Time for ASD Specialist GP's?

Hello

I am a high functioning sufferer of ASD. I am also a late diagnosis member of the lost generation, being diagnosed approx 3 years ago at the age of 43. (i am now 46)

over the past 3 years i have been to see approximately 5 different doctors and asked about their knowledge of ASD.


I have yet to encounter one GP that has more than the most basic understanding of the complex umbrella disorder and thus,

feel like us sufferers of ASD have been left out of professional medical health care, due to incompetence on the part of the GPs in question.

I was thinking that when considering how prevalent the condition is (thought to be over 1%), while not being so common that a majority suffers

from the condition (thus making knowledge on the area extremely common). 

I would say that there is a strong argument to say that this common minority condition warrants the need for GP's to set up specialist practices specifically

for this target market, so that this target market can receive high quality professional treatment form practitioners who not only know a little about their condition,

but have a good comprehensive knowledge on this specialist and much misunderstood field.

Better still, it would be awesome to have a surgery or practice set up that has not only a well versed GP who has an in-depth understanding of all the conditions

that come under the ASD umbrella, but a practice that also has a specialist clinical psychologist who is specialist in this area, an occupational therapist who is specialist in this area,

and a specialist psychiatrist who is specialist in this area.

A one stop shop to treat the 1% of the population, in their area.

I mean, the island that i live (jersey), there is a good but overly in demand service for evaluation and diagnosis, there is a drop in service for supporting people with ASD

that includes people who are occupational therapists, care workers etc. 

Which is great if things are going well.

However, what if one needs something such as medical treatment for meds for anxiety, sensory overload meltdown, aggressive behaviour.

That is unique to ASD (as the causes are different to other conditions).

Then, who does the person with ASD turn to for this advice, when most GP's and even psychiatrists are fairly clueless to the complex issues found in ASD.

In Jersey, we have a population of over 110,000.

Which means that we have more than 1,000 with a formal diagnosis.

Despite this, i still find it hard to find a GP or even a psychiatrist who knows what that are talking about, or who isn't in denial that the condition even exists.

Please consider.

Thanks 

  • Now as luck would have it. On the 5th November news was released that all healthcare workers are to have autism training. As to how long this will take to phase in and how extensive it will be, that is anyone’s guess but it’s a start. See the thread I started the other day for links related to this:

    community.autism.org.uk/.../autism-training-for-healthcare-workers-becoming-mandatory

  • I think that if the NHS listened, then they could set up specialists in each major city for helping people with ASD based issues. That would be different to being mistreated by GP's who do not have a clue. or by a factionalised service that prioritises diagnosis and other areas such as improving social interaction.

    If you suffer from high levels of anxiety and meltdowns, then your anxiety is a higher priority than hanging out with some people being nice to you so you don't get isolated/.

  • The maths still doesn't work out - we're still just 1% no matter how many people there are under each surgery - and what special treatment are you expecting?    If you're diagnosed, the 'specialists' (local MH team) should already know of you and be 'supporting' you.      What do you expect your gp to do differently?

  • Sure. i think that the area that i live is just much more backward than other areas. Due to the small population and greedy finance industry focus. The government are more preoccupied with finance (some their own personal) rather than helping the people they are in office to serve. That's the nature of politics. I am afraid. And it is the politicians that we rely on to save our lives. as they control change.

    Shame when they are clueless about change apart from their own bank account's change.

  • Hello. Yes, I understand your concerns and agree to some extent.

    However, if you consider the population of the UK. Which is over 66 million now. Even 1% of 66 million is a significant amount of people, and i feel warrants addressing the needs of this minority but still significant in numbers. 1% of ASD sufferers in the UK is then at least 660,000 people. which is over half a million.

    The numbers of GP's vary per amounts of individuals. with Scotland apparently having the most per head, with 76 GPs per 100,000.

    Although due to the nature of ASD, i would say that if the NHS were to set up a specialist service for ASD suffers, the ratio between ASD specialist GPs and patients would need to be higher.

    As for the entire GP training thing, yes, I agree, the GP degree is not long enough to cover all areas of health in detail and to include all variations. I therefore would propose that what the UK now need is a comprehensive course that explains all the ASD related conditions in detail, from diagnosis, to support to treatment (psychotherapy, occupational therapy, psychiatric based etc)..

    Such a qualification course could either be a supplemental post graduate course, or perhaps even be a specialist route in itself.

     Separate to GP.

    So when an ASD patient has an ASD problem. Then they can book an appointment with the ASD specialist.

    When an ASD patient has a normal non ASD related health issue, then they can see a normal GP who has a basic understanding of ASD.

    Make sense?

  • From my knowledge, surgeries should identify the focus areas of their GP’s - I now know that mine does not (I have asked for it/mentioned) but I now know who recognises my condition (diagnosed or undiagnosed) and they are the ones I want to see.  There still needs to be some basic training/information IMHO with all staff at the surgery.

  • There are 2 problems to this - the first is we are supposed to be about 1% of the population - so practically insignificant when compared to drug addicts, alcoholics, pregnancies, cancer sufferers etc.    There's a limit to how many courses someone can do and keep all the possibly conflicting information in the front of their mind.

    Second is the whole 'GP' thing - general practitioner - they are not experts in anything - they are front-line triage for whatever comes through their door - anything more complicated than a cold or a sprained ankle and they will normally refer you onto someone else - and that's where you meet the total incompetence of your local MH team.    These people are supposed to be qualified and experienced but are totally clueless - their 'go to' treatment is to call you depressed and drug you up until you go away - job done, boxed ticked.

  • Yes. I think that the medical community need to create a post graduate diploma or certificate (MA for example?) in ASD.

    Or perhaps develop a sophisticated specialist doctors program that teaches all areas of treatment for ASD patients, in terms of occupational therapy / clinical psychology / psychotherapy inc CBT / psychiatry.

    They would in essence become Super ASD doctors. Who in essence would be able to help the ASD sufferers with everything ASD based.

  • Yes, although I guess it is hard for GP's to know everything about all conditions. So as to keep their training within a given time limit, Each subject of knowledge is kept within a certain time frame. From what i have read, the info that they cover on ASD is very basic. 

    I mean, so basic that it only really covers the basics, and does not explain the more complex reasons as to why people with ASD end up suffering from related conditions such as anxiety. As the causes for these conditions does change how severe and how easy / hard the conditions are to treat using the standard methods of using SSRI's etc. 

    Without this knowledge, the GPs inevitably do not fully understand why their patients are still experiencing anxiety, and due to taboo areas in general medicine, decide not to prescribe medicine for their patients leaving their patients to suffer from distress instead.

    Not clever. But that's the size of it. And i am one the luckier people with ASD in that i am able to put into words what i think, can't help to think what life is like for many low functioning folk who do not even understand why they feel so bad, although the doctors / psychiatrists likely fill these poor sods up with strong anti-psychotics instead, which is like chemical castration for their personality.

    When other simpler medical interventions are likely more effective.

  • It would just be good if all GPs and Mental Health professionals were to have mandatory annual training on ASD. There seems to be a massive lack of knowledge and understanding of Autism in the very professionals that are very often the first point of care/contact for Autistic individuals!

  • I agree  that a GP  with autism centric  training is needed I'm sick and tired of my surgery and its s***t attitude towards me I don't go anymore due to the non help I get same answer, its you anxiety take some pills.