BBC's Doctor in the House

Has anyone been watching this? I know some of it will be down to good selection of cases but it makes me angry that someone can lose 20 years of quality of life because no-one's picked up a neck issue (lady with cluster headaches) or an genetic issue that could be treated with vitamins!

I wish the doctor could sort out my post concussion syndrome. Sick of being fobbed off by GP with there's nothing to be done.

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  • Can't say I have though just come out of a talk about concussion and sport where the consultant neurologist felt post concussion syndrome was a unhelpful term since it's a collection of symptoms collected into a label and nothing more, i.e. There are already good terms for each symptom so use and treat those etc.

  • Even taking symptoms one by one, GPS treatments are minimal. Chronic headaches and neck pain - take painkillers and do yoga.Chronic fatigue - GP shrugs though one eventually recommended a good course.

    I haven't even bothered asking about my light sensitivity and tinnitus.

  • There was also a comments from the legal/media lot that GP do get it wrong and at best patchy knowledge!

  • That is what they are mind you... General practicioners.

    I guess it's partly up to us as "patients" to push for more answers and to help ourselves as much as possible.

    Healthy diet, lots of exercise yoga, pilates, tai chi , walking, research other ways to help oneself. meditation rather than or as well as medications, good friends and a laugh, support groups etc .

    It's a sad fact that there isn't always a fix for everything (I still live with a partial blood clot on the brain which won't dissipate).

  • It all comes down to the fundamental flaws in the design of the NHS. GP's should be there to fix the simple things and manage general health. Beyond that, patients should be sign posted to the relevant specialist.

    The problem with a lot of GP's is they think they can fix the problem. Take for example knee pain beyond rest, recommending pain killers and physio there isn't much they can do. There approach should be if it doesn't ease within a few weeks, refer the patient to a specialist. There is no point in delaying the inevitable by requesting xrays, MRI etc. before hand as the specialist is better placed to request the ones they want.

    It is one many simple change in process / mindset would greatly improve the GP service for both staff and patients.

  • Surely the issue with this is that there aren't enough specialists. By trying to ensure you only see one if you really need to the GPs are freeing the time of the specialists for people that need them. I'm not saying there are not advantages with the process change you outline as there are plenty. But we have to remember it isn't quite as simple as it sounds.

  • The problem we have is that we adopt the same principle for our hospitals. i.e. hospitals in a geographic area all offer similar services but with degrees of quality spread amongst them. By that I mean there will be several hospitals within a relatively short distance each providing acute services - cardiac, orthopaedics etc.

    A better alternative would be to concentrate these services in "centres of excellence" where resources can be pooled, processes streamlined and budgets can reflect demand.

    Heart problems are good example. They are sadly very common. They can be routine or complex. In a specialist centre experienced surgeons and practitioners can develop the next generation of specialists surgeons, new techniques can be developed. A centre of excellence will attract better quality staff at all levels. Something that can't be achieved easily in generic hospitals.

    Given the choice, most people would be prepared to travel a little further to a specialist heart clinic rather than go to a general underfunded one locally. In terms of a heart attack, the most critical thing is to stabilise a patient and then once stable, arrange corrective treatment. We need to get better at this, as the current A&E and transport mechanisms aren't designed to provide the service we need.

    A good example of this Great Ormond street for childrens health and in Wales, where we have two burns units, a world class one in south treating patients from not only Wales but across the south west of England and a smaller one in the North. Nobody has ever complained about the distance to travel to these locations because they know they will receive the best treatment

  • Yes I completely agree.

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