GP: Withholding of medication to coerce attendance at tests

I'm posting this here as I'd like to know if this is common and/or accepted practice. Any comments would be much appreciated.

I consider what I describe below to be a form of blackmail or coercion that has, in practice, resulted in my (a) being without important daily medication for longer than could and should otherwise have been the case, and (b) already negatively impacted my health.

Background: I have a number of ongoing health issues and am prescribed several prescription medications for them. These health issues include high blood pressure, heart issues, diabetes, and related.

As part of this, I receive a number of regular medications that are exceedingly unlikely to need to change unless a miracle cure happens. Continued use of them is intended to prevent the conditions deteriorating.


Here is the situation:-

(1) On Friday 12/11/2021 I realised that I had allowed medication to run out and so wrote a letter to the GP's practice asking for a re-issue of all my ongoing medication which I hand delivered to the GP's practice early in the morning, before opening.

To be clear, I should have asked for a prescription renewal before this date but I had not actively monitored my stock of meds and had not noticed my previously diarised re-order date.

(2) Later in the day of Friday 12/11/2021 I received two SMS messages from the GP practice. The first received at 08:29 said:

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Please book an appointment (20 minutes) for a Hypertension review with a Healthcare Assistant.

This is to review your blood pressure and medication.[...]

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The second received at 17:15 said:

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Please book an appointment for your annual non-fasting blood test with out Healthcare Assistant.[...]

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I did not respond (and as of the time of writing have not responded) to these. There is no point going to a "Hypertension review" when my hypertension meds have run out; my blood pressure would not be indicative of the effectiveness of the medication. And the annual blood test is not urgent.

(3) I was not able to physically reach the pharmacy until Friday 19/11/2021 when I discovered that only two items of medication had been provided. One (out of two) blood pressure medications and one new medication related to diabetes that had been prescribed by a hospital consultant. There was no note or any other communication from the GP. My other regular (and very unlikely to change) medications for diabetes and control of heart condition were not there.

I put this down to incompetence by the GP's surgery. Afterall, I had had the temerity to send in a letter rather than the prescription counterfoil and I had previously noticed that they commonly made random prescription errors when reading such letters.

(4) The next opportunity for me to get to the GP's surgery to once again request my normal medication was Monday 29/11/2021. Yes, 10 days later. My fault of course to wait such a long time. This time I used one of the prescription counterfoils to request the missing medication. I delivered the prescription request by hand early in the day before opening.

(5) At some point on Monday 29/11/2021 (I don't know exactly when as my phone had to be off) I received this SMS message:

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We have issued a prescription for a reduced supply of medication as you have failed to respond to invitations for essential monitoring tests and review. Please contact the practice to book your appointment urgently to avoid further reduction in your supply.

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NOW they tell me!

And what the absolute flying F**K!!!

So they were (and still are to an extent) coercing me by withholding critical daily medication which is unlikely to change as a result of any "review" to get me to come to the "essential monitoring tests and review"! The only medication likely to change as a result of the hypertension review would be the particular mix of blood pressure drugs I am on.

Notwithstanding my own delays in asking (twice) for the medication I need, they are knowingly and intentionally withholding medication that they know I need on a daily basis, regardless of whether or not I have booked to come to the tests.

They also know that the "Hypertension review" cannot make any sense unless I am actually on the currently prescribed medication, half of which which they have withheld.

Furthermore, they also know that there is very little likelihood of many of the meds being changed, such as insulin, metformin, aspirin, and other more complex heart-related medications (which they nevertheless withheld). I am already suffering from the effects of removal of these meds.

I am happy to go to these tests in due course. I too consider them important. But, my own delays notwithstanding, I am not happy to be blackmailed in this manner by withholding of critical medication.

Questions:

Is this ethically acceptable?

Is this common practice?

Is this accepted practice?

What would you do now?

Actually, I think it's prudent of them (and MAY be a requirement). I have a doc who requires me to come in for a visit annually before he will renew my prescriptions.

When I run out in a situation like that, I visit my pharmacist. He/she always gives me a few days' supply to tide me over.

Good luck, Mark. Sorry for your unfortunate situation. :concern:

Tom

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Originally Posted by pacifichrono

Actually, I think it's prudent of them (and MAY be a requirement). I have a doc who requires me to come in for a visit annually before he will renew my prescriptions.

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Yes, there is prudency in making sure that nothing has changed. I am happy that they ask me to come to tests which I can book when convenient and feasible.

But it is negligent to withhold critical medications to coerce attendance at tests that are exceedingly unlikely to result in a change to most of those meds.

Furthermore, even if a change is indicated, the meds are still needed on a daily basis unless or until that change is discovered! There is no health-compatible reason to withhold them.

