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My G.P is dangerously useless Watch

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    (Original post by MENDACIUM)
    Well, if I go into medical school and am taught to not know of basic conditions like SVT which my patients ask me to explain, to not show them respect, to tell them to go away, to misdiagnose them, to not give them support, to seem disinterested, to not admit making mistakes, then I sure will be surprised.
    What support are you after? Maybe if you told your GP what support you need, they might be able to point you in the right direction?
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    (Original post by Mushi_master)
    The number of people who present to their GP after experiencing a simple faint (or following a few of them) is phenomenal. The vast majority of these patients will infact have no physical diagnosis, and the cause will often be anxiety or simply skipping breakfast. To distinguish between those with this problem and those who need a tilt-table test is incredibly difficult, and would generally require multiple or unusual presentations of the same problem, and even then the majority of tests will be normal (or infact demonstrate an anxiety phenomenon).

    In short, I'm glad you have a diagnosis and I'm sorry it took a while, but this is in no way suggestive of the GP's incompetence and in no way a story that you can use as an example of how bad a few doctors are, and you certainly can't generalise from an exceptionally unusual and difficult example.
    It actually is more serious than this. I agree there are many common conditions, and it is subjective, although I disagree it is that subjective. Sometimes it is the illness causing the anxiety, and no the anxiety being the illness. If I break a leg, I'll definitely show anxiety - but I have a broken leg, not anxiety!
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    (Original post by OU Student)
    What support are you after? Maybe if you told your GP what support you need, they might be able to point you in the right direction?
    I asked the G.P to tell me what SVT was. They had no idea. I asked them to tell me about POTS and to help me find ways to cope. They just put me on beta blockers! On the internet, on well established websites, I self-taught myself techniques , things to buy, adjustments to perform in my diet. A lot of G.P's are getting away with the old 'antibiotics, refer' method. It's a dog eat dog world. If someone wants treatment, they are going to have to fight for it.
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    The GMC are there for a reason, report anyone you feel is incompetent.

    If you feel you have been wronged there are hundreds of lawyers who will snap your hand off to get a shot at hauling said doctor through court and getting you some compensation (though clin neg comp isn't great you can still get a few grand with a half decent brief).
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    wow...dude youre being a tad harsh...i googled POTS and even on wiki it says that the symptoms overlap considerably with anxiety...and both that and SVT are not life threatening conditions. and beta blockers are a legit treatment for them. if youre so concerned about your gps not listening to you...maybe tell them exactly what you think/want so they can then explain to you what they think. doctors arent magicians, they dont know what youre thinking. and by you seeing them so frequently about a not very serious condition, im honestly not surprised they just diagnosed you with anxiety.
    hopefully once you get more into med school youll realise this, and when youre a gp or whatever youll be on the receiving end of some kid who thinks he knows better than you.
    im not trying to be mean, or antagonise you... but you just need to put your experience into the scope of things and see its really not that bad.
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    (Original post by MENDACIUM)
    It actually is more serious than this. I agree there are many common conditions, and it is subjective, although I disagree it is that subjective. Sometimes it is the illness causing the anxiety, and no the anxiety being the illness. If I break a leg, I'll definitely show anxiety - but I have a broken leg, not anxiety!
    I am fully aware of its implications and that seriousness. I did not say it was subjective, just that it can look a hell of a lot like anxiety induced syncope, and am fully educated on the causal relationship of anxiety and disease. However, often anxiety is the disease itself - much more common and likely a diagnosis than POTS.

