So my last GI appointment on the 14th of March was with a registrar who frankly seemed fed up. He was from NZ and told me they don't do blood tests there for coeliac follow ups. I told him I had liver pain and he immediately judged me and suggested I monitor my alcohol intake. He said he 'might' suggest another bone scan as I haven't had one for over 2 years and was found to be osteopenic on that one and started on calcium and vitamin D
So I went to my GP, who did a range of tests and found me to be borderline diabetic, and to have abnormal liver function, a liver scan was okay however, he will keep an eye on my blood sugar's.
No appointment for a bone scan has arrived..
So the registrar in my opinion has been quite negligent, didn't pick up on any of this and didn't even order the one test he said he would..
What are your thoughts?
Ellen
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weee
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Sorry to hear about the a*** of a registrar. It's difficult to know whether or not to complain, but he obviously wasn't doing the job properly. I think that 'negligence' means that harm was caused, and not having the test could result in harm ...
He (the registrar) typifies the attitude of too many health professionals these days, and frankly I find it infuriating. A written complaint is justified, but, is it worth the hassle I wonder? It will either be ignored, or if acted on could lead to the registrar being reprimanded or worse ....... He had no right to infer you were drinking too much, the same thing happened to me when I made a joke about a blood test result, and I found it really insulting. Maybe he was just having a bad day????
(Is this me being a wuzz?)
Hi Ellen, This would make me feel indignant as he was dismissive, made implications about your drinking and then did not give you a blood test, which's standard procedure in the UK.
Now should you make a complaint? This is a difficult one as you will end up reliving it over and over again instead of leaving it in the past. So what you could do is email the GI's dept and ask about the dexa scan and say how surprised you were that you were not given a blood test and fortunately your GP did. This will make them aware that standard procedure was not followed and they will check to see if you were referred for a scan, without you having to go through a complaint procedure.
What I think is important is that you sort out your blood sugar levels and concentrate on making your self feel well again ASAP and I would look at eating foods that help cleanse the liver: globalhealingcenter.com/nat...
Yes complain. However, the complaint should be tailored to show much distress it caused you, you should be careful not to judge his decisions too firmly as you are not the professional here, but he was suppossed to be.. You need to mention his apparent lack of compassion, consideration, and his, what you considered to be, negligent attitude. I feel the 'might suggest' is vague at best and insulting and unprofessional at worst. His views on how they do things back in his native country are irrelevant, he needs to follow the NHS guidlines and procedures. Also, if you found his reference to alcohol insulting then tell them such. If this person has a high success rate among his patients, or normally recieves good responses, then your complaint will do little harm to him. However, if he has recieved many such complaints then clearly he needs to be educated in these matters by his superiours. The bottom line is whether or not you are willing to follow this up and pursue it to its end if it got more involved, or if this is just adding to your stress. It seems you are stressed about this and so, if I were you, I would deeply consider a formal complaint.
Best of luck with your future treatments and health.
I'm afraid to say today, they're nearly all the same. I've recently changed hospitals completely as I couldn't stand the rude, patronizing attitude of the new consultant and registrar. They made too many assumptions, frankly were quite rude, didn't listen to any genuine complaints about by worries (about RA not CD). They dismissed blood results that were wrong as 'normal' which could have left me with life threatening problems. I complained through my GP but nothing came of it. I didn't want them to be sacked, but wanted the GP to realize there may be other people with issues coming forward. Best thing I did was changing consultants, but I know it's not always that easy.
Please don't let the stress of the situation make you ill, but if you feel (rightly) upset, complain.
It seems to be the way things are these days I'm afraid. If you have been upset or distressed by the registrar then I feel you should complain, there is usually a patient advice and liaison service for each hospital and I would start there with an email. I have used mine to complain about appointments in the past and always got results, sadly it seems its the only way to get anything done connected with the NHS just lately. I wish you well and hope you get better treatment in future.
Complain , he may be like this to everyone, it does not make it correct, if no-one complains the hospital will be unaware of his stinky atitude. You do not have to be heavy handed, just point out his attitude was upsetting and potentially had medical repucussions ('re liver function etc)
Thank you for all of your thoughtful replies. I think I will make the department aware that the Dr was not following guidelines and was in fact quite dismissive, I got the impression that this wasn't just a bad day but that he felt that all Scots were responsible for their poor health by their excessive alcohol intake. He pretty much said as much. Thankfully my GP was much more meticulous and he is watching my blood sugars so I'll ask him about the bone scan.
Penel: What is Paleo? I'm intrigued.
Jerry thank you for the liver cleansing link. I do eat a very healthy diet (gluten free of course) but I will make an extra effort to include some of those foods suggested every day, I love them all so its not a big hardship. I think I'll have a cup of green tea every day too.,
"Paleo" refers to a way of eating which eliminates processed foods and oils, gluten, legumes, soy etc. Some people cut out all carbohydrates, others keep some in. The level depends on you and your needs.
Hi I have just been to a meeting last week after i complained about a dr at our hospital. I was told that they welcomed complaints as it ensured that they did their job properly. I was told at the meeting that our complaint has made a difference as they have changed some admin procedures, I am also hoping that the doctor will change some clinic procedures after our conversation.
What you have to consider is that if you don't complain and another patient who attends his clinic is given the same treatment they may not have the confidence or the knowledge to go to their GP and have the tests that you did. You were completely justified in having these tests as they indicated you did have issues which should be monitored or treated.
I know its not easy to make complaints but if we don't then nothing will change unfortunately.