As I said, I am 'guilty' of my own delays but I would only have been delayed a couple of days if they had prescribed what they knew they should have done (regardless of what changes may or may not have later been indicated) when I first asked for them.

Mark, my advice is to work with the GP surgery and get this sorted. Arguing points of principle here instead of sorting things out is going to stress you more.

To answer a specific point, I have had prescriptions delayed until I have had annual or 6 monthly tests done so I sympathise but I have yet to see a system work perfectly. This is both at my GP and for long term hospital prescriptions.

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Originally Posted by thenikjones

To answer a specific point, I have had prescriptions delayed until I have had annual or 6 monthly tests done so I sympathise but I have yet to see a system work perfectly. This is both at my GP and for long term hospital prescriptions.

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Interesting, thanks.

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Originally Posted by thenikjones

Arguing points of principle here instead of sorting things out is going to stress you more.

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I am not here to argue or discuss points of principle.

I have asked here about how to deal with the presumably well-meaning, but in actuality damaging, coercive practices of the GP. My health is of concern to me.

The GP's method of doing business, whilst, as I say, being presumably well-meaning, has already in reality resulted in harm to my health that would not otherwise have occurred.

I never ask for renewal of my prescriptions. Boots (my local pharmacy) does it for me very efficiently (for free) and will give me gap medication when (as it happened once) the surgery hasn’t renewed on time. This way my visits to the surgery are limited to actual medical needs (blood test, for example) and nothing else.

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Originally Posted by Saint-Just

I never ask for renewal of my prescriptions. Boots (my local pharmacy) does it for me very efficiently (for free) and will give me gap medication when (as it happened once) the surgery hasn’t renewed on time. This way my visits to the surgery are limited to actual medical needs (blood test, for example) and nothing else.

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Nice to know but not relevant here. In fact you do ask for renewal of prescriptions; it's just your pharmacy doing it on your behalf.

In other words, the method of renewal is not relevant to the issue at hand here. I could have got my pharmacy to do it[1], I could have used the NHS app, or I could, as I did, have sent them a letter. It is what happened when the renewal was requested because it was needed that is problematic.

I too do not visit the (inside of the) GP for anything except actual medical needs.




Footnote:-
1: It's an aside but actually, no, it would seem that I couldn't have got my pharmacy to do it as all the prescriptions now have a note at the bottom to the effect that pharmacies can apparently no longer request renewals on behalf of patients. Also the GP doesn't accept prescription renewals by phone. So it's either paper or app. But however the renewal was requested, it wouldn't have made any difference in this case.

I sympathise.

Systems are designed for those who have less of a grip of processes and customer journeys than you do. They're also designed for risk management and implementation without input from someone who knows you well and that your prescription is unlikely to have changed.

My advice is to play the game and focus your firepower elsewhere as I know from experience it leads to confrontation rather than resolution and that is ultimately frustrating.

So have they issued a reduced supply of all your meds, or have they actually missed out meds from your prescription? If so, which ones?

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Originally Posted by AlphaOmega

They're also designed for risk management and implementation without input from someone who knows you well and that your prescription is unlikely to have changed.

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If you really believe this then it would follow that my health is greatly at risk! My GP should know better than I do that most medications I am currently on are very unlikely indeed to need to change as a result of either of the planned tests.

Furthermore, the GP should be acutely aware that withholding medication until I can make it to an available test date (which, based upon previous experience of booking similar tests, could be weeks away) is fundamentally likely to damage my health.

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Originally Posted by AlphaOmega

My advice is to play the game and focus your firepower elsewhere as I know from experience it leads to confrontation rather than resolution and that is ultimately frustrating.

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I do not know what I could do to play along better. Remember that the first prescription withholding critical meds was issued before they had even told me that they wanted me to come for tests!

In other words, they knew (or damn well should have known) that by withholding meds, the hypertension review at the very least could not be useful in terms of determining how the blood pressure meds I was supposed to be on were affecting my blood pressure.

At this stage, I suppose I am supposed to book the tests they want and then hope that the "reduced supply" of meds holds out until the appointments (or beg for more if the appointments are too far in the future).

I have to say that this does not sound like a reliable or sustainable basis on which to manage my health. It's a barely competent mess.

Risking harm to my health to coerce me into going for tests that are for my the benefit of my health is not a sane way to manage their business.

Moreover, I greatly dislike overt confrontation. I also greatly despise all forms of coercion. And I dislike giving into any kind of coercion, including passive aggressive coercion of the sort I am the victim of here, just as much.

Perhaps we'll see how long the "reduced supply" lasts for when I (hopefully!) get it today or tomorrow.

You are clearly very angry about all this - but assuming you are getting all the meds you need (just in a shorter supply) I don't see the issue. You are not being blackmailed and your health is not at risk. Your convenience might be, but to be honest that is your fault for letting meds get so low.

