At Your Service: Getting Past The GP’s Gatekeepers

I couldn’t tell you how many times I’ve heard people complain about the attitude of the reception staff at their local doctors surgery.  Not just at one particular surgery but at several, all over the country.  As a hypochondriac (brain tumours, pulmonary embolisms and good old breast cancer, I’ve had ’em all…almost) I’ve tested out the receptionists in towns and cities from London to Nottingham, Woking to Castle Donington, and can honestly say that the vast majority have been pretty horrible.

Yesterday I called my local surgery, the Market Harborough Medical Centre – let’s name and shame, to book an appointment.  I was going away for four days had four days of my regular medication; anti-anxiety drug Pregabalin and mood stabiliser Lithium, left.  The maths is pretty straight forward, I needed a repeat prescription sooner rather than later. I also wished to speak to a doctor because, let’s face it, a regular supply of Diazepam never hurt anybody (er…) and I’m getting a couple of unpleasant side effects.  A ten minute appointment with a GP is a fair request, right?  Five’d do, I’m an experienced GP hassler.

But if I thought I’d just be given an appointment because, as a British tax payer and registered patient of MHMC, I’m entitled to one, I was obviously living in cloud cuckoo land, surrounded by a herd of pink unicorns frolicking beneath rainbows.

The wonderful, sweet and caring receptionist I was unfortunate enough to be put through to had other ideas about how I should be managing my illness and medications.  With her phone set to ‘Voice of God’ volume so I needed to hold it away from my ear – I wouldn’t want to put her out by needing a second appointment for Tinnitus – she informed me with a irritated sigh that my usual GP wasn’t available until next week ‘and ANYWAY we’re not booking for Dr Yates until Friday’.

I explained my plight to no avail. ‘So you want a repeat prescription?’ yes please, oh merciful one, ‘well, you have to have a blood test.  You were SUPPOSED TO have had one in February.’

That was when I started losing my rag.  I shouldn’t have, I know, but seriously? I don’t think I told you it was a repeat prescription for Lithium (which does indeed require a regular blood test).  And besides, if you nosey in to my medical records further you’ll find I had the tests in March and my prescription states that it’s review with the doc time.  Also isn’t this filed under None Of Your Business?

She went on to advise me, in loud, exasperated voice, ‘you know you don’t have to have an appointment, you can still get your repeat prescription even if it says you’re due for review’.  I’m sorry but what?  You’re advising me to ignore the advice of the doctors and at the same time you’re trying to talk me out of booking the appointment that I called for?  I get that you’re busy but…but…*head explodes*

Eventually I was begrudgingly granted my appointment, not before being asked in the most condescending way possible; ‘don’t you think it would be better to wait until Dr Yates is back so you can see him?’ (I didn’t think of that, what a complete IMBECILE I am.  I’ll do this the right way and hold fire on the medication that stops me from LOSING MY MIND until he’s free), just so I was aware that I, pathetic minion, was being given something against the better advice of the highly qualified health professional manning the phones.

I hung up, I sat down in my kitchen and I cried.  I felt like I’d been bullied and belittled, like I’d lost control and worst of all, I felt uncomfortable at the idea of my medical records being open to this woman, in a small town where gossip is traded like sweets, especially by certain types of women.  The conversation went round and round in my head all afternoon and I was shaky, tearful and snappish for several hours. I was nervous about my visit to the GP – something I’ve learned to brave out and normally find fairly easy to do – and asked Mr H to go with me for moral support.

Actually, I should say here that since writing this I’ve seen the locum GP who happened to be pleasant, professional, interested in my condition and very helpful indeed.

My reaction to a situation like this is an extreme one, but that doesn’t excuse the receptionist’s behaviour, or the similar behaviour of others in her position. I wouldn’t expect anybody to guess that I have Social Anxiety and, specifically a phobia of the phone (I struggle to call my mum and it’s pretty much unknown for me to phone my best friend). However I think it’s fair to expect a level of patience, empathy and, well, just a smidge of professionalism from someone paid to speak to people who potentially have a life threatening illness, are scared for their health or have a mental disorder. Should not every call be answered under the assumption that the patient at the other end falls in to the category of ‘To Be Treated With Kid Gloves’?

The job of a receptionist at a doctors surgery is doubtless a stressful one and I imagine the women at MHMC encounter all sorts of not in the least wonderful people.  Nobody expects them to be infallible, but they are paid tax money to take it all on the chin and smilingly greet the next person. It’s just part of the job and if you can’t manage it try something else. You know how it always seems to me? It seems like these gatekeepers have been given the tiniest bit of power and it’s gone straight to their heads.  Pull your necks in girls, nobody’s impressed

So if the idea of being polite to everybody is just too much could the surgery’s computer system not flash up a warning for those who most need the special treatment? Not that long ago the unhelpful attitude of MHMC staff led to me not pushing for drugs I needed and in the past Mr H has dealt with my requests and requirements because, shot down in flames on a phone call, I timidly retreat. I can’t be the only one. At least the receptionists receiving a warning that a particularly vulnerable or awkward patient is on the phone would allow them to save their niceness quota for those who need it the most.