Hope you feel better and get the treatment you need
Errm I disagree. What guidelines was he not following? Yes you didn't like his attitude but does the hospital say you must have a blood test on every visit? A sore liver is not a sign of diabetes even one that needs treatment and he was a GI specialist not an endocrine one. Your already on bone treatment so if you have progressed from osteopenia to osteoporosis then there is unlikely to be any change in treatment. So doesn't indicate an essential scan. And what are the waiting time if he did.
So in other words is it a case of you are miffed because he hasn't done what you wanted rather than what he should. When making a complaint take the above into account. If you had discussed signs that may have suggested diabetes then he should have advised you see the GP, the sugar test is a fasting one and most people when they attend for a clinic aren't fasted. Your abnormal liver function I'm assuming there is nothing the GP is treating? So what was the cause of your liver pain?
Did he state that the fact you were Scottish had anything to do with it. I am from Inverness and we DO have one of the highest rates of alcohol disease. Although it would be a bit scary if even foreign Drs were being taught about our high alcohol intake.
So break it down. What is fact? Has he not done something he must? What did he actually say rather than infer? Even guidelines are only that not what MUST be done, though look at both NICE and the hospital website to see what they say.
After that start your complaint by talking to the hospital PALS office. You should find contact details through the hospital website. As it sounds more like attitude you could try writing directly to your consultant , failing that the chief executive again whose address is on the hospital website or possibly on your appointment letter.
What "TheGob" has said also sounds like really useful advice in thinking about how to word things. There is no negligence so don't use that word in any correspondence, you want to be taken seriously so deal with what happened and how it made you feel. (Which is just as relevant)
Asymptomatic coeliac patients should have blood taken yearly for FBC, ferritin, folate, B12 and bone profile. Coeliac serology may be of interest to assess adherence.
New or changed symptoms should be investigated accordingly and treated. It will usually be of value to repeat duodenal biopsy. It may be helpful to review dietary adherence. Small bowel bacterial overgrowth and microscopic colitis should be excluded.
If symptoms remain unexplained by conventional investigation, then specialist investigations should be undertaken to exclude secondary refractory coeliac disease and the possibility of enteropathy-associated T cell lymphoma.
(Recommendation grade C)
I'm aware that a sore liver is not a sign of diabetes, I am a trained nurse, however when I went to my GP and mentioned my symptoms and the fact that I hadn't had any bloods or investigations done at my coeliac appointment he was more than thorough and did a range of tests, including blood sugar.
He said (the GI Reg not the GP) ' I can't believe the amount of Scots I meet with alcohol related conditions' .
and also I suspect that if I have progressed form osteopenia to osteoporosis a bisphosphonate drug may be needed rather than calichew D3.
I emailed RIE customer relations and feedback voicing my concerns rather than claiming negligence or making an official complaint.
Yep but they are GUIDLINES and it states early in the article that treatment varies widely across the UK from people having access to specialists to having been discharged back to the GP with no follow up at all. So it is just as feasible for your GP to order these tests within those recommendations. Also within those guidlines glucose wouldnt have been done anyway.
So in that instance you are actually getting better care than others. Recommendation 8.10 says that those with an abnormal bone density should have a dexa every three years so you seem to fall just under this.
I did have a read of a couple of other posts and noticed that you were a nurse which is why i was surprised at your negligence comment. I also am a grade E ED nurse so like yourself know how to do the research and know what really happens rather than what we would like as an ideal.
The first post (prior to me realising this) was to try and help you make a proper complaint rather than have one that might make them take less notice of it. i.e that by knowing exactly what the hospital itself has written down or what is normal practice in your area you could then make the complaint showing them that you knew exactly what you were talking about rather than what you felt should have happened based your expectations.
For example with regards to the blood tests you may have then said
"Whilst I am aware that it is not essential for me to have a blood test on each visit; it is suggested in the .......guidlines that coeliacs have these tests once a year. As I was attending the specialist would it not make for best practice for all coeliacs to be offered such tests at yearly visits"
Now i know that isn't best English and could be said better but i'm sure you get the jist. As you know the goverment is trying to drastically cut the nhs budget and one of the ways of doing this is cutting back on what they consider non essential tests. Even in the ED some bloods that we used to do arn't allowed anymore, even if requested by a consultant, and some are only done after discussion with the lab itself justifying why we want them done.
By complaining in a reasoned manner with all the facts to hand the there is more likely to be change and people hopefully get a better service. It is true that there is a higher incidence of scots with alcohol issues, working in raigmore and doing time at the alcohol unit that was actually based about 200 yards of the dept i cant argue that. BUT that does not allow him to make a comment that makes you feel belittled so again you could have done something along the lines of
"whilst the is a higher incidence of alcohol isses within scotland, I feel it was inappropriate for ..........to have brought this up, thus suggesting he is making assumptions rather than treating me the patient as an individual"
Do you see what i am getting at?
I want people to flag up bad practice, but it has to be that, not what we feel it should be.
There's a difference between a complaint about someone's attitude and treatment of you that results in you feeling dismissed and belittled and a potentially serious problem being missed and a full-blown medical negligence claim that has to prove damage in court. I think you should complain in the first category, at least for the sake of others who may not have the confidence to go to their GP as you did. The experience of having the complaint followed up (which they have to do) will in itself bring his attitude to attention and cause him to think. I made a complaint a while back, it was investigated and I got a full apology from the person concerned whose attitude was appalling. It is worth the time spent writing a letter.
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