A vent about slack GPs

[ButtterflyLady]

I'm feeling quite annoyed today about those GPs who don't do anything when a person is prediabetic or even diabetic. Also those who immediately prescribe metformin with no dietary advice (or even not telling people they may get GI side effects and to come back if they do). Not to mention those who don't follow up to ensure people get their nurse appointments, follow up tests, and specialist referrals for T1 or complicated T2. Then there are the ones who think it's ok to have one month waiting times for appointments unless you're extremely ill, and then it's still 3 days! And the ones who pressure people to take statins when the harms are likely to outweigh the benefits for that person. And the ones who say T2s should not test because it will just upset them and make their fingers hurt.

Sorry, but it just gets to me sometimes. It's totally unacceptable.

 

[carol43]

Hear Hear. The advice given by Doctors and Nurses is non-existent. Everything I know about diabetes is gained from this site.

 

[Bluetit1802]

It isn't all GP surgeries, or maybe I'm just lucky because my surgery is part of a well run health centre. I can always see a doctor the same day I ring (not necessarily my own doctor), or I can chose to wait to see a doctor of my choice. I can book on-line, where all the doctors are listed with all their available appointment times over the following 6 weeks, and from that list I can chose my own appointment.

As for my diabetes I was put on the NICE recommended care pathway straight from diagnosis, and am still on it. My HbA1c on diagnosis was 53. Metformin was never mentioned. I'd never heard of it till I found this website. I was given 3 months to try and get my levels down "a bit" with diet and added exercise. I was given the usual NHS dietary advice of course, but I don't blame my nurse for this. She was just following NHS procedure. After finding this website I asked my nurse for a meter. She gave me one, with 50 strips, but said she was unable to prescribe further strips at this stage.

Since then I have had all my reviews, blood tests, eye tests, foot tests and everything else. I get letters well in advance telling me to make the relevant appointments. If I am having a problem I can ring my nurse at any time.

Yes, my doctor did try to put me on statins because I was high risk for CVD according to the Q-risk calculator, and I accepted them initially as I didn't know any better, but I took myself off them after 2 months. I also don't see this as my doctor's fault because she was following NICE recommended procedure, to the letter. When I came off them we had a long debate, which ended with her saying she still recommends I take them, but was quite happy to prescribe low dose aspirin instead. I have heard nothing more on the subject since.

 

[SunnyExpat]

I think in all my life, my GP's have been excellent.
(Even one that blamed my weight for everything, with hindsight she was correct)
Just good advice, same day appointments, specialist referrals, meter and strips on prescription, ongoing care etc.
As have my nurses.

So while there are some slack GP's, there are some excellent ones.

I'm sure somewhere, on a parallel GP forum, there is a thread about awful patients, who spent a few days on the internet, and then come in not prepared to listen to anything, but simply to tell them why their training of 10 years isn't worth anything to them.

 

[DeejayR]

My experience is similar to @Bluetit1802's and I'm actually grateful to my surgery for calling me in out of the blue a couple of years ago and diagnosing me as prediabetic. No drugs have ever been mentioned and I've been passed painlessly around between 4 GPs in that time (retirement resulting in locums & part-timers) who all show a mild interest in leaving me alone. Suits me.
My beef with the diabetic nurse is that she's not a diabetic and not much of a nurse as far as I can see, so boxes get ticked but she has no idea about me.
However, this is a rant thread, not a balanced discussion, and based on others' experiences related on this wonderful forum I entirely agree with @CatLadyNZ.

 

[ButtterflyLady]

I've had good experiences with GPs in relation to my diabetes, but I was feeling frustrated after reading about others' experiences on this forum. I wish more people could have good experiences... it's not that hard, the GPs just need to improve on a few things.

In most of my posts on this forum where the subject of doctors comes up, I tend to defend the doctors. I guess today there was a straw that broke the camel's back and I just wanted to vent. I hate seeing people suffer unnecessarily.

 

[zand]

My complaint is to do with the system, rather than individuals. You get to see a GP for 5 minutes and each time there's only chance to say the same thing as last time.