Likelihood is that none of this has been seen by a GP and has all been admin related or process driven. If you have genuine concerns for your health (I think unfounded?) then discuss it in a calm way with reception or the practice manager. Don't be an asshole to the people on reception - it is not personal.

If you are on meds like metformin and ramipril they do need monitoring as they can roger your kidneys and it would be negligent to just keep giving you the meds without any monitoring.

just ask to speak to the practice manager, explain what you need to and ask if they can supply all your medication until you can get the tests done (book the dates for them there and then).
sadly some GP's get 'god' syndrome and arguing with them just makes them dig in more , we also now have the unusual sistuation where surgery receptionists are acting as gatekeepers on who gets to see a GP - even though they have no medical training.

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Originally Posted by watchstudent

So have they issued a reduced supply of all your meds, or have they actually missed out meds from your prescription? If so, which ones?

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I did explain in numbered bullet points! ;-)

But I'll re-cap to answer your specific question.

(1) They have actually missed out the bulk of my meds. The first prescription collected on 19/11/2021 contained only two out of 10 required meds. Eight were missing. There was no note or communication to explain why the eight were missing. Initially I put this down to incompetence since they have a record of making random prescription errors (albeit not this big).

(2) The most recent communication from them (received yesterday) says that they will prescribe a "reduced supply" of the eight missing meds I am now in pressing need of. But this batch is not yet available for me to collect so I don't yet know how much or what exactly will actually be there.





I won't go into details in public on the individual meds that were missing on 19/11/2021 but of the 10 I asked for:

Three are for diabetes and blood glucose management and all three are exceedingly unlikely to change as a result of either of the tests coming up. The GP should know this. Two of them are important on a daily basis. (One drug from this category was supplied in the prescription collected on 19/11/2021 but it was, ironically, not one of those that is daily-important).

Seven are for blood circulation, blood pressure, and heart management. Of these seven, five are exceedingly unlikely to change as a result of either of the tests coming up. Again, the GP should know this. Three of them are critical on a daily basis and yet were withheld. The GP should definitely know this. (One drug from this category was supplied in the prescription collected on 19/11/2021, a blood pressure med that is important but not daily-critical, and not fully effective without another med that was withheld).

Whilst I appreciate your predicament Mark, you stress how detrimental to your health it is for you to not have your medications, yet you were happy to wait a week (from 12/11 until 19/11) to pick up your meds.

Surely if they were that important you would have moved mountains to ensure that you got the medications you needed on time?

I understand that you shouldn’t be without your meds but it is equally important that your GP knows that you are on both the correct meds and correct dosage.

Personally, I would also want to have the tests to be sure that everything was still good and would always aim to do so at the earliest opportunity. If that meant rearranging other commitments then so be it, my health is the most important thing.

Reading your story and the comments from others, I would say that there's a way of 'asking things' and 'telling things': the first SMS's you got were pretty 'compulsory' and are rather generically written - not personalized. (is that the correct term?). A message with a more 'inviting' and personal character would not have roughed your feathers (I think).

And, not making a joke here: it makes no sense testing your blood pressure. The moment you step into the GP's office, your blood pressure will be up and up! Sort of white coat hypertension, so to speak.

Menno

So, if I understand, you haven't actually gone without meds. Unless it was the bit where you waited 10 days...

You will get a shorter supply. Yes, good and understandable. If the BP meds and diabetes meds have messed with your renal function and the GP issued 6 months of meds then you really would be up on your high horse moaning about your health.

Maybe put your toys back in the pram, have a conversation with the practice if you are unhappy, get your tests done and move on. I promise you, no-one wants to be passive aggressive blackmail you, or the like. No-one has time for that.

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Originally Posted by markrlondon

I did explain in numbered bullet points! ;-)

But I'll re-cap to answer your specific question.

(1) They have actually missed out the bulk of my meds. The first prescription collected on 19/11/2021 contained only two out of 10 required meds. Eight were missing. There was no note or communication to explain why the eight were missing. Initially I put this down to incompetence since they have a record of making random prescription errors (albeit not this big).

(2) The most recent communication from them (received yesterday) says that they will prescribe a "reduced supply" of the eight missing meds I am now in pressing need of. But this batch is not yet available for me to collect so I don't yet know how much or what exactly will actually be there.





I won't go into details in public on the individual meds that were missing on 19/11/2021 but of the 10 I asked for:

Three are for diabetes and blood glucose management and all three are exceedingly unlikely to change as a result of either of the tests coming up. The GP should know this. Two of them are important on a daily basis. (One drug from this category was supplied in the prescription collected on 19/11/2021 but it was, ironically, not one of those that is daily-important).

