This was the title of the Dispatches programme on Channel 4 this week 'Can you trust your Doctor?'..
Worth watching if you missed it - available here....... but I think you do have to be UK based to view
http://www.channel4.com/programmes/dispatches/4od
I found this programme interesting because it goes back to what I've talked about on previous occasions - taking responsibility for your own health, not just sitting and nodding if the Doctor appears not to be on-board or dismissive, not leaving the surgery with a prescription for painkillers instead of a referral for assistance...however in some cases on this programme people were left with no help at all.
'Anthony' went undercover to film one particular GP. This GP had been investigated in the past (2006) for failing to spot cancer...
'Anthony' presented with typical symptoms of bowel cancer, rectal bleeding, abdominal cramps, very bad constipation - he left the surgery with a prescription for laxatives and instructions from the GP to 'eat mangoes'...One month later Anthony goes back and informs the GP that the symptoms have not gone away - he then leaves with a prescription for stronger laxatives and instructions from the GP to 'eat green pears'....Two other doctor's that 'Anthony' presented to (different surgeries) immediately referred him for tests on his first visit to them.
GP's are informed of the 'typical' symptoms to watch out for with regard to colorectal cancers, it seems ridiculous that some are still not aware of the signs.
Another lady went to her GP 14 times after suffering severe breathlessness...she was diagnosed with 'asthma'. Sounds acceptable until you hear that this lady had no previous breathing issues and had breast cancer a few years prior to the breathing issues developing.
Fast forward 9 months and this lady then demands a scan/x-ray as she remains unhappy with the 'asthma' diagnosis. The GP then fails to report the findings to her. Eventually she does obtain the results which show 'secondary lung cancer'. She passed away some time afterwards.
The GMC (General Medical Council) asked the GP to 'amend and improve practices'....
Young lady, 22 yrs old, presented to her GP with a lump in the breast that she was unsure about. GP examined her, said it was nothing to worry about, that it was probably because she was taking the contraceptive pill and she was too young for it to be anything serious.
Six months later she returns to the GP who decides she doesn't even need to be examined because she was previously examined 6 months earlier - sent away with reassurances of 'nothing serious' once again - despite knowing of a history of breast cancer in her family.
This time, her mother insisted she get checked out and she attended elsewhere - outcome was breast cancer, a tumour on her spine and further spread to the liver....
This programme examined how doctor's that are failing patients have very little to worry about. We are taught in life that our actions have consequences but in the case of GP's that fail patients it appears there can sometimes be virtually no consequences.
A three year old child died after the doctor on call did not attend to him adequately - the coroner reported 'failure to provide basic medical attention was total and complete. There was a clear causal connection between this gross failure and Joseph's death'...
So, you'd expect he would be struck off the medical register? Unable to practice again after such a damning report from the coroner? ....Well, you'd be wrong - because the coroner failed to inform the GMC and the local Primary Care Trust (PCT) also failed to inform the GMC so his consequences were? ...None.......
However, it's worth mentioning that around 800,000 people visit their GP's daily and by far the vast majority of patients ARE happy and DO get good care. But, if you find yourself thinking 'I'm not sure' after a visit then take responsibility and ask to be referred somewhere where you will leave thinking 'I'm now sure'......
About Me
- Carole
- I'm Carole, living in London, happily married and mum to two amazing boys.I was diagnosed with Stage 3 Rectal Cancer in April 2010. Surgery took place in November 2010 and I now have a permanent colostomy...Spinal mets were then diagnosed in October 2011...In January 2012 I was told of further spread to the hip area (multiple lesions)..My life expectancy is now 6-9 months. Walk alongside me on the last part of my experience with this..
Another great post, as usual!
ReplyDeleteHugs and stuff,
Carol
YOu're so right Carole. On a bad day I often wonder how different my staging would have been if the first doctor I had seen had refered me rather than fobbed me off with the piles senario.
ReplyDeleteHope you are getting some relief from your pain
take care
stef
Very interesting Carole! Guess this is a reminder to all of us to be our own best advocate. I continued to travel the distance of 120 miles to my 'old' doctor when we retired to the farm and, although fatigue is a major issue these days, I continue to use the same doctor's surgery. You are a champion for the cause lovely lady
ReplyDeleteSometimes I scare myself with too much info from the Internet but I'd rather have the information to present to the doctor than ask his opinion on what it may be. Speeds up their time too as they can quickly look up the symptoms. And as you have proved, you have to be an official nuisance. Good luck on Tuesday sis x
ReplyDeleteI can well believe these cases. My own GP took 18 months before he finally thought about sending me for a colonoscopy despite my telling him about terrible stomach cramps and rectal bleeding. When OH and I went to see him to discuss the results of the colonoscopy he lectured me on prostate cancer. After 5 minutes I pointed out to him that, being a lady, I have no prostate. The following day I changed GPs.
ReplyDeleteThis man also told my daughter that she had a terrible "mass" in her stomach which needed investigating ASAP. Since she was due to return abroad to study the next week, we paid for a private scan. The scan doctor was non plussed as she could find nothing at all.
