Jane Hodgkin discusses how to build a positive working relationship with your GP to manage your condition effectively.

Addison’s is very rare, so the GPs at your practice are likely to see only very few (if any) patients with Addison’s – even in a big, shared practice.

This is also true of other forms of steroid-dependence and so your GPs’ understanding of adrenal issues and replacement steroids may only be limited and theoretical. Add to that the fact you may well have one or more other conditions, and it becomes apparent that you may have to give your GP a helping hand in understanding your medical needs.

Making the most of your appointment
GPs have precious little time outside clinics to read and learn about your condition and your appointment is likely to be limited to 7–10 minutes. So if you have lots to discuss, you could enquire about making a double appointment. Many GP practices now encourage this for patients with complex conditions, to help the appointments schedule run to time.

As everyone knows, preparing bullet points and questions in advance means things can go more smoothly. You are entitled to take along a family member or friend if you’d like someone else to make notes, or help prompt you on important issues.

You are the expert on you
The aim of treatment for Addison’s is to enable you to feel well and to lead a full life. That’s you, in your life, not some standardised human being! This means that, blood tests notwithstanding, only you know the effect that your replacement endocrine medications are having on your wellbeing or otherwise. Let your GP know, as factually as you can, how well you are managing, and where it is a struggle. They can only help with the issues they are aware of.

ADSHG is expert on Addison’s
Do give your GP copies of all relevant information from the ADSHG website, especially 'Caring for the patient with Addison's: information for GPs'. It can help if you highlight on the leaflet what you are keen for them to do on your behalf, such as writing repeat prescription lengths of 2+ months for essential replacement hormone tablets, and including injectable hydrocortisone supplies on your repeat.

Be prepared and ready to explain the reasons for this, and don’t assume they will be familiar with what they need to do for you. You may be the first adrenal patient they have ever written a prescription for, and they may lack confidence. Highlighting the expert recommendations in our leaflets, written by the Addison’s Clinical Advisory Panel, can help to make your relationship a more positive one.

Hug your GP?
No, don’t! But you’re likely to get along better if you bear in mind that your GP’s aim is to help people – that’s why he or she became a doctor. However, GPs are only human and they have many stresses and constraints in their very busy working lives. So pleases and thank yous can oil the wheels of the consultation and, even if they seem to misunderstand you or refuse your requests, becoming tearful or upset can ruffle feathers and get in the way of the outcome you want.

 So deep breaths, keep calm and carry on explaining! If you feel yourself getting upset, take a moment to re-focus, then speak slowly and quietly.

 Some key words
If your GP makes a potentially unhelpful suggestion, for example 'you will have to ask the endocrine clinic for injection materials' or 'your prescription can only be renewed monthly', here is a useful formula for response.

  1. Thank them for their response – or something similarly polite, rather than a spluttering or weeping protest!
  2. Consequences – remind them of your concerns about the potential consequences and how your health could be put at risk.
  3. Ask for help – how could they, as your GP, help you to avoid the worst case risks that might arise?
  4. Other options – ask directly: 'please can we explore other options?'


If you get a defensive, negative reaction, then politely leave the subject. Be prepared to raise it again at your next appointment. You may be allocated a different partner in the practice, with a more informed or open outlook. You could consider asking your endocrinology department to write a letter on your behalf. And don’t hesitate to share your frustrations in the ADSHG forum. You will find you are not alone, and others are likely to have some helpful tips in how to win over a resistant GP.

Jane Hodgkin
Cognitive Hypnotherapist

 

ADSHG publications
Ask your GP to ensure the following have been scanned into your Notes and are highlighted in your Summary Care Notes.


PDFs can be downloaded for free from our ADSHG Downloadable Publications page .