Seven are for blood circulation, blood pressure, and heart management. Of these seven, five are exceedingly unlikely to change as a result of either of the tests coming up. Again, the GP should know this. Three of them are critical on a daily basis and yet were withheld. The GP should definitely know this. (One drug from this category was supplied in the prescription collected on 19/11/2021, a blood pressure med that is important but not daily-critical, and not fully effective without another med that was withheld).

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Originally Posted by watchstudent

You are clearly very angry about all this - but assuming you are getting all the meds you need (just in a shorter supply) I don't see the issue.

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(a) Having my health harmed (note, not merely put at risk but actually harmed now) is a problem.

(b) Even my health had not been harmed, my GP was explicitly using health blackmail or coercion against me. That is a problem. For you to deny that it is a form of blackmail is absurd.

(c) Being treated as a product is a problem.

(d) Being coerced into action is a problem.

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Originally Posted by watchstudent

You are not being blackmailed and your health is not at risk.

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As I have pointed out and explained, my health was explicitly, knowingly and intentionally put at risk and harm as a means of coercion. As I observed, it was presumably well-meaning but that's not an excuse. Furthermore, harm has now in fact been done to it. That harm is probably recoverable after a week or so back on the meds but that does not excuse it.

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Originally Posted by watchstudent

Your convenience might be, but to be honest that is your fault for letting meds get so low.

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I am at fault for letting my meds supply go so low but, as I am now aware, even if I had requested a renewal earlier it is overwhelmingly likely that I would still have been forced to run out.

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Originally Posted by watchstudent

Likelihood is that none of this has been seen by a GP and has all been admin related or process driven.

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Then that would be, in and of itself, negligent.

As such it would be a problem to be improved, not an excuse for anything.

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Originally Posted by watchstudent

If you have genuine concerns for your health (I think unfounded?)

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As I have pointed out, I have very clear and unambiguous reasons to be concerned for my health explicitly due to the actions of the GP practice. I would be healthier right now if they had not used the coercive technique they did.

If you had actually read, digested and understood what I have written, you would be aware of this.

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Originally Posted by watchstudent

discuss it in a calm way with reception or the practice manager.

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I shall do so. But let's face, I know I will get a blow off.

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Originally Posted by watchstudent

If you are on meds like metformin and ramipril they do need monitoring as they can roger your kidneys and it would be negligent to just keep giving you the meds without any monitoring.

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Absolutely, but it does not logically follow that withholding meds until the tests can be done a sensible way forward.

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Originally Posted by Dave+63

Whilst I appreciate your predicament Mark, you stress how detrimental to your health it is for you to not have your medications, yet you were happy to wait a week (from 12/11 until 19/11) to pick up your meds.

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No, I was not happy to wait a week. I got to the pharmacy as quickly as I was able.

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Originally Posted by Dave+63

Personally, I would also want to have the tests to be sure that everything was still good and would always aim to do so at the earliest opportunity. If that meant rearranging other commitments then so be it, my health is the most important thing.

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I agree. This doesn't excuse the issue at hand.

I've tonnes of experience of this kind of thing due to our daughter's ongoing health issues and the GP insistence on regular consultations before reissuing prescriptions, but as you are never in the wrong and always have to have the last word there is absolutely no point in me contributing more to this thread than to wish you good luck.

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Originally Posted by watchstudent

So, if I understand, you haven't actually gone without meds.

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Are you very cretinous or just pretending? I said that I have actually gone without meds. Despite my own delays, this would not have happened without the actions of the GP.

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Originally Posted by watchstudent

If the BP meds and diabetes meds have messed with your renal function and the GP issued 6 months of meds then you really would be up on your high horse moaning about your health.

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Wind your neck in and have the courtesy not to put words into my mouth.

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Originally Posted by watchstudent

Maybe put your toys back in the pram, have a conversation with the practice if you are unhappy, get your tests done and move on. I promise you, no-one wants to be passive aggressive blackmail you, or the like. No-one has time for that.

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I have presented the facts. No "toys", no "pram". Again, wind your neck in. Your lack of interest in reading what has been written and your likely biases are showing.

You presumably think you're helping. You are helping someone, but it's not me.

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Originally Posted by Mr Curta

I've tonnes of experience of this kind of thing due to our daughter's ongoing health issues and the GP insistence on regular consultations before reissuing prescriptions, but as you are never in the wrong and always have to have the last word there is absolutely no point in me contributing more to this thread than to wish you good luck.

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I am very happy to have regular ongoing consultations. Indeed, in the past, I have been keen to see the GP more often.

However, having my meds cut off without explanation or warning, which is what has actually happened and is at the centre of the issues here, is absolutely not beneficial to my health.

But have meds been withheld?! It doesn't sound like it. A reduced supply of all your meds is not withholding medication. It is ensuring safe prescribing. Honestly, you sound like a self-entitled, spoiled brat who can't get his own way and is going to scream and shout and sensationalise until he gets his own way.