    Don't try to claim superior knowledge as a medical applicant, you'll only make yourself appear arrogant. Especially when its not disproving what's been said already.
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    (Original post by MENDACIUM)
    I asked the G.P to tell me what SVT was. They had no idea. I asked them to tell me about POTS and to help me find ways to cope. They just put me on beta blockers! On the internet, on well established websites, I self-taught myself techniques , things to buy, adjustments to perform in my diet. A lot of G.P's are getting away with the old 'antibiotics, refer' method. It's a dog eat dog world. If someone wants treatment, they are going to have to fight for it.
    Have to be a troll. Self-taught techniques? You've fallen into a world of hokum medicine and I have one question. Care for salt with that chip on your shoulder?
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    (Original post by POWCATTY)
    wow...dude youre being a tad harsh...i googled POTS and even on wiki it says that the symptoms overlap considerably with anxiety...and both that and SVT are not life threatening conditions. and beta blockers are a legit treatment for them. if youre so concerned about your gps not listening to you...maybe tell them exactly what you think/want so they can then explain to you what they think. doctors arent magicians, they dont know what youre thinking. and by you seeing them so frequently about a not very serious condition, im honestly not surprised they just diagnosed you with anxiety.
    hopefully once you get more into med school youll realise this, and when youre a gp or whatever youll be on the receiving end of some kid who thinks he knows better than you.
    im not trying to be mean, or antagonise you... but you just need to put your experience into the scope of things and see its really not that bad.
    I am talking about the rude-ness which with I was dealt with. I had exercise intolerance out of the blue, rapid heart beats that just switched on, and not a single doctor thought : "so what illnesses give someone these symptoms". Not a single doctor even tried to give me the correct tests either, until two years had passed. Would it be hard to have given me a treadmill test, which would have shown my heart rising rapidly and my blood pressure lowering, explicitly after - for a year or so- I asked for a treadmill test and vividly explained in extreme detail all the symptoms ? Or would it be better - as the doctors did- to say I am making it all up and that I should stop coming to the surgery? What about the lack of apology when they were wrong?
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    (Original post by Mushi_master)
    I am fully aware of its implications and that seriousness. I did not say it was subjective, just that it can look a hell of a lot like anxiety induced syncope, and am fully educated on the causal relationship of anxiety and disease. However, often anxiety is the disease itself - much more common and likely a diagnosis than POTS.

    Don't try to claim superior knowledge as a medical applicant, you'll only make yourself appear arrogant. Especially when its not disproving what's been said already.
    I do not claim any knowledge as a medical applicant, but I do claim knowledge having been a patient , and know my illness better than the average person, having done quite a lot of research. I specifically told the doctor I had exercise intolerance. Is it anxiety when you are able to run marathons and play football any time of the day, and suddenly you can't even run without your pulse rising rapidly? Would it have taken two years to refer me for a treadmill test?
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    (Original post by Rooster523)
    Have to be a troll. Self-taught techniques? You've fallen into a world of hokum medicine and I have one question. Care for salt with that chip on your shoulder?
    Yes, self taught techniques. The doctors did not know about POTS, could not tell me how to deal with it, and I found a medically approved website online made by doctors who did give me the information, so I just learned it by myself. Now, the question is , if a G.P can not do a simple job like this, what is their purpose?
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    (Original post by MENDACIUM)
    Yes, self taught techniques. The doctors did not know about POTS, could not tell me how to deal with it, and I found a medically approved website online made by doctors who did give me the information, so I just learned it by myself. Now, the question is , if a G.P can not do a simple job like this, what is their purpose?
    They 100% would have done.

    Just nobody calls it 'POTS'.

    I've never heard it called that, but I've seen numerous patients with it, and diagnosed with it - or the equivalent - by GPs.

    Equally, SVT isn't a diagnosis - its a collection of different possible electrical rhythms, some of which are diagnoses, and some of which are merely pointers towards a whole other list of aetiological causes.


    GPs have an extremely difficult role, you will learn about it when you're at med school, assuming you're not a troll. Some are bad, the vast majority are very good.
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    (Original post by hslt)
    They 100% would have done.

    Just nobody calls it 'POTS'.

    I've never heard it called that, but I've seen numerous patients with it, and diagnosed with it - or the equivalent - by GPs.

    Equally, SVT isn't a diagnosis - its a collection of different possible electrical rhythms, some of which are diagnoses, and some of which are merely pointers towards a whole other list of aetiological causes.


