A vent about slack GPs

poshtotty

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1,012
Type of diabetes
Type 2
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Tablets (oral)
I have nothing but praise and respect for my GP, his surgery and diabetic nurse.

When diagnosed with T2 almost 10 years ago, diet and exercise were recommended and I was regularly monitored by my DN and encouraged to continue without medication because diet and exercise were working.

When I hit a blip last year and an operation was cancelled by the hospital because my bs had suddenly rocketed to a level which meant surgery would be dangerous, I received advice and support from the hospital endocrinologist who supplied me with a meter and a tutorial on using it and how often.

Together with stumbling upon this site, the generous support and advice of members here plus adopting a now very strict LCHF diet, my GP has supported my decision to come off medication for another condition which has gone into remission due to my change to LCHF diet, has supported my decision to decline statins and commented during one consultation that I knew about my diabetes than he did!

My diabetic nurse at my last review when asking how I had managed to achieve a reduction in my weight, bs and HbA1c told me she too had started cutting carbs from her diet and felt very much better for it and encouraged me to continue.

Until my diagnosis I was so ridiculously fit and healthy that I had only needed to visit a GP and hospital on 3 occasions when pregnant. My contact with them is now more frequent than I would wish but I have only respect for those I see regularly and I like to think it is mutual.

The only exception is dieticians. Don't get me started on them!
 
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ButtterflyLady

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3,291
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Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
I have nothing but praise and respect for my GP, his surgery and diabetic nurse.

When diagnosed with T2 almost 10 years ago, diet and exercise were recommended and I was regularly monitored by my DN and encouraged to continue without medication because diet and exercise were working.

When I hit a blip last year and an operation was cancelled by the hospital because my bs had suddenly rocketed to a level which meant surgery would be dangerous, I received advice and support from the hospital endocrinologist who supplied me with a meter and a tutorial on using it and how often.

Together with stumbling upon this site, the generous support and advice of members here plus adopting a now very strict LCHF diet, my GP has supported my decision to come off medication for another condition which has gone into remission due to my change to LCHF diet, has supported my decision to decline statins and commented during one consultation that I knew about my diabetes than he did!

My diabetic nurse at my last review when asking how I had managed to achieve a reduction in my weight, bs and HbA1c told me she too had started cutting carbs from her diet and felt very much better for it and encouraged me to continue.

Until my diagnosis I was so ridiculously fit and healthy that I had only needed to visit a GP and hospital on 3 occasions when pregnant. My contact with them is now more frequent than I would wish but I have only respect for those I see regularly and I like to think it is mutual.

The only exception is dieticians. Don't get me started on them!
Happy for you. I too am able to have respect for my GP and other doctors and I like to think it's mutual. Sadly, many people are not as fortunate as we are.
 
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poshtotty

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1,012
Type of diabetes
Type 2
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Happy for you. I too am able to have respect for my GP and other doctors and I like to think it's mutual. Sadly, many people are not as fortunate as we are.

Its sad and frustrating that not everyone has had the positive experience that I and the others who have already posted here have had. Varying opinions are essential to a balanced and healthy debate. I can only speak as I find
 

ButtterflyLady

Well-Known Member
Messages
3,291
Type of diabetes
Type 2
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Tablets (oral)
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Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
Its sad and frustrating that not everyone has had the positive experience that I and the others who have already posted here have had. Varying opinions are essential to a balanced and healthy debate. I can only speak as I find
This issue was covered earlier in the thread, when someone else pointed out that this was not a debate thread, it was a vent about those doctors who are slack (actually motivated out of empathy for others). Sharing your positive experience is great, but it's not what the thread is about. I agree with you, some doctors are great. Not denying that.
 