As a GP of 40+ years experience I find the original posting (which actually was very fair in that it was pointed out that the majority of GPs are well regarded by their patients - but that doesn't necessarily mean they are competent doctors) and the comments following distressing and a cause of some shame.
ReplyDeleteIn my later years in practice in London I was appointed to a team of lay and medical people to go in to assess "failing" practices and doctors, so I have some familiarity with the individuals who let us all down.
I do find it difficult to comprehend how doctors can behave is so crass a manner as the examples above suggest. So much depends on doctors listening to and hearing what their patients are telling them. It is actually a very demanding skill, as - for very understandable reasons - patients may sometimes not come directly to the point that is troubling them. They may, for example, fear that the doctor will think them foolish. Certainly many of my patients apologised as a matter of course for "being a nuisance" or said something along the lines that I must think them silly. I hope I never failed to put them at ease over these concerns. But what I often did was to say "can you tell me what you think may be causing you to feel the way you do" or "is there something really worrying you about this? did you think that your symptoms might be the result of something very serious?" and then the dam would burst.
Of course I got it wrong occasionally. But bless them - the patients were always generous in their forgiving of me.
I taught generations of young doctors training to be GPs. You may be sure that I hammered home these points, repeating often the famous aphorism: "Listen to your patient. He/she is telling you the diagnosis.
Please don't tell me I am exceptional. I really hope to God I am not.
Hi Author Doc,
ReplyDeleteI hope, truly hope, that you are one of the vast MAJORITY of GP's who consistently strive to get it as right as you possibly can...
I honestly do believe that most GP's become GP's not for the large salary but to help those in their local communities, to do good, to educate with regard to health issues and improve the lives of local residents.
Prof. Esmail who worked with Dispatches on this programme shook his head at one point and said something along the lines of feeling ashamed or embarrassed... (*this was after the mango incident)
He also teaches young doctors and had very strong ideas on GP's facing annual or at least regular checks for competency. Like you, he is a great believer in 'listening' to the patient.
If you didn't watch the programme, give it a whirl if you've got a spare hour...:)
Hello Carole - well, I would certainly like to think that I was one of that majority. When I retired from the practice I got a lovely book of compliments and thanks from more patients than I could remember, and I treasure it.
ReplyDeleteCan I relate one little tale to you? When I started there in 1976 a young man came to see me with some persistent lymph node swelling in his neck. The feel of them wasn't your standard tonsillitis type reaction. I'd not seen Hodgkins lymphoma in practice before, but what I remember being taught at medical school made me wonder if indeed this was what they were. I referred him to the appropriate specialist. He did indeed have Hodgkins.
In my last weeks at the practice, 30 years later, this same man returned to me - for something entirely different of course - and reminded me of our first encounter and said something along the lines of "if it hadn't been for you I'd have been dead long ago".
Now I don't accept the "if it hadn't been for you" notion. Because any doctor who is worth her/his salt would have made the same decision. And I like to think that the vast majority of doctors you refer to would have done as I did. There's really nothing exceptional about it. As I said, it's what doctors are paid to do.
I tend not to watch medical programmes on the TV as I got more than enough of the real thing in my career. I do read the debates about the NHS in a quality newspaper (and have written rude letters to the editor on one or two occasions). But for my leisure I like a good book (not medical) and a glass of light white wine.
I do enjoy your blog and I learn from it. I think your approach to your health service is entirely right. The ones I worry about are the frail and less articulate who can't stand up for themselves. But it's a Health Service for goodness' sake. No-one should have to stand up for themselves. Most people are treated more courteously at the Tesco check out than a few are treated at their GP surgery.
Doc,
ReplyDeleteI think you're selling yourself short....I agree with the man's comments 'if it wasn't for you' and I'll tell you why.
Sometimes if you feel you're not being listened to or are made to feel like a time-waster, fraud, neurotic, etc then you go away and get on with your life (*for as long as you can anyway) and sometimes this can be a fatal decision.
Therefore I agree that when you listened, and referred him you DID save his life.
For all you know he could have walked away *as my husband has done SO many times now* and decided it's just not worth going back.
I was initially diagnosed as 'depressed' when I first presented with my symptoms..it was a locum who finally listened to me, finally examined me and then immediately referred me by email... Prior to that I'd been prescribed antibiotics, pessaries, and offered anti-depressants (3 times)- at one point I almost did think about going back to work and just working through whatever it was...it was only the fact that I felt so very very unwell that stopped me.
I honestly do feel that locum made a difference and I do feel she probably saved my life.
Like you, I also worry more about people who are less confident, maybe older people ...me, I'll be okay because I'm not bothered if they all end up detesting my very presence.....but frail, elderly, scared people are the ones we must ensure get the SERVICE :)
Now, onto important stuff - you like to read (fiction?)..have you read 'A Thousand Splendid Suns'? Amazing book...also 'The Book Seller of Kabul' - another really good fiction read.