kravietz 🦇 on Nostr: Just had probably one of the most disappointing UK #NHS GP visits, which is ...
Just had probably one of the most disappointing UK #NHS GP visits, which is unfortunately also quite representative. Coming with a kid that had been through a severe bacterial infection in December, ended up in hospital on antibiotics, then for the last months suffering from a chronic abdominal pain. After listening for 15 seconds to the description of symptoms the GP already knew everything:
GP: - Oh okay, you’ve got gastritis! If you remember from chemisty, there’s this acid… [primary school level biochemistry lecture for 3 minutes] and I’m going to prescribe you Lansoprazole and it’s going to help in no time.
Me: - Ahem, but he had Lansoprazole prescribed by this very GP practice already a month ago over telephone, not sure if we talked to you or someone else…
GP: - Ah, okay then… Well, then we’ll prescribe a stronger one, Famotidine…
Me: - Thanks, but are you sure this is enough? It’s not only the abdominal pain but also he had bilirubin levels elevated, which is mentioned in this letter I filed here when we booked this visit.
A bit of context: in the NHS GP, nobody ever does even basic diagnostics like general blood test. At least I’ve never seen that done for myself or any of my relatives. I’m used to how healthcare works in Poland (and generally EU), where a blood test is the first thing to be done when you come with anything else than wounded knee. So when my son’s initial symptoms started and GP simply prescribed Lansoprazole without even seeing the patient, I just went to a private GP and paid for the blood test, which indicated a number of irregularities. And then we booked the GP visit with an indication that these irregularities should be examined further.
Back to the GP:
GP: - Ah yes, here’s the letter… So yeah, you know, elevated bilirubin could be actually beneficial [another 3 minute digression on entirely hypothetical genetic factors that could potentially cause raised bilirubin]
Me, a bit annoyed already: - Thank you, but how do we know if this is actually this genetic factor without doing any tests?
GP: - Well, okay, if you really want, we can do a blood test!
And he prescribed the blood test, exclusively for the bilirubin 🤷
Just to be clear, NHS also does regular blood test, just like every other healthcare service - but only in hospitals. You have to go to A&E and be actually severely suffering (or pretend to) to get admitted and have some actual diagnostics. I don’t even want to go into digressions about the cost of early diagnostics and treatment being orders of magnitude lower than advanced treatment in advanced stages of disease - that seems to be an obvious evidence-based medicine to every single healthcare service in EU, but not to NHS.
Want some more anecdotal evidence? Last year NHS announced a NHS Health Check program and actively encouraged people to do… well, essentially a basic blood test. So of course I subscribed, got my blood test done and I was told to call for results. I did, and the dialogue took roughly 15 seconds:
Me: - I’m calling for the results, here’s my DOB, name etc Receptionist: - Oh yes, I’ve got it here… you’re all fine! Thank you, bye.
Except I knew for sure, it’s not “all fine” because I like always had and have elevated cholesterol levels. She didn’t care to even open my results and look at them, because if she did she would immediately see the “High” marks on relevant indicators.
Talking to relatives I friends, it comes out it’s a very widespread practice - the GP receptionists literally lie about test results they lost or didn’t bother to even look for.
Another, entirely cultural factor, shared across the whole NHS and private healthcare too, is a total reluctance to share test results with the patient and red tape when you actually insist to see it, but that’s another story.
My subjective conclusion: NHS GP service is utterly dysfunctional. And it’s not only about “NHS being stripped of funding”, which is an argument often raised by Labour.
People use private GP because NHS GP is dysfunctional and it’s primarily on cultural or professional level, not only in terms of funding.
GP: - Oh okay, you’ve got gastritis! If you remember from chemisty, there’s this acid… [primary school level biochemistry lecture for 3 minutes] and I’m going to prescribe you Lansoprazole and it’s going to help in no time.
Me: - Ahem, but he had Lansoprazole prescribed by this very GP practice already a month ago over telephone, not sure if we talked to you or someone else…
GP: - Ah, okay then… Well, then we’ll prescribe a stronger one, Famotidine…
Me: - Thanks, but are you sure this is enough? It’s not only the abdominal pain but also he had bilirubin levels elevated, which is mentioned in this letter I filed here when we booked this visit.
A bit of context: in the NHS GP, nobody ever does even basic diagnostics like general blood test. At least I’ve never seen that done for myself or any of my relatives. I’m used to how healthcare works in Poland (and generally EU), where a blood test is the first thing to be done when you come with anything else than wounded knee. So when my son’s initial symptoms started and GP simply prescribed Lansoprazole without even seeing the patient, I just went to a private GP and paid for the blood test, which indicated a number of irregularities. And then we booked the GP visit with an indication that these irregularities should be examined further.
Back to the GP:
GP: - Ah yes, here’s the letter… So yeah, you know, elevated bilirubin could be actually beneficial [another 3 minute digression on entirely hypothetical genetic factors that could potentially cause raised bilirubin]
Me, a bit annoyed already: - Thank you, but how do we know if this is actually this genetic factor without doing any tests?
GP: - Well, okay, if you really want, we can do a blood test!
And he prescribed the blood test, exclusively for the bilirubin 🤷
Just to be clear, NHS also does regular blood test, just like every other healthcare service - but only in hospitals. You have to go to A&E and be actually severely suffering (or pretend to) to get admitted and have some actual diagnostics. I don’t even want to go into digressions about the cost of early diagnostics and treatment being orders of magnitude lower than advanced treatment in advanced stages of disease - that seems to be an obvious evidence-based medicine to every single healthcare service in EU, but not to NHS.
Want some more anecdotal evidence? Last year NHS announced a NHS Health Check program and actively encouraged people to do… well, essentially a basic blood test. So of course I subscribed, got my blood test done and I was told to call for results. I did, and the dialogue took roughly 15 seconds:
Me: - I’m calling for the results, here’s my DOB, name etc Receptionist: - Oh yes, I’ve got it here… you’re all fine! Thank you, bye.
Except I knew for sure, it’s not “all fine” because I like always had and have elevated cholesterol levels. She didn’t care to even open my results and look at them, because if she did she would immediately see the “High” marks on relevant indicators.
Talking to relatives I friends, it comes out it’s a very widespread practice - the GP receptionists literally lie about test results they lost or didn’t bother to even look for.
Another, entirely cultural factor, shared across the whole NHS and private healthcare too, is a total reluctance to share test results with the patient and red tape when you actually insist to see it, but that’s another story.
My subjective conclusion: NHS GP service is utterly dysfunctional. And it’s not only about “NHS being stripped of funding”, which is an argument often raised by Labour.
People use private GP because NHS GP is dysfunctional and it’s primarily on cultural or professional level, not only in terms of funding.