Do you think staff sit there, thinking right, how can I piss this patient off? Or is it more likely they are acting in your best interest?

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Originally Posted by markrlondon

(a) Having my health harmed (note, not merely put at risk but actually harmed now) is a problem.

(b) Even my health had not been harmed, my GP was explicitly using health blackmail or coercion against me. That is a problem. For you to deny that it is a form of blackmail is absurd.

(c) Being treated as a product is a problem.

(d) Being coerced into action is a problem.



As I have pointed out and explained, my health was explicitly, knowingly and intentionally put at risk and harm as a means of coercion. As I observed, it was presumably well-meaning but that's not an excuse. Furthermore, harm has now in fact been done to it. That harm is probably recoverable after a week or so back on the meds but that does not excuse it.



I am at fault for letting my meds supply go so low but, as I am now aware, even if I had requested a renewal earlier it is overwhelmingly likely that I would still have been forced to run out.



Then that would be, in and of itself, negligent.

As such it would be a problem to be improved, not an excuse for anything.



As I have pointed out, I have very clear and unambiguous reasons to be concerned for my health explicitly due to the actions of the GP practice. I would be healthier right now if they had not used the coercive technique they did.

If you had actually read, digested and understood what I have written, you would be aware of this.



I shall do so. But let's face, I know I will get a blow off.



Absolutely, but it does not logically follow that withholding meds until the tests can be done a sensible way forward.

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Go to the GP as requested

Problem solved, and blood pressure hopefully kept to a minimum

They may be trying a few tricks to get you through the door, but they are professionals and maybe they'd like a chance to check you out in person

Don't assume their intentions are sinister

The path of least resistance is often the best not only for your health, but your own sanity

Getting yourself wound up over the matter is only going to damage yourself

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Originally Posted by watchstudent

But have meds been withheld?! It doesn't sound like it.

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Yes, meds have actually been withheld.

I am currently without meds that I would not be without had they not been withheld by the GP.

I explicitly said so in #1, #3, and #13.

I wonder again, are you being wilfully blind or merely on a mission to provoke anger by your refusal or inability to read what has been written. What is your agenda here?

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Originally Posted by watchstudent

A reduced supply of all your meds is not withholding medication.

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I would agree, if that was all it was. However, as I pointed out, meds have been wholly withheld. You do seem incapable of reading the bits that don't suit your preferred narrative, don't you. I said that meds have been wholly withheld.

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Originally Posted by watchstudent

It is ensuring safe prescribing.

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I agree. But it is not any more safe to wholly withhold meds that are in fact needed. In yet that is the problem that I have explicitly pointed out.

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Originally Posted by watchstudent

Honestly, you sound like a self-entitled, spoiled brat who can't get his own way and is going to scream and shout and sensationalise until he gets his own way.

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You are in effect re-stating your previous insult about "prams" and "toys".

My concern is, as stated, about a threat to my health due to the what has been done (no matter how well-meaning it might have been).

You characterise what I have said as "scream"ing and "sensationalis"ing but no, I have merely stated the facts in a clear and accurate manner. Clearly that is deeply discomforting to you.

You have your reasons to respond in the way you do, including insulting me and putting words into my mouth, but whatever they are, they are not helpful here.

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Originally Posted by watchstudent

Do you think staff sit there, thinking right, how can I piss this patient off? Or is it more likely they are acting in your best interest?

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As I have also pointed out several times now, I think it was well-meaning but in reality it was (a) a toxic way to coerce compliance and (b) both threatening to, and actually harmful, to my health. In other words, despite being well-meaning it was counter-productive.

If your GP issued medication without checking your situation they’d be in trouble.

Play the game, go get tested and check the meds continue to be the most appropriate for you.

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Originally Posted by demonloop

Go to the GP as requested

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I am happy to do so as the next possible opportunity. But it's the time between now and then that is at issue.

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Originally Posted by demonloop

They may be trying a few tricks to get you through the door

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No tricks are necessary. In fact, tricks are counter-productive.

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Originally Posted by demonloop

Don't assume their intentions are sinister

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I haven't. I am observing, however, that their intentions are presumably well-meaning but in actuality damaging.

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Originally Posted by demonloop

Getting yourself wound up over the matter is only going to damage yourself

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I agree. That's why I came here to ask whether this was common or accepted and what others would do.

So when they sent you the message that they had issued a reduced supply, that was referring to the fact they had missed meds on your prescription rather than issuing a reduced supply of all your meds, ok.

In that case they are probably unaware that you have actually run out of medication. Because, you know, it is your responsibility to ensure you request medication in good time before things get anywhere near running out. If you have run out then that will just take a phone call to say - "oh, I have actually run out, sorry for being such a moron and letting that happen, please could I have a couple of week's supply while we sort the tests?". Done.

