GP has really panicked me. Should I complain?

[Bookist]

Had a lump/swelling appear on the outside of my upper left thigh in November. Nearly the size of my palm. Not hard (slightly soft). Not coloured. Not hot. Slightly tender sometimes. Occasional pins & needles sensation down outside of the leg. I think I noticed it a couple of days after doing a lot of physical exercise all day?

It's still there maybe slightly larger, not sure. So went to the GP today. She examined it. I mentioned there is a history of DVT in my family, to which she replied (and these are her exact words) "It's definitely not DVT, so no need to worry about that. I'd be much more worried that it might be cancer or a tumor."

I think I went into shock. I'd gone in thinking I'd torn a muscle or maybe bursitis, and she started talking about cancer! I was so shocked that I couldn't think to ask any questions. She then said she would refer me for an UltraSound and sent me on my way.

I can't believe she would be so brutal and callous, even if she does suspect it might be something sinister. I really don't know what to think, I think I'm still in shock. But surely there's better ways of speaking to a patient than this?

'Not really sure? But I guess I would have expected her to say something like 'There's lots of things this could be, most likely nothing sinister, but there's always a possibility, so to make sure you'll need an Ultra Sound.'

To be fair there was a post on here a few weeks ago complaining about doctors saying 'it's nothing sinister'

I don't think the GP was in the wrong, quite a lot of people (including me) prefer to hear it straight out, sorry you got a shock though.

well what did you want her to say?

The GP isn't in the wrong though, that's the point.

Why not just stop at 'I can't tell what it really is so will send you for a scan?'

A lot of patients would hear that as "There's nothing to be worried about so don't make an effort to go to the scan if it's inconvenient"

'There's lots of things this could be, most likely nothing sinister, but there's always a possibility, so to make sure you'll need an Ultra Sound.'

Translation = "I dunno what it is but it's probably nothing. I'll send you for an unnecessary scan anyway."

Don't assume everyone knows what the word sinister means, either.

Most scans & tests are actually genuinely 100% unnecessary because they don't find anything that leads to any necessary action to protect health. So why is OP leaping to assumption that she's in imminent danger? Pah.

nameychangerrrrrr no, the GP wasn't clinically wrong in this case, although it sounds like there is room for improvement in her communication.

I wanted to make the point that whatever the solution is to the very sad suicides of Drs under GMC investigation, it really is essential that patients are able to complain.

I despair at people, really.

The NHS is a publicly (under)funded service providing healthcare to the masses. GPs are civil servants, and of late they’re increasingly overworked / underpaid. They aren’t paid to treat members of the public with gentle patience for their best reactions; they’re there to allocate limited resources in the most efficient way.

For every patient like you who wants/needs to be treated with kid gloves so that they don’t experience shock, there will be a patient like me who can’t bear to be patronized and is capable of distinguishing between the message and its delivery.

What is a GP, who has to see x many patients per day and give each one no more than y number of minutes, to do?

Actual question. How is the very same human supposed to divine what kind of person each patient is, and tailor their bedside manner accordingly?

Do you really think that lodging a complaint is a reasonable response?

There's been a GP trainer on this thread who indicated what she'd say to this GP.

The GPs have ten minutes for a single slot. OP said she was in for about eight minutes.

It's not about kid gloves. The OP has already had a cancer diagnosis previously and has been through tough times. The GP could have at least faced her when relating her thoughts about cancer.

Well bully for you if you can't bear to be patronised and can breeze through consultations distinguishing between the message and the delivery.

I despair at people, really

Thank you so much for this, it's really kind. I wonder how many of the posters on here have had a previous cancer diagnosis? Only to be told by their GP that they suspect it might have come back 'while their GP won't even face them while saying it, as too busy typing on a screen.'?

But some potentially good news, the lump is definitely smaller. I thought it was yesterday evening but didn't want to get my hopes up. But it definitely is this morning 😊

It is so sad, I don’t think people realise the complexity of the role and the pressures HCPs are under. For an HCP who has invested so much in just trying to be someone that helps others to be shot down for not being super human, is it any wonder it drives them to suicide. Do people also realise the huge number of great HCPs who leave or retire early primarily because they know despite many appreciative patients and lives saved over the years, they know that if they were in the wrong place at the wrong time it could very easily be them.

