If I make a complaint about my GP refusing to prescribe medication

[Sconesandgravy]

My neurologist asked the GP to prescribe a medication to help with a medical condition. The medication is one can cause birth defects. I spoke to the pharmacist this morning who called to say she was putting the request through to the GP. The pharmacist messaged that afternoon to say the GP has refused to prescribe unless I go on hormonal contraception or the copper coil. He has claimed that guidelines say he can't prescribe if I refuse the above types of contraception.

I want to complain about this for several reasons:

• My husband is completely infertile. He had multiple samples of testicular tissue biopsied and it was confirmed he has a condition that means his sperm count will always be 0. The only way I'm getting pregnant is with a sperm donor. I obviously can't do this by accident. The pharmacist made the GP aware of this because she called me this morning and said contraception is recommended, so I said I'm not on contraception and disclosed about my husband.

• I checked the guidelines myself. NICE guidelines state the need for effective contraception must be expressed. The BNF says effective contraception must be advised. On gov.uk there is a 2022 safety review of the medication that states health care practitioners "should fully inform the patients of the risks and advise them of the need to use highly effective contraception". Nowhere specifies what contraception should be used, and none of the above bodies specify that medication should not be prescribed if long term contraception is refused. The only thing I can find is that alternative medications can be offered if the medication is long term and the patient doesn't want to use any form of contraception.

• Condoms and abstinence are also effective forms of contraception. If I were a man these would be recommended as they're the only available form of effective male contraception. It seems discriminatory to suddenly decide they're not considered effective contraception just because I have a vagina.

• I'm an adult with full capacity. I have the right to make an informed decision about what I put into my body.

In all honesty it just feels a bit like the GP has refused my prescription and intentionally given me misinformation about the guidelines to try and coerce me into going onto a contraceptive that he deems the most effective, rather than allowing me to make an informed decision based on my own personal circumstances. I know this is dramatic and I won't put that in my complaint but I just needed to get that thought out of my system

AIBU if I complain?

However, I want the GP to speak to me, and look at my medical history and my personal circumstances before he decides the risk is too high.

This needs to be done at an appointment. Is the GP refusing to see you? I know it can take a while to get one but will they not let you book an appointment to have this discussion?
If that's the case I'd honestly look to change GP and register elsewhere

Your GP is being unreasonable by refusing to see you and simultaneously insisting on the contraception. Women need to be completely aware of the risks and a provider can judge it acceptable for them not to have long term contraception if their circumstances are such that they will not get pregnant. They would sign a waiver which you have offered to do. As HCP, we need to use our judgement to establish which women are fully informed and which are saying all the right things but then may later present as pregnant (and trust me, we’ve heard pregnancy not being possible and then happening many times which is why he’s cautious). Without meeting you and at least discussing, he is being extremely difficult. The outcome maybe the same after he has met you as it could be that he is just unwilling to take the risk at all but the very least he could do is actually speak to you rather than go through the pharmacist.

My complaint would not be about his refusal to prescribe (the neurologist should have initiated anyway) but about the big communication barrier that has been put up by him

This alone.... id be complaining to the n'th degree about this GP.
How dare he.
Go complain - take it further and get from under his assertion and control. Hes actually banning you from getting another GP.... Another GP

I'm going to complain about the approach that has been taken, and the communication barriers, because I do recognise the GP is within his rights to refuse.

But I take issue with the refusal to communicate, the insensitive way infertility has been approached and the fact any communication has basically been "contraception or nothing". And that's before we even touch on the refusal to pass this onto another GP but is now working "collaboratively" with them due to my refusal to engage. I know I'm not a HCP, but I don't think asking for a direct conversation, and a discussion about how to move forward is refusing to engage. Yes, I'm refusing contraception. But I have said I am happy to discuss my history and my circumstances and see if we can find a way forward.

I don't throw the word coercion around lightly, but the approach taken makes me feel as though I'm being coerced into taking contraception because he won't see me to discuss my reasonings around refusing contraception but he will prescribe the contraception without seeing me or communicating with me directly.

