One appointment, one issue

[monkeymamma]

I genuinely think this policy (at our GP surgery and I assume widespread) is deeply harmful to patients.

I was given an appointment today with the paramedic - no idea why not a GP - to talk about worsening symptoms (painful, bloated belly, difficulty urinating, sickness, reflux, dizziness). I mentioned that the symptoms are making it hard to know what to take for migraine (chronic sufferer). She snapped ‘that’s a separate appointment.’

The thing is, it’s not really is it? The symptoms I’m having are clearly hormonally driven (worse/unbearable around ovulation) but she didn’t ask about that or really anything about me as a person.

And how do you decide which symptoms are connected to the issue you’ve booked in and which aren’t? Aren’t they going to miss really obvious things if they refuse to understand what is going on with the patient as an actual person, as opposed to a single symptom or problem?

The system is crazy. Some conditions have a multitude of otherwise minor-looking symptoms. Look at them in conjunction though...

Goodness we are so lucky with our local surgery. They regularly send out information on their FB page and are a huge part of our community. I went 2 weeks ago and my GP actually asked about my life and family and encouraged a conversation. Nothing is too much trouble they are amazing

Exactly. I totally agree. You're a whole person not just a separate series of symptoms. Things are often connected. 😬

I agree- means gp may not get the full picture.

I was diagnosed with underactive thyroid nearly 20 years ago. Things that would have seemed unrelated to me, or not relevant (dry skin during colder months) were all as a result of my thyroid.

Was diagnosed with anemia about 4 months later - had put the tiredness, hair issues etc down to my thyroid. I actually went to the GP for something totally unrelated. GP noticed I looked very pale, and so asked a variety of questions and did bloods - which showed my iron levels were very low ( and causing both the symptoms ).

More recently I was diagnosed as celiac. I hadn't gone to the go for anything linked to my stomach. Thought my thyroxine or iron levels would be the cause, but due to the symptoms I had given, GP did a selection of bloods, including a celiac antibody test. Results meant I was referred for an endoscopy for diagnosis. Gp didn't just determine iron levels were low, but found the cause.

All examples of how one issue can cause multiple symptoms, that to a non medival person may seen unrelated. I have found that by giving the symptoms that are concerning me, it leads to questions about other symptoms, that give the gp a better picture of what is going on.

I had a call from the gp today to discuss test results - we discussed my iron levels, thyroid levels, celiac antibody results and menopause in one call. Four different conditions but all have overlapping symptoms, and can impact each other, so can't be considered in isolation.

We are lucky with our gp too.

I have read others moan about getting appointments etc, but they have tried a few different ways of doing things, and the current way appears to be working. They have always been good at emergency appointments for children.

I have read terrible reports of some practices where a timer is set when you walk in and the consultation ends whether you have finished or not. I am not saying people should waste appointment time when there, but you also want to feel that the person you are seeing is listening and not clock watching or rushing you out of the door. Luckily we have some lovely doctors that do listen to what is being said.

YANBU. I just rock up now with a list and say this is what’s happening so in ops case I would list all symptoms as she did plus migraines

if they treat each symptom separately they could just miss stuff

I had to decide neck or elbow. Elbow won. Refused the injection offered as I really don't like needles. Asked for physio. Physio assessed me and discovered on her last question that it was my neck causing the elbow pain.
These days I'd self refer to physio as they're usually brilliant.

If I'd said neck maybe we'd have got to the same result but I suspect it would have took longer.
I'm glad I don't like needles.

I always thought the rule was for things like "I have been having bad headaches. Right that's dealt with and I have a prescription/tests have been ordered. By the way I also have a weird mark on my leg." Both are clearly different issues and the patient should book a double appointment. It shouldn't be used to discourage a GP from discussing related symptoms. For example, I went to the GP because I'd been sleeping badly. He asked for details on sleep habits, then asked about a few other potential symptoms i hadn't thought to link to sleep issues. Completely different situation.

Sounds like you came across someone who was being rude / was stressed about workload & timekeeping and that translated into poor service provision.

It's not totally separate, though. In the last couple of weeks, I've seen the nurse for annual bloods, for a smear and I will be having a covid jab next week. It would be far more efficient for both the practice and me if they could take my history, take the bloods, do the smear and then do the jab in a single appointment, or two adjacent appointments, rather than me considering just changing my address to the surgery, as I'm there so often just now. But the system can't cope with that at all, especially as the smear is unconnected to the bloods and jab.

Comorbidites can make treatment trickier, because treating one thing can have a knock-on effect on the other. And sometimes unrelated symptoms are actually linked - only it might not get mentioned.

I haven't seen my GP for a couple of years (whereas all the nurses...) But I've nearly always been asked, "is there anything else?" at the end. Although I think my answer has slways been no.

The worst one I’ve had was when I attended my appointment and the GP asked me if I’d googled my issue and the treatments for it. I said no so he told me to book another appointment when I’d done that.

Given I’d had 30 seconds so far I asked if I could ask him about a lump on my hand instead and he said no.

Not what you're asking, but vitamin B1 (thiamine) deficiency can cause all those symptoms. Your doctor is unlikely to know anything about that though as doctors aren't trained in nutrition.

EO Nutrition on YouTube has lots of videos about it if you want to find out more.

It might be done differently elsewhere, but when I’ve gone for flu jabs for example, they do everyone in a couple of days. It’s more efficient for them I guess to deal with them all at once. So mentioning another health issue really would be inconvenient at that time.

I agree with the rest though!

What… the…

I wouldn’t put up with that, honestly. I’ve told doctors on a number of occasions that I come to them because I value their training and experience, not just because I can’t write my own prescriptions. I guess I am behind the times!

I do Google everything but Google is not a doctor!