    GPs have an extremely difficult role, you will learn about it when you're at med school, assuming you're not a troll. Some are bad, the vast majority are very good.
    http://www.potsuk.org/ The full name is Postural orthostatic tachycardia syndrome "

    Instead of reciting that, most people call it by "POTS". Thanks for the reply. I do understand G.P's have a difficult role, but not being able to tell me what POTS is, and not even being able to direct me to information is certainly alarming. If I ever make it, i'll be pushing for more doctor accountability. Infact, that's exactly what the government are doing - so this really is a nation-wide problem. I am going to speak to my Dr about the SVT, although he barely knows what it is and the consultant could barely tell me anything.
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    (Original post by MENDACIUM)
    http://www.potsuk.org/ The full name is Postural orthostatic tachycardia syndrome "

    Instead of reciting that, most people call it by "POTS". Thanks for the reply. I do understand G.P's have a difficult role, but not being able to tell me what POTS is, and not even being able to direct me to information is certainly alarming. If I ever make it, i'll be pushing for more doctor accountability. Infact, that's exactly what the government are doing - so this really is a nation-wide problem. I am going to speak to my Dr about the SVT, although he barely knows what it is and the consultant could barely tell me anything.
    A GP doesn't need to need to know the name of every rare disorder under the sun - this is why we have specialists. Even then I've come across specialists coming across a disorder they've never heard of before.

    So get off your high horse and stop judging what a GP should and shouldn't know. It's very likely many, many doctors have not come across the disorder in the clinic or even in a textbook (it certainly won't be core examinable material).

    You need to rectify this attitude if you want to go to med school, otherwise you're in for a mighty shock.
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    (Original post by MENDACIUM)
    I am talking about the rude-ness which with I was dealt with. I had exercise intolerance out of the blue, rapid heart beats that just switched on, and not a single doctor thought : "so what illnesses give someone these symptoms". Not a single doctor even tried to give me the correct tests either, until two years had passed. Would it be hard to have given me a treadmill test, which would have shown my heart rising rapidly and my blood pressure lowering, explicitly after - for a year or so- I asked for a treadmill test and vividly explained in extreme detail all the symptoms ? Or would it be better - as the doctors did- to say I am making it all up and that I should stop coming to the surgery? What about the lack of apology when they were wrong?
    Many doctors won't automatically know you've got a particular illness, therefore, wouldn't always do the tests for that particular diagnosis.

    9 years ago, my dad fell down a flight of stairs at work and ended up with a few injuries. He had an ECG and was told to stop smoking and was banned from driving because they could find nothing wrong with him. 7 months later, he had an episode at home where he struggled to breathe, appeared to clutch his chest and was making some strange noises. He was then given an MRI and 2 EEGs, which showed that he had epilepsy.

    I've had similar. My parents were told for years (I was told this too when I asked) that there was no reason for me to have an eye condition I have. Some research I did suggested that some people have no other issue. A few years ago, I had a routine eye test done and the consultant discovered that I had a problem with my optic discs. He asked me to see him again where he did a test for tunnel vision, colour blindness and checked my eye pressure. He then looked at the back of my eyes again and was able to make a diagnosis. I have to admit that I am shocked that over 20 years, no-one had seen that my optic discs are white.

    Because there are many causes, (and no cause in some cases) no-one had tried certain things on me.
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    (Original post by MENDACIUM)
    http://www.potsuk.org/ The full name is Postural orthostatic tachycardia syndrome "

    Instead of reciting that, most people call it by "POTS". Thanks for the reply. I do understand G.P's have a difficult role, but not being able to tell me what POTS is, and not even being able to direct me to information is certainly alarming. If I ever make it, i'll be pushing for more doctor accountability. Infact, that's exactly what the government are doing - so this really is a nation-wide problem. I am going to speak to my Dr about the SVT, although he barely knows what it is and the consultant could barely tell me anything.
    It's not in Robbins, its not in Kumar and Clark, its not in the Oxford handbook, etcetcetc (that i can see). These are some of the major general reference books. I am therefore completely understanding of why GPs don't know it, and not at all alarmed by it.