When you go to see someone privately or an alternative therapist, they chat to you for maybe an hour during your first session. They get to know you straight away. Consequently my naturopath, who I only met 3 times knew much more about me than any of my GP's. I know time is money, but I can't help thinking if they knew their patients' history better than they would find the correct treatments more quickly and save money long term.

 

[britishpub]

I think we can be too hard on GP's as you cannot really expect them to have detailed knowledge of all the things that can be presented to them, although with Diabetes and the fact that they get paid to diagnose and treat the disease, they probably should be better informed. Diabetes Nurses, are not trained professionals, so we shouldn't expect them to be able to much more than repeat the "company" line.

Our GP is about to get something presented to him, which will be well outside his comfort zone. My dear wife, who weighs 7 1/4 stone and has not an gram of body fat, has just had a blood test with an overall Cholesterol level of 6.3.

Explain that ??

 

[zand]

I think we can be too hard on GP's as you cannot really expect them to have detailed knowledge of all the things that can be presented to them, although with Diabetes and the fact that they get paid to diagnose and treat the disease, they probably should be better informed. Diabetes Nurses, are not trained professionals, so we shouldn't expect them to be able to much more than repeat the "company" line.

Our GP is about to get something presented to him, which will be well outside his comfort zone. My dear wife, who weighs 7 1/4 stone and has not an gram of body fat, has just had a blood test with an overall Cholesterol level of 6.3.

Explain that ??

Well I would say if your wife is fit and healthy then there isn't a problem. Her cholesterol level, whilst higher than the medical profession like to see, would not worry me in the slightest. It's probably the right healthy level for her personally. But then I'm not a GP.

 

[Lynn1]

I'm feeling quite annoyed today about those GPs who don't do anything when a person is prediabetic or even diabetic. Also those who immediately prescribe metformin with no dietary advice (or even not telling people they may get GI side effects and to come back if they do). Not to mention those who don't follow up to ensure people get their nurse appointments, follow up tests, and specialist referrals for T1 or complicated T2. Then there are the ones who think it's ok to have one month waiting times for appointments unless you're extremely ill, and then it's still 3 days! And the ones who pressure people to take statins when the harms are likely to outweigh the benefits for that person. And the ones who say T2s should not test because it will just upset them and make their fingers hurt.

Sorry, but it just gets to me sometimes. It's totally unacceptable.

I was prediabetic for at least a year before anyone thought to tell me. Only found out when our GP of 31 years retired.

 

[Celeriac]

I have to say that when I was fat, years ago, not one of the GPs I saw ever suggested that I lose weight, let alone that I could be heading for diabetes. If they had, maybe I would have lost the weight sooner.

One of the reasons I was so hacked off at being diagnosed T2 was that I had already lost weight all by myself and was going to a gym and it seemed unfair.

 

[ButtterflyLady]

I think we can be too hard on GP's as you cannot really expect them to have detailed knowledge of all the things that can be presented to them, although with Diabetes and the fact that they get paid to diagnose and treat the disease, they probably should be better informed. Diabetes Nurses, are not trained professionals, so we shouldn't expect them to be able to much more than repeat the "company" line.

Our GP is about to get something presented to him, which will be well outside his comfort zone. My dear wife, who weighs 7 1/4 stone and has not an gram of body fat, has just had a blood test with an overall Cholesterol level of 6.3.

Explain that ??

I think they should be expected to have enough knowledge of most illnesses so that they can either treat them or refer the person to someone who can treat them. Diabetes is a very common illness and GPs should know the basics and not make silly mistakes like the ones I listed in my OP. Nurses are trained professionals, but their training is nowhere near as in-depth as a doctor's.

 

[Celeriac]

I was prediabetic for at least a year before anyone thought to tell me. Only found out when our GP of 31 years retired.

That's terrible, there's no excuse for that practice, I hope you complained!