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Originally Posted by markrlondon

Yes, meds have actually been withheld.

I am currently without meds that I would not be without had they not been withheld by the GP.

I explicitly said so in #1, #3, and #13.

I wonder again, are you being wilfully blind or merely on a mission to provoke anger by your refusal or inability to read what has been written. What is your agenda here?



I would agree, if that was all it was. However, as I pointed out, meds have been wholly withheld. You do seem incapable of reading the bits that don't suit your preferred narrative, don't you. I said that meds have been wholly withheld.



I agree. But it is not any more safe to wholly withhold meds that are in fact needed. In yet that is the problem that I have explicitly pointed out.



You are in effect re-stating your previous insult about "prams" and "toys".

My concern is, as stated, about a threat to my health due to the what has been done (no matter how well-meaning it might have been).

You characterise what I have said as "scream"ing and "sensationalis"ing but no, I have merely stated the facts in a clear and accurate manner. Clearly that is deeply discomforting to you.

You have your reasons to respond in the way you do, including insulting me and putting words into my mouth, but whatever they are, they are not helpful here.




As I have also pointed out several times now, I think it was well-meaning but in reality it was (a) a toxic way to coerce compliance and (b) both threatening to, and actually harmful, to my health. In other words, despite being well-meaning it was counter-productive.

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Originally Posted by joe narvey

If your GP issued medication without checking your situation they’d be in trouble.

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I agree. But one thing we can be certain of is that withholding of meds already known to be needed is also damaging. That's the problem here.

From reading your posts I would offer the following opinion: you are laying the blame at your GP when it seems to be the problem of the Practice administration.

My advice would be to speak to your GP, at least by phone if not in person to resolve the situation - this from personal experience(s) has sorted out supply issues.

R

There is a simple solution to this.
Yes it is an inconvenience but surely a quick chat and a check up with the quack has to be a good thing?
I am facing the same next month when I need a repeat prescription. A pain yes but for the good.

I am not a doctor but - some hypertension medication can cause damage to your kidneys. I would imagine that if they were to continue to prescribe you medication that was causing damage to your system, they would be open to a liability claim once the post mortem determined the cause of your death. Hence their insistence on having a check up.

It's normal, it's a daft hill to die on (possibly literally).

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Originally Posted by joe narvey

If your GP issued medication without checking your situation they’d be in trouble.

Play the game, go get tested and check the meds continue to be the most appropriate for you.

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I agree, go along with them and get your tests done. Obviously don't know your situation but you don't seem to be putting yourself out to get things done, are you really that busy, other things more important?

It you're worried about BP reading with or w/o meds get yourself a BP monitor and do it yourself. Should be more reliable done stress-free at home.

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Originally Posted by markrlondon

I agree. But one thing we can be certain of is that withholding of meds already known to be needed is also damaging. That's the problem here.

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I’ve been registered with my GP for 14 years, never been able to see the GP nearest slot for a meeting is nine weeks, by which time I’ve gone private.

My prescriptions are private and my appointments are £75 for 15min and you can discuss a single issue.

Your OP could easily be “my doctor gave me a repeat prescription without checking if it was still appropriate and it’s cause serious damage”

Play the game, diarise the meds and go with the process.

I wish you good health and a fast resolution.

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Originally Posted by markrlondon

I agree. But one thing we can be certain of is that withholding of meds already known to be needed is also damaging. That's the problem here.

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Nothing ‘certain’ about it, to me.............

You want the prescription without a consultation with the GP - but in his professional opinion, it is a requirement.

Eastern Europeans are good at going into surgeries and demanding the treatment they want - not what the GP/Practice Nurse wants to give (and they record the consultations to use against the practise)

Offshore workers do the same when they go to the medic onboard.

A work colleague out in S Korea couldn’t understand why the hospital who removed a nodule from his thumb - wouldn’t dress the wound with a concoction of powders that he provided.

At the end of the day - the GP/Medic/Practise Nurse are employed for their professionalism - but people want to play with their livelihoods by ‘bucking the system’ for their own convenience or homespun philosophies...........

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Originally Posted by watchstudent

So when they sent you the message that they had issued a reduced supply

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Having previously withheld meds. With no explanation.

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Originally Posted by watchstudent

In that case they are probably unaware that you have actually run out of medication.

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They were aware, or should have been aware, because I said so in the letter I delivered to them. I doubt they read it fully though. But they were told.

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Originally Posted by watchstudent

Because, you know, it is your responsibility to ensure you request medication in good time before things get anywhere near running out.

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I agree. And, equally, it's then their responsibility to prescribe needed meds in good time, not randomly withhold them with no warning or explanation.

Furthermore, I now know that, even if I had delivered my renewal in better time, I would still most likely have run out. Why? Because on previous experience, available test/review appointments are always weeks ahead.