    What is there is postural hypotension, otherwise called orthostatic hypotension - which is essentially the same thing, but defined by different parameters - blood pressure not heart rate, but the two are linked and it isn't the tachycardia that produces the fainting and dizzyness and the rest of your symptoms (except the palpitations). All the other symptoms are from hypotension.


    You'll be pushing for more doctor accountability? Doctors are acountable for all of their actions as it is, as you will soon learn - if you wish to make a complaint they will be held accountable. If you do not make a complaint, then how will anybody know that they may/may not have a case to answer?
    - if it bothers you that much then complain and let the doctor explain themselves to you, and apologise if necessary.

    EDIT - interestingly there has to be an absence of orthostatic hypotension, so I'm wrong about it being the same. Nonetheless, skimming through I couldn't find POTS in my text books, and it's definitely not material we're expected to know. Perhaps you should campaign for more disease awareness rather than asking doctors to know unknown hard to find diseases?
    I also note that you say the GP gave you B blockers, which are an appropriate treatment for 'POTS', while they wouldn't be appropriate, or rather would be contraindicated for postural hypotension. Perhaps the GP DID know what they were doing?
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    (Original post by MENDACIUM)
    There is literally no arrogance in me with regards to this issue. 20% of doctors i shadowed were brilliant. The fact is the majority of doctors (literally) were terrible.

    I'll name what they've done:

    > Hid a diagnosis from me, when i was 16 and competent.
    > Misdiagnoised me so many times
    > Started to use religion to patronise me
    > Told me to stop coming to the surgery, and then later acknowledged they mis-diagnosed me
    > An ENT consultant who i was referred to barely made any checks and was laughing at me, until we pushed him to actually help us.
    > Can't even tell me what SVT is, can't give me any help information and support.



    Clearly i am not trying to paint them all with one brush, but if you read the news, you'll see that negligence and incompetence, especially by G.P's is a growing issue in the NHS. There have even been under cover documentaries.

    We need to stop giving doctors immunity from their actions and start making them more accountable.

    So it is far from arrogance, it's concern, perhaps anger too.
    "An ENT consultant who i was referred to barely made any checks and was laughing at me, until we pushed him to actually help us."

    What were you seeing ENT for and what checks did they not do? [curious]
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    (Original post by MENDACIUM)
    http://www.potsuk.org/ The full name is Postural orthostatic tachycardia syndrome "

    Instead of reciting that, most people call it by "POTS". Thanks for the reply. I do understand G.P's have a difficult role, but not being able to tell me what POTS is, and not even being able to direct me to information is certainly alarming. If I ever make it, i'll be pushing for more doctor accountability. Infact, that's exactly what the government are doing - so this really is a nation-wide problem. I am going to speak to my Dr about the SVT, although he barely knows what it is and the consultant could barely tell me anything.
    POTS is a relatively new 'disease' invention which didn't exist when i was in medical school (so less than 10 years old). It is a diagnosis generally made only by cardiologists and frequently on the basis of guesswork only and ruling out other things.

    curious about the svt diagnosis - was that proven with a trip to A&E or on a 24 hour cardiac tape..?

    As for a GP not knowing what SVT is. Thats is a whole different matter and would be concerning lack of knowledge.
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    If one of your patients presents with sudden exercise intolerance, rapid heart beats upon exercise, after having a history of partaking in sport quite frequently, would you not send them for a treadmill test? Even if for two years they specifically mentioned extreme exercise intolerance? + It was my consultant who gave me beta blockers, my G.P showed me very little respect. I asked for a treadmill test for two years, and they refused, despite me explicitly stating that I had exercise intolerance that was abnormal. POTS is not a new disease,although it's formal name has only been in existence since the mid 90's. A lot of the G.P's I had were very irresponsible in my view. This is probably not a reflection of all doctors, but like I have always said, even a minority of bad doctors partaking in un-safe treatment is a minority too far.
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    (Original post by Jamie)
    POTS is a relatively new 'disease' invention which didn't exist when i was in medical school (so less than 10 years old). It is a diagnosis generally made only by cardiologists and frequently on the basis of guesswork only and ruling out other things.

    curious about the svt diagnosis - was that proven with a trip to A&E or on a 24 hour cardiac tape..?

