Friday, 25 November 2011

Tick box medicine

On a recent post on JD’s blog an anonymous commenter has made the comment, “my GP is crap, what can I do about it”. Well I suppose the simple answer would be simply to change his GP. But if we don’t know why he perceives his GP as crap it is possible that he may be equally dissatisfied with his new one.

If you take your car in for a new tyre these days you find, when you go back for it, that while they were replacing the tyre they found other things that needed replacing, brake pads, shock absorbers etc. You have to take their word for it in the interests of safety, but do you ever have a sneaking suspicion that you are being had? And aren’t you just a little irritated that they did not just replace the tyre as requested and not snoop into the other bits?

I very rarely visit my GP, but recently had to see him for a very minor simple problem. I sat down with the GP, who, to me, looked about 14. He dealt with the problem quickly and efficiently, so about 90 seconds after I sat down I rose to leave. Not as simple as that is it? I was sat down again and subject to a whole lot of stuff I had not gone in for. Yes, I do know what my cholesterol is, and no I don’t think it would be a good idea to go on a statin. No I don’t want my BP taking, I do it at work and it is fine. And when asked my alcohol consumption I managed a polite response even though I was thinking ”mind your own fucking business” 

Now I know full well that this was done because it is part of the tick box approach that has been forced onto my GP in the name of preventative medicine. But it still irritates me that my GP is having to act like a Kwik-fit fitter. And if that is how I feel just think how the lay punters feel.


  1. It's all about QOF doc' and the surrogate markers rather than any real evidence of sickness. I had a similar experience myself with my diabetic wife for whom I am a carer. They were just ticking boxes but worse they were doing it no purpose, because she is fitter than I, in pretty much all areas. Didn't stop him from wanting to prescribe simvastatin though, because she is diabetic, 'just in case'. Nearly told him to F-off but restrained myself in the interest of future relationships.

  2. Yeah but you're a well informed punter (one assumes - you're not an orthopaedic surgeon are you?). It's the same for us when we (heaven forbid) have to see our own GPs and know exactly the hoops they have to jump through and why they're asking all these things. It's always a idssetling experience to be the patient when you're used to being in control.
    Most of the punters just see it as you being thorough and in some cases, actually giving a sh*t about their "wellbeing" :-) Well, that's how I try to "sell it" anyway!

  3. "My GP is great"

    Actually so is mine. I just think he could be even better if allowed to function independently as a true professional rather than having his practice dictated by a committee.

  4. the a&e charge nurse25 November 2011 at 14:48

    My GP has been brilliant with my family although I have never had to consult him personally.

    When I was a boy my GP suggested ice cream (rather than an antibiotic) when I had tonsillitis - that little moment has always stuck with me for some reason, as did the environment in his consulting room.

    Fact is we can no longer afford the exponential costs of health care, so a focus on prevention seems not reasonable - at any rate, if you know your cholestrol level, Dr Zorro, perhaps the statin propaganda HAS got to you on some level?

  5. No SFdoc' certainly not. 'Orthopods' are close to being, along with Professors of Diabetes, (whatever they are) my most hated sector. I am just a simple Biologist who lost his way and stumbled into episodes of poor care, and then found there were more than I could countenance without some semblance of criticism.

  6. Hmm,

    It is becoming increasingly difficult for a perverse, thrawn, contrary witch to resist smoking nowadays.....

  7. Thanks for the new but old addition to my lexicon, 'thrawn'. Love it.

  8. Sorry BD. My comment was aimed at Dr.Z, knowing he's a consultant of some sort :-D
    Damn this lag affected moderated comments section!
    FWIW, I too am a diabetic (since aged 5) and know exactly what you mean re diabetologists!
    And apologies for my keyboard dysparxia! ;-)