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Originally Posted by watchstudent

If you have run out then that will just take a phone call to say - "oh, I have actually run out, sorry for being such a moron and letting that happen, please could I have a couple of week's supply while we sort the tests?". Done.

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If only it were so simple. They do not take prescription requests, renewals, or similar on the phone.

Thus my only option at that stage, operating under the impression that they had merely been incompetent (based upon previous prescription errors they have frequently made), was what I in fact did: Put in prescription re-request at the next available opportunity.

It was only when they received that re-request that they bothered to tell me that they were withholding medication to coerce me into coming for the tests.

However, as I have said in this thread, there is no point going for the hypertension review unless I have actually been on the full set of relevant meds for at least a few days. But that couldn't be because they withheld the meds that I'd need.

They're not thinking that withholding is the risk, they're thinking that not withholding is the risk.

There won't be IMHO at least any movement from this defender position officially.

However, I have certainly managed to put my case with positive results when dealing with my GP and specialists for my family if I am talking to them F2F.

Through normal channels, it's an absolute non-starter IME.

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Originally Posted by markrlondon

I agree. That's why I came here to ask whether this was common or accepted and what others would do.

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As somebody who is also on a long term medication, it is common for the practice to remind me that I’m due a medication review, and they will withhold medication as an ultimate sanction if I haven’t taken heed of those reminders. So yes, it appears to be common.

If it gets to that point though, it’s my own fault, and is mostly just a case of me needing to ‘be better’.

With the combination of meds you’re on, it’s probably even more critical to get those reviews though, so just get the review/tests done already! What can be more important than your health?

I get the impression the OP is unhappy to attend in person because he 'knows' the tests (BP, bloods, whatever) won't alter his medication needs.

The GP has an obligation to review and assess these sorts of chronic conditions and as others have said would be exposed to criticism if they were to simply continuously hand out repeat prescriptions without assessment of the underlying condition.

Furthermore, many of the conditions described respond to lifestyle changes, and the GP is ethically and also contractually obliged to raise these because it's a whole lot better (for the patient) to treat some conditions with lifestyle modification as far as possible, rather than meds.

This will be what underlies the OP's feeling he is being 'coerced' to attend the surgery - ie it is in his best interests.

Best wishes,
Martyn.

Best of luck Mark...damn good thing it's free at point of use, as nobody'd pay to be treated like that.

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Originally Posted by ralphy

From reading your posts I would offer the following opinion: you are laying the blame at your GP when it seems to be the problem of the Practice administration.

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An interesting perspective. I am tempted to say that I'm not sure it makes much difference who is to blame within their organisation.

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Originally Posted by ralphy

My advice would be to speak to your GP, at least by phone if not in person to resolve the situation - this from personal experience(s) has sorted out supply issues.

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Rationally this (or speaking to the practice manager, as others have suggested) sounds like it should be the best way to proceed. I've not tried this yet as I want to see what medication actually turns up now that they have said they will issue a limited supply compared to normal.

However... since the GP practice was merged into a larger business, speaking to people to have meaningful discussions about anything has become a special privilege that is seemingly doled out in small measures if one is lucky. When you get to speak to someone, the experience is rushed, unclear, lacking in clarity, and ultimately frustrating. I don't know if I can tolerate that sort of stress over this issue. Complaining to or trying to reason with the organisation itself won't change it.

I've got to speak to them at some point but I wish I didn't have to.

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Originally Posted by Passenger

Best of luck Mark...damn good thing it's free at point of use, as nobody'd pay to be treated like that.

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This.

If I could afford a decent private GP, I would do so.

From personal experience you've absolutely gotta be your own advocate, we'd have never had our son but for my wifes sheer determination not to be fobbed off BUT obviously not everyone has the bandwidth or inclination to 'play the game' and play it hard, personally don't believe health matters should be like that at all but here we are.


'If I could afford a decent private GP, I would do so.'

This is I believe the path they're 'nudging' the population down.

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Originally Posted by martynw

I get the impression the OP is unhappy to attend in person because he 'knows' the tests (BP, bloods, whatever) won't alter his medication needs.

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You don't need to get any "impression"; you can refer to what I have explicitly written.

I am keen to have the necessary tests at the first available opportunity.

I have said nothing whatsoever to the effect of "he 'knows' the tests (BP, bloods, whatever) won't alter his medication needs".

Have the courtesy not to put words into my mouth or to use your guesswork when I have stated the issues.

What I have said is that I think the tests are important, it is in practice exceedingly unlikely that most meds will change as a result of them (I have not claimed to "know" that nothing will change), and that randomly cutting off daily critical medication is (a) a toxic way to coerce me into going for tests, and (b) is not sensible in terms of maintenance of health, regardless of what the test might later establish.

