Disinterested GP

debrasue · Mar 16, 2016

I know it's been said before on here that GPs are often not very sympathetic to the LCHF approach for dealing with diabetes, but I hadn't expected to encounter such blatant disinterest as I did this morning!
I was diagnosed on the 1 March - via a terse phone call from him to say "You've got Type 2 diabetes, I'll put a prescription for Metformin in the tray for you to collect and ask the dietician to get in touch with you." (his exact words). When I got over my shock, I called him again a couple of days later to get some more information (numbers, etc.) and told him that I had done some research in the interim, joined this community, and decided I didn't want to go down the Metformin route at this stage, but preferred to see if I could make a difference through diet and exercise.
I went back to see him today to give him an update, showed him my readings for the past week (an early one at 8.3, two in the 7s, and the rest mainly 5s with one or two 6s) and told him I had lost 10lbs on the LCHF eating plan. He said "Well, there are lots of different ways to lose weight, so it's up to you which one you choose. Your glucose levels look about normal, but you really don't need to be testing every day - it's not necessary." He was rummaging in his bookcase for something when I left.
I still haven't heard from the dietician, but if he/she is going to have the same approach as my GP, I'll feel very inclined to just suggest that they "DO one!"

Oldvatr · Mar 16, 2016

Galja said:
As a relatively newly diagnosed type 2, you seem to be handling the usual rubber stamp apprach physician really quite well. Continue to do what you know is right for your own body and meanwhile check around for alternatives to his myopic approach. At least, in the UK, you don't have to usually pay a $30 co-pay in addition to premiums on insurance in order to have someone dismiss you so inexpertly.

In UK, we pay National Insurance. For me when I was employed, I had 12% deducted each month from gross salary (before tax), and my employer paid 14% as well. On top of this I had to make BUPA contributions since this was a condition of service. Then I had to pay tax on my BUPA contributions since these were considered perks by HMRC. So copay would probably work out cheaper.
I also paid income tax, which was at 20% of gross salary above the tax exempt allowance.

My GP earns his pay, and I am one of the lucky ones who has a supportive HCP team.

Sutherlandlass · Mar 16, 2016

Hi @debrasue I can totally associate with how you're feeling about your gp's flipancy! I got my diagnosis from a receptionist, who has a lot to learn about confidentiality! She told me over the phone, I am sure that other folks would have heard the conversation great stuff eh?! When I did get to see my gp, there was no offer of a dietitian, he just asked me if I had internet access, gave me a website address, and said you'll get all the information you need to know about diabetes on there... the joys!

Sutherlandlass · Mar 16, 2016

I am so grateful for this community, there are so many folks willing to offer sound, kind advice!!

debrasue · Mar 16, 2016

Sutherlandlass said:
Hi @debrasue I can totally associate with how you're feeling about your gp's flipancy! I got my diagnosis from a receptionist, who has a lot to learn about confidentiality! She told me over the phone, I am sure that other folks would have heard the conversation great stuff eh?! When I did get to see my gp, there was no offer of a dietitian, he just asked me if I had internet access, gave me a website address, and said you'll get all the information you need to know about diabetes on there... the joys!

Rubbish, aren't they!

TorqPenderloin · Mar 16, 2016

It sounds like his bedside manner could use some improvement, but were you expecting the appointment to somehow go differently?

Less than three weeks ago, he recommended a treatment that you chose to go against. On a personal level, I don't blame you for making that choice, but at the same time that was a decision to ignore his advice. As far as he's concerned, you're following an approach recommended by a bunch of online strangers and sharing two weeks worth of results. All I'm saying is to try to empathize with how he views the situation.

Either way, it sounds like you're making some strong progress and keep it up.

Stallen · Mar 16, 2016

We have a similar GP at my practice, I've only seen him twice in four years and both myself and and partner try and avoid seeing him at all costs, thankfully I get to book with one of the others and 99% of the time with one I particularly like. In November last year, I disengaged from my GP quit all my medication after 2 months of diet my BG numbers were down and I'd lost 10kg when I went back to the GP in January, I've continued to lose weight another 10kg and my latest Hba1c was 41 just in the Non diabetic range and my BMI is 22.3.

