GPs and functional doctors/nutrionists

[Bob74]

Hi there, hope you're all good!

Quick question to see if anyone has had this shared experience... I went to see a functional doctor as I have Hashimoto's and hoped maybe a change of diet etc might help... she did some routine tests including bloods, stool samples and SIBO. Among other things, the stool samples came back positive for calprotectin, lactoferrin, white blood cells and fecal occult blood. She referred me back to my GP for tests and wrote a letter to him to explain. His response was that, as she had ordered the tests, the outcome of them was her responsibility, not his.

Obviously these results are of concern but it appears the GP is offended (despite the letter being incredibly respectful) and seems unwilling to look into it further. I'm of course anxious and not really sure how best to handle this. I would appreciate any thoughts.

Thank you!

So he has sight of tests that indicate you may have some health problems, but is refusing to investigate further, regardless of the risk to your health because of his refusal...?

Hhmmm, not great, is it?

Regardless of who ordered the initial tests, he can’t refuse to treat you.

Call/complaint to the practice manager?

If you have health concerns speak to the GP yourself and ask them to conduct those tests. I wouldn’t trust the results given to you by a quack even though they have the terminology right for a change

Thank you both - I have an appointment booked in on Wed morning with said GP for an unrelated matter so was going to bring it up then and ask if he'll conduct the same tests given that he won't refer me on the basis of the results he already has. It's just tricky because obviously I 'should' have gone to him directly and would have done, had it been at the forefront of my mind but we discovered these results while focusing on something else...

Isn't it a bit rotten that we're made to feel like we have to tread on eggshells? I'm trying not to over-react to the situation but I have to admit it does make me want to change my GP practice. I'm concerned a complaint will just make my future care worse... and I'm not someone who likes the fight, if you know what I mean!

Speak to GP. Just be firm. Ask/insist/politely demand in a firm way, those blood tests, or similar tests, or a referral, or whatever it is you want.

The issue is that you can only interpret tests in the context in which they were requested.
I can send off a raft of tests, but unless I know why I've sent them then sometimes things may be positive but not significant. Ie your results could be raised due to something innocent or not be related to the symptoms you've had. Your test results are essentially the punctuation of a sentence without the words. They (the results) may be interpretable as shouting, but not what or why or if the shouting is important or just ranty.
That's what the GP is trying to clumsily say. If you want those tests, they need to start from the beginning to understand why they were requested (ie what was being looked for) and if they were even appropriate to do in the first place. Only then can they interpret the results. That would be a whole separate appointment from what ever you are going to talk about later this week.
Your GP is being responsible here, though I can see why its annoying.

It’s standard and a considered part of ethical practice for the practitioner requesting the test to follow up on it.

It is also part of ethical practice for science-based practitioners to order tests only when medically indicated.

Your best course would be to see the GP and explain the health concerns and symptoms they have so that appropriate testing can be arranged. It is possible that this will not include tests you’ve already had.

Alternatively follow up with the practitioner who ordered the tests. They presumably aren’t ordering tests they don’t understand, can’t interpret and the results of which they have no idea how to treat......

As above, it’s standard that the person who ordered the test should sort out the follow up. Your functional medicine doctor will be aware of that. It’s a slightly odd selection of tests to have organised for someone with hashimoto’s.

Thank you all for taking the time to reply, I really appreciate it - and it has absolutely made me see things from the position of my GP. He is a new GP to me as my former doctor retired so we have no real 'relationship' yet. The nutritionist said she would always follow up on tests that she can form a management plan for, but where potentially serious health indications are thrown up, she would rather know what we're dealing with medically before recommending her route - if that makes sense. She said the BANT guidelines say immediate referral back to GP if levels of certain markers are elevated eg blood, calprotectin etc. But I can see now how frustrating that must be to a GP. Let's see how we go then!

Thanks again

@negomi90 - just wanted to say that your sentence/punctuation analogy was so useful! I totally relate to that. Thank you for explaining it in layman's terms as that makes complete sense.