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Daibell

Master
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12,642
Type of diabetes
LADA
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Insulin
I have always had a good experience with the various DNs I've had over the last 10 years. Their diabetes knowledge has varied but they have always tried hard, listened and without pulling rank. The two diabetes 'expert' GPs have not been so good. The first one was pretty clueless about diabetes, diagnosed me a with a urine stick and missed all the Late onset T1 clues. I had to suggest medication to him. My second one is a good GP but a bit arrogant and doesn't listen about my diabetes. She refused to consider I was T1 and refused insulin until it become vital and then offered it. I was told to stop starving myself and have a normal balanced diet; all pretty silly really. The reality is that they are General Practitioners and even with a 1 week diabetes training course they won't be diabetes experts for years as they have to cover an amazing range of other health conditions.
 
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Blubee

Newbie
Messages
3
Type of diabetes
Type 2
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Diet only
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Ignorance
I have to agree. I have just had a long awaited operation cancelled because my GP had stopped my diabetes meds and left me with nothing. If I had known that my op was in jeopardy I would have gone straight back and asked for different meds. You cant ask for something you dont know you need can you? I struggled with metformin as it made me really ill. I took it for several months despite the gastritis and diarrhea but when he finally agreed it wasnt working for me he said to come back in 3 months (after my proposed op ) and he would start me on something else. The consultant was baffled as to why he didnt offer me anything when he knew I was to have an operation. Maybe it is that GPs are not specialists in any field but I feel terribly let down. I now have to wait months in pain to see if I can have my operation. My bs was not that bad to begin with I might add, 6/7 in the morning, but surgeons are not prepared to take the risk of infection if you are not on meds. I'm fed up with it all.
 
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ButtterflyLady

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Messages
3,291
Type of diabetes
Type 2
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Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
I have to agree. I have just had a long awaited operation cancelled because my GP had stopped my diabetes meds and left me with nothing. If I had known that my op was in jeopardy I would have gone straight back and asked for different meds. You cant ask for something you dont know you need can you? I struggled with metformin as it made me really ill. I took it for several months despite the gastritis and diarrhea but when he finally agreed it wasnt working for me he said to come back in 3 months (after my proposed op ) and he would start me on something else. The consultant was baffled as to why he didnt offer me anything when he knew I was to have an operation. Maybe it is that GPs are not specialists in any field but I feel terribly let down. I now have to wait months in pain to see if I can have my operation. My bs was not that bad to begin with I might add, 6/7 in the morning, but surgeons are not prepared to take the risk of infection if you are not on meds. I'm fed up with it all.
Sorry to hear that :( Would there be any value in making a formal complaint, and asking the consultant to reconsider? Or do you have to be on meds for a couple of months first?
 
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poshtotty

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This issue was covered earlier in the thread, when someone else pointed out that this was not a debate thread, it was a vent about those doctors who are slack (actually motivated out of empathy for others).

Many apologies. As someone who isn't prone to ranting I was unfamiliar with the protocol for this type of post
 
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Dillinger

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1,207
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Celery.
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 ??

Your GP will tell her that she needs to be on a statin.

Have a look at this though; Dr Kendrick on the HUNT2 study.

http://drmalcolmkendrick.org/2012/09/25/silence-was-the-stern-reply/

According to that your wife is in the perfect spot for CHD/All cause mortality. If she could get her cholesterol up a bit her all cause mortality risk will reduce. Her heart disease risk will rise slightly but not nearly so much as if her cholesterol was under 5.0 which is where your GP wants it.

Funny eh?

Science isn't magic; if one's theory does not work and does not fit the facts then one's theory is wrong. Cholesterol levels, saturated fat, and the use of statins all require magical thinking in order to conform to the orthodox theory of heart disease and blood lipids. The reason for that is quite simple; the theory is wrong.

Best

Dillinger
 
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ButtterflyLady

Well-Known Member
Messages
3,291
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.

Alzebra

Well-Known Member
Messages
604
Type of diabetes
Type 2
Treatment type
Diet only
It has seemed to me over the last 20 years that female patients being treated by male HCPs are most at risk of the "hypercondriac" diagnosis, regardless of presentation.

