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Otherwise - GP problems
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Message 1.Â
Posted by Kishtu (U14091165) on Thursday, 3rd June 2010
First off, it's not my GP that I have an issue with, so all this information is second hand from the Aged P's. It's *theirs*.
I am getting increasingly hacked off with the man. APs in their 70s. Dad diabetic (but untreated and with no idea what his management plan should be or how serious or otherwise his diabetes is), mild heart condition, cataracts, eczema. Mum recent-ish hip replacement and osteoporosis.
On holiday recently dad started to get swollen feet and ankles and breathlessness, saw an emergency GP who diagnosed him with congestive heart failure and gave him loop diuretics. Return to his own GP recently who has now taken him *off* the diuretics, said he can find no signs of heart failure, and said the results of his blood test show anaemia and potassium deficiency, and is sending him for further blood tests. (Dad suggested, mildly, that potassium deficiency is one of the side effects it mentions on the diuretics due to the excess of weeing. GP apparently giggled and said he hadn't thought of that.) GP also said (and this really bites my bum, so to speak) that one possible result of the investigations would be weekly B12 injections from the nurse, that they *would* hurt, and "I know you, you wouldn't like that".
Mum's anaemia is more severe and his first comment was "where are you bleeding from?". Not "are you bleeding?" but "where?". Well, she isn't, and she is now scared to death, particularly when he starts talking about sending her for an endoscopy. She's 70 and quite frail and she doesn't always take in what's being said to her when it's couched in technical terms. Surely to goodness he could have sent her away at least slightly comforted....She is on quite strong painkillers for back and hip arthritis - which may, or may not, contain NSAIDs - which may, or may not, contribute to anaemia. Has he checked that? Nooooo, heaven forbid he prescribes the flippin things in the first place...
He has previously given them other people's prescriptions. He seems to *enjoy* frightening them. He spends half of the appointment talking about his lady friends and holidays. He refuses to countenance ever being questioned. He knows almost *nothing* about them or their lifestyles, despite having been their GP for over 30 years. Dad not infrequently gets out of the surgery without having his BP checked, or blood taken... just a repeat prescription and a sidetrack onto the subject of holidays and girlfriends. Mum almost invariably gets treated for the wrong things and has to go back because she gets intimidated and nervous and tells him what she thinks he wants to hear rather than what he needs to be told.
Now it *may* be that APs aren't fully understanding what he's telling them (which I wouldn't be too happy about either), it may be they're only telling me half a story, (not impossible but he was my GP as well for some time when I lived at home and on one legendary occasion treated me for a fungal skin infection when what I actually had was a sleeping in a mohair jumper overnight reaction.... however...) or it may be that he's just a Bad Doctor. On the evidence *I* have I'm tending towards the latter. I'm probably biased because they're my parents, I love them, and I want them to be *better*, not scared and confused.
OH has promised that if as a result of GP's mucking about with this heart condition of my dad's he doesn't live to hold his first grandchild, he will personally see to it that GP is investigated to fullest extent of action.
They're in their early 70s. They deserve a better quality of life than this.
Sorry for rant, but do not know what to do ;-( -
Message 2
Posted by E Yore (U1479700) on Thursday, 3rd June 2010
Thu, 03 Jun 2010 07:53 GMT, in reply to Medhuil Webbestre in message 1
Medhuil, there is no advice I could give you, not living in the UK nor knowing anything about medicine but as someone who has elderly parents in poor health living a great distance away, your post has rung more bells than a church on Easter Sunday.
My GP here in France (when I told her how worried I was about my parents - even though they have an excellent set of doctors from what I can gather) suggested that I write a letter to their GP, stating all the concerns I have about their health and how they deal or don't deal with certain issues (eg. my father's feet are very swollen from mid-morning on, but since he always sees his doc early morning, the doctor doesn't notice and my father won't mention it, despite my mother and I nagging him.) Either, if the doctor is good, they will value and appreciate the extra information they are given or if they aren't good, it will be a warning shot across the bows.
