After watching Panarama the other evening and drawing from my own unfortunate experiences along with reading over a number of years the comments of others on this forum I have come to the conclusion that there is a growing danger that we are - speaking from UK.
Are we allowing ourselves to be over ... - Atrial Fibrillati...
Are we allowing ourselves to be over medicated and under treated?
Written by
CDreamer
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50 Replies
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Totally agree . The number of people who suffer from drugs and drugs given for one problem that cause several others . More thought needs to be given before doling them out like “chewing gum” which is how the chap who gave me bisoprolol described it . Chewing gum it was not !!!!!
Handing drugs out like smarties, then adding drugs in to counteract the bad effects of the original meds, it's a vicious circle and dangerous path in my opinion, totally Agree CD.
Agree with you 100% CD.
I can't help but think that GP's should be looking at our diet and lifestyle, way before handing out any pills. Obesity and a sedentary lifestyle have a lot to answer for regarding how we are feeling. Though I do wonder if people may be too lethargic to put the effort in to help themselves.
What would happen I wonder, if GP's could prescribe a range of exercise and healthy, perhaps fat free (if needed) cookery classes instead of pills?
Jean
Hi Jean Many GP tactics s now work with voluntary organisations to offer alternatives to medication. I work in an inner city GP practice & we work with our partners through social prescribing to offer a whole range of things. I think the issue is that it’s all relatively new & not all GP practices engaged with change. But it’s promising!
My practice don’t have a cardiac clinic or anyone who specialises in cardiology.
Nor mine and unfortunately the Dr I spoke to didn't come across as confident with heart issues
This is almost like Agism, they have an asthma clinic.
The practise I work at does this and it appears to be working well
After my first ablation I was offered subsidised gym sessions by my GP's practice. I took the offer and to be honest to start with the mental boost it gave me was amazing and I actually wondered whether to start running to the gym and back. Unfortunately AF kicked off and I was unable to finish the course.
Great to hear, we support regular farm visits known as Social Farming in the South East which is one of the Green Social Prescription options across the country.
They should bring back domestic science classes in schools for boys and girls as a prevention strategy
Good idea Peony.
They should bring back real GPs, not fast tracked, government/drug company advice led robots, who seem now to be in it for money 🤷♂️X
The demise of the good old family doctors is fuelling the argument that primary care is no longer fit for purpose . The way they are paid and rewarded has driven the box ticking mentality . Many people feel they can’t get help . There is no doubt that the steep rise in the population in recent years is overwhelming our public services and doctors/ hospitals can’t cope with the increased demand at a time when austerity has cut resource and red tape has left our hospital doctors demoralised .
Totally agree Peony. Its a total shambles all of it . We are all entitled to basic health care but this is taking BASIC to another leval. Solicitors will have a field day after this . Self medicating and self diagnosis is the norm now , I'm doing exactly that at the moment with my Bisoprolol dosage. Patients dont feel secure any more and its so sad all of it.
And unfortunately many GPs are just as unhappy with this state of affairs & if you look on Twitter many are quitting.
But how to we change things into a sustainable system?
I do think we all need to take some response ability but we also need individualised support an expert advice.
I would not like to see a return to the ‘old’ family GP system - it wouldn’t be fit for purpose in this technical era. I don’t need to physically see my GP to have a good working relationship but I know many older people do prefer that and I can see why.
I would only want to see one if I needed an examination . Otherwise would prefer not to go to the surgery . Good to have the option
I believe it's important to physically see a Dr. There's a lot a Dr should be able to to see about a patient by looking at their eyes and face and skin. Sadly the only thing most Drs here in the USA look at is the computer screen. I feel like yelling, hey I'm over here, not on your computer. 😠
Dead right Peony, no wonder so many have resigned or gone on reduced hours. Their stress is increased by knowing they can't do their best. I heard a doctor say recently around the mid 90's doctors concern over regulators and lawyers took over from treating the patient as they would like. Sad but probably true and a shining example is the current UK position regarding Covid where doctors dare not discuss Ivormectin let alone dispense it - for those 'not paying attention at the back' this is a tried and tested safe drug (according to top world doctors) that was already on the shelf and is now apparently being used extensively in poorer countries worldwide with amazing results to prevent or treat this serious virus e.g. India, Mexico, Zimbabwe, South Africa, South America etc etc Important: my comment is information not medical advice, so don't take any but do see what's on YouTube and write to your MP if you think something could have been done, together with the vaccine, to save more lives. In the UK the drug will no doubt be suppressed for longer but the genie is out of the bottle worldwide, thank goodness for those poor poor people.
Easier and quicker to write a prescription for pills!
