Your GP is a vital part of your healthcare team and it is important to have a strong doctor–patient relationship. This article offers advice about how to develop and maintain a good relationship with your GP as well as other practice staff.
The average GP practice has 8,757 patients on their list (NHS Digital, October 2019). The average person sees their GP about six times a year. For some GPs, a 12-hour working day is typical – their time spent consulting with patients, dealing with correspondence, interpreting lab results, issuing prescriptions, arranging referrals, and so on.
GPs are well trained and knowledgeable about common health issues. They are often familiar with conditions that cause secondary immunodeficiencies, even if they’re not fully aware of all the implications of being immunodeficient. GPs, however, tend to be less informed about primary immunodeficiency disorders (PIDs). A reason for this is that PIDs are rare.
According to the British Society for Immunology, about 5,000 people in the UK have a PID. The incidence of CVID is between 1 in 25,000 and 1 in 50,000 of the general population, and for other PIDs the incidence is much lower. Therefore, a GP can spend their whole career without ever seeing someone with a PID.
If you have been diagnosed with a PID, then you may be better informed about your condition than your GP. But remember that your GP is highly experienced in looking after your overall health needs, addressing your concerns and implementing management plans.
How to find a GP practice
In England, you can search for your nearest GP practices by entering your postcode on the Care Quality Commission (CQC) website. Immunodeficiency UK suggests you only register with a practice that is rated either outstanding or good.
Aim for a positive relationship
When registering with a GP practice, request that your named accountable GP is a permanent member of the practice who is not about to retire or take extended leave. For your first meeting, it is a good idea to ask for a double appointment. You may not always be able to see your named GP, so get to know two or three GPs at the practice and allow them to become familiar with your medical history and needs.
Ask for your notes to be flagged
This simple request will trigger an alert every time your notes are accessed and remind all staff at the practice that you have a significant condition and should be given quick and easy access to a GP.
Keep a folder containing your hospital notes
Ask your hospital clinicians to copy you in on all correspondence, then file it in a dedicated folder. Similarly, ask your GP for a printout of the notes that they hold about you and make sure you have the most up-to-date version if anything changes. Take the folder to all your GP appointments, along with any guidelines your consultant may have given, for example antibiotic prescribing protocols. Also have your folder ready in case you need to attend A&E or if you see any other healthcare professionals, such as your dentist.
Take notes at each appointment
During each appointment, jot down information that your GP shares with you about your condition and make sure you understand what is said. Consider taking a relative or friend with you to an appointment if you think this would be helpful.
Educate your GP
Direct your GP to the Immunodeficiency UK website or take to your appointments any Immunodeficiency UK leaflets that are relevant to your condition. We have leaflets on specific PIDs and secondary immunodeficiencies, and a useful booklet for GPs.
Your GP is your advocate. They can liaise with your specialist team, provide advice about your general health, manage any other conditions you may have and be generally supportive. A good relationship with your GP is beneficial and achievable.
Receptionists play a vital role in keeping the practice running but can sometimes appear uncooperative. Stay calm and remain polite. Tell them that you have a serious condition and that there is an alert on your notes. Explain that Dr X or Dr Y is familiar with your case and that you need to speak to them if no appointments are available. Most practices have a policy for emergency appointments, so do ask for one. If you feel that a problem is developing, seek help sooner rather than later. It is better to ask for help on a Thursday morning than late on a Friday afternoon.
Get to know the nursing staff at your practice. They are usually responsible for immunisations and for monitoring long-term health conditions, such as diabetes and hypertension. It may be helpful to provide your GP practice with the contact details for your immunology nurse, who can give specialist advice.
Pharmacists may query prescriptions, particularly if you are prescribed high doses of antibiotics for long periods or unusual combinations of drugs. It is helpful to always visit the same pharmacy, to get to know the pharmacist and share with them any prescribing information from your GP or hospital specialist.