do not have the authority to prescribe for unrelated conditions. That has to go through the GP (rightly) as they are supposed to be the ones who know about all your conditions. Like for example, whether your OH has ever had a blood clot or something, where Vit K might not be advised. It's a fucking pain the ass, I give you that! I'm so frustrated with the medical profession (or the NHS shit procedures more specifically) sometimes.

Here's another example of ambiguity.
I'm under an Endocrinologist. At the first consultation, he asked whether I ever felt palpitations. Now that is one that I didn't even know was a medical 'symptom'. My interpretation of it was that it was an old-fashioned way of describing feeling nervous. He clarified what he meant i.e. could I feel my heart fluttering (I'm pretty sure that "fluttering" was not the word he used 😆, but you get the gist). I replied that I occasionally did. He then asked, is it when you feel anxious about something or does it just happen? That was a difficult one to answer because I explained that I couldn't really answer as anytime I felt these flutterings lol, I attributed them to something going on in my life, but that I wasn't sure which came first haha i.e. stress causing the flutterings or the flutterings causing a feeling of anxiety. I'm pretty sure that I confused him lol.

God help any poor doctor who has to try to get a simple answer out of me! 😔

This is another thing that I would advise doing whenever you meet a doctor be they your GP or a consultant. Firstly, advise them of any new symptoms and/or illnesses you've had since last consultation - even if apparently unrelated. The other thing that I would advise is to let them know if you're taking any supplements (such as vitamins or herbal therapies or whatever) or indeed whether you're taking for example ibuprofen as well as prescribed pain relief for example as then they know that the pain management they have you on isn't sufficient.

In the case of the electrolyte that is always low for me, I take a supplement of that and it's still constantly low which makes it doubly unusual.

Speaking as a nurse, you have a point for some people. However everyone who has worked in the medical profession will also be able to tell you god knows how many examples of human stupidity which is why unfortunately not all members of the public can be trusted with this.

Sorry @Brainwave89 I had to laugh at the idea that having a phone call is classed as "using technology to its maximum". I was making phone calls at work in the late 1980's. It didn't seem particularly cutting edge at the time

But I agree with your point that a little info online is a dangerous thing

Mind you, one consultant described me as an "excellent historian" once and I replied to a thread on here which was asking why consultants start their letters with things like 'I met this lovely lady at clinic today' or something! I was most flattered at the time of receiving the letter (to my GP) that a doctor had made this astute observation of my obviously superior intelligence lol as I hadn't really discussed any historical events that I could recall but I was confident that I must have said something for him to realise just how brilliant I was! My ego was rapidly deflated by doctors here telling me that it simply meant that I had given a detailed history of my illness. Chapter and verse I suspect! 😆

Nope. I think you're being ridiculous

The other thing which baffles me about some doctor referrals or notes is the shortened version of things they write. 'Pt c/o upper left quadrant pain post C2H5OH' for example. Hx is another one that I now recognise. I thought that they were sending me 'care of' pain and that C2H5OH was perhaps a ward number they were fast-tracking me to. No, I'm not that thick, but I think they deliberately abbreviate some things so as not to annoy a patient perhaps.

Well QED then.

Have to say that I do agree with you in some circumstances. My dad’s new GP could have made him very ill by not reading his notes properly and prescribing a drug which was contraindicated with others he was taking.

My mum visited her GP on several occasions and was told her issue was just part of the natural ageing process. Nope, she was in heart failure.

I’ve been to my GP with hypothyroid symptoms for the last 6 years only to be told nothing was wrong with me. Had private tests done and I have central hypothyroidism. My GP was basing her diagnosis on my TSH level and had never taken my FT4 into account. Fortunately there are some very knowledgeable people out there on Google who knew straight away what it was!

@JetTail exactly what I was about to do to @Badbadbunny so I laughed instead, thank you.

@Iheartmysmart I have a similar problem, my Free T4 (with TSH in normal range)has been suboptimal on four occasions, that combined with the diagnoses of Fibromyalgia, PCOS and Bi-polar has led me to the conclusion that there is something out of whack with my HPA axis, but no one will listen (plus the chronic insomnia...)

And just to repeat can anyone on this thread name six types of Diabetes without googling?

Because I can with NO medical training.