Green Social Prescribing is on its way to Devon via Dorset! socialprescribingacademy.or...
That looks just what's needed, hope it's on the way to Devon too.
Maybe some are lethargic, I would love to get proper proven advice for health problems. I have felt for a long time that Dr's are pill pushers and a lot more care should be taken. Since getting ill in December and although was supposed to be back to normal in 2 weeks I am now months on and still feel ill and barely able to do anything normal
GPs can already prescribe exercise. I am the local GP referral exercise coordinator for my local area. This year, 11 years after we launched, we are finally getting funded by the NHS , but we still find it depends on the GP. The lazy, inactive ones are less likely to prescribe, funny that! We do, or plan to do, walks, exercise classes, water exercise, gym, falls prevention and cardiac, pulmonary and cancer rehab sessions.
It doesn't solve all problems, of course, but I've seen some miracles. Its wonderful, but it relies on the client giving it their best shot too. But I've seen people who need new knees, no longer need anything once they just strengthen their thigh muscles, to name one example. It also gives people a feeling of taking control not just been passed around in the medical system which is very empowering.
What we need to do next is get away from leisure centres, which add an (unjustified) element of intimidation and get out in the community, ie guided walks from GP surgeries, for example .
You might get the idea that I'm quite passionate about this!!!
I think its the way to go. Good luck.
Forget about it ... they want the $$$! You have to see a nutritionist MD for that type of doctoring.
I certainly think so. I didn’t see the Panorama programme although I suppose it will be on iPlayer. I have resisted taking anything for years but seem to have ended up on a cocktail of 8 different ones now as I was prescribed Dapagliflozin for heart failure earlier this week. There is a condition, iatrogenesis, which refers to the fact that other conditions can be caused by medication. I don’t see how anyone can really understand how all these different drugs react together.
Or indeed in different bodies
Il have a new one! Where can you order these new bodies, amazon?, il take an xl with the free bag or Doritoes 🧐X
Yes, thank you for adding that to the mix. It is clear from reading about different people’s responses to different medications on sites like this.
BobDVolunteer
Sadly a lot of this problem stems from the days of dear Tony who introduced QOFs or Quality Outcome Framework as part of GPs remuneration.
Certain criteria were selected for groups of patients and doctors had to treat those people with drugs regardless of any presented illness. GPs get points which count towards their final salary for doing this. For example, if cholesterol was either bordeline or high then statins had to be given. I think the idea was that these may prevent worse illness at a later stage in life but the one size fits all system does result in lots of people suffering bad side effects for years. What few seem to understand (so my doctor tells me) is that points are awarded not for prescribing but for having the conversation so there is no requirement for patients to accept the recommendation.
For several years I meekly took statins and suffered lower leg pains until I had the chat with my new doctor who explained this and had no problem with me stopping taking them She is also sensible enough to discuss with me what BP I am happy with (within reason) and accepts that too low for me may well be her prefered target.
CD you are right of course BUT we all need to be experts in ourselves, procative in our care and engage with and work with our doctors in our care. That way we become partners in our treatments not just customers.
Well said Bob. Health care (deliberately separate words) needs to be a partnership GP/Patient, GP/Consultant/Patient & Social response ability.
You are of course correct that competent care requires collaboration, but this breaks down if the physicians are wedded to protocols or incompetent.
It’s the system that GPs especially work in that is wedded to protocols. Incompetence or laziness or inadequate training or inability to communicate is thankfully rare in my experience but I have come across it.
I think in secondary care the need to specialise and for those specialisations to be so narrowly focussed instead of looking at the person as a wholistic system it emphasises treating A disease or condition and ignoring important makers for other conditions and the ignoring other possibilities.
I agree with all of that Bob but you have to See or Speak to a Doctor to do that and in my particular surgery its impossible to even get through. I write letters now and eventually I get a phone call maybe a week later. Hence the self Medicating and self Diagnosis
If the Dr's will let you work with them, some don't and go to the ' it could be anxiety ' and try to give more awful tablets. I've been in my body a long time and know when there's something wrong and know if anxiety is the problem, and if anxiety is making things worse I don't want their tablets I'd prefer other methods, the tablets make me anxious
You are the expert on you, their collective knowledge comes from text books & their experience of other’s experiences. Doesn’t always fit with ours.
I agree. Pill poppers by the dozen, no time to get to know patients. I watch GPs behind closed doors regularly on tv, all the doctors seem lovely and capable but it so often comes straight down to more pills.
We must not contribute to this by expecting a pill for every ill and take responsibility for how we live our lives, diet, exercise and mental wellbeing. We may all be better off for it in the long run.
