To refuse to take DD back into the GP surgery?

[Madeline637]

DD has been unwell for a week - fever and cough that’s got progressively worse and is now productive with phlegm and mucus. We have seen 3 GP’s, all said it was viral despite her getting more unwell everyday rather than improving and her never responding to a viral infection like this before.

Last night she deteriorated again and the out of hours GP called an ambulance out because of her breathing and oxygen levels. The ambulance stayed for quite a while, done loads of tests and observations and decided that she was safe enough to stay at home (which was good because DD has autism and really struggles with being in a hospital setting, it’s extremely distressing for her and often takes a few people to manage her behaviour in that setting). The ambulance did however say in the report to our GP that it’s a clear cut chest infection (they listened in to her chest and heard clear crackles) and that she needs antibiotics and it’s not fair that they keep hauling her back to the GP surgery and not giving her the medication that she clearly needs, especially when she finds this distressing.

I got a phone call to say that the GP wants to see her again before thinking about giving medication. AIBU to refuse on the basis that she’s already seen 3 GP’s in the space of a week (the last being on Tuesday), that she’s already been assessed this morning by a medical professional and they’ve told the GP all the information that they need and that DD will find this very distressing given the fact that she’s already been poked and prodded for hours today and having to wait in the surgery itself?

Usually they can prescribe the antibiotics over the phone and this particular doctor I’m not keen on anyway - she ALWAYS messes up the medication, expects you to tell her what diagnosis you have and how to treat it and honestly bloody clueless.

Honestly? If you want the antibiotics just go in.

I would go to see the GP as they are trained to a much higher level than a paramedic. They can give a better idea/treatment plan. Could you ask for a different doctor and express your concerns?

I think it's reasonable to put your foot down and given her needs advise the amount of times she's been seen including last night. I think If they still insist on seeing her you can't refuse but I would advise they adopt some common sense and send you the prescription!

Well you could spend all afternoon arguing the toss with the receptionist if you want...or just go in & get the antibiotics

The paramedics were the ones that found the crackles in the first place, I genuinely believe that the GP would have kept fobbing it off as a viral infection

@IfIHadAHeart @Iizzyb I take it that you don’t have any experience of children with additional needs? Because you clearly didn’t understand the point that I kept stating of how distressing this would be for DD.

I did. I also read the bit where the doctor wants to see her before they think about prescribing any drugs. So as I said - if you want the antibiotics, go in.

No doctor should be prescribing medication for a patient they haven’t seen on the say so of a paramedic or ambulance technician.

@IfIHadAHeart they saw her 2 days ago and then 2 days before that - what am I supposed to do, keep taking her in every 2 days whilst she keeps getting more unwell and they do nothing about it? It’s very clear even to those who aren’t medical professionals that this isn’t getting better by itself and she needs antibiotics.

I'd say that the key thing is to get her the antibiotics rather than arguing about it.

You've asked for opinions. So far all the PP - including me - think you should take her in.

But you're arguing with everybody. So why bother posting?

Then. Take. Her. In.

The GP (rightly or wrongly) did not feel antibiotics were required two days ago. They are telling you they need to see her again to make a decision. By all means complain after the fact, once DD has the medication she requires, about all the to-ing and fro-ing. But in the meantime, why would you even consider creating a potential further delay?

The GP has told you what you need to do to obtain a prescription for the child in your care. Sadly, unless you want to end up in hospital to get them (because that's where it might end up as you say it's only getting worse), going to the GP is your only alternative.

I was in the same boat my daughter was unwell took her in told its viral then a week later got told it she had a chest infection so got antibiotics for that and then on Monday took her back in to be told its tonsillitis so she has a different antibiotics all this time I kept telling then she has tonsillitis from day one as she doesn't present with typical symptoms and she has gotten so much better this time. You have to do what is best for her and if she isn't getting better than maybe take her in the sooner she gets the medicine the better she will be.

Viral illnesses can often lead to patients developing bacterial infections as the body's immune system is "busy" and the bacteria are opportunistic

As a Dr I'm not going to give a prescription of anything based on a message from a 3rd party passed on from another clinician, I'd want to examine myself and check for redflags as any issues would come back on me

Just take her in as asked

@Madeline637 - regrettably, the GP Surgery holds all the aces here. They won't give you the prescription you need unless you go in. I completely understand why you would rather not, given the effect on your DD, and your (completely justified) lack of faith in the doctors at the surgery, but there doesn't seem to be another option that would work for you. I would say raise a complaint with the Practice Manager, but that is not always helpful or successful. Sorry you are in this situation. Another reason why the NHS need s a review and a massive overhaul!

I think the priority now is to get your DD the medication she needs so I think you are going to have to take her in. I'd then make a written complaint at a later date though.

I have an autistic son who finds doctors very distressing. In this situation I would still take him in because I would be more worried about getting him the antibiotics than him being upset, which will pass. But once there i absolutely wouldn't be fobbed off and make them give me the antibiotics, by saying how many days it's been and they are getting worse etc etc

@BabaYagasLittleSister that’s exactly what I’m concerned about - making her go through all of that and them refusing to give the medication because then I would cause WW3 in the GP surgery! Especially with this particular doctor because I honestly don’t know how she got her degree

Ask for a different doctor to ring you - they might decide that you can have the prescription over the phone. And if they won't then ask if they could let you wait in the car until they're ready to see her so that you can at least go straight through. If that doesn't happen then you'll have to do the visit but then write a strong complaint afterwards because a bit of compassion really wouldn't go amiss and it's not like you haven't jumped through multiple hoops and actually got a decent medical opinion. (And I'd put more belief in the opinion of a paramedic, based on personal experience of them)
Once upon a time you'd have got a home visit, these days you should probably be grateful you actually get to see a doctor.

Especially as this doctor messes things up it’s best you’re there to ensure that you get the correct prescriptions.

Just take her in.

Honestly, just go in and get the medication.

People with special needs and who are ND still need to see doctors to
ensure they get the correct antibiotic medication.

Yes it’s hard going back again, but it’s a
medical necessity.

So sorry your going through this my 3 year old has had this cough and temperature for 8 weeks now coughing loads of thick phlegm up, 5 doctors appointments throughout all saying she's fine her chest is clear, give it until next week come back last night her temperature got that high and wouldn't come down with calpol or ibuprofen that she was hallucinating shaking crying, took her straight to a&e they done a chest xray and she's got pneumonia. Gp kept thobbing me off with it's the 100 day cough!

Two days before Tuesday is a Sunday, where do you live that a GP is open on a Sunday?? If the GP wants to see her then take her to the GP, better a meltdown in the surgery than a child that doesn’t get medication. I have ASD myself and kids who are also quite high needs so I do understand the trepidation but sometimes you just need to suck it up and do what’s best, and her seeing the doctor is what’s best.