Surprised Dr not interested..

[Ron1]

Hi, I only have to press the send button to hopefully begin loosing weight as have filled in the form. I had a few questions for juniper as I have health issues : fatty liver (non alcoholic) removed gall bladder, Hypothyroidism, pre diabetes , acid reflux. They suggested I contact my GP to ensure the medication is appropriate for me. Spoke to GP today, I felt they were quite dismissive said they have no input into the 'private' treatment and its up to the provider to care for my health as they are providing the medication. Wouldn't discuss anything other than tell me my Liver blood results have got better over the last year. Even though I know its double what it should be at 80.0u/L although 3 years ago it was 226. u/L. Why would they have this attitude I wonder, when I am trying to get my health issues under control? I need to loose 3 stone and have plateaued (I have to say they are normally very good so am surprised at the attitude towards this drug)!

The prescriber is responsible for checking side effects of any medication. As the GP is not prescribing the drug, their role is limited here. It is not on the nhs formulary apart from very specific conditions so I think it’s unfair to expect the GP to assess your suitability for a drug they aren’t going to prescribe for you.

I agree that they should monitor your chronic conditions and advise on general lifestyle measures but why should they assess suitability for a medication they aren’t able to prescribe for you!!

Everything that @surroundedbyid1ots said. I think the backside-covering caveats you've had from Juniper are more concerning than your GP's response, tbh.

I think because your GP is not an expert in the contra-indications to this drug and they don’t want you coming back later saying “you said it would be fine”.

I'm also not surprised your GP would not comment. If they aren't prescribing, then it's not their decision to make.

The online provider needs to take your full medical history and then make their own prescribing decision, which is what they are meant to be able to do. If they feel your medical situation is too complex to manage via the level of service they offer, then they can decline your request. What they should not be doing is trying to palm the decision off to someone who is not clinically responsible for prescribing.

He told you why they have ‘that attitude’ - it’s a private treatment.

The private provider is being paid (by you, presumably) to provide a treatment. They should be able to assess whether the treatment is suitable for you.

It would be reasonable to request from your GP practice a summary of your medical records (or you may be able to access this yourself online) - Juniper then can use this to assess whether or not the treatment is appropriate.

I doubt the GP would know this but it's particularly rich for Juniper of all companies to expect an overworked NHS GP to cover their backsides, given that they justify charging a higher price by claiming to offer an enhanced support service.

Thanks everyone for your input, I will stop this here.

Not the experience I had with my GP. They were very supportive of me looking into weight loss drugs to lose the weight I had gained since starting new medication. They looked into it and offered additional blood tests to keep an eye on the impact of one of my medications. Same with my consultant. However when the consultant kindly checked with their specialist pharmacist, the advice was not to go for it as the risks of damage to kidneys too high. But I got lovely support from both GP and hospital consultant and their team.

I can see this becoming an increasingly tricky area to be honest. The government want us to use private healthcare, to take responsibility for our health and not to overburden the NHS, and yet our healthcare records belong to the NHS. In this scenario the private provider doesn’t have enough information to make a decision to prescribe safely without input from the GP.

It isn’t the GP’s responsibility to determine if MJ is appropriate, but they should be able to confirm whether the other conditions are stable and well managed so that the prescriber can discuss the risks and benefits with you and decide how to move forward.

Do you meet the criteria for a GP to prescribe the drug? If not you probably shouldn't be getting it anywhere and if so why not go to your GP for it? They have all your medical information.

I can see this becoming a huge mis-prescribing problem particularly with the recent concerns about pancreatitis. I can understand why a GP wouldn't want to be involved at all if they are not the person providing the treatment

@dogcatkitten this is absolutely not the case. The NHS requirements are way and above the general prescribing criteria, that's an operational decision taken by the NHS. Currently for NHS GPs to prescribe, it's a BMI of 40 or more with at least 4 out of 5 specific weight related health issues. Very few people qualify for that.

The general prescribing guidelines approved by the MHRA are a BMI of 30 or higher, or a BMI of 27 for certain ethnicities, or a BMI of 27 with a weight related health condition.

You know the criteria for prescribing on the NHS is very different to the criteria for a private prescription right?

I guess it will be the usual- you can get stuff private but need to fall back to the nhs if something goes wrong ?

@greencartbluecart everyone relies on the NHS to fall back on when something goes wrong, in all aspects of life. Like making a poor driving decision and having a car accident, or just not looking where you're walking and having a fall. Or trying to get fit by exercising and having an accident as a result. And so on and so on.

Are you saying that's why the GP did not want to comment, because they view it as risking the need to "fall back" on the NHS?

Go with a different prescriber, there are plenty to choose from, some are better than others. Oushk seem to have a good reputation.

Why can’t your GP prescribe you something else e.g. metformin if you are pre-diabetic?

Ironically, it’s the good - and safe - suppliers who will be asking for additional information from GPs.

I wouldn’t recommend going to a provider who doesn’t bother, they are far more likely to supply against guidelines and put people at risk.

But should it be?

Mine doesn’t. Apparently you’ve to be diabetic for a few years, do all their clinics etc etc before they even consider any medication for it. They barely even see you if you are pre-diabetic.

I chatted with my GP about taking MJ in advance of buying it. I needed to speak to him about HRT so crowbarred the chat in. He was happy to chat about it, said to go for it and that loads of his patients are on it and he think it's brilliant. I don't have underlying conditions, but he would have discussed in more detail if I did I have no doubt. So what you've experienced is GP specific I would say.

I think there’s a difference between having a general chat about WLI, and being asked specific medical questions about a prescribing decision being made by a different (private) service. It’s my understanding that there are quite clear rules about private treatment being completely separate to any NHS process, that GPs would need to be mindful of.

The private providers are trying to offload work and clinical responsibility that you are paying them for, onto an NHS service which is not funded for this. I’m on MJ and have found it really helpful but realistically for most of us we are going to regain and the long term benefit isn’t clear yet. If the private provider doesn’t feel able to prescribe it to you, I’d take that as a reason not to take it tbh.

I have just been prescribed it though I went private (healthcare through employer)

I'm a GP. if we took every call like that, I'd fill half my daywith thenm