G.P. Practice – what’s gone wrong in this countryJanuary 6, 2010 at 1:24 pm | Posted in rheumatoid arthritis (RA) | 1 Comment
Tags: Ask the Doctor, aspirin, chemist, Daily Mail, diagnosis, doctor, Dr Martin Scurr, GP, health funding, Martin Scurr, minor illness, over the counter, pharmacy, public health
As usual, there’s something I’ve been trying and failing to put into words for ages, only to find that someone has done it very elegantly for me already! I’m going to copy it to our local practice manager (who is also a friend.)
I am not a fan of the Daily Mail, but I stumbled across an ‘Ask The Doctor’ article in their online paper because it was about R.A. Tagged onto the bottom of the article is this, which I’m going to quote in full, because it says everything I’ve been wanting to say for ages about continuity of care etc. (I’m not sure about the copyright implications here but I’m giving full reference to the original article by Dr Martin Scurr in the Mail Online (Wed Jan 6th), so hopefully it’s OK!
By the way… There was recently a conference organised by the manufacturers of over-the-counter medicines. Many of the great and the good attended – shadow health minister Mark Simmonds, and some of the leading lights from the Royal College of GPs.
The theme of the meeting was to change the way the public thinks about minor illness. There is a push to dissuade patients from consulting their doctors for what might seem to be small ailments, and to encourage self-diagnosis and treatment. It’s all about saving money.
But the involvement of the hallowed seniors of my profession – in what looks rather like a sales drive for those peddling over-the-counter medicines – has set me thinking.
In medicine, no complaint is defined as minor until it has been thought about, in context, with informed judgment. I was always taught that general practice is about the ongoing observation of someone’s health over a lifetime. A lot of apparently disconnected elements might add up to quite a lot.
Yes, I believe in personal responsibility for health – doctors are only guides on a rocky path. But now the leaders in our profession seem to be saying it’s time for patients to look after themselves – implying that doctors have created a culture of dependency. It’s just not so. The problem with academics and medical politicos is that most of them occupy those lofty positions because they opted out of full-time work at the coal face.
How many patients with acid reflux have Barrett’s oesophagus, which can lead to cancer? How many with indigestion have got helicobacter infection, which can lead to stomach cancer? And yet they are expected to go to the chemist. We are supposed to be entering a new decade, not heading back to the last century. We must retain our devotion to patients as guides on that rocky path.
I actually disagree about it being driven by the over-the-counter drug companies. I think it’s driven by the fact that there aren’t enough GPs to see the patients. Our practice has something like eight GPs for 20,000 registered patients, and although there are some patients registered that they never see (because they’re healthy) we have a high elderly population here and the practice is very over-stretched, but there’s no more funding available; so the government thinks the answer is to send us all into the chemist for an aspirin.