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Originally Posted by martynw

The GP has an obligation to review and assess these sorts of chronic conditions and as others have said would be exposed to criticism if they were to simply continuously hand out repeat prescriptions without assessment of the underlying condition.

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Yes. Several people have stated this. It is not in dispute.

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Originally Posted by martynw

Furthermore, many of the conditions described respond to lifestyle changes, and the GP is ethically and also contractually obliged to raise these because it's a whole lot better (for the patient) to treat some conditions with lifestyle modification as far as possible, rather than meds.

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Yes. Lifestyle changes, however, don't perform magic and cutting off meds that have been identified as necessary isn't a sane strategy, even if test show that changes should be made.

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Originally Posted by martynw

This will be what underlies the OP's feeling he is being 'coerced' to attend the surgery - ie it is in his best interests.

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The OP is here and you can establish what the OP's problems with coercion and direct harm to his health are by reading his messages.

You don't need to interpret them to fit them into your mental model of how things should be. I've stated the issues.

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Originally Posted by Tooks

As somebody who is also on a long term medication, it is common for the practice to remind me that I’m due a medication review, and they will withhold medication as an ultimate sanction if I haven’t taken heed of those reminders. So yes, it appears to be common.

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In my case, the first I knew was when they withheld the medication and, even then, there was no message by any means to tell me why they were withholding it. They just did it without warning or explanation. Very annoying, counter-productive and damaging.

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Originally Posted by Tooks

With the combination of meds you’re on, it’s probably even more critical to get those reviews though, so just get the review/tests done already! What can be more important than your health?

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I think health is very important. I'd really like my GP to not do things to harm it whereas, it seems, they have knowingly put it at risk and harmed it in the well-meaning urge to protect my health!

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Originally Posted by Mr Curta

I've tonnes of experience of this kind of thing due to our daughter's ongoing health issues and the GP insistence on regular consultations before reissuing prescriptions, but as you are never in the wrong and always have to have the last word there is absolutely no point in me contributing more to this thread than to wish you good luck.

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+1

Not having read all the responses; I would suggest, if not already, the OP buys a decent blood pressure monitor and downloads a trend which he could send to his GP. I did this and my GP was very appreciative. Plus, home recording in a stable environment morning and evening will give more meaningful results.


Sent from my iPhone using TZ-UK mobile app

You're clearly quite cross and no amount of perspective from anyone is going to change your mind.

It's pretty standard practice to stop prescribing meds until you have had an assessment. It won't be a process linked to your specific condition so I wouldn't take it personally.

I'm asthmatic, my doctor won't issue me my inhaler unless I have an asthma review every 2 years. So if they ask me to come in for a review and I delayed the appointment by not booking or ignoring it, then asked for an inhaler on prescription, they would not issue this until I had my review.

Sent from my Pixel 6 using Tapatalk

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Originally Posted by AlphaOmega

They're not thinking that withholding is the risk, they're thinking that not withholding is the risk.

There won't be IMHO at least any movement from this defender position officially.

However, I have certainly managed to put my case with positive results when dealing with my GP and specialists for my family if I am talking to them F2F.

Through normal channels, it's an absolute non-starter IME.

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Yes, I am sure you are right about this. Finding the right channels is the difficult bit, especially as they are intentionally locked out.

Unfortunately I can only observe that their withholding of meds has, right now, caused me harm that would not occurred had they not withheld them when I first asked for them (even though I was myself delayed in asking for them).

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Originally Posted by ALindsay

Not having read all the responses; I would suggest, if not already, the OP buys a decent blood pressure monitor and downloads a trend which he could send to his GP. I did this and my GP was very appreciative. Plus, home recording in a stable environment morning and evening will give more meaningful results.

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The issue is more than blood pressure. However, it is well tracked.

It's gone up significantly and worryingly since the GP withheld the most effective blood pressure medication without explanation or warning. Even if I had booked the reviews/tests immediately, I would still be in the same position as I am at this exact moment.

I am looking forward to getting my hands on the reduced supply they said they have now issued. Hopefully it will be actually available this afternoon or perhaps tomorrow.

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Originally Posted by r.dawson

It won't be a process linked to your specific condition so I wouldn't take it personally.

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It would be non-sensical not to take it personally. Afterall, it is my personal health that has been damaged in a well-meaning, but actually harmful, attempt at coercion to, ironically, protect my health.

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Originally Posted by r.dawson

So if they ask me to come in for a review and I delayed the appointment by not booking or ignoring it, then asked for an inhaler on prescription, they would not issue this until I had my review.

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I have not delayed or ignored any review.

The request for reviews came after I put in the prescription renewal and I did not know that they had withheld meds until afterwards. At that stage, the hypertension review in particular could not usefully take place until they let me have the full set of blood pressure and related meds they were withholding!