This site is intended for health professionals only

Rage against the migraine

A friend of mine phones her surgery. She knows a thing or two about migraines, having suffered from them for years, and just wants an appointment to discuss restarting prophylaxis.

No chance. Not for the foreseeable future. Oh. OK then, how about a telephone call from the GP as it could be sorted with a quick chat? No, the GPs don’t provide that service. Oh. Email? Skype? Turn up and beg? No, no, no.

Big deal. We GPs are under pressure, aren’t we, and simply can’t cope with patient demand. Sure. But here’s the big reveal: my migrainous friend is, herself, a GP. Despite this, she could not get anything even resembling help – she couldn’t even negotiate the receptionist.

Now, I’m not saying that GPs deserve preferential treatment. OK, actually, I am saying that GPs deserve preferential treatment: there are very few perks available for NHS staff, but you’d have thought that looking after our own might be one of them. Apparently not. My partner quickly found that playing the ‘I’m a GP’ trump card – which, in desperation, she did – was still met with immovable resistance, though she was told, helpfully, that she could of course go to A&E. Yes. For ongoing migraine.

Discussing this over our daily post-surgery caffeinated catharsis, it quickly became apparent that the migraine debacle was not an isolated incident. All of my colleagues had a similar recent frustrated tale to tell, about themselves, or about GP friends.

Perhaps we should get our house in some sort of order, before we become a complete parody of ourselves

Which makes me wonder quite how we GPs – who, remember, are repeatedly told not to neglect our own physical or psychological health – are meant to access primary care? Maybe we’re being forced to go privately. Or maybe we end up flouting GMC self-prescribing guidance simply because there is no realistic alternative.

It also made me think the following, which I realise doesn’t sit comfortably with my usual GP-against-the-rest-of-the-world schtick. Perhaps it’s time we took a look at ourselves. Yes, for as long as we can remember, we’ve been overworked and suffering change-fatigue.

But because we always assume we’re under siege, perhaps we’ve developed the mentality that goes with it, battening down the hatches and no longer listening to the clamour outside.

Perhaps the media acknowledgement of nationwide GP appointment delays has normalised long waits to the point that we’re no longer bothered about trying to resolve them.

And perhaps those signposting techniques our admin staff have been force-fed have resulted in triage so rigid that something as inappropriate as, say, routine migraine care is being diverted to A&E.

Which, if you put yourself in the position of the receiving A&E consultant, would result in a justified slagging off of GPs and which, if you put yourself in the position of his attending medical students, would not sell you general practice as a career.

In other words, perhaps we should uncover our eyes, unblock our ears and get our house in some sort of order, while we still have some professional self-respect and before we become a complete parody of ourselves.

In the meantime, has anyone got any spare topiramate lying around? I know someone who could use it.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at or follow him on Twitter @doccopperfield