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Dispatches: Can you trust your doctor?
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Author:  cloaked_wolf [ Mon Oct 03, 2011 7:15 pm ]
Post subject:  Dispatches: Can you trust your doctor?

Constipation + bleeding are not symptoms of bowel cancer. Factually incorrect. In fact, constipation can cause bleeding.

Red flags that we look for: diarrhoea and bleeding for 6 weeks if over 40yrs old; rectal bleeding alone for 6 weeks at age 60+; diarrhoea without bleeding for 6 weeks and age 60+.

But that first doctor was hopeless. He would have been of the product of the time when there was no formal training for GP. Nowadays, the exams are as hard as those who become consultants in other specialties.

Author:  cloaked_wolf [ Mon Oct 03, 2011 7:16 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

Angina pain - the patient describes it as burning, which is how indigestion is described. I've never had a patient with angina describe it as burning. This is from 8 months of Cardiology.


So far, the "presentations" are very misleading.

Author:  TheFrenchun [ Mon Oct 03, 2011 7:17 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

cloaked_wolf wrote:
Constipation + bleeding are not symptoms of bowel cancer. Factually incorrect. In fact, constipation can cause bleeding.

Red flags that we look for: diarrhoea and bleeding for 6 weeks if over 40yrs old; rectal bleeding alone for 6 weeks at age 60+; diarrhoea without bleeding for 6 weeks and age 60+.

But that first doctor was hopeless. He would have been of the product of the time when there was no formal training for GP. Nowadays, the exams are as hard as those who become consultants in other specialties.

If you have the chance of finding a good doctor, latch onto them because they are like gold dust.
Mine sent me a personal letter t'other day giving me advice on various things :)

Author:  cloaked_wolf [ Mon Oct 03, 2011 7:20 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

The breast cancer one is indefensible - if you have a mother or sister with breast cancer, your risk of breast cancer is sky high. I'm surprised the patient wasn't already screened when the sister was diagnosed.

Author:  jonbwfc [ Mon Oct 03, 2011 7:22 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

TheFrenchun wrote:
If you have the chance of finding a good doctor, latch onto them because they are like gold dust.
Mine sent me a personal letter t'other day giving me advice on various things :)

My doctors keep dying. I'm on my fourth GP in a decade, all popping off unexpectedly although through natural causes. I have a feeling if my current one keels over, they may deregister me.

Jon

Author:  TheFrenchun [ Mon Oct 03, 2011 7:25 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

jonbwfc wrote:
TheFrenchun wrote:
If you have the chance of finding a good doctor, latch onto them because they are like gold dust.
Mine sent me a personal letter t'other day giving me advice on various things :)

My doctors keep dying. I'm on my fourth GP in a decade, all popping off unexpectedly although through natural causes. I have a feeling if my current one keels over, they may deregister me.

Jon

an apple a day keeps the doctor away... We said an apple not a grenade ;)
In France the doctors are very quick on the uptake and they will run dozens of tests within days without really asking details beforehand.
I think I prefer the UK because doctors worry patients less. Apart from the ***** I had when I moved to London who was a soulless ****

Author:  cloaked_wolf [ Mon Oct 03, 2011 7:27 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

The representation of the "bowel cancer" - I'd have examined him but if found nothing special, would have given him the same (movicol) depending on whether I could see a source of bleeding or not. Piles and fissures are common.

Author:  cloaked_wolf [ Mon Oct 03, 2011 7:29 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

They talk about Shipman and competence. But Shipman was never incompetent. In fact, he was a clinically excellent doctor. He just also happened to have homicidal tendencies.

This is why revalidation is a load of crap - Shipman would have gone through with flying colours!

Author:  cloaked_wolf [ Mon Oct 03, 2011 7:30 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

TheFrenchun wrote:
In France the doctors are very quick on the uptake and they will run dozens of tests within days without really asking details beforehand.


The UK is one of few places where we still rely on clinical skills - history-taking, examination, diagnosis, and appropriate investigations.

Author:  cloaked_wolf [ Mon Oct 03, 2011 7:31 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

So 99.5% of GPs are fine? Sounds like some people expect 100% perfect GPs. You've got to remember that 50% of GPs will be above average.

Author:  cloaked_wolf [ Mon Oct 03, 2011 7:32 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

The GMC was deeply flawed? There are many of us who believe it still is!

Author:  TheFrenchun [ Mon Oct 03, 2011 7:36 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

cloaked_wolf wrote:
So 99.5% of GPs are fine? Sounds like some people expect 100% perfect GPs. You've got to remember that 50% of GPs will be above average.

I don't expect doctors to make no mistakes. However I expect them to be trained enough not to throw terrible news at people's face in a casual manner.

*edit for shoddy spelling.

Author:  belchingmatt [ Mon Oct 03, 2011 7:36 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

jonbwfc wrote:
TheFrenchun wrote:
If you have the chance of finding a good doctor, latch onto them because they are like gold dust.
Mine sent me a personal letter t'other day giving me advice on various things :)

My doctors keep dying. I'm on my fourth GP in a decade, all popping off unexpectedly although through natural causes. I have a feeling if my current one keels over, they may deregister me.

Jon


Well if they can't keep themselves healthy then what chance do you stand?

Author:  cloaked_wolf [ Mon Oct 03, 2011 7:38 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

The kid was unfortunate. That was indefensible. Kids bounce back very quickly but they also become very unwell very quickly, which is why I always ask patients to bring them back ASAP if there's any concern.

Author:  cloaked_wolf [ Mon Oct 03, 2011 7:39 pm ]
Post subject:  Re: Dispatches: Can you trust your doctor?

TheFrenchun wrote:
I don't expect doctors to make no mistakes. However I expect them to be trained enough not to throw terrible news at people's face in a casual manner.

Depends - as I've said, the new generation of doctors are trained to a far higher standard. I've seen some awesome GPs and some I'd probably avoid seeing even about a sore throat.

EDIT: If you want to be relatively sure of a good practice, join a training practice. These practices have to be run at a high standard to be able to train GPs and means all of the doctors are at the top of their game. They have to be! It's certainly what I'll be looking for when I (hopefully) pass my exams and can work as a GP.

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