I presented with severe abdominal pain and significant weight loss (associated with being unable to eat for 6 months) when I was only 19 years old. My father was terminally ill at the time. Rather than rule out physical causes my GP at Uni threatened to have me sectioned if I continued to 'waste his time'. Worse was to come, I can't share the full horror.
It was only when I returned to my hometown that basic scans etc were done and my gallstones and blocked bile duct were found. I had to have open surgery due to the level of infection and adhesions, but the pain then went away!

I wish all doctors would operate an 'innocent until proven guilty' policy before assuming patients are lazy / non-compliant / just plain attention-seeking. :banghead:
 
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SunnyExpat

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2,230
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Prefer not to say
Treatment type
Tablets (oral)
Your GP will tell her that she needs to be on a statin.

Have a look at this though; Dr Kendrick on the HUNT2 study.

http://drmalcolmkendrick.org/2012/09/25/silence-was-the-stern-reply/

According to that your wife is in the perfect spot for CHD/All cause mortality. If she could get her cholesterol up a bit her all cause mortality risk will reduce. Her heart disease risk will rise slightly but not nearly so much as if her cholesterol was under 5.0 which is where your GP wants it.

Funny eh?

Science isn't magic; if one's theory does not work and does not fit the facts then one's theory is wrong. Cholesterol levels, saturated fat, and the use of statins all require magical thinking in order to conform to the orthodox theory of heart disease and blood lipids. The reason for that is quite simple; the theory is wrong.

Best

Dillinger

Much better explanation in the entire study

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2753.2011.01767.x/pdf

But it does suggest the range 5 to 7 is the sweet spot, not that the 6.3 should be actively sought to be increased.

It also suggests the study may be true for those of Nordic origin, not that there is any read across to other populations.
 

AndBreathe

Master
Retired Moderator
Messages
11,320
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
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.

When you say if you had been told about the diabetes risk years ago, you might have lost weight before you dod, do you really mean it? I am pretty certain that most people think there is an every person walking through the door mantra HCP_s chant; That being, "lose weight and don't smoke". Anyone in the UK who has even watched then news, never mind had the messaging from HCPs says they've never heard that carrying weight wasn't good for them isn't being oncredible straight with themselves in my view.

I have spent years and years working with Change; working out ways to motivate how people, process and systems can be changed for the better. Of those three massive categories, the most difficult to achieve sustainable change is the people. Without a real and meaningful implication, with a matching "what's in it for me" benefit of making the changes, they either don't happen at all or they are only sustained very short term. Let's face it, before we were in this arena, how many of us gained a lost dollops of weight, like going through a revolving door? A fair few, I'd wager.

I could have done with losing a few pound pre-diagnosis. I am a highly, highly educated individual, with a background in the wider health care professions, so I had no excuse for ignoring the fact that love handles are sub-optimal to put it at it's most flattering. If I couldn't be motivated by the messages I had read, hear or been told, how can I really, really expect others to have reacted differently.

Once I crossed the diagnosis Rubicon, suddenly the answer to the "what's in it for me" question became a lot clearer. It had gone from being "well, in decrease my chances of being diagnosed with a condition" to "I have a potentially very damaging condition and I don't to deteriorate or have any complications coming my way". Suddenly it's more tangible.

On a more general note; I too feel for GPs and other generalists. Whilst in an ideal world, all GPs would have a great handle on diabetes - especially now it's been awarded the epidemic label, but how many more epidemics are they juggling, in terms of their time, investment knowledge - in a fast moving world. By those other epidemics, I'm thinking of stress, obesity, back ache, depression, substance abuse for all sorts, just for starters. Like the rest of us, they only have so many hours in the day, and also do deserve a decent quality of life and family time.

As I have mentioned, I used to work in the NHS, but left when I could see I wouldn't tolerate the direction is was taking 20-odd years ago. By now, I might have been well on my way to a fabulous NHS pension, but I am also absolutely certain I would have suffered burn-out or other forms of mental health. Rates of substance abuse and suicide are shockingly high within the wider health and veterinary professions. Whilst "Physician heal thyself" is all very well to chirp out, but who heals the healers?

