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How can I ask the Dr without..........

18 replies

sweetteamum · 14/11/2012 08:34

.........Putting words into his mouth.

DD is going the Dr's today to get a (sick) note for school, which confirms her absence is due to anxiety (relating to school). This should cover all absence and hopefully, she will keep her off sick so we can push for home tuition - without this, DD is going to be more pressure.

So, how do I say all this within a ten minute chat with dd in the room (she wont wait in waiting room by herself) and without putting words into the Dr's mouth.

All help and advice is so welcome :)

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pinkorkid · 14/11/2012 08:48

Could you either ask to speak to gp on phone before hand or put your concerns in writing for him to read in advance, explaining that you don't want to talk about her in front of her? Hope the appointment goes well.

sweetteamum · 14/11/2012 09:00

Thanks pink. Good idea to drop something off before her appointment. Ill send a letter in and take latest report.

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zzzzz · 14/11/2012 09:03

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KOKOagainandagain · 14/11/2012 09:34

Depending on where you are this may be problematic even if there is a valid history in DDs medical notes. See below:

"Dear Head Teacher or College Principal

Medical Certificates for Students absent from School or College

I write on behalf of X, the statutory representative body for all general practitioners in the county.

Dr???????? has recently been approached to provide a medical certificate for ????????.
In respect of his/her absence from school or college

NHS GPs provide medical services and have no professional involvement in education or school attendance monitoring. In general, family doctors do not provide sickness absence certificates for children as the parent?s explanation for the absence is should normally allow the school to ensure any health related concerns are addressed.

Furthermore, GPs do not normally provide short term sickness certification for periods of less than 7 days and they are unable to issue medical certificates for longer periods of sickness absence unless the patient was seen by the GP at the time of the illness. Please note that NHS medical certificates are provided only for employment and statutory sick pay reasons. They may not be issued for any other purpose.

If a certificate is required by you for education purposes, this constitutes a private service and the GP practice may levy a charge. The person or organisation that requests the certificate will be billed accordingly. Obviously any such request must be accompanied by the written consent of the parent or legal guardian if the student is under 16 and the student?s own consent if he or she is over this age.

Provision of medical certificates for school children is not part of a GP?s responsibility and a refusal to provide this certification is in accord with the Government policy to reduce GP paperwork and preserve valuable GP time for clinical care. Please see; www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4003147

When a child has missed an exam the examination boards do not require the GP to provide a certificate before special consideration of the case. Please see www.jcq.org.uk/attachments/published/428/Final%20%20RAG%2007-08.pdf

There is no statutory obligation on NHS providers to produce certificates covering absences due to illness for students claiming Education Maintenance Allowance.

In cases where recurrent short term illnesses or a more prolonged spell of illness is causing concern it may be helpful for an Education Social Worker to speak to the GP, again after proper consent has been obtained.

You will understand that it is most important that the GP retains the full confidence of any child, but it is particularly important for those children that have problems resulting in poor school attendance where a trusted doctor-patient relationship may be critical for the young person?s future care.

I hope you will understand therefore that it was not possible for the GP to issue a medical certificate as requested on this occasion."

It is not impossible - in the end my GP just signed one of the sickness certification pro forma. It took about 20 minutes which was mostly him staring at DS (in a world of his own at the time - DS not GP) and reading DS's notes.

Keep it practical - school want sick note to record absence as authorised - without a sick note they are pressuring DD to attend and this is having a counter-productive effect and increasing anxiety.

Good luck. Smile

sweetteamum · 14/11/2012 10:29

Thank you zzzzz. I do agree I'm trying to think of too much at once. I will focus on her anxiety as that's my only concern for the time being. I am always trying to think how I can get people to believe me.

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sweetteamum · 14/11/2012 10:35

Thank you keepon. That does make a lot of sense as each time I've taken her to the doctors for this issue in the past two months I've been told that usually the parents words are taken as truth by schools. I'm just hoping they recognise her reasons for absence.

I doubt she will talk but I will just make sure she does answer the very important q's where the doctor NEEDS her to answer. I'm going to take a copy of her little diary (with dd permission of course) to get her to show the doctor.

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KOKOagainandagain · 14/11/2012 10:56

Not talking or engaging is good from the GP pov. DC of her age displaying extreme anxiety do not sit down and have a discussion with the GP. I wouldn't force her to speak or speak for her. Let the doctor see the anxiety (manifest however it is manifest from silence to meltdown) for themselves. I wouldn't show them the diary - GP may think that you are prioritising being believed over an invasion of her privacy. DS is the same age and the GP will not want to treat them as they would a younger child.

Act as if her anxiety is a self-evident fact not that you are 'anxious' to persuade them to believe you. Why wouldn't they?

sweetteamum · 14/11/2012 11:20

In that case, I really don't have anything to worry about. She completely refused to speak to Dr the first time we wen. She refused to leave the house the second time, so I wonder what will happen this time.

I've never thought that her refusing to speak is anxiety, but have never forced her to talk, so thank you for your advice.

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sweetteamum · 14/11/2012 17:06

Hmmm doctor said that school need to get in touch with him so he can confirm why dd is absent.

BUT, and its a biggie, apparently there has been a meeting where all people involved with dd met and put a plan in place (oh and did I mention it was an invitation only event and parents weren't invited Angry !!!!)

I've had an email to say they're going to do x, y & z blah blah blah. So as her parents when do we get to see the minutes of this meeting ? And when will we be told this great plan which never involved the 2 people that know her best.

To say I'm fuming is an understatement!

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nothinginthefridge · 14/11/2012 17:10

What! I hope the dr was not part of this, and did not divulge any of your daughter's medical records without your consent.

I'd be ringing the secretary, asking who attended and then I would phone each of them asking for a copy of the minutes.

KOKOagainandagain · 14/11/2012 17:18

Not good to say the least!

Did the GP tell you about the meeting to which you were not invited? Who sent you an email and when and what is the plan?

Angry for you.

zzzzz · 14/11/2012 17:27

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sweetteamum · 14/11/2012 20:18

Apologies for the confusion. Dr wasn't part of the meeting. It's a coincidence that this has happened on the same day. Is this kind of thing normal or do us parents usually have a say?

Tbh I'm just amazed with the whole situation and want to make sure that my already dd isn't affected anymore. Of course I want her to be in school but not at the expense of her health.

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sweetteamum · 14/11/2012 20:19

I'm just on my phone but will use correct wording when I'm in the laptop.

It was school who emailed me.

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zzzzz · 14/11/2012 20:35

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sweetteamum · 14/11/2012 22:00

This is the exact email I received today:

Dear Mrs Sweet

I have tried to call today but could not get through ? I have left a message on your mobile saying I would email you

As we are aware of the difficulties that Dd is currently experiencing due to involvement with CAMHS and LASC we will not need to contact the doctor for confirmation of this but thank you thinking of that

We met today and have put together a plan to try to get Dd back into school in a gradual way ? staring with the lessons that she likes or lessons that do not require a move of building. Would it be possible for our nurture manager to come out to your house to discuss this with you and Dd one day this week or Monday ? I will try to call you again tomorrow to arrange a convenient time

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zzzzz · 14/11/2012 22:42

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sweetteamum · 15/11/2012 07:46

I suppose it seems ok. However the go saw her yesterday and will confirm with school that dd is not fit for school. Therefore she needs home tuition and work sent home until she's for for school. If that makes sense.

Shall I ask for it all in writing first? That way we can show dd something that will hopefully have more of an impact than just telling her. We can still be putting this into place whilst she is still so anxious.

Oh and do I ask for everything in writing as she wanted to explain more on the phone, but then I've not got in on paper

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