Tuesday, May 01, 2007

New Doctor - a follow up

A while ago I mentioned my concerns about how I am renewing my Disability Living Allowance (DLA) and they want a report from my GP, but my GP is on maternity leave, so the GP's report will be filled in by a locum.

Unhappily, it seems that my fears were not completely unfounded.

Today was the day that Dr M (the locum) had asked me to come in for a double appointment so that she could fill in her part of the form. I went into her office, exchanged greetings, asked how she was, and sat down, just like always. She scrolled through my notes on the computer for a brief moment - perhaps five seconds by the clock - and then scrawled across the first box, the one asking what my illness is... "Anxiety and depression".

Sure, I sometimes get a bit anxious. I sometimes get a bit depressed. But not clinically so. I was given a low dose of antidepressant in the early stages of my illness. I did feel, and tell my GP I was feeling, both anxious and depressed about the new limitations on my way of life. She told me she was prescribing the antidepressant to cushion the blow of losing my job/hobbies/lifestyle, and because "sometimes it helps with ME. It doesn't hurt to try." In time I came to terms with things, and I've now come off the antidepressants, best part of a year ago, perfectly successfully - an opinion my real GP, Dr W, shares. If she felt I required treatment for anxiety or depression, she would refer me for it and I would attend it. I have absolute confidence in Dr W to do stuff like that.

I try not to swear on this blog, but with all that in mind, where the shuddering FUCK does this new girl get off, casually writing an inaccurate, or at best, incomplete diagnosis across a form that has a big impact on my life?

Dr M then cheerfully moved on to the next part of the form, that asks about any specialists I see. Asking me, but looking at the computer notes, she saw that I went to the specialist ME/CFS clinic at one of the local hospitals, and that there is a report from Dr Terry Mitchell, an expert in the field. Only when she saw that Dr Mitchell himself had seen me, assessed me, and confirmed in writing and in so many words that I *do* have ME/CFS and *don't* have depression, did she go back and add "CFS" to the box on the form asking for my diagnoses. However, it's in small writing, tucked underneath the large central "anxiety and depression", which hasn't been crossed out.

From then on, the consultation felt like some kind of horrible parody. She spoke too quickly, confused the hell out of me, and I couldn't get my words in the right order or quick enough to stop her. She was looking at the form muttering "washing, feeding, [unintelligible], getting dressed, no, you don't have any problems with those..." and I only just managed to say in time "yes I do!" - she looked like she was going to cross through the box. A little later, she stated "I can't imagine you have any trouble being aware of danger," and I told her to tell that to the friends who keep having to pull me back from the road because I'm concentrating so hard on walking that I forget to pay attention to traffic. It was all going too fast, I didn't get a chance to describe any of my symptoms properly or adequately explain any of the problems I have.

I'm fairly sure my mobility is part of that form. It was Dr W who first suggested to me that I should get a wheelchair and a mobility scooter - Dr M, however, doesn't even know I have them or the difference they make to my life, and she certainly didn't ask me anything about what walking is like for me.

I'm fairly sure that equipment I use is part of that form. Dr W has spent time discussing with me all sorts of tips and equipment for remembering medication and managing stuff, but Dr M has assumed I'm automagically fine with it all.

I'm fairly sure that my care needs are part of that form. Dr W knows the extent of care and support I get from my family and friends, because she's my family GP. Dr M was filling out the form murmuring things like "you're pretty much independent then, yes..."

Dr W lets me bloody well finish a sentence. Dr M starts writing my answers in before I've opened my mouth.

After just under ten minutes of this gobsmacking whirlwind of misapprehensions (oh, looks like we didn't need a double appointment after all), Dr M squiggled her signature on the form and clipped it back together. God knows what she's written on it. It should get faxed to the DWP late today or some time tomorrow (so I'll call them in a week or so to make sure it's definitely been recieved, as they're notorious for "losing" documents). Then she made it entirely, bluntly clear that the consultation was over, and even seemed impatient with me struggling to stand - although I may have imagined that, as I was feeling pretty overwhelmed by then.

As I waited outside the surgery for a taxi home, the headmuddle resolved itself first into worry (oh no, her report will be completely different to what I've said on my forms because I didn't explain myself properly) and then into anger (godammit, her report will be completely different from the actual truth because she wouldn't listen to me or read the notes properly).

By the time I got home, I'd got the anger into annoyedness (gah, her report will be significantly different to what Dr W would have written) and worked out a plan. I've called the DWP, explained the situation, and asked what we could do. The call-taker asked if I wanted to request that they ignore the report, but I said no (because I understand that she's attaching Dr Mitchell's report from the CFS clinic, and that IS worth a read to anyone assessing me). But she put a note on my file, and read it back to me to confirm it, to the effect that I have "raised concerns" about my GP's report being from a locum, rather than the GP who manages my illness, and that I do not feel the locum is fully informed or understanding of my condition.

