Can anyone review this letter of complaint for me?

[Energize]

Is the social anxiety is only mild?

At least you have a friend unlike those with severe social anxiety.

It was very severe to the point of reclusiveness, and not even being able to make phone calls, but after leaving uni and with the help of local mental health meet up groups and possibly cbt, alongside the use of pro-social substances I have made very big improvements to the point of looking for work, but the funding combined with the poor sourcing of medications in the NHS and UK pharmacy sector makes normal antidepressant treatment not much of an option; for treatment refractory depression/anxiety, MAOI's are used and often they must be used in very high doses (you can't do this with many 1st like safer drugs because they manifest dangerous side effects), in the range of 6x the dose I'm on anyway and that could cost up to £1,000 per month for a generic medication. If the NHS infrastructure were altered so that they manufactured their own generics huge savings could be made, drug costs could be massively reduced, but they don't for some reason.

What version of the BNF are you referring to?

The online version.

Isn't it amazing how you know better than these qualified medical professionals.

Not really, they're GP's.

Letter updated anyway with a more toned down version. Thanks very much for the ~3 of you that bothered to read it with proper consideration and didn't spout hysterical nonsense or troll.

 

[IronWarrior]

Next time I need some drugs advice, I will need to speak to Enegize first since he knows more about drugs then GP's do and all from his "personal" experience and "wiki"

LOL

 

[Energize]

Next time I need some drugs advice, I will need to speak to Enegize first since he knows more about drugs then GP's do and all from his "personal" experience and "wiki"

LOL

Actually I prefer Rang and Dales textbook for general drugs, "Neuropsychopharmacology: 5th generation of Progress" also makes for good reading. Wiki is ok in a pinch though.

 

[frosty03]

"I say this because my physiotherapist said that my injuries were more severe than simply “sore muscles” and that I may have torn ligaments in my neck (private MRI results pending)"

Which "ligaments" in the "neck" would the physio be eluding to? This statement alone will ring alarm bells, in that if it is indeed what the physio did say, points to a clear lack of knowledge and overstepping of boundaries by the physio. Has it occured that the physio may be pushing you too hard too fast, hence the discomfort and pain? Why do you assume that the physio is right and the GP is wrong? If you step back and presume the converse, the things might just make sense?

As for your pain management, the letter does sound a lot like you're a drug seeker wanting more opiates. Sorry to say that, but that's what it reads like.

 

[Energize]

Who pays £500 for an MRI to score a few buprenorphine patches though?

The physio has only done relatively light therapy like massage type stuff for <20mins, she hasn't been walking on my back, how much less can she do?

She didn't specifically allude to any ligament as I recall, I think what she said was more based on her experience of treating victims of such severe impacts as myself, maybe as a precautionary measure.

I will probably end up sending the letter after MRI results are back anyway due to my compulsive editing. Or I may see the practice manager in person because I can explain things better.

You have brought up about an important issue though about GP and physio communication that I forgot to bring up in the letter, the GP should be liaising with other professionals treating me after my requests to him.

 

[Dr House]

So what is your end game to all of this?

Are you looking for compensation? if so do you have a number in mind?

 

[Energize]

So what is your end game to all of this?

Are you looking for compensation? if so do you have a number in mind?

Compensation for what, not being prescribed strong enough painkillers? No.

An apology would be nice, along with an explanation of why they decided to leave a car accident victim in severe pain effectively untreated for 2 weeks, and hopefully measures put in place to stop another poor soul being put in my position.

A couple of key points I read regarding NHS analgesia protocols that seemed relevant here though.

It is vital that in the absence of a diagnosis analgesia is not withheld
Treat according to pain score not your perception of how bad the pain should be.

It certainly seems that protocol was not followed, if they aren't following their own guidelines what good is that?

 

[ince]

Pathetic you must be after something for nothing.

 

[Destination]

Lol
Treat according to pain score
Give the chap strong opoids because he wants them, and has spent ages researching his drugs and doesnt want antiinflammatories for inflammatory damage.

 

[stockhausen]

... A couple of key points I read regarding NHS analgesia protocols that seemed relevant here though.

It is vital that in the absence of a diagnosis analgesia is not withheld
Treat according to pain score not your perception of how bad the pain should be.

It certainly seems that protocol was not followed, if they aren't following their own guidelines what good is that?

Paracetamol and Ibuprofen are both described as analgesics; Ibuprofen has the added advantage that it is an anti-inflammatory so I don't think you will get anywhere by claiming that analgesics were withheld and NHS "recommended guidelines" were not followed. Your stance all along is that the GPs used their medical knowledge rather than your layman's interest in stronger analgesics to decide on a course of action. Based on what you have written here, I suspect that ANY GP would be VERY suspicious of any description of the level of pain and suffering you offered. It may well be that your long-term history in the GP's notes simply adds to this scepticism.

... An apology would be nice ...

I have no doubt that if you post your letter of complaint you will get a sincere apology that you feel dissatisfied with the service you have received.

... an explanation of why they decided to leave a car accident victim in severe pain effectively untreated for 2 weeks ....

Dream on pal.

... and hopefully measures put in place to stop another poor soul being put in my position. ...

Sadly, patients like you are all too common; patients who believe that every ailment can be treated and that it is just the wicked, selfish, lazy, greedy, poorly trained GPs who are denying them effective treatment. "Care in the community", inadequacy and the breakdown of society have simply pushed more and more of these people into GP's surgeries where all too often they are treated by having pharmaceutical products thrown at them willy-nilly.

My doctor has no knowledge of any illegal/non prescription drug use ... it shows how good I am at not abusing medications.

