Well, it's 5am and after waking up an hour ago the first thing in my head is my continual lack of GP care and I can't get back to sleep.
Had an appointment yesterday but my GP wouldn't take the time to discuss my illness so I can better understand exactly what's wrong, wouldn't advise in any shape or form about my heart rate during exercise, completely dismissed my concerns about regular chest pain (potentially unstable angina) and then had the gall to call me pedantic when I asked her about statins and the subsequent muscle pain (if it wasn't actually angina)! Perhaps they don't get many people actually taking an interest in their own care but their poor performance so far means, if anything, I'm forced to take an in-depth interest... they're certainly not doing it. Do they really think I want to spend every waking hour worrying that I might drop dead any time (and non-waking hours!), as I do at the moment. I'm doing everything I should, perhaps they should start doing their bit!
I've hardly been ill in my life and have paid into the system for 30 odd years, but now that I actually need help the GP's at my medical centre won't provide any sort of care! Ship him in, ship him out, tell him nothing, offer nothing. Shameful!
I'm not sure where to go from here... they are supposed to be my primary care provider but they aren't providing it. I've seen all three GP's at my centre and every one of them simply isn't fit for purpose in my opinion... if anything they add to my worries and stress.
I suspect some will say how busy and under pressure they are but that doesn't excuse them for not providing answers when I've waited weeks for the appointment I made and am sat in front of them. They're too busy protecting their own backsides to offer any advice! I know what arse covering is.. I sometimes have to dissect long and extensive contracts for multi-million £ construction projects and have to pick out the unfair clauses, and regularly write several hundred pages of specifications where I have to cover my own, so I can spot it a mile off... I'm good at it.
In my profession, if I dismiss valid concerns, or don't provide an appropriate level of professionalism and care, and someone dies, I can get sent to prison for negligent manslaughter. As far as I'm concerned, my GP's should be subject to the same!
Apologies for the rant, I'm just at a complete loss as to how I'm supposed to get any sort of decent care from now on. I've hit a brick wall and have got nowhere to go. Looks like I'm on my own!
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Marc68
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Hello Marc, never apologise here for a good rant, we all love them and we all have similar issue with the system. Not going to defend the GPs as mine loves to Google what I'm telling him, I get they are busy and have at best 10 minutes but that should be a good ten minutes, if you've done your research they should listen they don't always know best, 100% with you. As you say you don't know where to turn, I'd be stubborn keep going back keep doing your research. Do you have a practice manager? You are allowed to complain
Hi Mark, that's strange, I responded to you earlier but it seems to have disappeared.
Thanks for your encouraging words. I'd be happy if any of them took a modicum of interest but they just won't. It's starting to drag me down now as I can't see a way it can improve. I may as well ignore them and medicate myself, and use them just for blood tests. Believe me, I know how ridiculous that sounds but it's getting to the point that it might be my only option. I've kept going back and have seen all 3 GP's over the last 8 months but not one of them has helped in any way. They're now part of the problem, rather than part of the solution, and that's just as ridiculous.
I'd not heard of a practice manager but it would appear there is one, although I'm not sure complaining would have the effect I'd hope.
I think you're right Mark. I spent an hour looking for one yesterday but reviews seem to have similar themes to them all. I also need to check they accept patients from my postcode.
This reminds me very strongly of the lancet paper called 'The Wizard and the gatekeeper' It was a very substantial statistical study that found GP's to actually are the highest skilled doctors when it came to identifying and diagnosing and serious diseases when presented with a large population- better than specialist specialising in the diseases they were diagnosing. Just because they do not do fancy test etc. People can perceive them to 'just be GP's' but ironically that is what makes them the most skilled doctors in the profession.