 

[sanguine]

I sympathise with GPs to an extent, because as Zand says it's the system rather than individual HCPs in most cases. I think there's also a tendency for GPs to stick with what they learned at med school (which could be some time ago) and not keep up as well as they might. And they are generalists after all. It's the 'sheep dip' approach to patient consultations that irritates me the most.

It would be nice to think that with diabetes increasing in significance with respect to NHS budgets etc more specific training would be given (I assume GPs have to do CPD like most professionals?) in its characteristics and treatment. There are some enlightened ones out there - David Unwin of this forum comes to mind - but strategic change has to come from government and NICE so I'm not holding my breath.

 

[Carriebooth]

I'm type one diabetic and have been for 21 years I've been struggling with a stomach problem for nine months! GPs can't help and my gastro consultant is blaming my diabetes saying I have a bacterial overgrowth but I'm sure it's something food related. I always get palmed off and told I have to wait etc etc. I think it's just not good enough! They are quick enough to moan if your diabetes isn't well controlled but when you need help they don't seem to know what's going on.

I've had good experiences with GPs in relation to my diabetes, but I was feeling frustrated after reading about others' experiences on this forum. I wish more people could have good experiences... it's not that hard, the GPs just need to improve on a few things.

In most of my posts on this forum where the subject of doctors comes up, I tend to defend the doctors. I guess today there was a straw that broke the camel's back and I just wanted to vent. I hate seeing people suffer unnecessarily.

.

 

[Brewers23]

I think we can be too hard on GP's as you cannot really expect them to have detailed knowledge of all the things that can be presented to them, although with Diabetes and the fact that they get paid to diagnose and treat the disease, they probably should be better informed. Diabetes Nurses, are not trained professionals, so we shouldn't expect them to be able to much more than repeat the "company" line.

Our GP is about to get something presented to him, which will be well outside his comfort zone. My dear wife, who weighs 7 1/4 stone and has not an gram of body fat, has just had a blood test with an overall Cholesterol level of 6.3.

Explain that ??

Sorry, but nurses are not trained professionals???!!!??? That is incredibly insulting to me and my colleagues.

I am a UK registered nurse.
I registered with a Diploma in Higher Education (level 5).
I have topped it up to a (second) 2.1 honours degree (level 6).
I have just completed my first module at Masters level (level 7) in Advanced Practice.
My next module will give me sufficient credits for a Post Graduate Certificate (PGCert) in Advanced Practice and will be on managing long term conditions (specifically diabetes).
There is a often a requirement for nurse specialists to be educated to level 7.
Advanced nurse practitioners work at the same level as physicians at F2 level in a large number of Emergency Departments around the UK, with the same responsibilities.
The problem is that NICE guidelines exist and if they are not followed then there is a real concern that nurses more than GPs are likely to be hauled up in front of the NMC for malpractice.

 

[Carriebooth]

Sorry, but nurses are not trained professionals???!!!??? That is incredibly insulting to me and my colleagues.

I am a UK registered nurse.
I registered with a Diploma in Higher Education (level 5).
I have topped it up to a (second) 2.1 honours degree (level 6).
I have just completed my first module at Masters level (level 7) in Advanced Practice.
My next module will give me sufficient credits for a Post Graduate Certificate (PGCert) in Advanced Practice and will be on managing long term conditions (specifically diabetes).
There is a often a requirement for nurse specialists to be educated to level 7.
Advanced nurse practitioners work at the same level as physicians at F2 level in a large number of Emergency Departments around the UK, with the same responsibilities.
The problem is that NICE guidelines exist and if they are not followed then there is a real concern that nurses more than GPs are likely to be hauled up in front of the NMC for malpractice.

