Type 1: Lack of GP/Consultant support

[Buxton1998]

My GP retired and my consultant has been moved over into a managerial position, both of these were a great support and knowledgeable, and checked up on me regularly, since I was diagnosed with Autonomic Neuropathy. Now I am left to my own devices, with 1 annual visit to a junior consultant, who tries, but not very knowledgeable and there is now no one at my surgery who deals specifically with diabetes. Feel I'm banging my head against a brick wall.

 

[Lanzarote]

Hi Bridget,
Don't be afraid to change consultant. I live near Otley and the diabetic care there is far superior to nearby Leeds. Hope this helps. Kind regards.

 

[6cats]

I have had to write a few strongly worded letters about the general support, accessibility and altercations! I regret having to do it but I am afraid that sometimes it is a must.

 

[Annie86]

Hi @Buxton1998

I'm sorry you're feeling a general lack of support now with a retired gp and moving consultant.
Do you have a good diabetes nurse specialist that you could link in with regularly for support? If you feel the consultant you've been given isn't very knowledgeable ask to be transferred to the care of another. I know at my diabetes centre there are several consultants. Each have their specialist areas such as pumps, frequent hypoglycaemia episodes, kidney disease and neuropathy. It may be that your diabetes centre has a Web page with details and achievements of the consultants detailed.
Try giving the centre a call to discuss your concerns and see if they can offer further support or like I said earlier link in with a good DNS and see if they will support and coordinate your care and support?

Best of luck

Annie x

 

[DavidGrahamJones]

My GP retired and my consultant has been moved over into a managerial position

That's the sort of thing that will happen all the time, we all move on in one way or another. If you don't have any confidence in the GP and consultant that you now have then you will have to mention this without being too aggressive. If your surgery doesn't have a DN that you trust it sounds like looking for a new surgery is required.

As for the consultant, in what way have you found him/her lacking in knowledge? Has he/she done something wrong or given bad advice or is it that he/she isn't grey haired with years of dealing with diabetics. I'm not sure how you gauge the knowledge of a consultant, they will have already spent 5 years in med school, 2 years Foundation Program as a Junior Doctor, then 7 - 9 years to become a consultant.

Feel I'm banging my head against a brick wall.

Definition - to do, say, or ask for something repeatedly but to be unable to change a situation. What have you tried so far?

 

[Buxton1998]

Sorry for delay in answering, just been to see my replacement GP, went to discuss a ref feral to see an Autonomic Specialist, that was agreed straight away, so no problem there, I went to see a Diabetoligist regarding some issues, I told my GP about the consultation, she never asked me anything about it or why I needed to go, or if anything was possible for her to do as a GP to help with conditions! Maybe I have been spoilt, but previous GP, would've been asking all about it. I have been described as a difficult, complex, interesting case, the kind that Dr's write papers on! Not a tag to be proud of, but my GP was the kind that investigated unusual cases and relished it, and would fight my corner. My new GP - You've not had a prescription for statins, why not!

 

[islelassie]

I have never seen a GP or a consultant with my diabetes , There is only the practice nurse. and sometimes I feel I am more advanced in my knowledge than she is. There are no alternative health centres in rural areas so you are stuck with what there is it seems.

 

[Buxton1998]

I also am more knowledgable than who I see , but then I excpect that most diabetics are as we're the ones living with it.

 

[Buxton1998]

I have had to write a few strongly worded letters about the general support, accessibility and altercations! I regret having to do it but I am afraid that sometimes it is a must.

I told GP today that I wasn't happy with services.

 

[Phil Watson]

I really do think, from experience, that the treatment / care you get from GP's is both a lottery and at best dismal. The GP who confirmed that I had T2 actually stated in his next sentence that I could eat five cream cakes as long as I lost some weight. Welcome to the world of GP diabetic care! Best thing to do is keep asking for a different GP at your surgery and if necessary actually swap to a different surgery if you hear of a good one. - Good luck

 

[TJR56]

