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Poor GP performance

User
Posted 30 Oct 2014 at 11:16

Hi to all

Does your GP have anyone who specialises in Men’s Health? Most practices have Well Women Clinic's but my GP didn't even have a doctor who specialised in this area.

I was diagnosed with PC in July and am currently undergoing Chemo. Unfortunately I had to visit my GP 4 times and still didn't have a diagnosis. I was 48 at the time so maybe that’s why they didn't check.

On my first visit there was no discussion of PC despite telling her that my father had the disease. However on my second visit to the GP I did have a Digital Rectal Examination, but it wasn't thorough enough. (Finger was in for about 2 seconds and I felt nothing). I also had a blood test and my PSA level was normal. Then on my third visit I was told I definitely didn't have cancer and tha I probably
had prostatitis. At least this time a non-urgent with an urologist was made. I was in ever increasing pain so after a fourth visit to my GP they recommended I went to A & E to check for urinary stones.

It was only after I went to A & E that I finally saw a Urologist who made the correct diagnosis organised the Scans and biopsy that I needed.

I think as part of this campaign we need to press for every GP practice to have a doctor/nurse with experience in this area.

DEJ249



 

 

User
Posted 30 Oct 2014 at 13:19

I too had problems at my GPs. When I went for my mot, I asked what my PSA was and was told 4 to which I replied that it had changed as it was normally 2 The nurse insisted that it was not a problem as it was still within limits. I was not happy and had a doctors' appointment and a repeat PSA read 4.8. A rectal examination revealed a prostate that was hard on one  side. I got an appointment with a urologists in seven day where I was referred for a biopsy. The biopsy revealed a Gleason score of 9. The usual bone scan and mri scan followed and I was relieved to find the tumor was still within the prostate. Had I followed the advice of the nurse I would have been walking around with this tumor for a further year before another PSA check. What would the the result then have been? As an aside, I take Finasteride following a previous diagnosis of an enlarged prostate which meant that my reading of 4.8 should have been read as 9.6. My doctor didn't know this.

User
Posted 30 Oct 2014 at 17:59

I didn't have problem with GPs , it was. The nurse who was taking blood sample she questioned if it was necessary and as I was seeing the GP for something else to ask him ,I told her to get on with it good job I did otherwise as showing no symptoms I would be still unchecked.

User
Posted 30 Oct 2014 at 18:44

I had a PSA test along with some other tests , it was not until three years later that it was discovered that the reading was 6.9. I still wonder how much better my outcome would have been if the prostate removal had been done three years earlier.

Thanks Chris

 

User
Posted 31 Oct 2014 at 16:03

It was a young locum who after the finger test started the ball rolling with a PSA test and referral which did it for me.

I say young, everyone who I saw was younger than me,strange innit I'm only 57.

User
Posted 31 Oct 2014 at 16:39

My GP basically talked me out of having a PSA blood test a couple of years ago......http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-frown.gif

It was only when I went back to see him earlier  this year and asked for an 'MOT' that a raised PSA level was found..... all the other blood results  were normal....

It was purely by chance that I decided ask for the MOT as my original visit was for an arthritic knee that was troubling me...

So no thanks to him that my PCa was detected at that time.....

Needless to say I lost all confidence in him and have changed to another GP now....

User
Posted 31 Oct 2014 at 20:51

I was exactly the same as BarryM

It was a young locum who after the finger test started the ball rolling with a PSA test and referral which did it for me.

I am also 57 and have since met many men with Prostate Cancer who are younger than me,and even two at 46 and 43 who have it.

User
Posted 31 Oct 2014 at 23:50

My GP suggested whilst taking blood for another problem that it was PSA tested - only wish he had suggested this previously.

There is an article in today's Daily Mail that highlights figures showing that cancer survival rates for some cancers are getting worse and that even where there is an improvement (as for Prostate Cancer), England is still well behind France, Germany and Scandinavia in it's survival rates. This has been partly blamed on GPs missing warning signs and patients not making an appointment when they first experience symptoms. For Prostate Cancer the best survival rates were in Austria and Finland. (Wasn't it in part of Austria a few years back there was a PSA screening that all men of a certain age were expected to have as an experiment? Maybe this has led to more men being screened over time there).

It was said that over the summer, Health Secretary Jeremy Hunt pledged to name and shame GPs who miss cancer (by listing them) on the NHS Choices web-site. He wants surgeries which don't send patients urgently for scans to be flagged up quickly. This sounds good but wasn't it not so long ago that GPs were being discouraged from sending so many patients for scans due to cost and overloading medical facilities?


9

Barry
User
Posted 01 Nov 2014 at 09:46

I don't suppose it will be long before the DoH offer the GP'S a financial incentive to dx cancer. After all they do work for a pittance

Bri

User
Posted 01 Nov 2014 at 11:48
Didn't realise until recently GP practices are run as a private business, and are not run by the NHS, no wonder they don't like these extra tests, as it will affect their bottom line, pity they didn't check my bottom when I ask.Or am I being cynical?