I can't fault diabetes nurses at all they are always very helpful! It's the GPs I struggle with. I feel their knowledge isn't always excellent as they have to deal with anything and everything. Every diabetic nurse I have seen has been brilliant and given me the best possible advice

 

[Brewers23]

I can't fault diabetes nurses at all they are always very helpful! It's the GPs I struggle with. I feel their knowledge isn't always excellent as they have to deal with anything and everything. Every diabetic nurse I have seen has been brilliant and given me the best possible advice

The difficulty is that GPs are meant to be jack of all trades and have 10 minutes maximum per consultation in which to make a diagnosis and formulate a treatment plan. If you are fortunate then you may have a GP who was an endocrinologist/diabetician in a previous life, but these are few and far between, which is why there is a requirement for nurse specialists and, perhaps more importantly, the expert patient who is prepared to critically examine the latest (or maybe not so recent) evidence and self-manage their condition. Also the GP has to be of the mindset to listen to the patient and be prepared to admit that the patient may know more about their condition than the GP themselves.

 

[Robinredbreast]

I'm type one diabetic and have been for 21 years I've been struggling with a stomach problem for nine months! GPs can't help and my gastro consultant is blaming my diabetes saying I have a bacterial overgrowth but I'm sure it's something food related. I always get palmed off and told I have to wait etc etc. I think it's just not good enough! They are quick enough to moan if your diabetes isn't well controlled but when you need help they don't seem to know what's going on.

.

When I was became ill, March/April time,( 3 years ago) I kept going to my doctor, told him of my systems, had blood tests and I kept googling. Then I noticed Coeliac kept coming up, I went back to him and suggested Coeliac, that got the ball rolling( and my GP did actually feel my tummy area and when he pressed in one area the pain was incredible) but I had to have 2 endoscopies, because they forgot to do the biopsy the first time around. After that, a diabetes hospital appointment with Mr T resulted in him telling me from the screen he was viewing, that he noticed I had been tested for Coeliac and he told me my results had come back negative and I didn't have it. WRONG, the test comes back in two parts and he didn't have the 2nd part. On November 1st of that year, I went to my GP and the first thing he said to me was " Ahhh hello ****, are you feeling much better now you have been diagnosed", no..................... because I didn't know, no one had told me and I found out later they knew from the blood tests that I had Coeliac and that was in June, 5 months before I was actually told. It was unbelievable, especially when I was so ill with it and feeling so bad with many symptoms. ps the 2nd endoscopy was on October 18. So not a pleasant experience for months tbh.

 

[Brunneria]

Every issue I have ever had with health care professionals, boils down to a single theme:

They don't listen. They don't pick up on clues. They assume I am a lazy, ignorant pig who is eating a stupid diet. They spout the same dogma they have been spouting for decades, without bothering to check whether that dogma has worked for me during those decades.

Every general practitioner I have seen has fitted into this bracket, which has included
- Diagnosing a dislocated ankle as a sprained ankle 'make her walk on it, she is pretending it hurts'
- Diagnosing a tumour and PCOS as 'fat women don't get periods, come back when you have lost weight'
- Diagnosing an allergy (to eye makeup) as a squint ***!
- NOT diagnosing reactive hypoglycaemia, for decades, and dismissing me as some kind of hypochondriac

Around me, I have lost a friend to breast cancer 'pregnant women don't get breast cancer, that lump is your milk coming in'
and seen a friend left for 6 weeks with an untreated broken vertebra 'It's a bad back, no I don't need to examine you, just rest it and take over the counter pain killers. and please don't waste my time with a home visit again, unless it is an emergency.'

The flip side is that I have had 3 absolutely splendid HCPs who have profoundly improved the quality of my life.
- one was a very experienced/highly qualified consultant who was covering a shift in a family planning clinic and who spotted that my hormones were insanely out of wack - after 20 years of doctors ignoring them - which lead to a diagnosis of prolactinoma and PCOS
- another was an endocrinology registrar, who listened enough to fine tune medication
- the third was this spring, another endocrinology registrar who listened, understood, and made genuinely helpful comments allowing me to (yet again) improve the quality of my life.

As things stand, I will do anything I can to avoid more encounters with my local surgery, yet I happily trot off to the endocrinology clinic to have grown up conversations with people who answer questions, explain their thinking, and look me in the eye while saying things like
'You have lost half a stone in a year, that is really impressive for someone with your issues. Well done!'