I'm knackered, so sorry that this wasn't my best ever post. I'm also a bit concerned that if my application is turned down on the basis of Dr M's assumptions, I don't know how I'll manage to see through an appeal. I really could have done without this. I don't think I'm the illest person on earth and I have no desire to play the system, but I would like the doctor I see to listen to me, and I want to receive the benefits I am reasonably entitled to.


Anonymous said...

(((hugs))). What a stinker. Good -plan for ringing the DWP and explaining the situation.

Only other advice I can give, is whether you're still in touch with JP clinic (I'm under them too) and whether the OT would be able to write you an up-to-date report? Depends how long ago you've seen them of course.

Thinking of you - it's a bad as (or probably worse than) waiting for bloody exam results!

Mary said...

It has been quite a while since I went to the JP clinic - just over a year, perhaps. The OT said that since it was such a problem for me to get there on any kind of regular basis, we would do an intensive session and then I could phone or write or email if there was a particular thing I wanted to discuss.

Because I had such a very supportive GP, in the form of Dr W, I agreed with this. Dr W was asking me to come in every couple of months to discuss how things were going as well as making it clear that I could make an appointment any time I wanted to, so really I was being perfectly well monitored.

But now Dr W is gone, and I don't have any kind of medical person or care professional looking after my case on what would be called a continuous basis. The only people who know first-hand just how things can get for me (apart fom me) are Steve, Pip and my mum, and I fear their input would not count for much versus the opinion of a doctor who's seen me for a few minutes.

Marvin -The Hollow Hound said...

I feel for you! This country is in such a mess with the NHS etc,

I do not know what else to say here, just that I am disgusted by this so called Health Service...........

Why should we struggle to fight them, when they should be caring for us.

Take care, my thoughts and heart are with you xxxx

Jeannie xx

Anonymous said...

I send you sympathy. Hope it is all sorted out to your satisfaction.

Anonymous said...

Why are doctors like that? Even if you are well, (like in pregnancy) and organised, they still rush through things and don't listen well enough for you to tell them things that really matter.

It's bound to be worse when you are ill. You would think that they would get some training on how to listen to patients.

Hope it all turns out OK

Mary said...

I should have stopped trying desperately to keep up with what was going on and fumbling for words and trying to make out what she was saying, and just yelled at the top of my voice "I NEED YOU TO SLOW DOWN!"

Actually, no. She should have been paying proper attention to me and to Dr W's notes. And if she believed that I was suffering from anxiety and depression to the extent that it made me jobless and I was applying for DLA, then she should have treated me accordingly and been alert for signs of stress, such as, ooh, stumbling over words.

The Goldfish said...

Oh, I'm so sorry about this Mary. I'm particularly sorry as I was so confident that you had nothing to worry about...

Mary said...

Goldfish: well, at least it meant I walked INTO the consultation feeling fairly happy and confident - you did successfully remove from my brain several days worth of pre-appointment worrying :)

Maggie said...

Dear Mary, what a horrible "consultation", sounds more like a bullying session to me. Perfect example of how to communicate with a patient! ;-) Sounds like you've done the best you can for now to raise questions over her report.

I know this will sound trite, and it's something I mostly can't manage to do myself, but do *try* not to worry too much prematurely. What I find helps a bit is to begin collecting the information I am likely to need at the next point in the process. If that makes sense!

For example, when I was looking for continuing NHS care for Dad I did a lot of research on the Age Concern website, printed off a load of their leaflets and read them as and when I felt up to it. And used highlighters to mark what seemed to be the most relevant bits.

So now we're over the beginning of the process (assessments and Case Conference and so on), we're into the next stage, which is writing to request copies of the documents. Once that's done I'll begin reading up the next stage, which is where I think it begins to get complicated.

Would it be OK with you if I submitted this post to Dr C's BritMeds?

Hugs coming from Liverpool to help soothe you a little over your ordeal

Mary said...

Hi Maggie

I don't know about "ordeal", it's not that bad yet. I tend to worry before things rather than after. Right now, I know that in phoning the DWP I did all that realistically can be done, and the ball is therefore out of my court. I know that what's coming next is probably going to be a request to hike over to Norwich or Ipswich to see one of Their Doctors. But this IS the DWP, so that probably won't be for a couple of months yet. For now, I just get on with life until the next Brown Envelope arrives.

Pass it on to Dr C if you like - it would be interesting to hear what medicalbods think about this.

Jenny Bear said...


I am sure the report will be fine. I have always found the dla peopl to be very fair, even if they can be slow.


Sally said...

Mary, masses of sympathy, and reading your description of this horrendous session brought it all back to me ... the baddies me and my Bump have encountered over the years. I wonder if it would be appropriate, or even helpful to you, to write to the DWP again, stating it as strongly as you have posted it here.

