"You'll have to come in to the surgery for that"

How often do you hear this and how do you respond?

Just yesterday I was told I would HAVE to go in to the office for a therapy type offer (not for ME) which involves no exam or physical contact whatsoever, and I am 99% sure they were using it as an excuse to put me off because they have been declining my request for years and I'm being very persistent now and asking for a formal refusal in writing explaining what I need and why I can't have it.

I said "well what do you usually do for people with less mobility, are they not able to access your service?". She said she'd find out.

Recently the same service wanted me to collect a handwritten prescription, which they ended up sending somebody to drop off on their way home, after two conversations.

I always challenge this even if I feel I might be able to make it in, because every service needs to learn to make these accommodations. Just wondering how everybody else responds and deals with these situations and how often they become a barrier to getting the service, or whether it has been used to put you off pursuing help?

 

I remember back in 2009 when I was mostly housebound I phoned my GP to ask for a home visit, he said "You've only got CFS, you can't be that ill".

 

Until covid happened, here in BC where I live all appointments had to be in office. They did not offer phone or video appointments, email was never an option and it's been decades since doctors did home visits. Either you come into the office or go to the ER. I'm hoping that now that we have the option of phone appointments that it will remain post-covid. Already they are limiting phone appointments to after 4:00 pm and the office shuts at 5:00.

 

The only time i ever had a home visit was for an infection post major surgery, and that was 25yrs ago. I never tried since though tbh, i'm certain i wouldnt get it.

my GP surgery is still offering only phone appointments. You book a call (sometime on a particular day -you are not given a time it's just 'when it suits the doctor'), then IF they deem it necessary they will call you in to see them face to face - whereupon you are just supposed to hightail it down to the surgery at whatever time it happens to be that they ring you.

The whole thing is set up for doctors' convenience and for healthy people. The idea that you might be too ill to be able to just talk on the phone about something important at any time, waiting by the phone between 8 am & 7 pm, & unable to just magic a carer/friend/family member out of thin air at some point that day if 'The Great Doctorini' should grant you an audience, is inconceivable to them.

Not like im irritated or anything

ETA i do understand they are massively stressed and far too many patients to manage, but i do wish they'd recognise that some of their patients are ill.

 

Here we have to phone to book a phone appointment and we are given a time, just like you would get with an in office appointment.

 

Home visits, to me, by an NHS GP;

When I was a child, probably around 5 or 6, mumps or something.
When I was 17, 'probably a virus' was his diagnosis, actually the result of an overdose (aspirin, but a lot of 'em)

That's it until 2 ish years ago when my GP turned up, unannounced, accompanied by 2 huge plod that it's possible would have required surgery to fit through the door, because I didn't reply to an email.

Seriously.

I have had a consultant from the local hospital just turn up at my home 2, maybe 3, times around 2012, regarding my cognitive issues, but he stopped, saying he'd have to pass me onto 'adult services' as he couldn't help, and they still haven't made contact.

Home visits have been requested on a few occasions, but have always been refused - every home visit I have ever requested has been refused.

NHS GP's do not do home visits, at least for me.

I do not do phones, and am not prepared to do zoom calls to officials (the only person I use zoom with is my sister, and that's under familial pressure, as she was concerned, and wanted more contact, during the pandemic - and 'difficult' to object now)

 

Unless there is a good reason that they need to see you in person there is no excuse really. Way before Covid many healthcare services of all varieties had a mixture of some tel and F2F appointments. Video calling become much more common during the pandemic. There are pros and cons to each method. But all are easy to use and readily available.

No excuses now - patient preference is likely to be appropriate - unless there is good clinical reason to be seen F2F - and for that you really need to be told what that reason is! If this is for therapy/psychotherapy appointment then virtual/tel would be fine for the vast majority of the time, unless there were clear communication needs that could not be met this way or if there were specific risk or other issues that could not be addressed remotely.

It must be irritating for you to meet this resistance. It is a bit odd, tbh. Keep pushing for what you want. You have reasonableness on your side I'm wondering if there is a practice manager that you could speak too? In the UK, that can be helpful. I'm not sure where u r based.

Referring to authority can be helpful. The severity rating scale in the 2021 NICE guidance are clearly written on Page 8:

https://www.nice.org.uk/guidance/ng206

"Mild ME/CFS
People with mild ME/CFS care for themselves and do some light domestic tasks (sometimes needing support) but may have difficulties with mobility. Most are still working or in education, but to do this they have probably stopped all leisure and social pursuits. They often have reduced hours, take days off and use the weekend to cope with the rest of the week.

Moderate ME/CFS
People with moderate ME/CFS have reduced mobility and are restricted in all activities of daily living, although they may have peaks and troughs in their level of symptoms and ability to do activities. They have usually stopped work or education, and need rest periods, often resting in the afternoon for 1 or 2 hours. Their sleep at night is generally poor quality and disturbed.

Severe ME/CFS
People with severe ME/CFS are unable to do any activity for themselves or can carry out minimal daily tasks only (such as face washing or cleaning teeth). They have severe cognitive difficulties and may depend on a wheelchair for mobility. They are often unable to leave the house or have a severe and prolonged after-effect if they do so. They may also spend most of their time in bed and are often extremely sensitive to light and sound.

Very severe ME/CFS
People with very severe ME/CFS are in bed all day and dependent on care. They need help with personal hygiene and eating, and are very sensitive to sensory stimuli. Some people may not be able to swallow and may need to be tube fed."

Perhaps identifying which relates largely to you and letting them know might help to change perceptions.... Also, let them know how you feel about them not knowing... It is there job, but also few have been trained. Clearly telling them how, for example, irritated, frustrated etc you might feel about this, if you haven't already can be a lever along with above info.

Wishing you all the best.

 

Yes I lost all medical access because of that sentiment. This is a few years ago. After several exchanges via phone and email with the Nurse and practice manager they insisted I had to go in and would not do a home visit. It was ridiculous. I lost benefits, yearly checks etc.

I can't tell you the dry humour at finding myself this past year or so on the phone joining my husband up to a local practice and having the opposite argument where he needed to be seen by a Dr and they were insisting on email consultations and then the phone. The system is still a nightmare. I am considering joining up with the same surgery but really don't want to. I've had enough of the bad service, micro (and open) aggressions because of the label ME, the threat always hanging over of getting labelled with a mental health illness because the Dr takes a disliking to you, is ignorant, doesn't like evidence based medicine. It's all appalling.

 

In BC where I am from, pre-covid, the gov't would only pay doctors for in office visits. Therefore doctors stopped phoning patients with test results and no longer did prescription repeats over the phone. And it sounds like the gov't intends on heading back in that direction once covid is no longer a concern like it is today.