That is what I would like - a partnership with my GP - but never seem to have managed to achieve. However, the GP on the Cardiac team who look after me changed last year due to retirement of the previous incumbent. The new one seems very good but what is missing so far are face-to-face meetings. I have seen him a couple of times but mostly contact is via the telephone now, presumably because of Covid, which I find more difficult. However, he does seem to want to help me and has been juggling around with my meds.
They all need lessons in communication!
Last time in A&E, the Dr had spoken to a cardiologist as he obviously had no clue as to what to do. He came in with a prescription clutched in his had and said I have to take Apixaban and up the bissoprolol to 2.5mg. 1) I do not need anticoagulant as my chadsvasc is 1 and 2) Bisoprolol at that dose gives me Bradycardia. Went on about I need anticoagulant. I said I’ll pass it by my consultant first. Then, after all that said the cardiologist has made an appointment for me to have a cardio version!! Why’s didn’t he explain first?? Consultant said in email I do not need Cardioversion, I’d gone back into rhythm 🤷🏼♀️
Communication, I did tell the original dr if he’d said that in the first place we could have avoided disagreement.
Reminds me of the post recently by a gentleman who was supposed to have an ablation. The Dr who was to perform it looked over the man's records first. The Dr told this gentleman he didn't need an ablation. That he did not have Afib. He had atrial tachycardia. Similar but not the same thing. So the man had been misdiagnosed and almost had a procedure he didn't need. He did end up with a med for arrhythmia I believe. Yes, communication means a lot. Something terribly lacking in Drs around the world. How many people have procedures they don't need because of no communication........ Just awful.
I don't put a lot of faith in my GP surgery. One Dr is ok, and so is popular and difficult to get an appt with but the other 2, I reckon, did their training with a GPing For Dummies manual!!! This is why, I tend to go directly to the experts and am lucky to have a helpful EP and endocrinologist who are fine with me contacting them directly. I only trust them to prescribe meds as our surgery also uses nurse practitioners, one of whom as twice prescribed meds that contraindicated my existing ones and my excellent pharmacist alerted me to that.
During a recent spell in hospital with AF, the consultant doing the rounds said, in front of a junior Dr, "I think we need to put you on Amiodarone before cardioverting you again" I said, "well, that's jolly lucky that I've been taking it for 10 months already then, isn't it? ...... I'm surprised it's not on my notes" Cue red face and hasty exit. I also had to remind them of my trans thoracic impedance before the cardioversion as that hadn't been clocked either and they need a registrar or above to be there or in the vicinity for that.
😳😳😳 The surgery nurse did my ECG to check it, was ok. Then said why are you not on anticoagulant, then a tirade. My Consultant cardiologist said I am more at risk of anticoagulants than a stroke I tell her, more tirade. I replied my Consultants decision ‘I think he knows what he’s doing’! Oh I’ll have to tell the Dr!! 😱 I repeated this conversation to my lovely Consultant l, who shot off an email to head Dr in practice.
You couldn't make some of this stuff up could you? 😁
I had an ablation in March 2020 and am yet to have an ECG because I have only had phone appointments and only had those because I had ongoing problems. I have a Kardia so I have been able to monitor my heart and I have medics in my family who I can consult but my Cardiac team don’t know that! My EP has increased the dose of one of my medications but I am yet to persuade my GP to prescribe it. I have a copy of the letter my EP wrote to my GP and I have tried to request the medication but I don’t have the special form to request medication and when I went to the surgery to get the form I was not allowed inside because I didn’t have an appointment! I suggested that if they require prescription requests on a set form could they upload it onto their website so patients could print it out at home and deliver it to the surgery. They just laughed and said that wasn’t possible. That was 4 weeks ago. When you don’t feel well you don’t have the energy to deal with this sort of nonsense.
I’ve never heard the like! They certainly are making life difficult!
Do your surgery do the Friends and Family test? Ask to complete - it’s measure that surgeries are encouraged to do for the Quality Care Comission. I believe it was suspended during Lockdown but it’s worth asking as the QCC publish their results when they do an inspection on a GP surgery.
Members of the public may also feedback on GP surgery to the QCC
cqc.org.uk/give-feedback-on...
Write to the Surgery Manager with a complaint - everything is on line these days. Ask if they use the NHS App and if not - why not?
I have no problem accessing our surgery - doors open, we can walk in to drop of and collect paperwork, have appointments by telephone and see GP in person again, though that is carefully controlled. Everything is on line and I can request view and download all of my test results through the NHS app. It’s a bit of pain to register with high level of checking but worth it.
Thanks CD I was half believing that I was being unreasonable. I just readthe latest CQC report on my GP practice in 2018 and it got “Good”. I think maybe I should considerChanging Practices.
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