I think we, the many whose GPs do not take us seriously, do not treat us adequately, do not understand the struggle to keep going, should remind the GPs and non-believing consultants that one of the tenets of Medicine is 'First, do no harm.'
Hippocratic oath: I think we, the many... - Pernicious Anaemi...
Hippocratic oath
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I am going to have to leap in here and defend GPs again.
First off you need to understand that they are under enormous pressure to do the impossible with minimal resources.
As a student they will study vitamin deficiencies (including all the ones with much cooler names than'pernicious anaemia') in a few hours one afternoon. After that they will have little time to keep up with the latest ideas.
So, they treat patients according to what they have been taught to do. If the patient has low B12 (according to the arbitrary range chosen by their labs) then they treat them according to what it says in the BNF.
Of course, there's no excuse for not reading the second paragraph (where it instructs on treatment where neurological symptoms are present).
"But", you say. "I gave him a printout with the latest quidelines and he ignored it."
Yes, do you know how many people go to see him clutching nonsense printouts about how wombat faeces can cure their problems, and can they get it on the NHS?
If you really want to educate them try buying a copy of Martyn Hooper's book for them. They may be less likely to ignore that.
I must say my GP will happily research things online while I'm there and look for information, following all my neurological symptoms he has decided to speak to a neurologist himself for advice then contact me.
"...are under enormous pressure to do the impossible with minimal resources."
In that case whoever is in charge of GP training needs to be made aware. It's the same with migraine and presumably countless other conditions: not enough or adequate training or resources afterwards. And how long has this been the case? I had problems 30 years ago with dismissive and ignorant GPs, and subsequently, and treatment I would call abusive from two consultants during pregnancy.
We all know what is happening to the NHS currently and that is not the fault of the GPs. There aren't enough GPs or consultants to meet demand, there aren't enough or adequate treatments available, hospitals are being closed etc etc. and the awful threat of privatisation hangs over everything.
But speaking personally, I must say I find it hard to be understanding and rational about the plight of the GP or consultant when I (or a relative) have been in terrible pain for a very long time, my life (or my child's life) is going down the toilet and the GP or consultant is dismissive or actually laughs about it. Evidently I must try harder.
Excuse the rant: it's a bit of a hot topic right now.
Like you, Frodo, I am very aware of the lack of knowledge/training that GPs have. I can understand that it seems unfair to lay blame on them when they do not know enough. But when I am faced with dismissive attitudes, inadequate explanations and the stark statement that it is too late for me to recover, which is what my GP told me, I feel let down and, dare I say, bitter, that I have effectively been left with pain, weakness, extreme fatigue and the rest for what is left of my life. I am being a 'poor me', I know but there are days when it is hard to accept. Sorry.
Hi,
I don't think doctors in UK have to swear the Hippocratic oath.
patient.info/doctor/ideals-...
I think that writing a letter to GP containing extracts/quotes from relevant documents may have more effect than giving them printouts of the whole document.
My understanding is that in UK, letters to GP are filed with a person's medical records whereas I suspect that printouts are sometimes filed in the bin. I sometimes included a request in letter that a copy was placed in my medical notes.
A good GP will work with a patient .
"But", you say. "I gave him a printout with the latest quidelines and he ignored it."
My experience with some of my GPs is that they had the time to look up the local B12 guidelines for the area I live in, so I feel they could have used that time to look up national UK guidelines eg BSH Cobalamin and Folate Guidelines.
Don't get me wrong I have had a terrible gp in the past who was so dismissive and often laughed at me, probably why I have never had a b12 blood test until recently, I had never heard of a b12 deficiency so never asked to be tested, it's only now there is a new young dr at the surgery who has been testing me for loads of things and found the deficiency, and only now that I've felt confident enough to tell him a lot of the neurological symptoms, and he was quite concerned. It must be awful feeling this way and having to speak up to dismissive Drs as I just wouldn't have the energy or words to do that. (It's taken several attempts to type this and thank god for auto correct!)
When I first saw my GP, he was not receptive at all. It was not going to be easy but after having a face to face honest chat, which was forceful at times on my part, I brought him round with a bit of a shock after reminding him, gently, of his, and the practice's responsibilities, I didn't like or enjoy having to do it, but I was left with no option. He has now researched B12D and it's related side effects for himself and I would like to think he has become a more enlightened practitioner who now takes it all more seriously.
I had to see another GP recently over the severe pains in my left leg, he read my history and was totally different even appearing quite knowledgeable about B12D and related issues. It was like a breath of fresh air, even supporting me in my move to SI for my coming holiday. I feel I am at last making positive progress, but it has been a tiring and frustrating experience for both myself and my GP!
Stick with it, and just make yourself clear and that there a documented processes already in place to guide them, and yourself, through the initial experiences.
Its not about enough time ! You are there with an appointment.
Its about them hearing what we are saying! Not being labels/dismissed by them.
When will they ever learn etc...
They are paid s lot of money , dont firget that fact