Complaining

For those unaware, I am a GP, a General Practitioner. I believe it’s called Family Practitioner elsewhere.

GP’s are known as the gate keepers of the NHS as we tend to see people who are acutely ill or have a chronic illness and manage them in the community and refer them to see a specialist only if we cannot manage them. As such GP’s get to know patients over their life and vice versa.

Due to the nature of this, GP’s are the most complained at profession. Some of the complaints are genuine, often where a doctor has been at fault, but mostly the complaints are petty in nature. I have received complaints.

All hospital specialists and doctors have received a complaint at least once in their lives, although some may not be aware they have, because their bosses have dealt with them.

I suspect because that infertility specialists don’t receive many complaints.

Well last week, E and I attended another difficult infertility consultation and for the first time ever in 5 years, I decided it was time our fertility doctors knew the truth of how I was coping and feeling and how we were coping and feeling. Let’s say she was shocked and didn’t know how to react.

I didn’t shout at her or get physical, I just told her how hard things have been, how I didn’t feel it was working, how I’d lost confidence in the treatment (and her skills, although I did not say this, only implied it), how despite years of treatment, we were no nearer to having a baby than when we started nearly 5 years ago.

What provoked this outburst?

Well I planned to say something. I spoke with E before the consultation and said I would try and say something.

But questions on the day irritated me and provoked my response. Questions such as (paraphrased):

– How are you doing, are you going to an Christmas parties? No we’re not. We don’t get invited to parties with friends with kids because they don’t think of us or don’t want a ‘sad’ couple sitting in the corner surrounded by their kids.
– Why are you so sad? WTF. It’s Christmas. A time for families to come together and kids to open prezzies and think about Santa. We’re currently out of that circle.
– If your upset- have you been to counselling? Yes done that. Even me, a man, went with E recently. Any other ideas? *Awkward silence*
– Oh E, your lining seem thin (when scanning) but you have follicles. – It’s like we’re going round in circles. E does not have a standard 28 day cycle- she is nearer 31-35, so her mid point at ovulation is different. Why do we have to keep on telling her?
– And the worst: E you really should try and lose some weight!- E’s BMI is well within the criteria. She lost an amazing amount of weight at the start of this infertility journey and does fantastically well losing weight when needed, but we both love good food, so our weight fluctuates. The infertility specialist goes on about her weight a lot- almost as if she has nothing else to say. She has said that weight loss would be great, but not essential and without any weight loss, her odd have magically increased from 33% to 38%.

As a specialist who prides herself on being evidence based and attending conferences, she go on about weight loss a lot. She has suggested faddy and ridiculous diets which E has sensibly ignored.

Overweight woman still have babies. And so do underweight, drug addicted, alcoholic some and even women over 40 years age. I see it all the time in my practice.

Our infertility doctor’s response to my quiet but seething anger, suggests to me she has no awareness of what infertile couples really go through- the true stress and anxiety which we all hide within. I suspect no-one has ever complained about or to their infertility doctor worried it would affect future care.

A doctor cannot improve their skills without experiencing a complaint or few in their working lives. You won’t know how good or bad a doctor you are until you receive a complaint or compliment. I have received several complaints in my 12 year working life and they have been stressful to deal with, but I have reflected on those complaints and feel I am a better doctor from having read them.

If your fertility doctor is clinically not very good, you can chose to see someone else, but if they are all terrible with emotional support, it’s likely you just put on a brave face and grin and bear it, which is sad. We should be able to be honest with our specialist and for them to be able to give us some genuine empathy not stunned awkward silence.

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