I'd be very worried that the diabetes isn't being managed - you can live for a long time with it, only if it is managed carefully. Managing the diabetes would be a start to improving your father's health.
If you write a letter and their GP doesn't reply or explain or suddenly clean up his act, then could you put your concerns to the competent authorities (GMC?) -
Message 3
Posted by Kishtu (U14091165) on Thursday, 3rd June 2010
Yes, E. Yore, I think that is a very good idea.
Both OH and I have spoken to them about perhaps changing their GP within the practice and they are reluctant to do so, because they've had chappie for so long and because basically he lets them get away with murder.... because he *doesn't* give them a hard time about poor diet or smoking or lack of exercise. Tough. I think they *need* to be given a hard time.
If you weren't in France I might think your dad and mine were related
what is it with men of a certain age?!!
I suspect it's generational... not wanting to be a nuisance.... only to us, their children! -
Message 4
Posted by E Yore (U1479700) on Thursday, 3rd June 2010
Thu, 03 Jun 2010 08:09 GMT, in reply to Medhuil Webbestre in message 3
what is it with men of a certain age?!!
I suspect it's generational... not wanting to be a nuisance.... only to us, their children!Â
Tell me about it. Earlier this year, my father was knocked down by the sliding doors in their local supermarket. He is an 80+ diabetic with mobility problems. Staff at supermarket rushed to pick him up, the manager told him they were covered by insurance and not to hesitate to see a doctor, even wanting to call a taxi to take him to A&E etc. Aged P refused outright, went home, did NOT tell my mother (she found out the next day when the manager asked how AP was) and insisted he only had bruising and didn't need to see doctor, have an x-ray or go for physio. 5 months later during a routine exam, the GP noticed my father could no longer flex his arm fully. The bruising on the bone had led to some problem on the elbow joint. Physio at the time would have given him back full movement quickly. Now, it is damage-limitation. Grrrr. -
Message 5
Posted by Kishtu (U14091165) on Thursday, 3rd June 2010
Hah! They ARE related!
Dad walked into (and broke) a - closed - glass shop door a couple of years ago. Because he laughed it off, so did the shop assistants. I was absolutely *livid* that they had laughed at him and not made sure he was okay. He's always been somewhat clumsy (very tall) but with the cataracts his eyesight is getting somewhat haphazard... -
Message 6
Posted by Small boy in third row (U2247664) on Thursday, 3rd June 2010
Thu, 03 Jun 2010 08:26 GMT, in reply to Medhuil Webbestre in message 3
The letter writing is a good idea but I'd also think seriously about persuading them to change their GP. There are wonderful GPs out there but also some terrible ones. A few months ago I ended up in hospital (and having to have an emergency op) because of something that could have been treated with antibiotics if my GP (ex-GP now) hadn't been so hopeless and complacent. It's made me mistrustful of GPs, to be honest. The experts are in hospitals and they can do all the tests on the spot. I don't know how the system works in the UK but any chance of getting check-ups in hospital for them? -
Message 7
Posted by smee (U2226513) on Thursday, 3rd June 2010
Thu, 03 Jun 2010 08:35 GMT, in reply to Rachel in message 6
I guess some older people feel it's somehow disloyal to change doctors but of course it isn't. I'd do what Rachel suggests and try to persuade them to do just that. He sounds ghastly. -
Message 8
Posted by E Yore (U1479700) on Thursday, 3rd June 2010
Thu, 03 Jun 2010 08:42 GMT, in reply to smee in message 7
At one point, after their excellent common GP retired, my mother had a different GP from my father and it was obvious he wasn't very good for a variety of reasons I won't go into. When my father and I pleaded with her to change docs, her worry wasn't that of being disloyal but she was frightened she might change to someone worse or no better. Sometimes, with the elderly, the fear is that of the unknown. We solved the problem by my father's doctor (not a GP as such but a diabetologist) agreeing to see her as well, which simplified things very greatly. -
Message 9
Posted by Kishtu (U14091165) on Thursday, 3rd June 2010
Thanks all.
I think the main part of the problem is that they collude with him and he colludes with them... it's a sort of symbiotic relationship which is comfortable for all parties and doesn't take any real work on either side.
