Yesterday I had to go to see the GP. It's not that I had taken ill over the weekend but because I needed a Doctors certificate and they no longer issue them in hospitals. So I had just spent 4 weeks in a hospital, seeing three Doctors regularly on the ward who are specialists in their field and my illness but had to get my GP to assess how long I was likely to need off work even though she had to ask me what I operation I had just had! Crazy. They don't even issue you the yellow certificate anymore that proves you've been an in-patient hospital and what you've had done.
All you get given now is a 'discharge summary', usually typed up by the most junior Doctor who hasn't always been responsible for your care and usually has to read your notes before he can tick the right boxes on the forms. On my most recent one they had gotten my medications wrong and only noticed when I pointed it out and on the one last October to the question 'Has an operation been performed?' they put 'No' (probably selected from a drop down list!). If I hadn't had an operation last summer I wonder how I managed to get a scar that runs the entire length of my torso, or what I had been doing for 6 weeks on the surgical ward? Having a mini break??
Anyway, back to the GP appointment. The GP I saw was one of the nicer ones (I refuse to go to the one that accused me of 'misusing or perhaps selling' my liquid morphine...but that's a whole different blog post!). As well as the certificate I also needed her to give me some prescriptions for some medication that I was prescribed in hospital but they didn't have in the hospital pharmacy when I was discharged. One of these medications is a nutrient/calorie liquid that I need for the time being as I am unable to eat. It contains 100 calories per 30ml shot and all the vitamins and minerals that my body needs to keep functioning. I have three of these 30ml shots a day; that's what I was doing in hospital, prescribed by the dietician and consultant.
The GP sits there looking at her screen for ages. Then she looks at me and says "If you're having 3x 30ml a day, then that's a bottle every 2 days." (The bottle is 200ml). "Do you know that one bottle costs £5, so for you to have 3x 30ml a day, that's £2.50 a day. In a month..." I can see her doing the sums in her head. "Do you really need it?"
Er, yes, I bloody do. At the moment the only thing I am able to tolerate eating without pain is eggs and rice. I tried cheese on Sunday/Monday but was in agony so have had to ditch that for the time being. If I'm very lucky I will be able to introduce potatoes later this week but eggs, rice and potatoes is hardly a balanced, healthy diet is it?
"So how long do you think you will need this for?" she asks me. Until I can eat properly again I tell her. It could be weeks, it could be months. Who knows. "Mmmmm" she says. I can still see her mentally totting up how much this could cost. Now I know that the NHS doesn't have a bottomless pit of money and that GPs now have to be mindful of what they prescribe and use the best value medication to treat patients but this is a specialist liquid for people with intestinal failure. People like me. And although it's not cheap, surely it is cheaper to give me the liquid, keep me well and healthy at home rather than me get malnourished and need to go back into hospital? The estimated average cost of an in-patient stay for 24 hours is £500. £2.50 for the liquid or £500 for the hospital bed...you do the maths.
This is the first time I have ever encountered a Doctor discussing the actual cost of the medicine with me as a patient as part of the clinical decision making process. I know for example that the antibiotic I am prescribed for my line infections costs £60 a vial. But I was only told that because the nurse wanted to make sure I didn't drop and smash the glass vials on the way home! Not because she was thinking of not giving me the antibiotic.
The GP did eventually print the prescription for my liquid but if she hadn't then I would be making a complaint and kicking up a right fuss. 'I've paid my taxes and so does my husband' is what I wanted to shout at her...it's not like I sit around on my wall drinking cider every day like you see on Benefits Street...no I've worked whenever I have been well enough (and even when I haven't!). But I didn't say that, I'm too polite to talk to a Doctor like that!
NB x
All you get given now is a 'discharge summary', usually typed up by the most junior Doctor who hasn't always been responsible for your care and usually has to read your notes before he can tick the right boxes on the forms. On my most recent one they had gotten my medications wrong and only noticed when I pointed it out and on the one last October to the question 'Has an operation been performed?' they put 'No' (probably selected from a drop down list!). If I hadn't had an operation last summer I wonder how I managed to get a scar that runs the entire length of my torso, or what I had been doing for 6 weeks on the surgical ward? Having a mini break??
Anyway, back to the GP appointment. The GP I saw was one of the nicer ones (I refuse to go to the one that accused me of 'misusing or perhaps selling' my liquid morphine...but that's a whole different blog post!). As well as the certificate I also needed her to give me some prescriptions for some medication that I was prescribed in hospital but they didn't have in the hospital pharmacy when I was discharged. One of these medications is a nutrient/calorie liquid that I need for the time being as I am unable to eat. It contains 100 calories per 30ml shot and all the vitamins and minerals that my body needs to keep functioning. I have three of these 30ml shots a day; that's what I was doing in hospital, prescribed by the dietician and consultant.
The GP sits there looking at her screen for ages. Then she looks at me and says "If you're having 3x 30ml a day, then that's a bottle every 2 days." (The bottle is 200ml). "Do you know that one bottle costs £5, so for you to have 3x 30ml a day, that's £2.50 a day. In a month..." I can see her doing the sums in her head. "Do you really need it?"
Er, yes, I bloody do. At the moment the only thing I am able to tolerate eating without pain is eggs and rice. I tried cheese on Sunday/Monday but was in agony so have had to ditch that for the time being. If I'm very lucky I will be able to introduce potatoes later this week but eggs, rice and potatoes is hardly a balanced, healthy diet is it?
"So how long do you think you will need this for?" she asks me. Until I can eat properly again I tell her. It could be weeks, it could be months. Who knows. "Mmmmm" she says. I can still see her mentally totting up how much this could cost. Now I know that the NHS doesn't have a bottomless pit of money and that GPs now have to be mindful of what they prescribe and use the best value medication to treat patients but this is a specialist liquid for people with intestinal failure. People like me. And although it's not cheap, surely it is cheaper to give me the liquid, keep me well and healthy at home rather than me get malnourished and need to go back into hospital? The estimated average cost of an in-patient stay for 24 hours is £500. £2.50 for the liquid or £500 for the hospital bed...you do the maths.
This is the first time I have ever encountered a Doctor discussing the actual cost of the medicine with me as a patient as part of the clinical decision making process. I know for example that the antibiotic I am prescribed for my line infections costs £60 a vial. But I was only told that because the nurse wanted to make sure I didn't drop and smash the glass vials on the way home! Not because she was thinking of not giving me the antibiotic.
The GP did eventually print the prescription for my liquid but if she hadn't then I would be making a complaint and kicking up a right fuss. 'I've paid my taxes and so does my husband' is what I wanted to shout at her...it's not like I sit around on my wall drinking cider every day like you see on Benefits Street...no I've worked whenever I have been well enough (and even when I haven't!). But I didn't say that, I'm too polite to talk to a Doctor like that!
NB x
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