In terms of how I manage my relationship with my GP (I've encountered Practise nurses immediately after diagnosis and for one single review), I always make sure I am well prepared for my appointments, and will often have notes with me, if there is something I particularly want to discuss (as opposed to an acute issue like a chest infection). Up front, I make my objective clear, so that we both know my expectations. Yes, I have been told by my GP that I know more about certain topics than she does, but I have time to focus on my specifics. I'm not juggling all those other epidemics too. I have also made it my business to ensure that if my GP isn't so confident as me on a certain topic (as has been the case with my lipids), I ensure that I leave her with notes, and references to my reading material, so that she can pick up on it if she chooses. Her lipid knowledge os coming on a treat!

(Whhhooooooooooooaaaaaaaa...................... Yes, that was a bit of a rant. :) )
 
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Baruney

BANNED
Messages
928
Type of diabetes
Type 2
Treatment type
Diet only
When you say if you had been told about the diabetes risk years ago, you might have lost weight before you dod, do you really mean it? I am pretty certain that most people think there is an every person walking through the door mantra HCP_s chant; That being, "lose weight and don't smoke". Anyone in the UK who has even watched then news, never mind had the messaging from HCPs says they've never heard that carrying weight wasn't good for them isn't being oncredible straight with themselves in my view.

I have spent years and years working with Change; working out ways to motivate how people, process and systems can be changed for the better. Of those three massive categories, the most difficult to achieve sustainable change is the people. Without a real and meaningful implication, with a matching "what's in it for me" benefit of making the changes, they either don't happen at all or they are only sustained very short term. Let's face it, before we were in this arena, how many of us gained a lost dollops of weight, like going through a revolving door? A fair few, I'd wager.

I could have done with losing a few pound pre-diagnosis. I am a highly, highly educated individual, with a background in the wider health care professions, so I had no excuse for ignoring the fact that love handles are sub-optimal to put it at it's most flattering. If I couldn't be motivated by the messages I had read, hear or been told, how can I really, really expect others to have reacted differently.

Once I crossed the diagnosis Rubicon, suddenly the answer to the "what's in it for me" question became a lot clearer. It had gone from being "well, in decrease my chances of being diagnosed with a condition" to "I have a potentially very damaging condition and I don't to deteriorate or have any complications coming my way". Suddenly it's more tangible.

On a more general note; I too feel for GPs and other generalists. Whilst in an ideal world, all GPs would have a great handle on diabetes - especially now it's been awarded the epidemic label, but how many more epidemics are they juggling, in terms of their time, investment knowledge - in a fast moving world. By those other epidemics, I'm thinking of stress, obesity, back ache, depression, substance abuse for all sorts, just for starters. Like the rest of us, they only have so many hours in the day, and also do deserve a decent quality of life and family time.

As I have mentioned, I used to work in the NHS, but left when I could see I wouldn't tolerate the direction is was taking 20-odd years ago. By now, I might have been well on my way to a fabulous NHS pension, but I am also absolutely certain I would have suffered burn-out or other forms of mental health. Rates of substance abuse and suicide are shockingly high within the wider health and veterinary professions. Whilst "Physician heal thyself" is all very well to chirp out, but who heals the healers?

In terms of how I manage my relationship with my GP (I've encountered Practise nurses immediately after diagnosis and for one single review), I always make sure I am well prepared for my appointments, and will often have notes with me, if there is something I particularly want to discuss (as opposed to an acute issue like a chest infection). Up front, I make my objective clear, so that we both know my expectations. Yes, I have been told by my GP that I know more about certain topics than she does, but I have time to focus on my specifics. I'm not juggling all those other epidemics too. I have also made it my business to ensure that if my GP isn't so confident as me on a certain topic (as has been the case with my lipids), I ensure that I leave her with notes, and references to my reading material, so that she can pick up on it if she chooses. Her lipid knowledge os coming on a treat!