I had been hoping that when Splodge is born - July - they would give serious thought to moving nearer their grandSplodge, and they may yet, which would necessitate a change of GP all by itself, but I think one of the things that I find most distressing is that both of them now say forlornly "I wish you had had a baby 10 years ago when we were fit enough to enjoy him" and (dad) "I'll never be able to play football with my grandson"....
I *know* they are both scared of hospitals, or of "what they might find" if they have tests, or of being separated. I just feel like they are being written off as too much trouble for the crime of being Old People. -
Message 10
Posted by Small boy in third row (U2247664) on Thursday, 3rd June 2010
Thu, 03 Jun 2010 08:55 GMT, in reply to Medhuil Webbestre in message 9
That is totally understandable, I do sympathise. Nonetheless (and I know I'm stating the obvious), it's better to find out sooner, through tests, than later (when it may be harder to treat so effectively). It can also be a relief to find out exactly where you stand, face up to problems and have a plan to deal with them, and perhaps find that things aren't so bad as your worst fears.
Early 70s isn't that old. They shouldn't be written off. They shouldn't write themselves off, either! -
Message 11
Posted by E Yore (U1479700) on Thursday, 3rd June 2010
Thu, 03 Jun 2010 08:57 GMT, in reply to Medhuil Webbestre in message 9
Medhuil, one of the reasons I wanted my mother to change GPs was that hers went on at her one day about not "inflicting" treatment on elderly patients, and giving the example of prostate cancer: he told her he wouldn't send a 70+ patient for treatment if the patient had prostate cancer as it wouldn't be worth it. He also decided not to test my mother for her platelet count, despite her having a condition that required it twice yearly, nor for her cholesterol (which is naturally high). They are in Switzerland where there is a whole complicated thing between doctors and the insurance companies to keep costs down but this was akin to rationing treatment and excluding the elderly. Who the hell was he to play God with my parents' lives? -
Message 12
Posted by Kishtu (U14091165) on Thursday, 3rd June 2010
Indeed - to GP they may be a pair of unmendable and grumpy coffin-dodgers but they happen to be my parents and my son's grandparents, and I'd like him to retain the full set for as long as possible!
I'm increasingly thinking change of GP would be the best thing all round.
In fact I'm thinking that the best thing all round would be to export them to the same locality as us, and try and get them registered with *my* GP, who may be a damn nuisanxce at times but at least is thorough as all get-out. -
Message 13
Posted by Jane (U1484860) on Thursday, 3rd June 2010
and (dad) "I'll never be able to play football with my grandson"....Â
My parents are now in their mid 70s and my niece & nephew 7 & 10, and they still do all sorts of things together including playing football.
I would strongly suggest changing GPs and, sad tho' I feel saying this, you have to be firm and demanding with the GP (IME). My sister & I both try to keep up with their medical stuff and to check that tests are done/ appts made etc and (if necessary) wouldn't hesitate in making a few phone calls.
Hope you can work with them to achieve a better working relationship with GP (current or new one)
Jane -
Message 14
Posted by halftidy (U8567554) on Thursday, 3rd June 2010
Our practice encourages patients to see whichever partner happens to be available, this means not only do you have a better chance of a convenient appt but that you get to know all the partners so that in an emergency you are not faced with a total stranger, also if you start with a young Gp when you are young, chances are that when you really need them they retire! I always advise newcomers to the area to register with the youngest gp, on the basis they are still interested and actually young GPs do have a great preference for treating children and the elderly (and they are more up to date with new treatments too!)
On the subject of the old refusing treatment - try the young too - my youngest got hit by a 4 x 4 when on her bike in central London - she landed on her head on its roof - then bounced into the road - 100% his fault - driver was terrified she was dead - what did she do??? Dusted herself down, wiped away the blood and refused not only any help but to take details of driver as "he had had a horrid shock and did not deserve a law suit or the worry of one" - I shook for some time when she eventually got round to telling me. -
Message 15
Posted by MrsGks (U14084771) on Thursday, 3rd June 2010
When I had concerns about my mother's memory I wrote to her gp because I knew neither she nor my father would mention it. I also asked her not to mention that I had contacted her. I was lucky, gp was very discreet but asked some pertinent questions and then refered her to a specialist.