My niece, who has terrible acne, was refused Roaccutane because she is a young woman of child bearing age. She explained that she was a lesbian, always had been, always would be and that there was therefore no possibility whatsoever of an unexpected pregnancy. She was fully aware of the side effects and concerns, but wanted to try it, as her skin was so bad.

When I had Roaccutane I had to sign to say I was aware of risks and that I would be taking the pill + using condoms, but no one checked that I was actually on the pill.
I also had to provide a urine sample so they could do a pregnancy test on it before I got each prescription.

The GP has offered an appointment in three weeks but OP doesn’t want to wait that long. Three weeks for an appointment is pretty standard around my area.

The GP offered you an appointment. It wasn’t as soon as you wanted but three weeks isn’t an unusually long wait. I don’t think a complaint will be taken seriously.

The GP hasn’t said the husband’s infertility doesn’t exist. He has said this isn’t a barrier to the OP getting pregnant.

Yes, I was told I could book an appointment in 3 weeks. I agreed to book the appointment. But yesterday, the pharmacist (who the GP has made deal with this as he's too busy) told me the GP has since said he's not going to see me and won't pass this onto another GP.

Instead he's going to work collaboratively with a different GP because I'm "refusing to engage". I cannot get an appointment regarding this at all. My requests are just refused because I won't accept the contraception and therefore the risk of pregnancy is too high. He won't consider other options so no waivers, no alternative meds, no contacting neuro and telling him to prescribe as he doesn't feel comfortable doing it.

I'm complaining because every avenue to do anything other than go on the contraception he has approved has been blocked off.

I'm guessing you haven't read the whole thread. The GP has claimed there is no such thing as infertility, only sub fertility. I was then told that even if my husband is "sub fertile" I could still get pregnant by another man.

So yes, both have been said

Your GP is correct in that you could get pregnant by another man!

The issue is that hcps are well aware people lie as recommended multiple times in this thread

As a hcp I've seen multiple people who have got pregnant while on less dangerous meds who claimed before it was impossible (including lesbians, people who've had multiple unsuccessful ivf attempts, people on the pill and using barrier style protection). These boards are full of people who get pregnant due to missing a pill, or being the small percentage where a condom isn't successful. The pill for example has an estimated 7 in 100 failure rate per year.

Thus the highest risk meds will only be prescribed in women of non childbaring age or women on permanent/long term contraception. With the higher classes there can be no risks

understandably people who are desperate for a medication to alleviate something horrible will lie if they think they can get asay with it. I can't check if you take the pill, I can if you have an iud

I mean, I take my wedding vows seriously, so really wouldn't. It's also incredibly insulting and inappropriate for the GP to refuse to have a conversation with a real patient, who has a real medical condition, and needs a real solution, because he's too focussed on a hypothetical affair, that could produce a hypothetical foetus, who could then be diagnosed with a hypothetical birth defect, resulting in a hypothetical termination, or hypothetical disability.

Complain away!

Your GP is basically saying you can't be trusted to take the pill, or be faithful to your husband. It just just smacks of "poor little women can't be trusted".

I really hope you get this resolved, but with every update, I just lose faith in the medical system when it come to women and their own bodily autonomy.

Apologies if I’ve missed this, but have you made an appointment to see your doctor? You say that he refuses to see you, did the surgery block an appointment?

Go into the surgery and ask to change who your named doctor is. Have a face to face appointment with that doctor. If that doesn’t work, change surgery.

Im really sorry that you’re going through this, but as an outsider looking in, it does read like you are expending much more energy on being angry than taking practical steps to get your medicine.

At the moment you’re just dealing with the pharmacist. I’ve never gone to a pharmacist until I know doctor has sent over my prescription? Surely doctor comes first, even if it’s only an email to the surgery to request prescription?

I was on toprimate for migraine for over 10 years. I was never forced to take contraception, in fact I wasn't on any initially (we just used condoms until DH got his vasectomy) but I have come across others who have been told they need to use 2 forms of contraception while using this drug.

I would complain, about the contraception issue.

Although the neurologist was right that the GP prescribe it as it's not a second tear drug and GP'S can prescribe it off their own back. In fact it was my GP that prescribed it for me.