So far in the last 2 months I've seen 4 consultants, 3 different specialist nurses covering different conditions, each one has been positive about LCHF, even today I met my surgeon again, he told me the last time he saw me in December he was really worried about me coping with the prospect of irreversible surgery he needs to preform and my withdrawal from medication, this time the first thing, he said he could see I look different my body shape has dramatically changed and that both recent testosterone treatment and diet has really improved both my physical and mental outlook.

I'd suggest If you have other GPs and you can see one of them, make an appointment and tell them you are in charge of what happens and LCHF is the approach you are going to try first, and you want to see if that works for you, and that you would appreciate having some positive support and commitment from them.

Since my own incident with my GP last November they have been very supportive and willing to go the extra mile in offering me lots of positive care and support.

Good luck with LCHF and your GP.

Avocado Sevenfold · Mar 16, 2016

debrasue said:
I know it's been said before on here that GPs are often not very sympathetic to the LCHF approach for dealing with diabetes, but I hadn't expected to encounter such blatant disinterest as I did this morning!
I was diagnosed on the 1 March - via a terse phone call from him to say "You've got Type 2 diabetes, I'll put a prescription for Metformin in the tray for you to collect and ask the dietician to get in touch with you." (his exact words). When I got over my shock, I called him again a couple of days later to get some more information (numbers, etc.) and told him that I had done some research in the interim, joined this community, and decided I didn't want to go down the Metformin route at this stage, but preferred to see if I could make a difference through diet and exercise.
I went back to see him today to give him an update, showed him my readings for the past week (an early one at 8.3, two in the 7s, and the rest mainly 5s with one or two 6s) and told him I had lost 10lbs on the LCHF eating plan. He said "Well, there are lots of different ways to lose weight, so it's up to you which one you choose. Your glucose levels look about normal, but you really don't need to be testing every day - it's not necessary." He was rummaging in his bookcase for something when I left.
I still haven't heard from the dietician, but if he/she is going to have the same approach as my GP, I'll feel very inclined to just suggest that they "DO one!"

Well done on your great numbers and weight loss achieved by taking control of your condition and thinking for yourself.

Your doctor will not be interested as many believe that improvements are the work of the diabetes fairies

donnellysdogs · Mar 16, 2016

This makes me tired of reading GP reactions to be honest.
They now have to display the average earnings on their website... (It has to be there somewhere but may well be hidden). Our GPs in our Practice averaged £76,000 last year.
If a GP isn't bothered about my care now I am so tempted to say "you earn £76k and you aren't exactly earnng it with me!!"... Fortunately I do have a superb lady GP... Thankfully. One male GP refused to send me for a 2nd opinion on my right boob... The lady GP did and thank goodness. The films did indeed show a small cluster last year and now finally I get my biopsy tomorrow...

Avocado Sevenfold · Mar 16, 2016

@donnellysdogs All the best x

TorqPenderloin · Mar 16, 2016

donnellysdogs said:
They now have to display the average earnings on their website... (It has to be there somewhere but may well be hidden). Our GPs in our Practice averaged £76,000 last year.

Wow, I had no idea. So that's why all the doctors want to come to the US.

debrasue · Mar 17, 2016

Stallen said:
We have a similar GP at my practice, I've only seen him twice in four years and both myself and and partner try and avoid seeing him at all costs, thankfully I get to book with one of the others and 99% of the time with one I particularly like. In November last year, I disengaged from my GP quit all my medication after 2 months of diet my BG numbers were down and I'd lost 10kg when I went back to the GP in January, I've continued to lose weight another 10kg and my latest Hba1c was 41 just in the Non diabetic range and my BMI is 22.3.

