Wasting The Time Of A GP

I’m not aiming to annoy GPs, but the day after the “heart attack in the waiting room” I went to another case where the GP had been less than helpful.

It sounded like one of our ‘crap’ calls – “6 year old female, losing weight, tired”, not what you’d mark down as needing an emergency service.

The ill child did look very thin, and her concerned parents told us that she had been losing weight for the past couple of weeks.  She was lethargic, wasn’t eating well (she was mainly drinking a lot of fizzy drinks) and had been having spells of dizziness.  To my eye the child did look rather unwell.

The father had taken her to the GP earlier in the week, and the GP had told him that he was “wasting his time”, and that the child would soon put the weight back on.  The father asked for the child to be sent to the hospital, and the GP refused this.

We got the child into the ambulance and starting running our tests.

Her pulse was normal, as was her blood pressure and oxygen levels.

Her blood sugar was not normal.  It was above 33.0 mmols (which is, I think, around 660 dg/l).  The normal value is around 5 mmols.

The child is (almost certainly) an undiagnosed diabetic.

In my ‘big book of how to tell what might be wrong with someone’ there are six probable causes for severe long-term weight loss.  They are Malignancy,Depression,Thyrotoxicosis,Uncontrolled Diabetes,Infection and Addison’s disease.  Within minutes of meeting this child for the first time, we had a provisional diagnosis.

It’s not hard to do a blood sugar test in a GP surgery, it takes about 30 seconds.

So why did the GP tell the parent to go away?  Was it because the GP was so busy trying to fill the governments targets?  Or was it the case that the GP considers severe weight loss in six year old girls a ‘phase’ that they will grow out of?

However now I realise why the ambulance service is doing diabetes screening.

This is the last moan I’ll have at GPs for a while now – I’ll see if I can balance it out with a tale of a heroic GP at some point in the near future.

13 thoughts on “Wasting The Time Of A GP”

  1. In 1985 I did something bad to my knee. I heard it crack and an elongated crunching sound and I couldnt move my leg more than a few inches. A local GP said it was rheumatism and sent me for physio. For weeks this went on and I was eventually in such severe pain I took a second opinion. Thankfully the second doctor sent me for tests including an Arthogram X-ray. These tests found a shattered cartilage where it had broken into four pieces and fallen to the back of the knee. This needed an immediate operation. Some medical people need training in common sense.

  2. well, here's a lovely GP report – mine. She's usually running behind schedule but that's because she will take the time needed – if you've popped in for a checkup after six weeks to check that the swelling really has gone down, then you'll be in and out in two minutes, but if you've got a scary diagnosis from the hospital and need half an hour to make sure you understand what that means, what is done next, and where to find out more, then that is what you damn well get.The other thing I like about her is that if there's something she isn't sure of she admits she isn't sure, to your face, and will look it up right there. Recently my neurologist wrote to her with a list of possible obscure medications to try me on. The first one didn't work, so we checked the letter for the next, and she actually *said* “I've never heard of this” and looked it up so she could tell me what it did and so on, as opposed to “I AM DOCTOR! I KNOW ALL!”.

    She also shows me all the letters from the specialists that she gets regarding me so that I know what's going on, which is another thing I appreciate.

    The bad news? She's fully booked up and then some. Even if you're on her patient list, it can sometimes take *weeks* to get a non-emergency appointment with her.

  3. A friend of mine had a similar thing but with a snapped tendon. He spent several weeks in agony before they bothered doing an ultrasound (I think it was) and saw this massive injury. He reckons it took him so much longer to heal after the surgeries and all because the GP assumed he was making a fuss over a sprain.

  4. Still, keep hold of her if you can. She's a rare breed.I worry reading all these things, I've got hypothyroidism and have had a recurring lump on my neck since last october, I went to the doc twice about it and got told to take a nurofen. He put me on a week's antibiotics in the end but it keeps coming back. I daren't go back again, I can't bear that look on his face* when he sees me waddle in. The bane of the NHS, I am.

    *Although it has recently been shown that I miseread looks on faces.

  5. ***Its not hard to do a blood sugar test in a GP surgery, it takes about 30 seconds.


    30 seconds???

    My GP told me that it will take 2 days to get the result if I had a test at the surgery.


  6. Takes about 15 seconds (less, really) to get a blood sugar reading with a meter. It's about half the size of a deck of cards. Maybe they're doing a whole battery of tests? Hard to imagine a clinic wouldn't have a glucose meter available. Still, it's worth waiting two days for, if you don't know.

  7. Ack, sorry. My husband just (very kindly) explained to me that they were probably going to do an A1C (glycohemoglobin test), which they use to find out if you actually had elevated levels of glucose in your blood not just temporarily but long term, which would indicate diabetes. Your GP might be looking to confirm his or her suspicions. Good luck.

  8. To put a positive spin on GP's. I had one GP who probably saved my life twice. The first time was a diagnosis of Guillain Barre Syndrome with an immediate hospital referral, lucky because the following morning I could not stand. And 3 days later was on a respirator. Also after 3 visits to a hospital by me for chest pains and shortness of breath (diagnosed without x-ray as bruised/cracked ribs). He actually decided to use that advanced piece of equipment, a stethascope. Not hearing any sound on the right side of my chest, he sent me for an x-ray. A few months later and still alive but lighter of one 5.5lb malignant tumor, I thanked him personally.

  9. My son had severe long-term weight loss which was put down as psychological by our GP. After 18 months it was discovered that he had a pineal germinona, extremely rare but does give symptoms typical of anorexia and diabetes. Possibly one for the big book of unlikely ailments.

  10. This is shocking. Funnily enough I was at a course today wand a consultant paediatrician was showing us copies of crap referral letters from GPs- and tere was one that read a lot like this patient you saw – along the lines of “this child is drinking a lot, passing a lot of urine and has abdo pain. Please see and treat” No urinalysis. No BM. There's no excuse. Without exception we were all (all of us GPs) cringing and saying that we can't believe there are still people out there like that. It's a sad fact that it is true. Probably more true in cities than elsewhere. But there are some of us who, if not heroic, do a bit better than this at least.

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