How to Get the Most out of Your General Practitioner
Last updated: December 2022
Did you know your general practitioner (GP) can do a whole range of useful things for you when you have psoriasis? I didn't. I view mine as the gatekeeper between myself and my dermatologist, in the UK you can only visit your dermatologist with a referral from your family doctor. As my GP has never said no, as I have always had active psoriasis plaques, it seemed like a monumental waste of time and resources for what is essentially admin.
That was until I interviewed Dr. Dan Maggs for my podcast this week. It turns out your doctor has a critical role in maintaining good health if you use them effectively. These are the top tips I learned from our discussion.
You are a 21st century patient
I don't know about you, but I have had some negative experiences with dermatologists when trying to discuss new medications I had read about in the news, or as a result of online research. I research loads before an appointment and then hesitantly ask minor questions to suss out the dermatologist's mood and attitude that day before embarking on a full discussion about my research.
Dr. Maggs informed me that most doctors enjoy receiving patients who are well informed. A GP is an expert generalist, and as such, they have been too busy catching up on the developments in another disease category. If you take your research in and discuss it, it is not out of the question for your doctor to either search online during the consultation, or ask for time to research your topic of interest further and book an appointment for a follow up (or call you later in the week).
He explained that patients who turn up with research are his favorite because they are taking an active role in their healthcare. This means that they will most likely follow up on the advice and prescriptions given and are more likely to attend follow up appointments. You should aim to be that patient, do not be afraid of the doctor's response. If you are nervous, print the article out for feedback. If your doctor is intolerable, that's a sure sign you need a new one.
If your doctor is intolerable, submit a complaint
I know Dr. Maggs, I met him while slightly inebriated one night and shared rather candidly my experiences with dermatologists. He remembered, ha! One incident stands out, and at a later meeting, he informed me I should have lodged a complaint. I write about this here because I never considered it an option. I do not know why. I would not have tolerated such behavior in any other aspect of my life. The lesson here is this, even if the dermatologist is your only option for care, that person is a professional, and if they do not behave professionally, then a complaint should be made to the relevant place.
Now, this may sound dramatic, but part of their role is to assess your quality of life and your mental health. Psoriasis is linked to increased rates of depression and suicide. If they respond to your questions in a manner that does not support your healing, then they have been inadequate in their care.
Your GP is your healthcare control center
If you have psoriasis, it is not unexpected that you see multiple doctors; perhaps a dermatologist and a rheumatologist or as I was at one point, a gastroenterologist and a dermatologist. If you have other healthcare issues, then it may be even more. If you are taking several medications that require blood tests and symptom tracking, then your medical situation needs effectively tracking. This is the role of your GP.
Your GP (at least in the UK) receives the instructions from all of your specialist consultations and is in charge of prescribing and monitoring drugs. They see the test results from all of the different tests, they receive all of the letters from various specialists. They know everything about you. If you are like me and get hacked off with your dermatologist because they don't think outside the skin, then spend more time with your GP.
I asked Dr. Maggs if I could ask my GP the questions I forgot/was too intimidated to ask my dermatologist, and he said YES! If the questions where beyond his scope he would email or call the dermatology nurses for clarification. So do not wait months until your next dermatology appointment if you have any questions or uncertainties.
If you need a lot of time- book more than one appointment
I usually wait until small problems have accumulated before I see my GP ‘to make the visit worthwhile,’ I thought I was saving them time and the National Health System (NHS) money, but it turns out I am wrong, and this is a huge problem. In the NHS a GP has ten minutes per appointment. That includes the time after you have left to type up the notes. If you want to have a detailed discussion, take one appointment per problem, so your GP has enough time to address your issue thoroughly. This way you will be able to get more attention from your doctor and you will not feel rushed.
I hope some of this gives you food for thought. I know that I will spend a little more time investing in my GP as an ally. I encourage you to do the same. Try to book appointments well in advance so you can build up a rapport with the same doctor and hopefully you will be able to continue your healing journey on a slightly smoother path.
Does your psoriasis management change with the seasons?