This said a rushed GP appointment can feel very much like a waste of time. So some suggestions 1) Write down concerns/questions in advance in decreasing importance order- time wise you will probably manage to ask 2-3 with good answer. 2) Find a GP you get on with even if that means changing practice 3) I really do not suspect not answering your questions is covering their own backsides. My GP is prepared to intervene in things that he is not specifically trained in if it is in my best interest. I am a congenital heart patient so see a Cardiologist not a GP for my heart condition. But as a generalist my GP will intervene in my Cardiac Meds if they are dangerous to my other congenital conditions. He will also offer advice from General perspective if my Cardiac care is affecting my quality of life. Yes he pre cursors the advice with the warning 'I am not trained in congenital heart but....' then says what he knows about the drugs. However this only happens if the issue I present is well worded and specific. This said I have come across the backside covering medic- namely my cardiologist.
Hi Midgeymoo. I'm afraid you are way off the mark in this instance. I went in with my questions listed and everything was very precise. I've tried all 3 GP's in the practice, and I know that they are covering their backsides.
I had a long response written out detailing what has been asked, and said, but decided not to post it. Your mind is made up based on your experience which is fair enough. There's no benefit to anyone in me trying to change that.
I'm glad you seem to have a GP that gives a monkeys but not everyone is so fortunate I'm afraid.
Don't know if this will help Marc, but I requested to go back to see a cardiologist which my GP agreed to it. She was scathing when I asked questions and said she didn't have all the answers. In that case I said, if you can't answer me then I'll have a referral. I am seeing cardiogist on 17th this week. Are you seen annually by cardiologists? If so phone the secretary of the consultant and ask for your appointment to be brought forward as you have some major concerns about your hearth and health.
Hi Twobells. The day before I went to the GP last week I phoned the BHF Helpline to get another perspective on my exercise rate, which doesn't seem right to me. I spoke to a very helpful lady who suggested I contact the cardiologist's secretary and speak to them about it. I did that and will be writing them an email which I should hopefully get some good advice from once he is back off holiday.
I didn't get a chance to see a cardiologist after the stents as he didn't think it necessary and as far as I'm aware there are no plans for me to see one. I'm 9 months post MI and no-one has mentioned seeing a cardiologist again. I've got a yearly follow up ECG in November to check my aortic valve regurgitation hasn't got worse but that's it as far as I know, and that's not done by a cardiologist.
If I could get half an hour to speak to a cardiologist I'd hope that my questions could be answered so your suggestion is a good one and I think I'll try to get a referral, as well as change my GP practice if I can.
Thanks for your advice, it's much appreciated.
Hi Marc - sorry to hear about the experience you've had with your GP surgery. Have you thought about setting up an appointment with the practice manager to let them know about your concerns? It's also worth noting that if you have quite complex needs or multiple problems/conditions then booking a double appointment can help ease the time pressures.
You can also think about changing GP surgeries if you're really unhappy. You can search for GPs in your local area here: nhs.uk/Service-Search/GP/Lo... they're often rated by users too, which can be helpful in making your decision.
Hi Chris. I could meet with the Practice Manager but even if their care improved, the thing that worries me is that the GP's don't seem to have the medical understanding of heart conditions, as borne out by the advice that if I get chest or arm discomfort when not exercising, it isn't angina. That is incorrect as far as I understand it, and is potentially fatal advice. That sounds melodramatic, I know, but in a worst case scenario (not necessarily mine) it is possible.
Thanks for the link.. that is where I spent an hour or so the other day looking for an alternative practice. My current practice rate fairly highly on the scores though so it's hard to differentiate between who has experience of dealing with heart patients and who doesn't. My GP's are fine if you have an "everyday" illness like flu as that fits in with their quick turnaround approach but they've fallen very short with my condition and care.
Thanks for your help Chris, it is appreciated even if my post comes across as a bit defeatist.
Have just come across your 'angry' initial post and read through the responses. I am so with you on this!
I moved home over 18 months ago and therefore new practice/new GP. He has failed me miserably. Prior to move I had the most brilliant GP, so much so that I was recently in so much despair that I considered moving back to the previous GP area!
What I did as my health and quality of life became so bad was to contact my cardiologists secretary who called me immediately and confirmed she would speak to the cardiologist that day. She called me the following day to confirm a hospital admission date.
