It is often assumed that there is a linear relationship between symptom severity and GP attendance. Thus a lack of GP attendance is taken to denote mild symptoms even though a claimant may report symptoms that are severe and disabling. In my clinical experience there are multiple factors that disrupt the relationship between symptom severity and GP attendance. Specifically, there are many reasons other than a claimant having mild symptoms that account for a lack of GP consultation post-accident. These include: having a poor relationship with one’s GP, having previous negative or dismissive consultations with the GP, a belief that a GP is not psychologically minded and therefore will have little interest in one’s symptoms, an expectation that a GP’s response to report of psychological symptoms will be to prescribe psychotropic medication, shame and embarrassment about reporting psychological symptoms (particularly relevant in men), not wishing to have psychological symptoms detailed in one’s medical notes, a belief that one’s symptoms are trivial relative to the GP’s other patients and having an independent coping style such that going to one’s GP takes place only as an absolute last resort. The above reasons explain why, in many cases, individuals do not consult with their GP and live instead with severe and enduring accident-related symptoms, sometimes years post-accident. Thus although an absence of GP attendance can be viewed as weakening a claimant’s case, there are many reasons why this is not necessarily so.
Dr Jacquie Hetherton regularly holds clinics in London, Ashford and Canterbury.