Your relationship with your doctor
Developing and maintaining a good relationship with anyone involved in your clinical care and treatment is very important, especially if your condition requires long-term care.
It is very likely that a number of health professionals will be involved in your care. This may include:
- your GP
- your specialist (hepatologist, gastroenterologist or infectious diseases consultant)
- a clinical nurse specialist
- a pharmacist
- a dietician and a variety of other health professionals.
Whilst all of them may have specific roles in your care and treatment, they are also likely to have shared roles and responsibilities. For example, your specialist and your clinical nurse specialist will work closely together and may even consult with your GP at times.
Of course it would be unrealistic to assume that all health professional relationships are of equal importance. In most cases the relationships you have with your specialist, clinical nurse specialist and your GP are likely to be the most significant.
Dealing with GPs
For most people your General Practitioner is the first person you contact if you are feeling unwell. If your condition requires specialist input, then you will be referred to a hospital for tests, diagnosis and possibly management of your condition. However, the GP is primarily responsible for your primary care: that means any care that does not require specialist knowledge or intervention.
If your GP is likely to be involved in your hepatitis C care, then a good relationship with them is essential. Remember that your care and associated needs may stretch over a long period of time. As a consequence your needs are likely to change, requiring input from other services (e.g. social services).
Part of your GP’s role will be to ensure all your primary health and social care needs are met. Your GP may be involved in referrals to other service providers, including referral for specialist care.
When considering your relationship with your GP, it is worth remembering that hepatitis C is still a relatively new illness and as a result the impact it has on people is often not well understood. You may be the only known patient with hepatitis C in your GP’s practice. The best way to ensure your GP is aware of all your medical and social care needs is to be open with them and keep them well informed.
If you feel that the relationship you have with your GP may be detrimental to your care, you may decide to consider what steps to take to address this. In the first place, and if at all possible, it is best to address your concerns either directly to your GP or the practice manager. Some people will find this difficult and feel that this will result in them being viewed as troublesome. This does not have to be the case.
If your approach is non-confrontational and merely aimed at expressing your concern with a view to resolving the problem, it is unlikely to be viewed as confrontational. You could start your conversation with "I feel that maybe we have not understood each other very well and I would like to take the opportunity to explain how I feel about ..." - hardly an aggressive approach.
However, if after trying to resolve any difficulties you still feel unable to continue with your current GP, you have the right to change your GP. Alternatively, if you feel you have a valid complaint against your GP or GP practice you can consider using the NHS complaints procedure.
See how to complain
Getting the most from GPs
In general GPs are very busy people. Most appointments are made for specific time periods and while your doctor will want to ensure your consultation has enabled all the relevant information and advice to be shared, they will also be conscious that they have other patients waiting to see them.
For this reason it is best to consider what you want to gain from each appointment. It may be that you have a specific symptom you want to inform the doctor of, or you may be returning for test results or want to discuss a specific treatment or medication. Whatever the purpose of the appointment, it is best to be prepared with the relevant questions or concerns prior to entering the consultation room and this will enable you to get the most from the appointment.
Checklists (see below) made prior to any doctor's appointment are very useful as they assist in remembering things and ensure the appointment remains focussed.
If your appointment is about a specific symptom which may be physical or emotional, you are likely to be asked whether you have experienced it before, how long you have had it, exactly how it feels, whether it comes and goes or is constant and whether anything makes it worse or better.
Keeping a diary about how you feel, both physically and mentally, or noting any reaction to medications or problems you may have with any treatment may be really useful. This is a way of ensuring things don't get forgotten or confused and will, most likely, be beneficial both to yourself and your GP. Your doctor will need time during the consultation to consider the information you have given him/her and to formulate advice. They may also need to consult a reference book and/or seek additional medical advice.
If medication is prescribed, your doctor should explain:
- what they are prescribing
- why they are prescribing it
- how long it will be before you experience some relief
- whether to expect any side effects.
You will probably be advised when to return to review the situation. If you are not offered this information or you are unsure about any aspect of the medication you are prescribed, you should ask for a further explanation, possibly in writing.
Remember that your GP is responsible for your primary care. Your specialist hepatitis C care will primarily be the responsibility of your specialist.
Your GP is unlikely to be aware of the current condition of your liver or any other aspect of your health directly linked to your condition. It is also unlikely that your GP will be aware of all the possible interactions between any medication you are currently receiving and anything he/she may prescribe, or the impact any medication may have on your hepatitis C. For this reason it may be advisable to contact your consultant or clinical nurse specialist to ask about any drug interactions or contra-indications.
This checklist is designed to assist in keeping your GP consultation focused and to help you get the most out of the time available to you and your GP during your appointment. The list is not a comprehensive one and you will have many of your own questions. Hopefully it will assist you by prompting some thought about how to use your appointment time as constructively as possible.
Firstly, you should establish what the main reason is for visiting your GP. For example it may be that you have been experiencing some distressing symptoms or that you are concerned about a recent deterioration in your health. More specifically you may be visiting your GP for a test, to receive test results, for a statement of fitness to work, to ask about a referral, for general advice or to discuss current treatment.
- Have you been experiencing any symptoms?
- How long have you been experiencing these symptoms?
- How long do the symptoms last?
- Are they there all the time or do they come and go?
- Is there anything that makes them better or worse?
General State Of Health
- What is your main concern?
- Is it one isolated concern or is it connected to something else?
- Has it affected your ability to work?
- How is it affecting your everyday life/relationships?
- Why are you having the test?
- Will the test be carried out at the surgery or will it require a hospital visit?
- How long will you need to wait for results?
- Who will give you the test results?
- What is the result of the test?
- What does the result mean?
- Will the test need to be repeated, if so how regularly?
- Are further or additional tests necessary?
- Will treatment be necessary?
- Will you need to have your care referred to a specialist?
Statement of Fitness for Work (fit note)
- Why you need the statement, e.g. for your employer, benefits agency, etc?
- How will the GP explain your condition on the certificate?
- How long will the certificate be valid?
- What if you need a repeat certificate?
- Do you need help or information regarding what to do with the certificate?
- Are you seeking a referral for additional or secondary health care, e.g. referral to a specialist?
- Are you seeking a referral for additional social care? If yes, why do you feel you are in need of these additional services e.g. are you having trouble coping with everyday tasks, such as washing or cooking?
- What is the advice you are seeking?
- Are you concerned about your general health or a specific aspect of your health?
- Are you concerned about transmission of hepatitis C?
- Is there something about your care that you would like some additional information on?
- Are you having difficulty with your current treatment?
- Is it a particular aspect of your regimen or is it a general difficulty?
- Have you tried to remedy the situation yourself? If yes, has this been successful?
- Do you want some additional information about your treatment?
- Is there any alternative/complementary treatment that could replace or assist your current treatment?