As a HCP would you not take a patients previous history and personal situation into account? Would you not take into account the fact that a patient hasn't had a pregnancy since 2013? That they only came off long contraception in 2022 after their husband's diagnosis? Would you not take it into account that they am happy to have a conversation and discuss the risks and go through their history? Would you choose to work collaboratively with a GP to try and get a patient to agree to contraception when they've requested to speak to another GP?

Would you go against NICE guidelines that state a patient must be informed of risks and advised to go on effective contraception, without actually having a conversation with the patient about why it's seen as too high risk to follow the guidelines? Would you hide behind a pharmacist and deliver all of these messages via her?

Would you agree to prescribing long term contraception with no appointment to inform a patient of the risks or without assessing their health to see if the pill is suitable. Because before my GP withdrew the "option" of the pill because I'm "refusing to engage", he was going to put me on a pill I cannot take due to one of my medical conditions. He didn't withdraw the option of a pill because of my health, he withdrew it because I won't comply.

After the last couple of days, it's no longer complaining because he's refusing to prescribe. It's complaining because of the lack of communication and the refusal to see me as anything more than a uterus. He obviously cares more about risks to a hypothetical foetus than he does about risks to an actual living patient. Because if he did care about me as a patient, he wouldn't have even considered putting me on the pill without checking my records and assessing me to make sure it was safe.

@Sconesandgravy In sure your aware of this but your options for hormonal contraception are limited anyway due to your migraines. In fact that was the reason why my GP was happy for me to take it without a hormonal contraception (Yes and IUD could have been tried but due to problems using them previously that wasn't an option for me either). I had come off hormones for a reason as they just weren't working for me.

And before anyone asks I'd tried every form of hormonal contraception avaible to me. They all made me much worse and had unacceptable side effects.

I appreciate I was very luckily in having an understanding GP.

What’s worse, waiting three weeks or the doctor seeing your husbands medical records? I know neither option is perfect but you are painting a picture that you have no options, when you do.

You do really need an appointment at your surgery, though ideally it wouldn’t be the GP who is your current named doctor at surgery. It does sound like you need to change to a different named doctor as going forward it will be them doing prescribing.

Why wouldn’t you just buy this private. Of course make a complain but as well known it takes time these days with so many bars and probably sad events to be listened too. Only the other day I had to hear how bogged down they the consultant were with big waiting lists … after having 4 weeks off.

I purchased Mefanimic acid to stop period blood flow 7 days on the trot - I had the option for chemist to inform GP, I duly did do.

When medication arrived it seems to help with headaches and some people with arthritis and much other conditions when you read the patient leaflet.

Reached a point I don’t want to see a stressed GP who couldn’t give a shite, nor do I.

I updated yesterday - I tried to book an appointment with him to discuss and the GP has refused to see me. I did call up and change my named doctor either Tuesday or yesterday because I felt it was a good middle ground that means I'm not making a complaint but I also don't have to see him. I said I don't consent to him treating me anymore and requested this is tasked to someone else. When the pharmacy called she said the GP has made the decision to work collaboratively with another GP because of my refusal to engage.
My husband has refused to consent because he's not happy with the approach taken, and he feels it's completely inappropriate to request his medical history and take that into account, when my medical history hasn't been taken into account and I'm the patient. I was even told my medical history hasn't been taken into account because it doesn't eliminate the risk of pregnancy. While this is true, the GP shouldn't even consider prescribing contraception without making sure it's suitable.

Who would be a GP now? It’s no wonder so many of them are at crisis point.

You think a GP INSISTING a woman has a device inserted inside her before he'll prescribe a drug recommended by a neurologist is perfectly reasonable do you? You think a GP insisting a woman be forced to have a device inserted inside her because she can't be TRUSTED to take the pill is reasonable? You think a GP saying that infertility doesn't exist is reasonable?

The GP sounds like an absolute fucking nutjob! Where did he (I'm assuming he's a he because would a woman insist on forcing another woman to have something inserted inside her against her will?) get his medical degree, Asda?

@DetOliviaBenson

Oh god it’s you again. Are you stalking me or what?

Yes ok then, your theory must be correct. The GP is mentally unwell. Rather than being overstretched and worried about prescribing a potentially very harmful drug, outside of his comfort zone or area of expertise, which could then lead to him being struck off.