Good, hopefully will get some reassurance soon, and do put in some general feedback to the surgery. As said before HCPs do want to know how they could do things better/more sensitively (although frustratingly they sometimes know but don’t have the resources/time) but people do change their practice over time with more knowledge and experience

Thank you for the responses @Bookist and @TiptoeTess

Hope all goes well for you OP, have read your update.

Thank you. I'm genuinely not a precious snowflake who needs banging. I'm actually known for being rather no nonsense IRL.

However considering my previous diagnosis, I don't think it too much to expect my GP to actually turn and face me, and make eye contact, when voicing her opinion that it could be cancer again. Is that too much to ask.

Aaaaggh! No I definitely don't need banging ta very much. I meant babying.

No you should not complain.
doctors do not need to treat their patients like infants.

you should want all the information the doctor has available.

This!

Time

If cancer is a possibility, then you will get a fast-track referral, and it should be under 14 days.

If routine, then it could be several weeks (or even months during the winter virus season) before an appointment and that time lost can really matter if the cause is not benign.

And if you're put on the 14 day cancer-check pathway, it's better to be told that by someone at the outset (even if their manner is blunt) than have it mentioned randomly at a different appointment.

I haven't read all the comments but I'm kind of with you on this op. Far too blunt, almost flippant, and a touch condescending! Honesty and action are what you want from a gp but they can do that without sounding quite so blunt surely. All the best op.

Yeah yeah. Aren't you the invincible one.

OP didn't mention kid gloves. She's a previous cancer patient so if course was reeling from a casual mention of a scary differential diagnosis.

I'm glad she's come on here to talk it through rather than sitting worrying.

The delivery of a clinical message is important for several reasons. We are coached from the first year of medical school. If patients feel they are on solid ground there are numerous benefits for both them and the NHS- clarity of messaging and expectations, less stress for the patient which can aid symptoms (obv depending on the issue), reduction in unnecessary follow up visits and calls.

It isn't always got right every time and the GP fell short here.

I don't agree this needs a complaint as she has referred the OP as needed but it would not have taken a moment to explain her clinical reasoning, say, 'unlikely to be a DVT or bursitis as no heat or pain. Could be a common benign fatty tumour called a lipoma or less commonly (if appropriate to presentation) a new lump could turn out to be a cancer so best to have it checked by ultrasound'. That should be a standard approach, not particularly tailored.

I don't agree with fudging differentials at all if cancer is a possibility but you can't just chuck that out there, especially if the patient has been through it once and will be on high alert now. These things do matter on a population level as well as individual if you're looking at resourcing as paramount. It's not that hard.

I do agree she should of handled the communication better, stopped what she was doing and given her full focus to telling you that cancer could be a possibility and so she was going to refer you for a scan. I’ve no doubt that this is what I imagine my amazing GP would have done.
I can also see from the other side a clinician who is overwhelmed (and perhaps inexperienced) being hyper focused on prioritising her focus and very limited time just making sure she doesn’t miss anything. It isn’t ideal at all I know

Giving me their full attention and actual eye contact isn't asking to be treated like an infant. It's only polite (and professional). What she gave me was the back of head whilst busily typing.

And she didn't give me all the information she had. She didn't bother to impart that the risks of it being a sarcoma are less than 1%. She didn't bother to impart that it was much more likely to be a benign lipoma. This was knowledge she had but that I've since had to find out for myself. She had the time to impart this knowledge, as I left the appointment earlier than my allotted 10 mins. But she didn't.

Because in a couple of weeks after the test if it was cancerous the patient would be complaining that she can't believe the GP didn't tell me she suspected it might be cancer!

Giving me their full attention and actual eye contact isn't asking to be treated like an infant. It's only polite (and professional). What she gave me was the back of head whilst busily typing.

Exactly.

The people saying "GPs can't get it right" are choosing not to read your posts properly. Of course they can get it right. They can be open and straightforward about the possibility of cancer, while actively engaging with their patient rather than while staring at their screen and typing.

No, I absolutely wouldn't be complaining that she hadn't mentioned it might have been cancer.

Plenty of GPs manage to be efficient doctors whilst also having a personable bedside manner.

Well yes, quite. But apparently wanting your GP to politely face you and make eye contact whilst suggesting you might have cancer (again) is outrageously self indulgent and babyish.

I suppose I should be grateful that she didn't cuff me round the back of the head when she told me, you know to teach me resilience.