Frustrated by my gp not investigating

[HibiscusGardens]

I'm really frustrated by my doctors surgery not taking me seriously, I went away last October on holiday and became unwell, sickness, diarrhoea ect and since then my bowels haven't been the same I've had chronic diarrhoea ( yellow stool a hour after eating) low b12 and low grade fevers, but the past 2 months or so i now struggle to pass stool normally, feel pressure in my back passage and pain in abdomen along with fatigue and still low grade fevers. I have been to the gp and been fobbed off, told to change my eating habits ect. What should I do? I'm not very good at advocating for myself and just feel like I'm getting made out to be a burden... I keep getting seen by paramedics who fob me off.

How do you know that your B12 is low, if you have not been investigated?

Ask to see a different GP if that's possible? Insist on being referred? 'I would like a second opinion' kind of thing? If all else fails, a preliminary appointment with a private specialist isn't terrible money if you can afford it.

How are you being seen by paramedics? Are you calling ambulances for diarrhoea? Can you go privately to get a stool test or colonoscopy?

Have they tested for C dif

I was found to have low b12 by my rheumatologist ( I have other health conditions)

Loool no, my gp surgery has 3 doctors based at our surgery all part time to get a appointment with them is like gold dust, to get seen you have to call the gp surgery on the day (no prebooked appointments unless for a nurse) and the receptionist then books you with a clinican who they see fit...which is generally an ex paramedic or a nurse prescriber.

Ask to see a doctor not a paramedic. If you’re seeing your rheumatologist any time soon mention it to them too, particularly if you’re immunosuppressed - they’re usually really good ‘general’ physicians.

I would be making a direct request to be seen by a GP and then ask to be referred to a gastroenterologist as your problems have been going on for quite some time.

Where did you go on holiday? You need to consider parasites, local diseases, anything spread in water, for example. Did you need any jabs and if so did you have them all?

Insist on a FIT and microbiology culture of a stool sample

Write a letter to the practice manager detailing everything you had said. those symptoms in someone who has been abroad (you don't say where) definitely warrant blood and stool tests. The creeping delegation of GP services to people who are not GPs is unsafe. I have huge respect for paramedics and practice nurses, but they aren't doctors. That said, a practice nurse would know all about required tests.

Change GP surgery. I had to do this after a totally crap consultation with a physician associate (avoid them too). She offered me the details of a private clinic but said the NHS couldn’t resolve.

Couldn’t be bothered to make a complaint, just moved surgeries. Had a quick google, read a few websites and completed a few forms. Had my problem sorted within a few weeks …thank you NHS!

Sometimes we have to vote with our feet.

The creeping delegation of GP services to people who are not GPs is unsafe. I have huge respect for paramedics and practice nurses, but they aren't doctors. That said, a practice nurse would know all about required tests.

I think, used appropriately and wisely, paramedics can play a useful role and take pressure off GPs for some routine consultations. However, it very much depends on the practice, the patient's knowledge and cooperation, and the conditions needing investigation and/or treatment.

I recently saw a physician associate who was both knowledgeable and lovely. She took her time, listened and actually examined me. She checked my blood pressure and pulse and asked detailed questions about my diet. She ordered not just the test I had requested but an additional test as well. I think the entire consultation took at least 20 minutes. Once the results were in she texted me a summary and comments.

Incidentally, when I saw the practice nurse for my blood tests I requested an HbA1c, which wasn’t part of the tests that had been ordered. No problem!

I have no idea how typical my experience was - from reading here I get the impression that my surgery may be ahead of the curve. However, if this system could be replicated widely for routine complaints it could free up a lot of GP appointments. What would be required is clear guidelines - maybe with an online flowchart - on when to see which practitioners.

Since October 2024, how many GP appointments have you had, OP?
How many hospital consultant appointments have you had?

Where did you go on holiday? Have you looked at the potential culprits? C diff has been mentioned above.

You might have colitis- this happened to a friend following a nasty stomach bug, her bowels weren't the same. You definitely need further investigation. Can you write it down as an e consult? I find making my case easier in writing as im quite passive in person.