General Medical issues thread

[MARTINE]

Yes but who? There are 3-4 decent doctors at the Medical centre we visit. They all know a little bit about something but I don't think they are good all rounders.

So aside from medical centre how do we find a good GP? It is very difficult.


Which recommendations? I can go to 3 different GPs and each one will recommend something different.

I see it a lot with my wife's issues. She's been having lower back and sciatica issues, the last GP we saw (and one I least expected) recommended muscle relaxant and that has done the trick. We also saw quite a few urology registrars and it was only the previous one that advised Hipprex and the latest registrar also recommended cranberry tablets and probiotics.

It is so difficult to find a great GP and even specialists.

Also in Australia we have a huge problem that we don't provide free mental care. Yes if you're suicidal there's help but what about the rest? Get a referral to see a psychiatrist and hope they have the answers?

A good GP knows you very well and practices evidence based care — seeing multiple drs invariably means none get the full picture as good health is a complex long term partnership. It also adds confusion, does not promote health literacy and is ultimately counterproductive and stressful for the patient who finds the disparate advice hard to understand.

The pressures of time makes continuity even more important. Good GP’s may also push back on automatically prescribing what you think you need. Good doctors also spend as much time on the lifestyle determinants of health (weight/nutrition/smoking) as they do writing prescriptions. This is positive not a negative if they are thorough and know what not to miss.

These are general observations as a retired medico - you asked what is a good GP.

By all means patients should seek advice elsewhere your real needs are not well understood

That said - it would be unlikely there is not a single good GP in all of Brisbane.

Ask colleagues or friends whose opinion you respect.

I do wish you well as I can see you struggle with your health. Beyond Blue and many organisations provide good free resources to promote health literacy. As a good GP can help you access.

 

[Flashback]

A good GP knows you very well and practices evidence based care — seeing multiple drs invariably means none get the full picture as good health is a complex long term partnership. It also adds confusion, does not promote health literacy and is ultimately counterproductive and stressful for the patient who finds the disparate advice hard to understand.

The pressures of time makes continuity even more important. Good GP’s may also push back on automatically prescribing what you think you need. Good doctors also spend as much time on the lifestyle determinants of health (weight/nutrition/smoking) as they do writing prescriptions. This is positive not a negative if they are thorough and know what not to miss.

These are general observations as a retired medico - you asked what is a good GP.

By all means patients should seek advice elsewhere your real needs are not well understood

That said - it would be unlikely there is not a single good GP in all of Brisbane.

Ask colleagues or friends whose opinion you respect.

I do wish you well as I can see you struggle with your health. Beyond Blue and many organisations provide good free resources to promote health literacy. As a good GP can help you access.

The challenge I have here, is the earliest appointment I can get with my preferred GP is a 3-6 week (and that's booking with them while in an appointment). Needless to say (for better or worse) I just don't go to the GP anymore unless it's absolutely necessary. The same GP gave me a plan B way of getting in touch, but I tried that recently and it...... didn't work, so I just gave up. I've tried 3 other GPs there and they've been useless. When I did finally wait and get to see my preferred one and told her the 'advice'/'care plan' I was given by the other GPs she was shocked..... and requested that I just see her (easier said than done). For now, I just continue to white knuckle it. But, I'm following all other (useful) guidance and eating well/exercising (and no, underlying condition isn't related to weight, albeit at 80kg I feel quite overweight), but even that's not working now and having little effect. C'est la vie!

 

[MARTINE]

The challenge I have here, is the earliest appointment I can get with my preferred GP is a 3-6 week (and that's booking with them while in an appointment). Needless to say (for better or worse) I just don't go to the GP anymore unless it's absolutely necessary. The same GP gave me a plan B way of getting in touch, but I tried that recently and it...... didn't work, so I just gave up. I've tried 3 other GPs there and they've been useless. When I did finally wait and get to see my preferred one and told her the 'advice'/'care plan' I was given by the other GPs she was shocked..... and requested that I just see her (easier said than done). For now, I just continue to white knuckle it. But, I'm following all other (useful) guidance and eating well/exercising (and no, underlying condition isn't related to weight, albeit at 80kg I feel quite overweight), but even that's not working now and having little effect. C'est la vie!

I am sorry to hear its not going well Flashback.

The UK system is one of which I am unfamiliar and can see access is an issue.

Is there any way the system will allow you to book regular reviews frequently so you have more time with the good GP even if relatively well at some visits?

All the best

 

[Flashback]

I am sorry to hear its not going well Flashback.

The UK system is one of which I am unfamiliar and can see access is an issue.

Is there any way the system will allow you to book regular reviews frequently so you have more time with the good GP even if relatively well at some visits?