If it is any consolation, that doctor's attitude to you, may be why s/he/it is a locum ... no one else wants it permanently around ?!

Sue said...

I'm dismayed and disgusted but sadly not surprised that your "medical" was conducted like that. Its all too common. And disrespectful of you.

I really hope that you get the DLA award you deserve.

Best of luck

Mary said...

meezermagic - I'm going to follow the tone of your comment and assue you meant "disrespectful TO you" rather than "disrespectful OF you". :)

Jenny - the impression I get is that they either work efficiently and fairly, and get a claim sorted out within less than three months, OR you get a nightmare from start to end.

My initial application, two years ago, went pretty smoothly, apart from two bouts of lost paperwork. But the number of nightmare stories I've heard mean that I can't take it as read that I'll get any award at all.

I don't want any more than I am really and honestly entitled to, but what I am really and honestly entitled to, I would like to receive.

Thanks everyone for all your support.

Anonymous said...

Mary, if they stop yiur DLA or reduce it, appeal. Get CAB or a law centre to do the appeal -- CAB win a massive number of DLA cases on appeal.

Anonymous said...

That is exactly why the NHS needs to be shut down ASAP.

Patients have to come begging cap in hand to some arrogant stranger with an ego problem about their profession and hope that they are in luck and their GP can be asked to do some work for the £100k they earn. They don't need or want patients, since they get paid regardless of how lazy, incompetent and rude they are.

Would you approach a car mechanic with the same trepidation as your GP? Would you trust a mechanic with that bad an attitude to fix your breaks in the first place? You would tell the man to bugger oooof and find a garage that actually gets the work done without ripping you off or potentially killing you with sloppiness. And he certainly would not have a say whether you keep your driving license or not, and if he is paid to do an MOT with a report, he'll do just that and not confuse a Mercedes with a Jaguar.

It's outrageous that you have to put up with that treatment because your livelihood depends on it. I know you don't have the energy, but someone should complain about that, because if that GP does this to you, what will she do to others? Lord knows how many people she is hurting with that slapdash arrogance of hers :(

Mary said...

Hi Cinnamon. Well, the thing is, that Dr W, my family GP, is DEFINITELY worth £100k (if that is what she gets, which in an area like this I really doubt). She's looked after my whole family for many years and we trust her implicitly.

She has every right to go on maternity leave. I am happy for the birth of her child. I accept that I have to see someone else while she is on maternity. And there was no real reason for me, the DWP, or anyone else, to think that the locum covering her work would be anything less than 100% professional.

Trouble is, you can shop around for your "regular" GP (or your regular mechanic), ask to be put on someone else's list, whatever, but if they're unavailable then you get what you're given. Sometimes you're lucky and sometimes you're not.

I don't think it'd make much difference if I had a private doctor rather than an NHS one. The DWP want additional information about my illness. They want it from the professional who manages my illness. That's reasonable. It's just a shame she's not about at the moment.

Shutting down the NHS would just leave me, and people like me, stuffed beyond the telling of it. I can't get privately insured for a pre-existing condition. Any insurance I do get will (a) have massively inflated premiums which I certainly can't afford while on benefits and (b) refuse to fund any investigations or treatment for anything that might be even remotely associated with my pre-existing condition. I need the NHS.

Anonymous said...

Sorry for delay have been away and playing "blog catch up" - addicted to blogs, moi?! ;-)

Anyway, I think it might be worth getting in touch with JP - a year, sadly, isn't a long time in ME. I say this as the DWP seem to believe consultants more than GPs anyway. One tribunal I went to pretty much implied my GP (who, similar to your's, has known me since before I was born!) was helping me swing the lead.

Also, you might like to know that I think DLA doctors come to your house (mind you this can lead to other problems), thought they were trying to revert to people going to centres. You can also ask to have home visits (certainly for IB), but you do need a letter from your GP.

Keeping my fingers crossed for you.

Mary said...

The lead-swinging bit is where I am glad that it is documented in my employment record and my medical notes that:
- I turned down the first sicknote I was offered in the belief that I could "work through it" and that I was indispensible at work.
- I was repeatedly sent home from work and ordered to make a doctors' appointment.
- After the first sicknote (1 month) ended, I went back to work for a week before being sent back to the doctor.
- On one occasion, an ambulance was called to me after I collapsed en route to work. I had to sign documentation to say that I was refusing to go to hospital as the ambulance staff wanted me to.

All of the above was extremely stupid of me. If I'd taken the time off when I first got sick, if I'd gone to hospital with the ambulance, if I'd known when to quit, then I probably wouldn't have got as ill as I did. But, at least it backs up my claim that I'm NOT a workshy wimp.

Anonymous said...

This is too common that Doctor's prescribed wrong medicine instead of the original one.