Gout

Gout: experiences with health professionals

Men and women discussed their diagnosis and treatment with GPs or specialists (rheumatologists), though a few had talked about gout with other health professionals like nurses, dieticians and chiropodists. Interactions with health professionals were often positive, many people saying that their GP or specialists were supportive, helpful and reassuring. 
People often acknowledged how difficult it must be for GPs to advise and treat patients with a wide range of issues, but sometimes felt that their doctor’s knowledge of gout could be better. Some felt that GPs should refer people to specialists if their own knowledge of gout was limited. Others wished that their GP had referred them to specialists earlier rather than trying to find a solution themselves. Simon felt that his treatment was ‘a bit trial and error’ at times. Several people were dissatisfied with interactions they’d had with doctors in Accident and Emergency (A&E). Arthur felt that his first (incorrect) diagnosis was ‘just really a shot in the dark’. Jean’s diagnosis was complicated because her GPs were unsure if it was possible to get gout with artificial toe joints. Some people felt that seeing a different GP each time caused problems because they gave different advice. 
Some people felt that their doctor understood how painful gout could be. Others thought that it was impossible to understand the pain unless you had gout yourself. People sometimes felt that doctors or practice staff were unaware of how urgent it was for them to have an appointment if they needed painkillers or anti-inflammatories during an attack. Paula thinks her GP did not realise how bad her symptoms were because she could never get an appointment when the pain and inflammation were at their worst. Others, though, found they could get appointments quickly and easily. 
Several people thought that managing gout effectively was a ‘low priority’ for GPs or that they were ‘not interested’ because it is not ‘life-threatening’ and not a ‘sexy disease’. John thinks that doctors are now more aware of gout and take a greater interest in it. One man thought that his GP needed more training on gout. Eddie’s doctor told him that very little research had been done on gout. Some people felt their doctors were only thinking about relieving the pain of attacks and not preventing them.
Some people felt that their doctors did not allow enough time to talk through the diagnosis and treatment options. A few felt that their doctors did not have time to discuss things with them in detail or that they were ‘fobbed off’. Others were pleased that they could make decisions with their doctor, and that their doctor was supportive of their choices. Alastair appreciated his doctor treating him ‘as an intelligent human being’. Several people were happy with the information given by their doctors, while others would have liked more. A few were given conflicting information about diet or medication. (For more see ‘Finding information on gout’). 
Even though gout can have a major impact on everyday life, Eddie and others felt that there was less help with it from health professionals than for other conditions like heart problems or strokes. Kate felt that she was ‘left to get on with it’. Like others, Harry felt that sometimes the ‘aftercare may be a little sketchy’ once gout is diagnosed and treatment options are agreed. Some felt that there was no follow up to ask how they were getting on, and to find out if they were taking any prescribed medication. (For more see ‘Monitoring gout’). Jacqui thinks that health professionals should consider the implications that pain has on people’s everyday lives.
Some people felt they needed to be quite assertive to get what they wanted from their doctors. Others felt annoyed or upset by interactions they had. Michael’s GP was dismissive of the kit he had bought to test his uric acid levels. One man felt angry that his GP did a screening test for prostate cancer (PSA test) without asking him when he took a blood sample to check his uric acid levels. When Carole started allopurinol, she did not see her usual doctor. The doctor she saw would not prescribe any anti-inflammatories for her because he was concerned about her kidney function. Carole knew that starting allopurinol could trigger an attack, and she ended up with gout in several joints at the same time before she was eventually prescribed medication to treat the attacks. Shirley was disappointed that her doctors would not refer her to a pain management clinic when she asked. One said it was too expensive and another told her she didn’t take enough tablets to need it.
Most people who had seen specialists (rheumatologists) were pleased with the care they were given. Some had been referred to specialists for other conditions but not for gout. Hazel would like to be referred to a specialist to get her gout under control but her GP has never suggested it. One man was told by his consultant to phone if he had any more problems, but he did not get a good response when he did this. 
Some people talked about gout with other health professionals. Carole saw a podiatrist (for a different issue) who insisted that it was only possible to get gout in feet. She felt cross because she knew this was incorrect but the podiatrist would not accept that a patient might know more than a health professional. Janette has shared information about gout with her chiropodist so that she is aware of the condition if she comes across other people with symptoms in their feet. Jean’s chiropodist was the first person to suggest that she might have gout and told her to go to her GP. Sam found it difficult to discuss her symptoms with a pharmacist when she was abroad because of the language barrier. Kate had an x-ray and felt that the technician was not very gentle with her hand considering she had an attack of gout.


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Last reviewed December 2016
Last updated December 2016

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