All the best

Unfortunately not! Just 1 at a time. I'm used to it, so I just work within the constraints and try not to let it get me down That's all you can do really and hope in the meantime things don't spiral. There is only so much you can control.

For 1 thing, I'm able to take a semi private route (didn't have the £10k handy to go fully private as I've been out of work more than a year now), but still a 6-9 month wait (beats the 5-8 year wait in our area for public at least...).

 

[Freq Flier 2013]

Years ago at a coughtail party we were discussing medical matters. The lady I was speaking with said for anything important you should never go to a doctor on your own but take an advocate with you. Because half the time you only absorb half of what the doctor says. She also suggested jotting down notes in the event of more serious matters. Perfect case in point - My husband had a heart attack some 6 months after that discussion and then years later had tongue cancer. I started a journal with the heart issues and every checkup, with doctor visit,s surgeon, professors that have gone on for the last 20 years I have noted down. It's amazing what I hear as opposed to what he hears. It's also quite illuminating to find out stuff s& symptoms said husband may not have mentoned. I should add that over those last 20 years I've never had a doctor be dismissive or unhelpful if I've asked for clarification. He's in good health thankfully - and I'll never ever complain about our Medibank premiums

My mother in law records all medical appointments on her iPhone. Reasonable being so that she can listen to it again and not forget things.

 

[Freq Flier 2013]

Unfortunately not! Just 1 at a time. I'm used to it, so I just work within the constraints and try not to let it get me down That's all you can do really and hope in the meantime things don't spiral. There is only so much you can control.

For 1 thing, I'm able to take a semi private route (didn't have the £10k handy to go fully private as I've been out of work more than a year now), but still a 6-9 month wait (beats the 5-8 year wait in our area for public at least...).

We book an appointment with our GP every 3 weeks. If we don’t need it, then we share the time with family members and transfer the appointment. If not cancel it a few days prior and it’s always snapped up.
It’s mostly taken up by us or with family members.

 

[n7of9]

Can I ask for some moral support, please?

I started seeing a new GP within the last year and I very much like her. 2 weeks ago from a blood test result she says I'm now officially Type 2 Diabetic. She says my results over the past few years were 5, then 7, now 8, so she put me on Metformin immediately, and Ozempic 2 weeks later - i took the first shot today. The whole thing is a lot, I've not properly processed it.

Most of what I read online is concerning (skeletal celebrities, there's even a term for it, ozempic-face), or people saying they were really sick on it and couldn't function, or that it slows your metabolism to the point you have no will to eat. They do say the worst of it should dissipate after the first few weeks, so I'm glad I'm on staycation until 7Jan before i need to return to work.

Is anyone here on Ozempic and would be willing to share their personal experience?

 

[Quickstatus]

The whole thing is a lot, I've not properly processed it.

It's totally Ok to have to take time to process all that. It can be a bit scary and you feel like you don't have the tools nor empowered to navigate this conditions

I would strongly suggest Diabetes Australia and NDSS as a highly reputable and trusted resource including hotlines to speak to someone. They are very good.

Maybe also get a referral from Gp to see a credentialed diabetes educator. Medicare rebate available and credentialed by the Australian Diabetes Educator Association.
Good luck with this.

 

[mrsterryn]

Can I ask for some moral support, please?

I started seeing a new GP within the last year and I very much like her. 2 weeks ago from a blood test result she says I'm now officially Type 2 Diabetic. She says my results over the past few years were 5, then 7, now 8, so she put me on Metformin immediately, and Ozempic 2 weeks later - i took the first shot today. The whole thing is a lot, I've not properly processed it.

Interesting how medication has changed in so far as ozempic is now one of the first given and so quickly. Without any attempt to reduce via metformin, though perhaps now that is norm

 

[JohnK]

I do wish you well as I can see you struggle with your health. Beyond Blue and many organisations provide good free resources to promote health literacy. As a good GP can help you access.

I'm sure Brisbane has good GPs everywhere but for me it's a number of factors I use to decide. Firstly cost is main one. Will only see GP that bulk bills. Secondly if I want to see GP I want GP available 7 days a week not make appointment for some time next week especially for things like cellulitis infections etc. That is where this Medical Centre comes in handy. They are open every day but have some poor doctors. You need to find the good one(s).

I just saw GP today. Christmas Day and no one in queue. Had a chat about recent anxiety attacks. He recommends Venlafaxine at lowest 37.5mg dose a day for 4 weeks then review.

 

[MARTINE]

Interesting how medication has changed in so far as ozempic is now one of the first given and so quickly. Without any attempt to reduce via metformin, though perhaps now that is norm

There is an evidence base supporting early use of Ozempic for diabetics due to its benefits on cardiovascular and other metabolic benefits over and above the weight loss (which was found to be a side effect).

 

[MARTINE]

Can I ask for some moral support, please?