(Whhhooooooooooooaaaaaaaa...................... Yes, that was a bit of a rant. :) )
 

Cl1ve

Well-Known Member
Messages
193
Type of diabetes
Type 2
Treatment type
Tablets (oral)
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.[/QUOT


Hi .the problem is that we reward people who make money . No the people who save lives . You ar undervalued and under paid . And I don't know what we would do without you
Clive
 
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Blubee

Newbie
Messages
3
Type of diabetes
Type 2
Treatment type
Diet only
Dislikes
Ignorance
Sorry to hear that :( Would there be any value in making a formal complaint, and asking the consultant to reconsider? Or do you have to be on meds for a couple of months first?
Thanks, I am still deciding what to do. I see my gp in a couple of weeks so I will wait to hear what he has to say. I may still make a formal complaint. The consultant said I have to be on meds for at least 3 months, then I can have my op at Christmas. I will probably wait a bit longer than that! I dont know if it is standard practice to only operate on diabetics if they are on meds, but it is worth noting as it has caused such problems.
 

AndBreathe

Master
Retired Moderator
Messages
11,320
Type of diabetes
I reversed my Type 2
Treatment type
Diet only
Thanks, I am still deciding what to do. I see my gp in a couple of weeks so I will wait to hear what he has to say. I may still make a formal complaint. The consultant said I have to be on meds for at least 3 months, then I can have my op at Christmas. I will probably wait a bit longer than that! I dont know if it is standard practice to only operate on diabetics if they are on meds, but it is worth noting as it has caused such problems.

The usual criteria, for elective surgery, is the bloods have to be in decent order, and I understand that means an HbA1c of below 8.5%. A quick consultation with Dr Google gave me the number - exactly the same across 4 varying NHS Trusts. Your story, whilst extremely frustrating is one we hear relatively regularly here, when people turn to the internet to achieve action, now.

I'm fairly positive the guestimation of waiting 3 months would be to allow your bloods to come into order. As you probably understand, the HbA1c test measures your average blood scores from the last 8-12 weeks.

The rationale tends to be that a higher HbA1c at the time of elective surgery increases the chances of any unfortunate infection or other complication not resolving so readily, so my understanding is these deferrals are primarily for your own safety and well-being.

There's lots to read on Google about elective surgery for diabetics.

Clearly if an emergency arises, worrying about a potential risk is more dangerous than not treating the emergency.

Good luck with it all.
 
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eddie1968

Well-Known Member
Messages
3,661
Type of diabetes
Type 2
Treatment type
Insulin
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Pasta, sorry to me it's vile, yeuch lol (and full of nasty carbs)
I think GPs dish out the M&Ms (Metformin & more Metformin) is they are a generic and cheap tablet to dispense. I had terrible GI effects and they did not a lot for my HbA1c levels. Metformin is therefore cheap as chips to the NHS compared to other meds. Doctors should spend 2 minutes explaining on the extra toilet rolls you will need and what to do in event of an "accident" lol. :eek::D
 
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Celeriac

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Messages
1,065
Type of diabetes
Type 2
Treatment type
Tablets (oral)
So few people seem to tolerate bog standard Metformin (pun intended) that I really don't see why GPs bother with it. Is it that much cheaper than SR ?

My GP and consultant are stellar but the nurses argh. Not just practice nurses but those in walk-in centre, hospital, clinics. Bossy, not as knowledgeable as they think they are, often downright abusive. It's never OK to restrain someone physically to get your point across, for example.

Even when I spoke to a nurse on 111 re: the cream recall, I got the tutting that I, as a diabetic had dared to eat it in the first place.
 
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Baruney

BANNED
Messages
928
Type of diabetes
Type 2
Treatment type
Diet only
Jese - you think that bad - went to Argos in Cockney capital and was treated like it was a privaleige to be there!