The gutting side of this was that had I contacted her 3-4 months sooner, my Afib would not have deteriorated to heart failure.
Once I had been treated as much as they could do, I had the strength to be angry, and the strength to change GP within the practice, but only after explaining in detail why, to the practice manager.
I am wondering now whether its better to 'stay with the devil you know' as the other GP is even worse! I have now put every detail in writing to the practice manager as it is my life they are 'messing with'. I also did my own recent referring and appointment making at the hospital as the doctor has failed to do so. My arrhythmia person was very impressed!
So many tales of failure to tell....but good on you to be concerned and to make it right.
As you are aware stress is so bad for your heart, so moving practice would be on the right path(we hope) to helping with your health.
Hi Ktomoph. Thanks for your reply. I'd call my feelings more frustration rather than anger but it's a very fine line. Since my HA I've tried very hard to reduce stress and it's been difficult changing the habit of a lifetime. I've made progress but the GP situation cancels it all out in one swipe. It seems this problem is commonplace and I'm at a loss as to why nothing seems to be being done about it. A lot of GP's just don't seem able, or willing, to provide such care, which leaves patients abandoned and waiting for the worse to happen, and as your post sadly proves, it sometimes does. When I was in rehab I was pretty upbeat about the future but the GP's have knocked every last bit of that out of me.
There are a lot of people much worse off than me on the forum so I feel like a bit of a fraud complaining but having chest pain every day is wearing me down. Before the HA I had no pain whatsoever but now I can't remember the last day I didn't have chest/arm/back pain. I've got it as I write this now. I shouldn't have to live the rest of my life like this because they're not doing their job. I've made appointments with two GP's to discuss it and neither of them has even tried to do anything about it, not even ask a single question! I've been kicked out both times without anything being done. That can't be called "care" by anyones standard. I've deliberately made appointments with all three GP's in the Practice to try and find the one most suitable but they have all failed miserably.
It's strange you should mention writing the Practice Manager a letter. I was having a chat with a good mate of mine earlier who has his own serious health problems, and he suggested the exact same thing. Your statement "my life they are messing with" rings very true. I think the letter is where I'll start and follow up with an appointment with the Manager. I've got to get this sorted one way or another. I've also got to write to the cardiologist next week after speaking with his secretary recently.
Thanks again for your advice, it's been very helpful.
Hi Marc, as you are aware, the way it should work is - according to the NHS - (1)'primary care' GPs, listen, diagnose, treat and/or refer if needs be to (2)'secondary care' who do further tests, evaluation and precise diagnosis, and refer for treatment/cure etc with (3)'tertiary care' surgeons, specialists.
What appears to fail when it comes to heart matters is the primary care!(barring my initial diagnosis doctor who does not fall into this category - he was brilliant! Called into use everything at his disposal in getting me diagnosed and seen by cardiologist within days. There was no '10 minute slot' with him and all his patients happily waited no matter how delayed their appointment)
We read, every day almost, how 'overworked' our GPs are. But they receive an excellent salary for this so called 'overwork'. They chose/choose to do this and if this is their chosen career then one hopes that they have chosen it for the right reasons - that they actually do care about people and their illness. Patients are ill. They do not want to hear that the doctor is 'overworked' - it is passing a guilty card to an already worried and stressed patient.
I personally want to feel that my GP cares what is happening to me and my health. I don't ever want to hear that he is so busy and thats why he hasn't forwarded surgery based results to the cardiology team. Each minute, each hour, each day, each week, each month of delay can be vital in deterioration and whether we can be treated, and also affects our quality of life.
Past experience has also taught me that it is a complete waste of time seeing a locum, particularly if you have an ongoing medical condition. Understandable, as they cannot read all your notes and speak with you in that 10 mins!
So, its interesting to hear that you deliberately set out to speak with each GP in the practice - and that none of them has gained your confidence. This in itself, particularly as you are in pain and discomfort after having such a life threatening and scary HA, should tell you to change practice completely! I don't know you but I am worried for your anxiety levels as you need to have faith in at least one person who can care for you in the NHS system.