So far in the last 2 months I've seen 4 consultants, 3 different specialist nurses covering different conditions, each one has been positive about LCHF, even today I met my surgeon again, he told me the last time he saw me in December he was really worried about me coping with the prospect of irreversible surgery he needs to preform and my withdrawal from medication, this time the first thing, he said he could see I look different my body shape has dramatically changed and that both recent testosterone treatment and diet has really improved both my physical and mental outlook.

I'd suggest If you have other GPs and you can see one of them, make an appointment and tell them you are in charge of what happens and LCHF is the approach you are going to try first, and you want to see if that works for you, and that you would appreciate having some positive support and commitment from them.

Since my own incident with my GP last November they have been very supportive and willing to go the extra mile in offering me lots of positive care and support.

Good luck with LCHF and your GP.

Thanks, @Stallen I appreciate the advice.

Jaylee · Mar 18, 2016

TorqPenderloin said:
Wow, I had no idea. So that's why all the doctors want to come to the US.

That was only "Dr House" wasn't it??

Prem51 · Mar 18, 2016

Jaylee said:
That was only "Dr House" wasn't it??

There will probably be more junior hospital doctors going after the imposition of new contracts in August. And registrars and consultants will be next in the Government's sights.

donnellysdogs · Mar 18, 2016

As many GPs are not salaried ones they have to raise their income somehow... If they are Partners in business (my old Practice was Partners) compared to my new Practice. Old Practice Partners earnt more... So the only way to earn more is by prescribing more and hitting their targets with DES and QOF ie so many diabetics getting the bloods under the target that has been set. Do GPs just hand out tablets to do this in preference (and limited 10 minute appts) rather than dietary advice?

Oldvatr · Mar 18, 2016

donnellysdogs said:
As many GPs are not salaried ones they have to raise their income somehow... If they are Partners in business (my old Practice was Partners) compared to my new Practice. Old Practice Partners earnt more... So the only way to earn more is by prescribing more and hitting their targets with DES and QOF ie so many diabetics getting the bloods under the target that has been set. Do GPs just hand out tablets to do this in preference (and limited 10 minute appts) rather than dietary advice?

GP's specialize in medicalcare. They tend to refer dietary matters to specialist nutritionists, beyond the general guidance that they give. They have enough on their plates in their 10 min consultation.

Brunneria · Mar 18, 2016

The more I hang around this place, the more sympathy I have for doctors.

- I know, bizarre, isn't it? (and don't worry, I still have incandescent trantrums when something goes wrong with MY care )

But, you see... a doctor must see this many times a year:
- a new diagnosis, controllable by diet, or lifestyle (could be T2D, could be kidney/heart disease, alcoholism, smoking, could be any one of 30 other conditions)
- the patient is shocked, horrified, galvanised into action
- the patient vows to manage by transforming their life - gym membership, total diet re-think, change of lifestyle
- it works! patient sees wonderful, transformatory results
- everyone celebrates! Yay! The demon is vanquished.

And a year (2? 3? 5?) later, that same patient has backslid to worse that they were before, higher weight, larger waistline, same old diet, lapsed gym membership...

And poor old doc has to pick up the pieces and reach for the prescription pad. Again. Over and over. Every year of their 40+ year career. Why on earth should they be interested in progress in the first few weeks? It is the next few decades that matter. And they are treating the Tragic End Game on a daily basis.

Sorry to throw such a downer into the thread, but I am absolutely of the opinion that we should be treating our T2 as a Long Game, with steady, gentle, enjoyable, sustainable measures.
What good is a mad fitness regime, if it is going to lapse in 3 months? Or a back injury undoes all the good work?
What good is an uber strict 3.5g carbs a day diet regime, if it only lasts till Aunt Maud's birthday? Or it is Saturdays off, down the pub?
Or 'I eat what I like, on holiday?
Or...

Sorry @debrasue I am dumping a rant into your thread, and it isn't even aimed at you!
In fact, it isn't aimed at ANYONE.
It is just a reflection of human nature, and our natural human tendency to cheat on ourselves and reach for the easy couch potato option no matter how good our intentions. Willpower ain't gonna get you through every minute of every day, for the next 60 years, is it? Doesn't work that way.