I started seeing a new GP within the last year and I very much like her. 2 weeks ago from a blood test result she says I'm now officially Type 2 Diabetic. She says my results over the past few years were 5, then 7, now 8, so she put me on Metformin immediately, and Ozempic 2 weeks later - i took the first shot today. The whole thing is a lot, I've not properly processed it.

Most of what I read online is concerning (skeletal celebrities, there's even a term for it, ozempic-face), or people saying they were really sick on it and couldn't function, or that it slows your metabolism to the point you have no will to eat. They do say the worst of it should dissipate after the first few weeks, so I'm glad I'm on staycation until 7Jan before i need to return to work.

Is anyone here on Ozempic and would be willing to share their personal experience?

Second what Quickstatus says. Discuss your concerns with accredited qualified people and avoid the web/celeb BS.

Take your time to process and know that there are good treatments and people who will support you.

 

[JohnM]

Can I ask for some moral support, please?

I started seeing a new GP within the last year and I very much like her. 2 weeks ago from a blood test result she says I'm now officially Type 2 Diabetic. She says my results over the past few years were 5, then 7, now 8, so she put me on Metformin immediately, and Ozempic 2 weeks later - i took the first shot today. The whole thing is a lot, I've not properly processed it.

Most of what I read online is concerning (skeletal celebrities, there's even a term for it, ozempic-face), or people saying they were really sick on it and couldn't function, or that it slows your metabolism to the point you have no will to eat. They do say the worst of it should dissipate after the first few weeks, so I'm glad I'm on staycation until 7Jan before i need to return to work.

Is anyone here on Ozempic and would be willing to share their personal experience?

I don't have diabetes or weight issues, but I stumbled on this very clear YT video the other day that you may find informative:

 

[RooFlyer]

Is anyone here on Ozempic and would be willing to share their personal experience?

I'm on Mounjaro, does a bit more than Ozempic, but its not on PBS! $400/month. Went to it as Ozempic didn't seem to do anything. I was started on a low dose, and built up over a month with no ill effects appearing with each increment.

Yes, you don't feel like eating, which is one of the main functions of it but I don't think I have any other side effects. My cardiologist was very happy I went onto it, due to other benefits @MARTINE mentioned.

The 'don't feel like eating' thing for me comes and goes. Sometimes I'll have a 'normal' meal and then realise 'oops - that wasn't meant to happen'. But I am losing weight. 'Theoretically' if we haven't been able to control weight by other means, then 'on it for life', but I have no intention of paying $400/month hereon in! Once I reach my target, I'll change over to Ozempic then see what happens.

 

[prozac]

I'm on Mounjaro, does a bit more than Ozempic, but its not on PBS! $400/month. Went to it as Ozempic didn't seem to do anything. I was started on a low dose, and built up over a month with no ill effects appearing with each increment.

Yes, you don't feel like eating, which is one of the main functions of it but I don't think I have any other side effects. My cardiologist was very happy I went onto it, due to other benefits @MARTINE mentioned.

The 'don't feel like eating' thing for me comes and goes. Sometimes I'll have a 'normal' meal and then realise 'oops - that wasn't meant to happen'. But I am losing weight. 'Theoretically' if we haven't been able to control weight by other means, then 'on it for life', but I have no intention of paying $400/month hereon in! Once I reach my target, I'll change over to Ozempic then see what happens.

Saw the tail end of a news story the other day which I think suggested Wegovy was going to be added to the Pharmaceutical Benefits Scheme (PBS) for adults with established cardiovascular disease with obesity.

 

[Quickstatus]

Wegovy

Is fundamentally exactly the same molecule as Ozempic

However, the approvals for its use are different because of the original applications but the drug companies

 

[Freq Flier 2013]

It's totally Ok to have to take time to process all that. It can be a bit scary and you feel like you don't have the tools nor empowered to navigate this conditions

I would strongly suggest Diabetes Australia and NDSS as a highly reputable and trusted resource including hotlines to speak to someone. They are very good.

Maybe also get a referral from Gp to see a credentialed diabetes educator. Medicare rebate available and credentialed by the Australian Diabetes Educator Association.
Good luck with this.

Please see an endocrinologist. They will be able to manage the whole process properly. Most important part of Ozempic ect .. is to start with a small dose and to very slowly build it up. Don’t rush to increase the dosage.

 

[Quickstatus]

They will be able to manage the whole process properly

Sure, in terms of correct medication, dosing, medical management but I don't think that was the concern.

I get the sense that the issue is much bigger and general that that and maybe even non medical. . To me it is trying to process the new diagnosis, its implications, treatment options. Basically "what does this mean for me".

I think a diabetes educator, and organisations like NDSS is likely better placed to help patients walk through this.