Stupid GP- fair to complain?

[Steve G Registered Pharmacist Find all posts View Profile Close Steve G]

Ok, so here's the situation: I requested a symbicort 200/6 and two salbutamol inhalers from my GP. I recieved a Rx for two symbicort (with a dose of one puff qds!), but no salbutamol, so I requested the salbutamol again. I later got a message from the surgery asking them to call them. When I eventually got through to the GP he said he would not give me any salbutamol until I saw either himself or the nurse, as I had not had if from the surgery before, though I've only been with them for 10 months.

Now, I only get asthma during the summer, and it is well controlled, so I don't use salbutamol much. I only asked for some as the ones I've got are going out of date. What I can't understand is why he was happy to issue the symbicort, but not the salbutamol. If they had asked me to come for a review when I requested the symbicort then fair enough, but to issue symbicort but not salbutamol seems almost negligent to me because it is vital that asthamtics have access to a short acting beta agonist.

I also found the GP extremely patronising on the phone, and almost rude, which I am going to complain about, but my question is do you think it is reasonable to complain about my GP not issuing the salbutamol? Also who should I complain to -the practice manager?

[admin Forum Creator Find all posts View Profile Close admin]

Steve

I guess that because Formoterol fumarate is a long-acting beta 2 agonist he maybe wants to see if you are controlled well enough on the combination, without the need for additional inhalers? He will also be aware that salbutamol is widely abused, so is wondering why you are already asking for it when you haven't given the symbicort a try. Formoterol opens the airways for longer than short-acting beta 2 agonists, such as salbutamol or terbutaline, so it is used to prevent shortness of breath rather than to treat it. Maybe he has this in mind???

Most GP's are "extremely patronising" so that's no real reason to complain. If I were you I'd just give the symbicort a try, and if you are still having problems then request a salbutamol. I don't think you really have a complaint, because you haven't listened to his clinical opinion and tried the medication he wants you to.

We read all the time that beta 2 agonists are over prescribed, so maybe he is trying not to do that. I guess it all boils down to communication, and the fact that he won't be forced into prescribing what you want him to. Why don't you just go and see him, and discuss your concerns with him?

If I were you I wouldn't complain because of this. It doesn't seem a big enough issue for that, in my humble opinion. Whatever you decide to do, will you let us know how you get on?

Cheers

[Steve G Registered Pharmacist Find all posts View Profile Close Steve G]

I do use the symbicort and it works well, I only requested the salbutamol because my current ones are going out of date soon. As well as the symbicort works, I do not want to be in the position of not having a salbutamol on hand in case I do have an attack, because that would be very scary.

What has annoyed me is that the symbicort was issued without any problems (probably indicating that he doesn't look at the repeat Rxs he signs), but a routine request for a salbutamol was turned down - its not like I've had five in the last five months. Surely if my asthma is severe enough to warrant symbicort (i.e. step 3 of the BTS guidelines), then I need a salbutamol as rescue medication. If he wanted to review me he should have picked it up when I requested a symbicort for the first time in seven months.

[admin Forum Creator Find all posts View Profile Close admin]

I do use the symbicort and it works well, I only requested the salbutamol because my current ones are going out of date soon. As well as the symbicort works, I do not want to be in the position of not having a salbutamol on hand in case I do have an attack, because that would be very scary.

What has annoyed me is that the symbicort was issued without any problems (probably indicating that he doesn't look at the repeat Rxs he signs), but a routine request for a salbutamol was turned down - its not like I've had five in the last five months. Surely if my asthma is severe enough to warrant symbicort (i.e. step 3 of the BTS guidelines), then I need a salbutamol as rescue medication. If he wanted to review me he should have picked it up when I requested a symbicort for the first time in seven months.

I don't disagree with you, but don't you think you'd be best talking this over with him rather then lodging a formal complaint? If you complain your relationship with him will be very strained and you'd probably end up leaving the practice.

[Steve G Registered Pharmacist Find all posts View Profile Close Steve G]

I don't disagree with you, but don't you think you'd be best talking this over with him rather then lodging a formal complaint? If you complain your relationship with him will be very strained and you'd probably end up leaving the practice.

I'm not particularly bothered about that as I'm moving next month anyway. The surgery have also annoyed me in the past, refusing to send a prescription to the pharmacy I requested without me signing a form (fair enough), but then sending my next Rx to the same pharmacy without me having signed the form or even asking for it to go there. Its also one of these surgeries that is closed half the time, but their phone message never tells you when they reopen.

[admin Forum Creator Find all posts View Profile Close admin]

Ok Steve

It seems you are ready to move on anyway. Why are you so against just going in there and speaking your mind? You'll feel better if you do!