Patient choice

I see that in Liverpool there is some soul searching going on about the provision of homeopathy on the NHS. One of the arguments that the altmed lot like to trot out is the concept of patient choice, that if a patient wants homeopathy, or chiropractic, or any one of a number of alternative therapies, he should be accommodated, and the NHS should pay for it.

Far be it from me to question "patient choice". That a professional, with years of specialist training and experience should have his practice dictated by some twat waving a google printout.

Of course if I take my car to the garage and the mechanic identifies a problem, then naturally my uninformed opinion on how he fixes it will take precedence over his view. And if I want him to fix the brakes guided by astrology then that's what he should do. I don't think!

I once had a patient turn up in clinic with a particular problem. I set out the treatments that were available, with advice of efficacy rates, adverse effects etc. She replied that she didn't want any of that but instead demanded that I provide an alternative medical treatment. In the fullest spirit of "patient choice" I spelled out her choices. I didn't put it in the following words exactly, but the meaning was clear. "If you don't want the treatments I'm offering just fuck off and stop wasting my time" She never came back. Result!