Here in the UK I have had fairly good care for my T1, twice yearly appointments at the local (teaching) hospital's diabetic unit being my primary diabetes care. The consultants I have seen over the years vary in the concern and interest they show and seem satisfied with my control etc. (but then so am I, via experience, reading, monitoring blood glucose etc.). The one I saw this morning was new to me, second time running. It was only a check-up, and she did ask if I had anything to raise, but seemed busy-busy (running over an hour late) and not too concerned, as no apology. I broached the subject of a LC diet and she said I would have to lower CHO slightly and lower insulin doses accordingly. No surprises, there then! (Have already adjusted.) Just signed off (tick in a box!) and I am to remember to phone in September to fix an appointment for my annual review. I would have liked to talk about how far this diet relies on burning ketone-producing body fat (ketosis having been seen as a really dangerous thing in all my experience of hearing about it) but had a feeling that such engagement would have been unwelcome. I was also conscious of all those running late behind me. I am lucky enough to be able access information via Diabetes uk and elsewhere and have a long experience (58 years in November) of T1, so I am relatively fortunate Having just turned 60, I wonder whether a bit of, 'Oh, pretty good for her age.. let's move on,' is at work here?

 

[prancer53]

Here in the UK I have had fairly good care for my T1, twice yearly appointments at the local (teaching) hospital's diabetic unit being my primary diabetes care. The consultants I have seen over the years vary in the concern and interest they show and seem satisfied with my control etc. (but then so am I, via experience, reading, monitoring blood glucose etc.). The one I saw this morning was new to me, second time running. It was only a check-up, and she did ask if I had anything to raise, but seemed busy-busy (running over an hour late) and not too concerned, as no apology. I broached the subject of a LC diet and she said I would have to lower CHO slightly and lower insulin doses accordingly. No surprises, there then! (Have already adjusted.) Just signed off (tick in a box!) and I am to remember to phone in September to fix an appointment for my annual review. I would have liked to talk about how far this diet relies on burning ketone-producing body fat (ketosis having been seen as a really dangerous thing in all my experience of hearing about it) but had a feeling that such engagement would have been unwelcome. I was also conscious of all those running late behind me. I am lucky enough to be able access information via Diabetes uk and elsewhere and have a long experience (58 years in November) of T1, so I am relatively fortunate Having just turned 60, I wonder whether a bit of, 'Oh, pretty good for her age.. let's move on,' is at work here?

I find the whole thing of under educated consultants, GP s & DSN s, who don't listen to one word that their patients utter, to be absolutely dismal. In the bad old days of glass syringes and wee testing docs seemed to have far better understanding of diabetes--or is it just that I have learnt far more through experience....I don't know...!!! I have had 2 consultants shout at me--one that he knew far more than I clinically and another shouting "how on earth did you know that?" I referred to a previous conversation with him so then he shouted at me again and asked me if I realised how much medics had to spend on research to arrive at the same conclusion as I had, through my own experience. He finished with "I thought you knew nothing about diabetes when I first met you". At that stage I had had type 1 for 25 years & was pregnant with my 1st child, 33, skinny etc.Now it is 55 years (I am 63) and have been lucky/ very careful to maintain normal blood sugars & do not have any complications. One day I am afraid I might lose my temper with the ridiculous & derogatory remarks I receive rather than just make a joke about it all......!!!!

 

[prancer53]

...oh & I also find that since I have turned 60 I am no longer taken seriously at all. My GP also seems to think that my type 1 has turned into type 2 ("hypos are caused by eating sweet food which makes your body produce more insulin = hypo--I sat there with my mouth open & totally unable to believe what she had said

 

[donnellysdogs]

There is a huge difference in hospital care and knowledge. My local hospital (which only 'needy T1's' will get referred to, the rest must come under GP care) doesn't have a pump consultant, one DSN that reads of a script whilst training two patients, with a fellow DSN and others there too learning one type of pump.

40 miles down the road, a totally different story. Multi disciplinary teams, pump specialist consultants, dietician/pump trainers - totally and utterly different. Any pump, not just one. Other options talked about too.

Such a vast difference in care between hospitals. However, this is the first CCG that I have lived in that I had to prove I am a needy T1 and GP care wasn't adequate for my needs. In the end my local hospital admitted they were also unable to help me. The Manager telephoned to suggest a change of hospital, that I had already suggested to her and had already spoken to my GP about twice that very morning.

I think having moved so many times, I have seen a huge difference in CCG's and it is a postcode lottery but if patients aren't happy with care then they can actually ask to be referred to a specific consultant at a specific hospital...