Sunday, 15 May 2011

There's gratitude.

More doctor bashing in this morning’s Telegraph in an article which would even look over the top to Mail readers. And if the article itself is misrepresentative and ill informed just take a read of some of the comments.

GP’s are berated for failing to pick up a third of cancers at the first presentation. But if you turn that round what that means is that two thirds are picked up at the patient’s first attendance which I would have said is pretty damned good. 

But for those not picked up, the blame is laid squarely at the feet of the GPs. No mention of the referring restrictions placed on GPs by the PCTs, no mention of referral management systems,  limits on consultation times etc etc. All the factors imposed upon GP practice that make it a miracle that in your allotted 10 minutes with a GP you have a 66% chance of him picking up your new cancer.

We are all worried that the NHS is becoming a shit service, but when you read this crap you can’t help feeling that the punters get what they deserve. Look out for the next installment when I predict the Telegraph will turn it's guns on the Consultants.


  1. Fairly typical "GPs are all crap" rubbish. Biased, superficial and third-rate rubbish.

  2. I've Tweeted yours and JD's posts, Dr Z.

    All this stuff in the NHS (and ditto other public services, and the ones already privatised, and Univs) put me oddly in mind of the main refrain in Joni Mitchell's Big Yellow Taxi.

    "Don't it always seem to go, you don't know what you've got 'til it's gone"

  3. My doctor picked up my kidney cancer first time out - send for U/S scan after 3rd UTI in a few months and bob's your uncle - I owe her BIG TIME and will never forget her.

  4. so, the third (gosh, trivial..) were all picked up at appointment 2? So, diagnosing within the 10-minute time is adversely affected by restrictions on referrals? So, it's just fine for a GP to send away, with reassurance, a patient s/he would have referred but for restrictions?

  5. You are obviously not medical anonymous. People with early cancer don't walk in with a sign around their neck giving the game away. People present with symptoms, some of which are present in cancer, but may also be present in many other conditions. For example, a brain tumour may present as headache, but obviously not all headaches are from tumours. What would you do, refer all patients with a headache for a scan? A sure way to overwhelm the system. Diagnosing cancer is not easy and as with all human endeavours there is no 100% success rate.
    What are your expectations exactly?

  6. My 2 year old nephew had gross haematuria and my sister rapidly took him to the GP, along with a sample of the wee (as it had been done in a potty). He was otherwise in very good health, with no fever, no pain, no tiredness etc.

    The GP sent him away with a prescription for antibiotics for a urine infection without even doing a dipstick test or examining his abdomen.

    Even a complete numpty with 30 minutes of medical training would know that that is not appropriate management. Thankfully his parents didn't accept his diagnosis and took him to A&E, where he was diagnosed with a Wilms tumour.

    Many GPs (mine included) are diligent, intelligent, caring professionals. But some are absolute arseholes who cut corners and hope to get away with it. Remove those from the system and even with the referal restrictions I'm sure that figure would increase significantly. I know the GMC are a big bugbear of yours, but somehow these incompetent idiots need removing from the profession. Somebody needs to oversee this and make sure they do not continue to put people at risk with their incompetence

    There. I feel better for that.

  7. Yes of course there is always the bottom 2% of the distribution curve I'll admit that. Known some myself, the odd surgeon you would not let cut your toenails etc. Unfortunately the GMC never seem to get hold of these types and I have no doubt they will not be sieved out by revalidation either.

  8. It does seem to me that those with the best CPD portfolios (regardless of the profession) are those who do the least work.