Dear, merciful God


Now, this is probably the only interesting / sensible thing you have posted in this entire thread:

... Many drugs are not licensed due to economic reasons like patents expiring ...

Do you have a credible basis for this assertion? It would make interesting reading


You give no indication as to where you live, is there more than one GP surgery in your area? If so, why don't you move to a different practice where the new GPs can break the monotony of their dull days by discovering that you are a hypochondriac with an analgesic dependence?

 

[cyclops12]

The sort of drugs you're after they don't even like prescribing in orthapedic hospitals to patients after a major RTA let alone whiplash.

Sounds like you already made up your mind what pain killers you wanted before you even went to your gp, then because you didn't get what you wanted the toys are out of the pram.

That's the problem with thinking you know better than the doc, as soon as you made your mind up the meds wasn't strong enough... then they weren't!!

You was told to take the correct pain meds for your injury and like i said you wouldn't get much stronger pain meds even as an inpatient.

 

[regulus]

Well I am going with "Doctor knows best"

Yea, I would necessarily go with that. I had 2 kidney stones removed two weeks ago after the doctor at first suggested I might have an STD, despite having recently been tested and showing him my results. And I don't go to doctors, I find them understandably patronising and desensitised due to the large amount of time wasters and hypochondriacs they have to deal with. Haven't been to one for 8 years before the kidney stones. He pretty much wasn't interested in doing anything.

After chucking me some generic antibiotics, I had to go to the A&E a few days later as the pain of a stuck 7mm stone is something to experience. Anyone who had them can tell you that. I was giving 10mg of Morphine and it never helped.

Anyway, none of this is relevant, I'm just saying that Doc doesn't always know best.

However, the OP sound, I don't know, all this medication and medical problems. Sound strange.

 

[Danthus]

Compensation for what, not being prescribed strong enough painkillers? No.

An apology would be nice, along with an explanation of why they decided to leave a car accident victim in severe pain effectively untreated for 2 weeks, and hopefully measures put in place to stop another poor soul being put in my position.

A couple of key points I read regarding NHS analgesia protocols that seemed relevant here though.

It is vital that in the absence of a diagnosis analgesia is not withheld
Treat according to pain score not your perception of how bad the pain should be.

It certainly seems that protocol was not followed, if they aren't following their own guidelines what good is that?

But the doctor did tell you what medication you needed, you just happened to disagree with it.

 

[tom_nieto]

I'm so glad I'm not ever going to be a GP.

Some points in your previous thread made me smell a rat: you said you had chronic back pain for some time before the accident and are now demanding investigation. This reeks of someone looking for compensation from a car accident. Also your attitude regarding pain killers is terrible. I chose to ignore that first thread.

Moving on to this thread: What do you think the GMC are going to do about this letter? How is it going to improve practice exactly? I think you'd be hard pressed to find any GP that would be comfortable prescribing the strong painkillers that you're quoting. These are usually prescribed at chronic pain clinics by specialists. This is your next step rather than stomping your feet in your GP surgery. If you're not happy with your doctor, change them.

Codeine is an opioid.

 

[Pestilence]

Healing hurts. I think it's rather unrealistic to expect them to keep you fully pain-free throughout the entire ordeal. Sure, it sucks, but hey... you said the stronger codeine removed most of the ambient pain but didn't prevent the attacks of stronger pain. Isn't that good enough? Personally I'd probably accept it, believing I'm being reasonable about the situation (as I have done with injury pain in the past) and grit my teeth during the worst.

In terms of the letter, this line:

Unfortunately given the doctors' positions on painkillers it seems I will just have to try and bare it as best I can.

... should use the word "bear", not "bare". You shouldn't be baring anything in front of your GP, unless specifically requested to.

 

[MrMoonX]

The letter reads like some desperate junkie looking to score

 

[Cold_And_Miserable]

It was very severe to the point of reclusiveness, and not even being able to make phone calls, but after leaving uni and with the help of local mental health meet up groups and possibly cbt, alongside the use of pro-social substances I have made very big improvements to the point of looking for work, but the funding combined with the poor sourcing of medications in the NHS and UK pharmacy sector makes normal antidepressant treatment not much of an option; for treatment refractory depression/anxiety, MAOI's are used and often they must be used in very high doses (you can't do this with many 1st like safer drugs because they manifest dangerous side effects), in the range of 6x the dose I'm on anyway and that could cost up to £1,000 per month for a generic medication.

I didn't think the NHS would prescribe MAOI's for social anxiety but it looks like they're more effective than SSRI's. I really should go back on medication.

 

[[FnG]magnolia]

Is this the guy who was buying in drugs from outside the UK and self-prescribing or have I got the wrong chap/forum?

 

[yer_averagejoe]

Having read your letter with an open mind, my over-all impression is that you're trying to prove that you know as much, if not more, about the field of medicine than multiple GPs. When in reality, you've done a little research on the internet and have no actual experience with the treatment options you've suggested. This holier-than-thou attitude is what makes me think the GP isn't even going to make it to the end of your letter.

If it's the GPs' attitudes you're complaining about, that is what you should complain about. Don't bother questioning their reasons for not giving you something stronger as you are not qualified. Did you at any point consider getting your physiotherapist to write a formal request to your GP for stronger painkillers? Did you try a different practice?

Basically, you've gone about this in completely the wrong way. As a patient, you don't get to decide what treatment you get, for fairly obvious reasons. If your physiotherapist required stronger drugs for the treatment he/she was giving you, they should have drawn up a treatment plan with your GP.

 

[PardonTheWait]

Is this the guy who was buying in drugs from outside the UK and self-prescribing or have I got the wrong chap/forum?

You're not allowed to bring that up, when I mentioned it he told me I was being hysterical and trolling his thread