GP's

[zippyRN]

reading this thread (and others)

my initial response is what cereal packet did some of the posters sudden acquire a medical degree from ...

if you go into any healthcare setting and demand treatment, threatening staff if you don't get what you want right now, it's unsuprising the service may suggest that if you are that unhappy you seek your care elsewhere...

people seem to think they are 'customers' of health care , not you are not you are patients ...

it is an accepted fact which i am not going to try anddipute that there are some within healthcare who do not measure up... but to be insulted , threatened or treated like an idiot becasue you do not do what a patient or their friend / relative wants , rather than what is appropriate / clinically indicated is a very quick route to an irretreviable breakdown i nthe relationship between the health professional and thepatient.

[zippyRN]

Originally Posted by craigwalsh

My GP prescribed the Durogesic DTrans patches (fentanyl) -- 50 mcg/hr. This caused all sorts of problems, so I was then put on BuTrans 10 mcg/hr (buprenorphine) patches plus eight 50mg Tramadol a day --- plus eight Paracetamol (prescribed) for good measure.

If this is a reduction in the prescribing of strong opioids for chronic non-malignant pain, what were they doing before?

never heard of the WHO analgesic ladder?

paracetamol has synergistic properties in conjunction with opiate and opioid drugs

tramadol has both opioid and none opioid pin releving properties ...

[craigwalsh]

Did the private GP discuss the side-effects of the medications he was recommending?

The private pain specialist did not discuss the side effects of the medication he suggested. He also did not write the prescription, saying it would be much "better" (for whom?) for me to get the prescriptions from my GP. And my GP also did not discuss side effects. I have read the little leaflets that came with the medication --- and you don't always get these. The leaflets seem fairly generic, and spell out virtually every complication known to man. It's hard, as a mere patient, to make much sense out of all of this.

Since OOH services now record telephone conversations it has become obvious that some patients are obviously untruthful when they later complain.

The head of the Worcester OOH said that he thought my problems with the OOH came from the fact that they didn't properly triage me when I made my initial telephone call. Of course, he came to this conclusion without actually listening to the recording. I asked if the calls were recorded and he said they were. I asked for a copy so we could all hear (rather than speculate) on how well the call was handled. I am still waiting. The latest excuse I received was that the recording had been "archived." Where? To the moon?

It's fine to record telephone calls, but if the recordings cannot be easily (and quickly) retrieved it doesn't make tremendous sense.

[gp2]

"It's fine to record telephone calls, but if the recordings cannot be easily (and quickly) retrieved it doesn't make tremendous sense."

You must be naive to believe that.

[jenny]

"people seem to think they are 'customers' of health care , not you are not you are patients ... "

Breathtaking arrogance. "YOU" might be a patient one day - oh dear, poor you if you get treated with that kind of contempt.....

[zippyRN]

Originally Posted by jenny

"people seem to think they are 'customers' of health care , not you are not you are patients ... "

Breathtaking arrogance. "YOU" might be a patient one day - oh dear, poor you if you get treated with that kind of contempt.....

professional relationships rely on the client of the professional being willing to take the advice of the professional ( with second opinions if necessary) however it;s not like choosing a new kitchen whenere you can ultimately decide what you want ...

[jenny]

Ultimately the decision rests with the consumer - the patient. Whether the person providing the service is paid for by the state (the NHS) or by the patient (privately) the ultimate decision is made by the consumer of the treatment. Professional relationships rely on mutual trust and respect - that goes both ways. The patient can definitely decide what they don't want - and should do, in my opinion.

The last time I came across a rather ridiculous stereotypical consultant who prefixed his monologue "with all due respect, the patient cannot necessarily make the decision about the treatment" I walked out of the consulting room. As it happened, I had read most of the papers that had been written on the subject, so I was very well informed. I decided the best thing to do was to make a consultation with the person who had written most of the papers - bingo! A true professional, involving the patient in the decision-making process all along the way.

[craigwalsh]

Jenny, I think your comments are spot on.

I developed restless leg syndrome after I fractured my back. It's known to be caused, among other things, by back injuries and opioid withdrawal. And I'd done both.

There is often a long delay in making a correct diagnosis of RLS, and it has this silly sounding name. I was one of the lucky ones. I'd read an article about RLS and the fact that most doctors didn't know much about it --- or how to treat it. I went to the RLS website and read all about it. The symptoms described on the RLS forum by many people who suffer from RLS were, in most cases, exactly what I was experiencing.

I printed off a couple of research papers (one from the Mayo Clinic) and went to see my former GP. He wouldn't even look at what I'd brought with me. He dismissed it as "internet junk." Instead, he prescribed an addictive sleeping pill instead of the medication I'd requested (ropinirole).

His sleeping pills did nothing. When I called the surgery again I was told that only a neurologist could prescribe ropinirole. So I called all over the country trying to find a neurologist who could see me (essentially) immediately. I found a great one at the Cromwell Hospital in London, a 250 mile round trip from my home. But it didn't matter --- I couldn't stand another sleepless night.

I've been on ropinirole for a couple of years now. No side effects. And no RLS symptoms. If I am late in taking my nightly tablet I can start to feel the RLS "pain," and it goes away once the tablet takes hold.

ZippyRN says that medical care is "not like choosing a new kitchen whenere you can ultimately decide what you want ..." I absolutely agree that it is not as insignificant as selecting a new kitchen. But I am the only person (and the right person) to ultimately decide what I want.