I can say, hand-on-heart, that there are things that keep my D under control:
- blood testing regularly (All Praise to the Mighty Freestyle Libre)
- feeling utterly cr$p if I eat too many carbs
- having dogs that need walking every bl$$dy day
- logging into this (and other) forums every day, without fail (stops me from feeling isolated and as if 'just once won't hurt')

Oldvatr · Mar 18, 2016

Hi @Brunneria I won't copy your rant again, but I agree with it. It makes me sad that HCP bashing is so prevalent in the Forum. Its an easy thing to do, and, yes, there are bad practices and poor staff that could do better. But there are also many who do the best they can, but still evoke ire here,
Many of their antagonists seem to be Newbies, and I remember being similar when I was DX'ed. The problem seems to be that there is no proper introduction process to give the info and support data that a newly diagnosed person requires.
I was a User Representative on the comittee that was formulating the Desmond / Daphne courses. One thing we pushed for was a small booklet similar to the startup advice given by Daisy1 here, that the GP could give to each Newbie, But the NHS shot it down as being too expensive and of being 'one size fits all'. So we still have this sudden brick wall.

This info chasm opens up, and stays as a barrier for possibly all future contacts with HCP's.

If GP's just gave out the details of this website, and forum then this woukd help, but that opens up access to the web, which is not an APPROVED source. My GP practice has a large notice warning against using the NET for info, especially WebMD and Drugs.com

End of MY Rant.

debrasue · Mar 18, 2016

Brunneria said:
The more I hang around this place, the more sympathy I have for doctors.

- I know, bizarre, isn't it? (and don't worry, I still have incandescent trantrums when something goes wrong with MY care )

But, you see... a doctor must see this many times a year:
- a new diagnosis, controllable by diet, or lifestyle (could be T2D, could be kidney/heart disease, alcoholism, smoking, could be any one of 30 other conditions)
- the patient is shocked, horrified, galvanised into action
- the patient vows to manage by transforming their life - gym membership, total diet re-think, change of lifestyle
- it works! patient sees wonderful, transformatory results
- everyone celebrates! Yay! The demon is vanquished.

And a year (2? 3? 5?) later, that same patient has backslid to worse that they were before, higher weight, larger waistline, same old diet, lapsed gym membership...

And poor old doc has to pick up the pieces and reach for the prescription pad. Again. Over and over. Every year of their 40+ year career. Why on earth should they be interested in progress in the first few weeks? It is the next few decades that matter. And they are treating the Tragic End Game on a daily basis.

Sorry to throw such a downer into the thread, but I am absolutely of the opinion that we should be treating our T2 as a Long Game, with steady, gentle, enjoyable, sustainable measures.
What good is a mad fitness regime, if it is going to lapse in 3 months? Or a back injury undoes all the good work?
What good is an uber strict 3.5g carbs a day diet regime, if it only lasts till Aunt Maud's birthday? Or it is Saturdays off, down the pub?
Or 'I eat what I like, on holiday?
Or...

Sorry @debrasue I am dumping a rant into your thread, and it isn't even aimed at you!
In fact, it isn't aimed at ANYONE.
It is just a reflection of human nature, and our natural human tendency to cheat on ourselves and reach for the easy couch potato option no matter how good our intentions. Willpower ain't gonna get you through every minute of every day, for the next 60 years, is it? Doesn't work that way.

I can say, hand-on-heart, that there are things that keep my D under control:
- blood testing regularly (All Praise to the Mighty Freestyle Libre)
- feeling utterly cr$p if I eat too many carbs
- having dogs that need walking every bl$$dy day
- logging into this (and other) forums every day, without fail (stops me from feeling isolated and as if 'just once won't hurt')

A whole bunch of very wise words there, @Brunneria!

TorqPenderloin · Mar 18, 2016

debrasue said:
A whole bunch of very wise words there, @Brunneria!

I have a lot of respect for you for in taking all of this constructively. That's not always easy to do.

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