Do your APs tell you before they go to the GP? Would it be possible fr you to write/telephone before the appointment and ask the gp if "x y z" tests could be carried out even if your AP don't ask for them as you are concerned about their overall health. I assume that you live too far away to go with them and insist the gp carries out these tests.
Is there a Practice Manager who may be able to help you?
I'm sorry you have this worry. -
Message 16
Posted by Vicky S (U2258400) on Thursday, 3rd June 2010
Medhuil, it sounds as though your APs GP is in a largish practice. Are there practice nurses? At our surgery they run quite a few of the well being clinics plus the diabetes clinic. They are very good, have a lot of specialist knowledge and experience and do know when to refer on if needed. I'm only suggesting it because I wondered if your APs would feel more comfortable with a practice nurse appointment and would be able to tell him/her more. Some elderly people still have the 'this is too trivial to bother the doctor with' attitude but might tell more to a practice nurse, plus the practice nurses almost certainly have better people skills than that awful GP.
I think the idea of writing to the GP is another good one though, for one thing he needs to know that someone is watching out for your APs. -
Message 17
Posted by carrick-bend (U2288869) on Thursday, 3rd June 2010
Thu, 03 Jun 2010 20:26 GMT, in reply to Medhuil Webbestre in message 1
MW, my parents both have major health issues, but their attitudes are very different; my mother has told her surgery in writing that it's ok to discuss her with me, so there are no patient confidentiality issues.
This means that I can also have Mums issues explained to meand interpret/explain them to her in addition from the explanation she gets from her (exceelent to good) GPs.
Dad is very different, very independent and I hear from him what he wants me to hear.
He was young in an era when his family often couldn't afford the doctor - I think he sometimes goes back to that time in his mind. -
Message 18
Posted by Nomadnomore - XNo - Quiz Queen (U3180380) on Thursday, 3rd June 2010
I think that writing to your parent's GP is a good idea as well. You should also tell your parents that you are doing so and give them a copy. If they choose to have you involved in their medical care (as Carrick outlines) then that is fine as well.
They are in their 70s and that isn't really old in this day and age.
As for giving them (or not) a hard time about their lifestyle do you really think this is the doctor's role? He/she can give them information about the effect of their lifestyle upon their health so they can make informed decisions and offer support if they want to change their lifestyle but that is the limit of the role (IMHO).
It is a shame they feel too old to enjoy their first grandchild. I am in my 50s and expecting my second grandchild later this year and I am thoroughly enjoying the 18 month old poppet who slept here last night.
Very best wishes for your upcoming parenthood. -
Message 19
Posted by Bearhug (U2258283) on Thursday, 3rd June 2010
I too contacted my mother's GP about my concerns about her health, and also had the discretion and not mentioning we'd been in touch thing. He did say he couldn't discuss much, because of patient confidentiality, but I know he took note because of something Mum later said after she'd been for a check-up.
However, I already knew that Mum trusted him and thought him a good GP - the problem we had with Mum's care was her, not the medics (and all the medical staff I talked to about her did say she was difficult, although they didn't all phrase it like that.) I would find it more difficult to deal with were there not confidence in the GP - I would of course recommend they change, but I know that parents don't always behave the way you'd want! And I know myself - I had a GP I didn't really get on with, but I just put off making check-up appointments at the time I had been told, and then moved house (not because of the GP, but I did know it was coming up,) which also involved moving GPs.
My current practice is good, because you can book with a particular GP (though that might limit when you can get an appointment) or you can make an appointment with the duty GP and just see whoever's doing it, which means you can get continuity of care for on-going problems, but if you've got something new, then it doesn't really matter who you see. However, it's a big practice, and they've got the staff that they can work in a flexible way like that. At my last practice, in a small town with just 3 GPs, it wouldn't really have been possible to work like that.
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