The GPs have become “Vending Machine” for the pharmaceutical industry and the word PREVENTION does not exist in their dictionary. No matter what is wrong with you, Paracetamol is the answer (or Statins or anti-depressants). GPs are all too quick to prescribe medications (for stomach ulcer, for example) without carrying out proper tests and considering all side-effects. We must all remember that side effects very often lead to other problems and… to more medications. Many patients are happy to take palliatives and tests show that even placebos sometimes work better than the actual drug. I am disappointed with my local surgery because proposed alternatives are, very often, leading to wasting my time, they are not addressing the causes and eventual remedies to my complaints, and are wasting resources and money for the whole NHS. To follow is my letter to the surgery….
Dear Ms. S.
I am writing to you to inform you that I have not received satisfactory service from your surgery. This letter should be considered an official complaint. I fully understand that your surgery follows general guidelines and I am aware that you are often over-stretched and that you are also under all the usual pressure to deliver the best service possible. Indeed I am generally reluctant to use your surgery because I do not wish to waste either my time or yours. I consider you to be an emergency option – however, and as such, I expect you to offer professional solutions.
Firstly – I have now received four standardised letters from your surgery telling me that you do not have my blood pressure on your records. You should have this information because a) I have given you the information in the past and, b) my blood pressure has also been checked by the doctor. I don’t know how many patients you have but if you are experiencing this problem with even a small number of people then you are wasting your resources – time and money.
Secondly – your referrals have proved to be a disaster on many occasions and there has been a general lack of understanding on the part of the doctor(s) as to what my final aim is or will be. For instance, if I ask to see a dietician, it is probably because I need to lose some weight as I am obese. But if I also mention that I am concerned with my metabolism, the doctor should know that the dietician is not the right person for me to see. This has finally been worked out by your staff but, in the mean-time, I have been passed around from referral to referral and this has been an utter waste of time (and NHS resources). I doubt that mine is an isolated case and I suspect that a great deal of time and money has been expended on badly estimated and ultimately unnecessary referrals of this sort at your surgery.
Thirdly – recently I have been on the receiving end of negligent decision made by your doctors. If I telephone the surgery requesting a morphine injection from the GP it is sensible to assume that there is a rational reason for my request – that I am probably in serious pain. In this instance I have also informed the GP that I have been taking Tramadol (2 x 50mg every 8 hours) for the last 24 hours, which should be a good enough indication of the severity of the pain.
As per NHS guidelines:
- Step 3 (moderate to severe pain) = morphine injection 10mg/mL, 15mg/mL, 20mg/mL, 30mg/mL: see BNF
The GP should “remember” that I have access to MST (morphine sulphate) and Temgesic (buprenorphine) tablets. It seems sensible to assume that a person in my position might decide to take such tablets should the pain continue unabated. The only reason that I am not taking them is because they give me headache and do not take away my symptoms – and I know this from experience. Suggesting that I take utterly redundant co–codamol only shows indifference and an uncaring stance on the part of the doctor and – worryingly – a lack of concern about the other medication a person such as myself might take should the doctor refuse to help in a difficult situation such as this.
Fourthly – there have been a number of worrying incidents concerning my mother who is also patient at your surgery. I am currently her primary carer and I was promised that a GP would come to see her four weeks ago. This has not yet happened – despite three repeat requests! I have also made three requests for my mother to be seen by a Counsellor. These have fallen over a two month period. I have not heard back on this either. There are numerous reasons for such requests and I will gladly discuss them with anyone at the surgery should they be prepared to listen. Neglecting my mother will only increase her dissatisfaction and my own. I strongly believe that a counsellor will be able to generate a positive experience, rebuilding and renovating aspects of her life. As I am also suffering from chronic stress – and because there is a clear antipathy between my mother and myself – the presence of a counsellor would give me more “space” in which to look after my own health while still guarantying her with her wishes of an independent life.
Fifthly – I am the patient and should seem like an ignorant party when compared to my GP. Why then is it that when I mention LDL [subclass phenotype A] and [subclass phenotype B], PCS or Mirizzi syndrome, the GP has no idea what I am talking about? Does this mean that my levels of LDL type-B will never be found out – ? – or that my cholecystectomy is just part of some previous life?
Finally – I understand that your being explicit about the problems of your patients may cause offence in some instances; nonetheless, I expect a sincere and frank attitude from my GP. You will achieve nothing by treating me like a child. For instance – should I refuse to take Statins; it is because I have what I deem to be good and valid reasons for not doing so. And should you wish to argue the contrary with proven details – i.e. not those of the Allhat study, Ascot-LLA trial or Jupiter trial – then I will gladly listen. There has been no attempt to do so on your part. Instead your staff has reiterated the same tired arguments.
In conclusion – the service delivered by your surgery has been severely lacking in the above instances. Generally speaking, the level of professionalism from almost all of your doctors has been excellent when compared to other surgeries in the area and I will not move on, yet. However – I must stress that I need solutions.
I am coming to the end of my personal capacity to deal with this situation. If nothing improves I feel that I may have to involve an external party in order to take this complaint further. I really hope that this does not become a necessary course of action!
I very much enjoyed a lengthy conversation with the senior doctor at your surgery some six months ago. She has always been very caring and understanding. It is a real shame that she has decided to retire. I am always available and happy to communicate should your current management wish to respond. I sincerely hope that you do.
Please note that I have not mentioned any names in my letter because it will also be published on my blog and NHS websites.