Roy

User
Posted 01 Nov 2014 at 12:16

Originally Posted by: Online Community Member
Didn't realise until recently GP practices are run as a private business, and are not run by the NHS, no wonder they don't like these extra tests, as it will affect their bottom line, pity they didn't check my bottom when I ask.Or am I being cynical?

Roy

My ( ex ) GP never once examined me no matter what I went to see him about......so no chance of him giving me a DRE!

It took all of my efforts to get him to take his head out of the computer screen when he was talking to me...... http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-frown.gif

User
Posted 01 Nov 2014 at 13:51

It's been since the start of CCG'S (Clinical Commissioning Groups) Roy.

I never got offered a PSA test with my GP until he did a DRE to check something else out and I suspect he felt something. He then deliberated when it returned a score of 22 thinking the DRE a week earlier had caused it. I took action and went for another PSA and saw another GP who referred me.

Having said all that I have a good relationship with my GP. The one who deliberated has since told me I probably know more about PCa than he does. They also prescribe what I need eg cialis, pump etc with no hesitation

Bri

Edited by member 01 Nov 2014 at 13:52  | Reason: Not specified

User
Posted 01 Nov 2014 at 13:55

Yes, private businesses which explains things like the £55 offer for diagnosing dementia (which will then cost the GP practice money for referrals etc) and some of our members' difficulties in getting vacuum pumps, Cialis and so on - it all comes out of their budgets now.

As an aside, GPs are the only professionals in this country who don't have a legal duty to deal with child abuse issues which is a significant factor in many of these serious case reviews and child deaths you see in the press. I have been involved in cases where the GP wanted £75 to attend a professionals' meeting where child abuse had been discovered and refused to be involved when there was no payment. I suspect Bri has also come across this problem in the adult sector.

It is shocking but I don't think we should blame the GPs .... it is successive governments that have created a health marketplace.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 01 Nov 2014 at 14:11

From collective experience here we know that quite a number of GPs don't give sufficient consideration to patients. Whist not attempting to excuse GPs, I would point out that the number of patients per doctor in the UK is far more than in countries such as France, Germany and Italy for example, so the workload here is much greater than in those countries and likely explains why the service is not as good as it should be and perhaps deters people from becoming GPs. For sure it's not GPs pay as they they do well nowadays, so much so that foreign doctors come here on temporary assignments to make some extra money.

This bears out the relative shortage of doctors in the UK :- http://www.telegraph.co.uk/health/10550335/UK-has-fewer-doctors-per-person-than-Bulgaria-and-Estonia.html

Edited by member 01 Nov 2014 at 18:03  | Reason: Not specified

Barry
User
Posted 01 Nov 2014 at 14:16
The only problem is that our life is in their hands and if you can't trust your doctor to make the right call without money coming into the equation then what chance have we got. Like any service, if you have a bad experience more than once vote with your feet.

Roy

User
Posted 01 Nov 2014 at 14:24

I agree with Lyn regarding what successive governments are responsible for.

My gripe has always been with the individual GP's. But as in any industry you will get good and bad.

Yes Lyn we do come across similar problems particularly with attendance at CPA meetings. One thing I have noticed over the last year or so though is that GP's are getting better at making safeguarding referrals....although some way to go yet :(

Bri

User
Posted 06 Nov 2014 at 15:20

Thanks all for taking interest  in this topic. I would of responded earlier but I've been undergoing chemo, which knocks me out for a while.

Not only did my GP fail to perform so did my brothers'.  The explained that there brother and father had PC and that I had the disease but my PSA was normal.  They didn't seem to believe that it was possible to have PC and a normal PSA result. Their GP's reluctantly carried out a DRE, but then went on to recommend just a blood test each year but no DRE.

ARE OUR GP'S EIHTER EMBRASSED OR LACK KNOWLEDGE IN MENS HEALTH.

This made me so angry I emailed the Prime Minister, Deputy Prime Minister, Leader of the Opposition and my local MP.   Suggesting that all GP practise should have a medical practitioner experienced in Men's Health issues.  I at least expect a response from my local MP, but the only response came from the Deputy Prime Minister's office.  No reference was made to my suggestion but the did recommend complaining to NHS England.  (I have done this)

Is ProstateUK trying to raise awareness of the disease with our GP's as well as the General Public.  Quite rightly a lot of work on has been done on Women's Health so that most practices are proactive in this area.  We need to do the same for Men's Health. 

DEJ249 

 

User
Posted 07 Nov 2014 at 09:46

It does seem that GP's need more training in recognising and investigating possible PC. My experience was much the same as those above. A general reluctance by my GP to test or examine, to be fair though I didn't have any major issues, in terms of peeing etc. I just felt unwell. As above it was a Locum who asked if I had ever had a PSA test, it came back as 4.7 but he subsequently carried out a DRE and then referred me for a biopsy. That was 2 years ago. Since then I cannot fault the system, 3 monthly PSA tests, further biopsy in July, radical prostatectomy 9 days ago.Histology results in around 3 weeks but feeling optimistic. I am so grateful to that Locum.

 
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