GP searching on Google!!!!

[Roseshavethorns100]

Hi to anyone who reads this post.
I was in my doctors for an appointment last week regarding getting hrt, told her I'd had a subtotal hysterectomy three years ago and listed my current symptoms, told her I just can't function properly anymore.
The next thing I know she's on Google reading out about the type of hrt that should be given after said hysterectomy.
Is this normal for Dr's to do? Am I wrong to be really annoyed about it?

The "usual practice". Shouldn't a gp be aware of this if it's the usual prescription to give though?

That's such a shame and I can imagine it's hugely frustrating.

There's a gyno/menopause nurse at my surgery which is really helpful. I had naively thought that maybe by now every practice has one!

I went to my GP about something that was bothering me and told him I'd Googled it extensively and he said nothing wrong with that at all, just make sure you're using reputable sites. He said a lot of people do now and often bring the answers/suggestions as to what it might be, to the GP which saves a lot of time and bother.

It's crazy that we have to pay to see a specialist for perimenopause and menopause and the prices are bloody extortionate.

No because it's a specialist issue often and a GP would need to see your notes after surgery I assume. It's not straightforward when there is your cervix or some of it left. Many GPs struggle with 'bog standard HRT' because the meno training for GPs is minimal. Unless they have paid for extra training (CPD) they will not be up to speed.

@chipsticksmammy That fee is outrageous. Even in London the top consultants aren't charging £500 per consultation.

Supply and demand I guess.

I recently saw a BUPA surgeon for knee pain and the steroid injections I was given were £600. This was on top of the initial fee.

Been waiting 6+ months for an NHS consultation.

Its crazy and privately doesn't always mean better its just a bit quicker than waiting for public healthcare.

Goodness, no, do you know how much we have to remember? Being a GP is an incredibly complex job. We can't remember everything. We may be experts in several areas but not the one you are consulting about. I qualified as a GP in 1992 and retired in 2023. The advances in medicine that happened over those 30 years was phenomenal. No we can't keep up to date on everything but what we do because we are highly intelligent individuals is known when we have to check up on something.

I've been to see our family lawyer today for my husband's father's estate. It has a very complex trust in it. Guess what she's looking to others for advice and help on what to do with it. Bet noone is berating her for looking stuff up. No it's only GPs who should be super human. And I know some GPS aren't good but the majority are!

I would totally expect a GP to use an appropriate reference source for most things that aren’t dead straight forward. Staying absolutely up to date on every topic they deal with isn’t realistic.

A GP working full time will have over 200 patient contacts a week. Covering a huge range of topics and medical histories. Some of those will be high volume and straight forward (first line antibiotic for adult with no complications from medical history). Others will be less common, or have more specific sub details, or be fairly rapidly evolving. Menopause being one of those areas. Long covid being another. Fertility treatment protocols and criteria being another.

That said, I’d be expect to leave the appointment with something constructive. That might be info on options to consider before coming back to talk through choices. It might be advice on management strategies. It might be a referral. It might be a prescription.

I wouldnt refer to menopause being "less common".
Yes I would expect to leave with some information and I would also expect the gp to ring with blood test results and not the practice nurse!!

It’s never bothered me. You can’t expect them to know about every health issue known to man in minute detail.

Menopause really isn't an obscure health issue. It's not rare, it's not unusual even.

I don't expect them to know every detail but I do expect them to have more information on common conditions.

Irrespective, I know heaps about my work area but I always do a quick Google type refresher on each thing that comes up because it is so diverse and I like to be diligent. To me it's a sign of thoroughness not incompetence

That's good and you're entitled to that opinion.
But as far as I'm concerned she wasn't thorough enough or as thorough as other doctors in the practice.

Menopause with partial hysterectomy is less common.

Put it in context of every GP appointment you or a member of your household has ever had. How many were sore throats / backache / general viral / bacterial infection.

vs one for menopause after partial hysterectomy. While it’s a big deal in your life, as a portion of patient interactions they’ll see it’s low.

(and if cost bothers you, then nurse making results calls is thoroughly sensible).

I doubt anyone saying anything is going to shift your thinking on this OP!

However, a partial hysterectomy is not that common. There is a reason why you have kept your cervix or part of it.

Asking for HRT after that surgery is not that common either. Ideally, the person best placed to answer this for you is the surgeon who performed the surgery. They know why they did it and that has a bearing on whether you need only estrogen or you also a need a progestogen.

You're being unreasonable to expect a GP to give you an immediate answer.
Menopause is a common condition, clearly. Prescribing HRT needs extra training and doesn't come as 'standard'. HRT for women with a partial hysterectomy is more specialised again.

Depends entirely on your overall medical history. GP medicine is a sum of many parts. If you have other medical conditions it’s important to look at the whole picture. Once they have ruled out other problems a referral to a specialist who will concentrate on their specialty area. A lot of money and time can be wasted if you are bumped around the specialities if the GP has made a quick assumption.
I had sciatica, it was actually caused by fibroids. I could have wasted a great deal of time seeing orthopaedics and being told there was nothing wrong. A referral to gyni confirmed the fibroids and that is was compressing the nerves. No amount of physio would have solved the problem.
The same with acute neck pain after breast cancer treatment. It would have been easy to jump to the conclusion that I’d had spread to the bone in my spine. A quick visit to the physio and it was diagnosed as a trapped nerve and successfully treated.
It’s seems like everything is attributed to menopause if you are between the ages of 40-60. My DSis died last year from pancreatic cancer er. Early diagnosis may have afforded her a few months extra but more importantly she would have received better pain relief throughout her ordeal if she and GP hadn’t assumed her vague symptoms were all down to peri menopause.

Your OP was all about the dr looking for advice on the internet, and ended like this:

Is this normal for Dr's to do? Am I wrong to be really annoyed about it?

But you don’t like the fact that most people have told you it is a normal, in fact praiseworthy, thing for doctors to do, and yes you are wrong to be annoyed by it.

Whether or not you got good treatment is a completely different issue.

As for the practice nurse rather than the GP ringing with the blood test results, I see absolutely no problem with that unless they were giving you medical advice they weren’t qualified to give. The GP was rightly prioritising how they use their valuable time.

It seems OP as if you don't understand that HRT prescribing is not part of what GPs learn unless they and the practice invest in CPD.
Most use a simple online prescribing tool (maybe what yours did?) for GPs.

The issue you have by retaining your cervix is that some endometrial cells may be present- or they may not. This determines the type of HRT you should use.

Did you do any research yourself before your appointment? Because you could have, and gone in with the necessary information to speed it along.

Yes and this is the issue that we appear to be excusing. Doctors have about an hour of menopause training. It’s completely insufficient and unacceptable. It’s a very complex issue that 50% of the population will go through!

I found the same OP. I had to go private and pay but they are complete experts and you get half an hour of their time with dose tweaking etc.

The nurse couldn't even fully explain the results so what good is that when it comes to costs.
I pay for my gp appointments and blood test so yes I expect better.

I'm not berating her at all, and I'm entitled to my opinion.
I'm not stupid either and understand that research is an essential part of many jobs. You are all completely missing my point in that she was completely unhelpful regardless of what I said to her, the fact that she spent more time looking on Google than listening to me pissed me off, and is unacceptable in my opinion.

Thank you, finally someone who actually gets my point.
It's unacceptable that they know so little, even when it comes to period problems they are unsympathetic and unhelpful and that's going from gp to consultant level.
Prescribe a man with viagra though no problem at all.