Have you experienced the Gatekeeper treatment at your GP’s surgery?  Or perhaps somewhere else? How do you think NHS services could be made more accessible to patients? 

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How Social Networking is Working For Mental Illness

This week certain events have made me realise what a powerful set of tools we, the nutters, have at our disposal in Internet social networks.

First the level of understanding I witnessed on my Twitter feed following the suicide of Wales football manager Gary Speed was truly heartening even if one did feel that a handful of tweets were more out of a morbid desire to be involved or to have said something. Equally impressive was the quick work of mental health charities, many of whom I follow, in tweeting information related to suicide and depression in an attempt to quickly dispell myths surrounding Speed’s death and to, for want of a more appropriate term, ‘cash in’, using his death as a springboard to raise awareness amongst people who perhaps had given little thought to mental illness previously.

The second thing that made me consider the strength of social networking for mental illness was an accusation made by somebody at my partner’s place of work today.

I’ll make the story short as it really isn’t the point of this post.

Around three weeks ago I began experiencing by far the worst manic episode I have had since diagnosis. My GP promptly took me off of my usual anti-depressants to tame the crazy. In the meantime however he struggled to get in contact with my psychiatrist for a new, more effective prescription.

Yesterday on learning that there was still no progress after a week’s hard fall off of my regular drugs I lost it, calling the community mental health team in what I like to call the all-the-words-are-one-long-snotty-word tears to beg for an appointment which, bless the poor lady translating my slurps and nose blows, was immediately granted.

This meant my husband would need to leave work to look after the kids and, to his concerned mind, me. He did exactly that. I went to my appointment. I got my shiny new lithium and the promise of a lifetime of blood tests and thyroid problems.

Today my already stressed husband was pulled up by his workplace for lying. Because I was cheerfully chatting on Facebook and Twitter whilst between appointments and in waiting rooms, the only conclusion drawn from this was that he lied to get out of work or I lied to him about the illness.

Make of that what you will but I mention it as an illustration of just how wonderful a tool something like Twitter can be.

No sooner had I made my 4sq check in at the hospital (I WILL BE MAYOR OF CRAZY TOWN) than a good friend tweeted me; ‘you ok?’. Having reassured her that it was nothing she needed to rush round with my Valium and a cup of cyanide antidote for, we continued making plans to go to the cinema later this week.

I posted some stuff about music and did a Shoe of the Day post on my other blog , probably talked about owls or Leveson…whatever. It helped. It distracted me.

In this way Twitter, and the members of its social networking family, has been instrumental in keeping me sane over the last few months.

You see a large part of my problem is social anxiety, an inability to deal with day to day interactions. So on days when I can’t face talking to the woman on the till in Sainsburys or picking up the phone, even to my best friend, being able to merrily chat to people makes it all the easier to feel normal and connected with the rest of the normal world.

Twitter has even led to new friends – people I’ve got to know well before having to take the plunge and actually have one of my nonsense red-faced conversations with them. Some I’ve still yet to meet but would consider more than mere acquaintances, others I now regularly spend ‘real’ time with including the concerned friend I mentioned above who despite living just metres away became a ‘tweep’ first before flushing me out of my hole.

I’ve also met other people with bipolar through the web, had conversations with representatives of charities such as Mind and Time To Change and generally learnt more about my condition while also being able to treat it with a degree of honesty I’d shy away from in a face to face conversation.

But most important is the sense of purpose and distraction that social networking can give to a person with mental illness. Pre-Twitter what would one do in the middle of the night warding off a panic attack or fighting insomnia? Now the answer is simple – post ‘can’t sleep. Fucking insomnia!’ and receive three replies from people you sort of know all over the world; ‘me too, need…more…sleeping pills’, ‘try getting up for half hour & trying again’, ‘get off your iPhone then you dozy cow!’ etc…

Or even better are those moments when you engage yourself in a conversation about something entirely unrelated. I’ve distracted myself on numerous occasions debating the relative merits of cats and dogs, discussing international bacon festivals and naming the fourteen top moustaches of the twentieth century. All conversations I’m pretty sure busy real life friends and family don’t want to be pulled out of work for but that there’s invariably an American/home worker/abuser of lax office internet policy available for.

Whatever its faults – and it has ever so many – I think that social networking has probably saved a life or two. It’s undoubtedly saved my sanity more than once. Not only that but without Twitter where would I find an captive audience for the tale of running out of shower gel and using my son’s Ben 10 Foaming Alien Slime to wash with?

Exactly.