To think my GP just dismissed me

[NuttyNut98]

I went today for a couple of issues which I told the receptionist about on the phone. One was insomnia and headaches. I did explain I was stressed at the moment. Her first thought was to prescribe anti depressants with a sedative effect. Apparently these ones help you sleep quite deeply which I don’t feel too good about as I’m a single parent to a young DC. I also think she didn’t try and get to the cause of why I felt stressed or even do any things to see why I’m getting headaches so often, she just went straight to anti depressants. I also have chronic shoulder pain, which gets worse and when it flares up, I’m struggling to move it. I thought she would have a look and ask me to put my arm into positions so she can see where the pain is. She also didn’t ask me if I’d injured it or try to see why it might have started. I was just asked to self refer to physio. Aibu to feel dismissed?

Why are people saying that OP has unrealistic expectations? She told the receptionist what her issues are (personally I object to having to discuss my health with the receptionist but we are where we are) and the receptionist/gatekeeper gave her 10 minutes to discuss them all, of course she would have liked longer.

The fact of the matter is, it is a substandard service. Our expectations are in the gutter not the other way around.

Edit to say. I’m not blaming the GP surgery as such, it’s a system failure. Healthcare in this country is at breaking point.

I sympathise OP especially because those symptoms could easily be corrected in which case discussing them together made sense.
if you can afford it, a good osteopath could help you find out what’s going on.

GPs are unlikely to do much of a shoulder assessment as physios are the specialists in musculoskeletal pain and will do a full, much more indepth assessment when you see them, then treat it. The GPs role in musculoskeletal pain is to make sure you see the right person- (physio, orthopaedics, A&E). There would have been more of an examination for a shoulder that was hot/red/swollen/had recently been fallen on or had more consistent, worsening pain but in this context, with a 10 min appt I think this is maybe a case of your expectations not being aligned with what the GP can actually provide

I don't know what help you think the GP moving your arm into different positions would be. So they know when it hurts in a certain position? Waste of time.... You'd still need a referral to a Physio. They're a GP - their job isn't always to fix you, but to know someone else who can. Send refer to Physio like you've been told to.

Regarding the sleeping.... "Deep sleep" is more like better quality sleep, not dead to the world sleeping through the apocalypse sleep.

Too much to discuss in one appointment.

I'm a GP and would book shoulder pain directly in with the physio. she's much better at MSK stuff than I am and she can look for red flags, scan and do joint injections if needed.

I agree with this.

The main role of a GP in this country seems to be to dismiss and patronise, and avoid putting any effort into diagnosing a problem.

You'd refer straight away to an NHS physio? That seems very unusual! Good service, though.

I found that as well, I think the therapeutic dose for depression is 60 or something? Treatment for pain is 10-30 but I found it really reduced stress anxiety at a low level too.

The effect depends on the dose. It varies.

Your GP did dismiss you. I honestly feel like it’s a waste of time going anymore. What if those symptoms are linked- no wonder things get missed.
I was referred to physio and my GP told me ‘it’ll be a waste of time and so is pain relief’. She said she lives in chronic pain, and it’s to be expected with sciatica. So that was the end of that.

If you can afford a private appt that’s what I would suggest. It’s what I’ll be doing.

I don’t think it’s unusual. At my gp thereceptionist would tell you to fill out online form (paper forms are available) to self refer to physio. Saves time / money.

I think this is the way that GPs work - they go on balance of probability, and if the first thing doesn't help, they move onto the next thing. So the GP has suggested physio for the shoulder and anti-depressants for the insomnia. You are free to say that you don't want to take anti-depressants and would like something else to be investigated. If you want the cause of your stress to be examined you probably need to go to mental health support in your area (you can self refer) - not something a GP would do.

I can't see how your GP dismissed you. I think you might have expected too much.

When you book an appointment at my surgery you have to fill in a form where you say what the problem is and what you hope to get out of the appointment,. I think this is a useful thing for you to think about in advance of going.

GPs are there to give out pills. That’s it. They will never try to get to the root cause.

They need to investigate and diagnose what is causing the issues ffs!

It doesn’t sound like they dismissed you. amitriptyline is commonly prescribed for chronic acute pain, so it would make sense they prescribed this based on your symptoms. I have had it when I had terrible back pain and it was brilliant, it took a couple of weeks to work. I also had a young child and no issues waking at night.

...which the GP is doing by referring to a physio, who will be far more knowledgeable on MSK issues.

Given that the op is not a doctor though, how is she to know the problems are not unrelated? They could be a number of symptoms for one underlying issue. I’ve only scanned this thread quickly but spotted two posters with the same symptoms who managed to get a diagnosis. When I brought my dd in once with multiple issues the doctor asked me to make a second appointment to deal with one of them separately. Surely they should have done that rather than fobbing her off?

I've been on mirtazapine when I wasn't sleeping during a particularly stressful period. It was amazing for helping me sleep totally knocked me out, but there's no way I would take it if I was on my own with young children. I was a zombie for the first few days of it. Fortunately I no longer need it.

We have an in house physio who usually has an appt within a week or two

A physiotherapist doesn't provide a medical diagnosis; they do not have a medical degree.
The assessment that they do is focused on rehabilitation of movement, not identifying any underlying pathology/ disease.
Appropriate healthcare requires both.

But I suspect some of these are connected. The ten minute thing is a problem but I don't actually know what service a patient is supposed to access if they want someone to take a look at a bunch of stuff that may be connected. I've said I have two issues and the receptionist has said one appointment is fine, but then you end up really rushing. I don't blame the GPs for being overworked, but there is a problem.

Ask for a double appt

When i went to a GP with insomnia they wouldn't even consider prescribing me anything. I was later prescribed amitriptyline for migraine prophylaxis and they have a sedative effect which made me so sleepy! I would fall asleep in seconds when going to bed. I've since come off and the insomnia is returning... I miss my sleepy tablets haha. Although it is nice that I don't become completely useless at 10pm now.

I think your GP’s did well in a single appt when you raised several issues

a physio is completely appropriate for shoulder pain and dealing with that could help the headaches.

try the meds abd get physio started and go back to gp if it’s not helping