don't be palmed off with drugs

bonj2

Guest
Just though i'd share my experiences of this morning's little trip to the doctor's.
I have had a dodgy knee for a while now, whenever I put pressure on it it hurts very slightly right on the front of the knee-cap, I wouldn't really call it pain so much as a twinge, so can live with it comfortably, but wouldn't mind getting it sorted as some days its worse than others and borders on pain.
My mum highly recommended the physiotherapist she went to for a back problem so highly that since then my bro and dad have also gone to him, so I thought i'd give him a try aswell. I thought I might even be able to claim it back off westfield, so I phoned them up and said I could claim back 75% but only if i got a GP's recommendation first. So I made an appointment for this morning, and when I got in to see the GP, a wispy-haired asian fella, it went a bit along the lines of
"Hmmm...., i've got a bit of a dodgy knee, it hurts a bit when i put pressure on it, right on the front of the knee-cap, and I was wondering if you could write me a recommendation for going to a really good physio that my mum knows."
"Well I don't know about that, I don't think physio would be what you need."
"Well, he is very good, and I am going to go to him anyway, so you might aswell."
"just roll your trousers up." (I did, and he looks at my knees and calves for about 4 seconds.)
"
"Well, it's probably that ligament that goes right down the front of your leg." (no shoot sherlock...)
"I can feel it when i'm cycling a bit, aswell, and when i'm playing squash."
"Ah! well, you have to stop doing that my friend. When you be cycling on level surface that ok but up a hill it cause it."
"Hmmm... I still get it when I haven't cycled or done anything strenuous for a while though. So are you saying I should lay in bed all day, maybe that will cure it?"
"No! that be counter productive. We tell back patients not to lay in bed all day because it be counter productive."
(all the while he's tapping stuff into his computer, and I can see the next bit he's typing is about what drugs he thinks i should have)
"er... i'm not sure tablets are really the best thing for me, you know."
"Well you not know until you have tried them will you."
"So what are they, ibuprofen?"
"No, they're stronger than ibuprofen. They're presecription anti-inflammatories."
"But I haven't got an inflammation, that's not the problem. I need to go to a physio, I know what I need, I just need you to write me a recommendation for it."
"But the physio he might not be able to see you for month."
"Well that's ok, but can you not write me a recommendation for this one I already know of, so I can go to him."
"Oh, private? well, I can't do that. But if you really want I can refer you to the one here, it will cost you nothing."
"ok, thanks."
(at this point he's backspacing out the bit he's typed about drugs and is putting 'wants to go to physio. referring.')
"Here give this in at reception."
"ok, thanks doctor. cheers"

!
So it just goes to show you needn't be palmed off with drugs if you know that isn't the best thing for you. I think there's a vicious circle nowadays, of people being far too happy to be palmed off with drugs, and GPs being overly keen to dole them out because of the commercial muscle of the drugs companies pushing them.
I think it's also a bit of a travesty how under the labour government the real health professionals that actually do things to sort people's bodies out like chiropractors and physiotherapists are normally private and have to be paid for, not to mention they still have a bit of a reputation as witch-doctors, but the GPs who are basically just a front-end for glaxo-smithkline or whatever, that don't ever actually do anything of benefit or fix you, are the ones that you have to go and see first unless you want to get your chequebook out.

But the moral of the story is if you stick to your guns and know what you want and aren't afraid to insist on it, you will get it.
 
Indeed. Request that you see a different doctor at your GPs surgery. Sometimes you just have to keep going back and argue until you're blue in the face to get what you want. We have had the same with ours over various ailments.
 

domtyler

Über Member
Shame, you should've got the drugs mate. You never know when they will come in handy on a Friday night out!!
 
OP
B

bonj2

Guest
What if the physio tells you to go back to the GP for a course of anti-inflammatories?
Because it's in his best interest to cure me, not to make bonuses off drugs companies.
 