What about your cardiology team? Did you get assigned anyone from the hospital who would be involved with your care upon discharge?
As said, I made my own echocardiogram appointment - called the echo appointment dept and booked it after my GP failed to refer/book the requested appointment. Someone has to listen to you AND do something, even if it is only to confirm that this may be something to be expected after HA. But more important, to listen to YOU. Fear is one of our worst enemies when our illness is heart related!
With regard to 'practice manager'. I spoke with mine first - no appointment needed, which you should be able to do at your practice. Mine was totally unbiased and made me feel that she understood what I was saying. The recent detailed letter was written after realising that the different GP was even worse. The P manager called me within an hour of receiving it to arrange a meeting with her, myself and both GPs to discuss the problems I had raised. This is not happening until beginning of October due to holidays, on duty etc, otherwise I would be able to let you know outcome.
You are important Marc. Your good heart health and peace of mind is not only their duty but should be their main concern.
I so wish you well and that if this practice is causing you so much stress and not allaying your fears, it is time to move on to another, and switch off from aggravation.
Marc...I used the analogy - when there is something wrong with my car, I know there is something wrong with my car. I take it to the garage. The mechanic looks at it (primary care)and tells me what he thinks it is. He then does tests and tells me either that he can fix it, or (secondary care)that it needs parts from supplier, or (tertiary care)that I will need to take it to specialist garage.
He does not look at me and say, 'what would you like me to do?'
With regard to cost:
The mechanic usually says, 'if you get this done now it will save extra expense later down the line'.
Hi Ktomoph. Sorry for the late reply, I've been away for a few days.
Yes, i totally agree that the primary (GP) care is the point that fails miserably and it seems pretty commonplace. Everyone else has been very good but GP's cancel out a lot of the good work done by them. Surely the NHS see this problem.
You're also spot on regarding them being busy. All professionals are busy, it's the nature of working in a professional environment, so that excuse holds very little merit in my book. Whether they care or not, commanding a salary between £60-90,000 should at least ensure they act professionally.
I didn't initially set out to speak to all of the GP's in my practice. I gave the first one several chances and he was, in my opinion, unable to deal with a heart patient. He simply had no idea what he should be doing. I then waited to be seen by a second who got very defensive when I asked for tests when he increased my ramipril for no apparent reason (he didn't even take my BP before increasing the dosage and wouldn't answer the question I went in to ask, repeating the same generic arse covering response despite it not being relevant to what I was saying. He became downright rude.
I then asked to see the last one who I had high hopes for. The cardiologist letters were sent to her and she was the one GP I'd previously been seen by, albeit several years ago for something minor. She simply couldn't be bothered and made more effort avoiding my questions than trying to answer them.
I didn't realise anyone from cardiology should be assigned as it has never been mentioned to me, but I have made contact directly with them about a couple of things the GP's won't, or can't, help with.
Thanks for your concern about my anxiety levels. I've had a stressful job for over 30 years and can handle it for the most part, but what I find most stressful is not getting straight answers to a straight question. My profession is science based which requires information. When I can't get the relevant information my brain struggles to settle and won't until I get answers.
I'd love to be able to think that there is someone actually concerned with my care but there isn't. It's as simple as that. I (enviously) read about others experiences where their GP's ask questions, make changes to meds etc and it's all completely alien to me. It's so far removed from my experience it hardly seems we're talking about the same thing. I can handle keeping track of my own care to an extent but when everything you read says "speak to your GP" it becomes a major problem.
Honestly I feel so p'd off about this. My doctor as im sure I said before started off useless then moved up a gear. So many on here face issues with their GPs and aftercare it's not like heart disease is a new thing. I hope Marc and Ktomoph you both get a better set of GPs or at least get the answers needed
Hi Mark. Thanks for your best wishes. I can't stop until I get answers as, literally, my life depends on it. We'll see what the Practice Manager says when I get time to see him/her.
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