    As for a GP not knowing what SVT is. Thats is a whole different matter and would be concerning lack of knowledge.
    When I told the G.P that I got rapid heart beats absolutely suddenly , they blamed it on anxiety. I specifically told them there was no anxiety there, and that these beats were much much faster than my normal beats and they did not even feel like there was a break between them. I even self-diagnosed myself with SVT OR VT (didn't know which one. I assume SVT as it's harmless according to what the consultant later told me, and I could gather that because I've had it frequently(20 times in my life). I had to phone A and E and get them to give me and ECG when it happened. Now, I don't expect the doctor to by a psychic, but instead of telling me it's all in my mind , can doctor not fathom that maybe there is an illness there, and the illness causes the anxiety, and not the other way around, especially if a boy goes from being sporty to almost unable to walk (as I was back then when I just had POTS). The consultant even tried NOT to give me tests until I made it clear I wanted them. The G.P had influenced her by telling her I had 'anxiety'. It's dangerous to be fair. I would have suffered without help or support if they could not bother to give me the right tests after explicit descriptions of my own illness.
    And yes, the doctor neither knew what POTS was not SVT in the sense of explaining it to me, giving me information, telling me how I can cope with it. I welcome any of the recent NHS reforms which force doctors - ALL of them- to be more competent. POTS is around 10-15 years old in terms of being a formal diagnosis. My only problem is , why on earth did it take the doctors so long to give a boy who explicitly told them he had extreme exercise intolerance, his heart raced upon minimal exercise, to give him a test that would actually diagnose problems like that? I.E a treadmill test (which definitely helped the diagnosis). I even had one rude doctor in A and E shouting at me telling me I am just an anxious boy and he had other patients.
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    (Original post by hslt)
    It's not in Robbins, its not in Kumar and Clark, its not in the Oxford handbook, etcetcetc (that i can see). These are some of the major general reference books. I am therefore completely understanding of why GPs don't know it, and not at all alarmed by it.

    What is there is postural hypotension, otherwise called orthostatic hypotension - which is essentially the same thing, but defined by different parameters - blood pressure not heart rate, but the two are linked and it isn't the tachycardia that produces the fainting and dizzyness and the rest of your symptoms (except the palpitations). All the other symptoms are from hypotension.


    You'll be pushing for more doctor accountability? Doctors are acountable for all of their actions as it is, as you will soon learn - if you wish to make a complaint they will be held accountable. If you do not make a complaint, then how will anybody know that they may/may not have a case to answer?
    - if it bothers you that much then complain and let the doctor explain themselves to you, and apologise if necessary.

    EDIT - interestingly there has to be an absence of orthostatic hypotension, so I'm wrong about it being the same. Nonetheless, skimming through I couldn't find POTS in my text books, and it's definitely not material we're expected to know. Perhaps you should campaign for more disease awareness rather than asking doctors to know unknown hard to find diseases?
    I also note that you say the GP gave you B blockers, which are an appropriate treatment for 'POTS', while they wouldn't be appropriate, or rather would be contraindicated for postural hypotension. Perhaps the GP DID know what they were doing?
    The consultant prescribed them to me. The G.P on the other hand, spent two odd years giving me on and off anti-biotics. I even went to the other G.P's in the surgery, and not to my surprise, even they began with giving anti-biotics. As if there are no other illnesses from the plethora of possible illnesses that maybe require a little bit of time to investigate and diagnose.
 
 
 
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