OP
B

bonj2

Guest
papercorn2000 said:
You sure it was drugs for your knees he was tryin got get you to take. Could you read Ritalin upside down?
It does sound a bit ridiculous taking drugs for your knees doesn't it...
 

ChrisKH

Veteran
Location
Essex
Au contraire Bonj. I would like to take NSAIDS or Voltarol for my (much operated, arthritic) knee but cannot do so because of another inflammatory disease I have.
 

papercorn2000

Senior Member
bonj said:
It does sound a bit ridiculous taking drugs for your knees doesn't it...

Well, might take your mind off it!:smile:
 

Globalti

Legendary Member
I would like to buy this software all the doctors are using, then I would never need to bother them again. I could even open a surgery.
 

Will1985

Über Member
Location
South Norfolk
User76 said:
I am afraid the days of individual Drs making cash money and being taken on lavish trips abroad etc are gone.
You think? So what is the week long expenses paid trip to Spain that two of my dad's colleagues are taking courtesy of a drug company this week? Doctors can still squeeze a hell of a lot out of drug companies, but often it is payment for 1 day courses and expensive books more than anything.

Bonj - inflammation could be under the knee cap, which has happened to me in the past, confirmed in my case by an MRI and ultrasound. If anyone makes bonuses off drug companies, it is the reps. Having said that, dispensing GPs often get discounts for buying in bulk or long commitment to a particular company, but business is business and the GP will buy whatever is cheapest of the competition.

If you don't like the service, look elsewhere. It shouldn't matter to the GP where he refers you, but if he either has no private friends or gets a type of commission for referring you to the practice physio, that isn't so good. It takes less than 5 minutes to dictate a simple referral letter TWIMC....some GPs even charge a fee!
 

CycleWidow

New Member
Location
Aberdeen
User76 said:
They won't be going on a week long all expenses paid trip to Spain, they will be going to attend a week long educational meeting, sponsored to attend by a drug company. If your dads colleagues are going on holiday for a week with a drug company he, or even better you, should report them immediately to the GMC and report the company, and it's representative to the ABPI. While they are at the meeting, your dads colleagues are under absolutely no obligation to attend any functions or symposium put on by the drug company, and if the companies representative told them that the only way he could arrange for them to go was on attendance at such functions, your dads colleagues should immediately report the rep to his company and the ABPI.

If any drug company puts on an educational meeting, the content cannot be promotional, if they do promote at the meeting, your dad should immediately report them. The issue of books, if a company buys a book for someone the book should become the property of the team in which the dr/nurse works. If someone offers to buy your dad a book, he should make it clear it is for the surgery/dept in which he works, as should the rep. Otherwise report them. The regulation system only works though if people report wrong doing. If you look in the BMJ nowadays you will find a list of named and shamed drug companies following complaints to the ABPI. It's just a shame there is no mechanism for naming and shaming Drs who try and blag absurb freebies from drug companies, by the sounds of it your dads colleagues would be on it!!!

User76 I totally agree with you and with your earlier post. The ABPI rules and to a degree the annual (or supposedly annual) appraisal system exmining Doctors Probity ensure that a GP/hospital doctor practices without biases imposed on them by the drug companies. GPs can adhere to the local PCT formularies, but there can be times where there are drugs available that all agree are better but have not received the local approval for the formulary yet (funding etc).
My concern regarding Bonj's GP is his reluctance to refer to a private Physio....perhaps the preferred treatment plan for Bonj would have been
1. Thourough examination...and yes it is possible to do a good knee exam in a 10min appt.
2. Agree about a referral to Physio and explore options regarding NHS (usually long waiting time) and private (quicker) an emphasis here due to Bonj enjoying regular sport.
3. Offer a solution for some relief from the pain in the interim period...and in this case I do agree that despite Bonj claiming that there is "no infalmmation" a good NSAID such as Diclofenac would be indicated (unless contraindicated by concurrent health problems or allergies) would be the best course.
Perhaps it would be best to request an alternative GP next time.
 
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