dreadful GP appt about B12 treatment

[Caradoc1a]

I've made some notes!! I will be contacting the practice manager with a view to them providing training in B12 treatment. (Also posted this in PA forum but thought it might be useful in here as well )

• ‘On the day’ appointment to replace a scheduled appointment the previous day, which had not been inputted into the system

• Did not read the notes I had provided. I had explained that I had a great deal of cognitive deficit from the B12 deficit, I offered to summarise but this was refused

• Did not ask about my neuropathic or other symptoms of b12 deficiency – I tried to volunteer these but was talked over

• Did not realise that my B12 levels had reduced by almost 50% in 12 months - just looked at the latest test from late November after I had take sublingual B12 for 3 weeks

• Did not ask about the history

• Said I needed coeliac test when I had already had a negative test for this

• Did not realise that I was awaiting the results of a H Pylori test

• A difficult consultation as I had to correct several mistakes. I encountered some resistance/hostility and was asked if I had a medical background as I had used medical terms and showed knowledge about this subject.

• GP made erroneous statements - ‘as you have a negative coeliac disease test, there won’t be another reason for malabsorption of B12 and oral B12 is fine to take’ & ‘as your serum B12 is now within range (624) there is no need for injections’

• When asked if he would arrange a test for Intrinsic Factor, he said there was no indication this could be Pernicious Anaemia. When I suggested it could be a type of atrophic gastritis which has led to malabsorption of B12, he said only a gastroenterologist would conform that and there is no need to refer. When I pointed out that this is one of the most common reasons for B12 malabsorption, this was ignored

• GP said that he would not follow Endocrinologist’s recommendation to give B12 injections (letter 3/12/24) When asked why, he said he did not know enough about the subject and as a GP he isn’t in a position to prescribe them.

• The GP said he did not feel comfortable to follow the NICE guidance and BNF guidance for when there are neurological symptoms with B12 deficiency.

• When I said that BNF and Shropshire Formulary give a green traffic light for GPs to prescribe these for B12 deficit, there was no response apart from he wanted to research it further and then he would make a decision. I asked when that decision is likely to be made and communicated to me and he said about a week

• He says he will refer me to neurologist and I asked about the timeframe and he said about a week (I really do not see this as a realistic timeframe)

• When I wanted to talk about the ongoing Left ear infection, GP made the point that the appointment was time limited and he was only paid for that amount of time. I would need to make another appointment.

[humanbean]

Wow! Was he really a doctor? Or was he a pretend doctor i.e. a Physician Associate?

His attitude towards you absolutely stunk. He obviously wanted to put roadblocks in your way after practically every sentence.

I encountered some resistance/hostility and was asked if I had a medical background as I had used medical terms and showed knowledge about this subject.

Doctors really hate it when they discover their patients have a functioning brain.

.

Its experiences like yours that remind me why I move heaven and earth to treat myself if at all possible.

[Caradoc1a in reply to humanbean]

Yes - a doctor, not a PA!!!🙄

[Obsdian in reply to Caradoc1a]

Sounds like one I saw a few months ago.

[Sparklingsunshine in reply to Caradoc1a]

Is that short for piss artist? Asking for a friend 😆

[Doris11 in reply to Sparklingsunshine]

😂😂😂😂 my Dad used to say that 😂 are you from Devonshire?

[Kowbie in reply to Sparklingsunshine]

very good sparklingsunshine

[Rapunzel]

Rude vile pig - to quote Elton John in 'Tantrums & Tiaras'. Dig it, Elt. Do let the practise manager know that this statement - 'GP said that he would not follow Endocrinologist’s recommendation to give B12 injections (letter 3/12/24) When asked why, he said he (my italics)did not know enough about the subject and as a GP he isn’t in a position to prescribe them. The Endo, who presumably does have enough knowledge to prescribe should not be overridden by a clueless, arrogant buffoon who is overreaching himself. Squash this bug!

[Sparklingsunshine in reply to Rapunzel]

Well my GP practice has been prescribing my B12 jabs for over 12 years. What do they know that this idiot doesnt?

[Caradoc1a]

I will post the text of my letter to the practice manager. I'm also writing to the Endo.

[Amethist]

there is an organisation called PALS that may be helpful with making a complaint.

Your gp clearly has significant gaps in his knowledge which could be harmful to all patients.

Personally I would make an official request for your GP notes , ( incase they have written stuff you can’t see online) requesting also any referrals that have been made and copies of letters sent to & from consultants. Any other stuff you want too.

Then you will be in a better position, having written evidence, if you want to proceed with a complaint.

Best of luck 🤞

[Alba68 in reply to Amethist]

I also agree with Amethist to see your GP notes. That’s the only official record of what happens at these visits. I recently requested mine for the first time as I moved abroad so wanted to be able to provide them to new Dr if necessary. It can be very enlightening and allows you to challenge incorrect information. I discovered false comments on mine from 30 years ago but a bit too late to challenge!

I also discovered a complete set of blood work from 10 years ago which had been ordered ‘in error’ so I didn’t see the results at that time. Annoyingly it showed high cholesterol which no one spoke to me about and I could have been working on. On plus side it also showed I had normal TSH/T4 at that time which helps to know this is something that’s developed sometime since.

[Emaych61]

It was my understanding that GP’s pretty much have to do as they’re told if a consultant makes a recommendation or, if they don’t, they should know that it is not wise to go against it. Basically if something goes wrong as a result of their decision to ignore such a recommendation they (the GP) can end up in very serious trouble!

[arTistapple in reply to Emaych61]

Seems like many GPs do what suits themselves. If they can twist the Guidelines to suit themselves, great. GPs not obeying endocrinologists, I think, is why so much power was taken away from GPs in the first place. Initially that was a ‘happy place’ for them. Less work as they probably saw it. This also now allows endocrinologists (dodgy ones) to do what they like. It seems it’s all about power and empire building. Nothing to do with the patient at all.

In between all these connections we also have another layer of the sandwich called ICBs? who can also choose which part of the National Guidelines to ignore eg blacklisting T3.

You just could not make it up. If this was a novel, there would be too many twists and turns to make it believable.

[Emaych61 in reply to arTistapple]

😥😥😥😥

[Doris11]

Omg 😦 I was point blank refused by my Gp! I was likely deficient (as per NICE guidlines) I did explain this and even said I would inject myself! My GP is a partner in the practise as well 😏😏 I was diagnosed with Gastritis after a endoscopy so clearly not absorbing tablets after a year 🙈I gave up and do it myself.

Why oh why won’t GPs make a decision for themselves? It’s always “I will write to them and ask their opinion” etc.. Good luck anyway 🌲🌲🌲

[dunestar]

Your GP's comment re the B12 injections is staggering. In effect he's saying he can't do his job properly. Should he be practising at all if he's so incompetent?

[Catlover1981]

I once had a course of Vit B12 injections. Not now but I know if my blood showed low then I would 💯 per cent be given them again As for your GPs attitude I think because you went in with all your ideas his back went up. My old GP once had a right go at me and I came out of his room feeling like a naughty school girl. When he diagnosed me with hypothyroidism I decided I no longer trusted him and found out there was a GP practice around the corner of my estate so I transferred to them

I found out they had ignored my white cell count being very high and diabetes had not been diagnosed My GP now says where's your list of questions lol.

[serenfach]

Trouble is, you cannot be straight rude to the GP. I have had to bite my tongue a number of times. I bet you felt like asking "so you dont know about the vitamin that is essential for the formation of red blood cells. That is worrying!"

Lets hope in "about a week" he opens a book and has a read! You could not make it up! Sending a hug.