Slightly off-topic but interesting look at the prevailing view that patients are demanding (in this case) antibiotics, and the reality ..... blogs.bmj.com/bmj/2019/02/0...
The bmj "Educating patients or blaming them? P... - Thyroid UK
The bmj "Educating patients or blaming them? Public education campaigns on antibiotic resistance"
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MaisieGray
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I read a social psychology paper ages ago that found doctors often felt patients were demanding antibiotics whether they asked for them or not! Very interesting the power of what they expect to see.
Yes, definitely. But we'd be forgiven for thinking that what they believe they are hearing from us is "Please don't give me any more thyroid meds, what I want more than anything else in the world right now is some antidepressants ...." lol.
Hehe, very true. The idea is they feel this overwhelming pressure from patients to prescribe antibiotics.
But it doesn't ring true when we really ARE begging for thyroid hormones, and they don't feel the slightest pressure to give in to us!
Yes, it would be interesting to ask those Drs that do admit to feeling this real or perceived pressure to prescribe antibiotics, whether they feel the same regarding other meds, including thyroid hormones. And of course, that would identify whether our own perceptions/beliefs about them, are in fact, accurate ......
This kind of stuff I'd love to have researched back before I got sick. There's quite a lot of resesrch in public health /psychology kind of field about the emotions patients might be feeling in various situations.
But it's really noticeable that the emotions, assumptions, expectations of doctors are not really researched. I think it's part of the same huge power imbalance we're operating under. Doctors are the ones make the observations, and are assumed to be a cool, neutral figure that doesn't bring any of their own baggage or human 'failings' with them into the consultation.
In situations like this I think it's probably the doctors themselves feeling conflicted about denying people antibiotics, so they fill in the blanks with their own anxieties. But unfortunately we almost never get anyone looking into what doctors are anxious about!
• in reply toSilverAvocado
Very good point. It is so hard to remember that doctors are human too, and often under immense pressure and stress, from both outside and inside.
LindaC• in reply to
Point taken. In which case doctors require appropriate training to deal with those patients who are also:
feeling immense pressure when disregarded, disbelieved and ridiculed by their colleagues, and where the stress of their own work [those who still can]/family/life are made even more intolerable due to the shoddiest conduct via all too many doctors.
Having worked for an agency where psychiatrists used to ban their more difficult patients from the hospital setting, [well qualified] colleagues and me used to 'pick up the tab' to work with those people. Oops, we also socialised - within our work role - with them once a month when doctors couldn't even do their job.
Apols but, being hypothyroid, the 'poor doctor' line no longer washes with me.
• in reply toLindaC
I understand, and I'm not saying "Poor doctor" but that we need to find some way to relate to them as fellow human beings, in the hope that they may at last listen to us. Even if it means bursting into tears in front of them! Being confrontational makes them even less likely to listen. Catch 22 in many cases
LindaC• in reply to
Again, I entirely get what you're saying but it is not incumbent on the ill person to try to jolly along a doctor, that is their duty to relate to the patient. Yes, it is Catch 22 for so many patients. It is not for people already ground down/ill to try to humour the poor 'communication inadequacies' of a professional.
Especially in the case of antibiotics, doctors need to surely learn how to deal with 'confrontation'!? For the chronically ill [hypothyroid, CFS etc], perhaps doctors could considering whether they are actually a big part of the problem? Perhaps they need to handle such issues, as any other professional has to do, both for them and for their 'target market'. Confrontation can mean that the doctor has been and is so off beam that the patient, with sufficient to deal with, then encounters... inadequacy seeking to 'patient blame'; hardly surprising that they'd feel as they do. Simply not good enough in this 21st C.
Wow - bursting into tears before any doctor is pretty much bound to get their hackneyed reaction; something I've seen/heard from many women on here and in person, "Here's some pills dear, you're obviously depressed". Not something to ever do!
• in reply toLindaC
"it is not incumbent on the ill person to try to jolly along a doctor"
True, but if it works...? A matter of self-preservation, not jollying for the sake of it!
I take your point about bursting into tears. Ideally it should be only when you have hopefully established that you are NOT depressed, just desperate to get well and frustrated because nobody seems to be listening or doing anything to help you.
LindaC• in reply to
I find game playing anathema... that's just me. However, in the unequal doctor patient relationship, playing that one could lead to all manner of confusion.
And who can establish, hopefully, that they are not depressed PLUS also in the eyes of a doctor!? Some of us can. All too many see doctor as still 'knowing', or patients have to 'do as they're told'. It is those people who seem to suffer most, not just with illness but the additional label to boot.
Isn't there something, somewhere, in between the two approaches, that works better, if not best, in many situations? There can't ever be one single approach that is the only way for every interaction between every two people, or even between every Dr and patient. And whilst game playing is unlikely in, and of itself, to be successful, unless we are particularly good at dissembling, nevertheless having regard to the needs of, and being responsive to the person with whom we are interacting, is likely to be more useful than steamrollering a mono-approach with everyone. Don't we all gameplay to some degree? We might be thinking "What utter bilge you're talking", or something far more colourful, but instead we tactically say "Yes, I do understand the point you are making, but ...", if we don't want the conversation to come to an abrupt end.
Indeed on several counts - yet what is needed is cohesive, not abusive, policy on hypothyroidism/CFS etc, etc, - not everyone is in a position to 'second guess' their doctor within whichever 'post code' they find themselves. 21st C Patient Care ought not to be trying to 'pacify professionals' who often have no clue what they're doing.
Not everyone - I'm sure I could if I set my mind to it - 'sweeten' the views of a doctor; that approach, in these times, hmm. We need proper treatment.
I don't think anyone starts off on the 'offensive' with a doctor - that would be crazy - but years/decades of the same old drivel, getting nowhere, would try the patience and health of anyone. Yes, being responsive etc, etc, in human interaction is usual, but when it all falls on cloth ears - as the patient being 'humoured' within a one sided [treatment] dialogue it becomes - it is futile and a waste of resources for all.
Perhaps if doctors today could find it within themselves to:
1.Accept when it comes to efficacy and/or treatment side effects, the patient most likely knows best.
2.Accept that your job could be more interesting if you learned to co-ordinate the experience and the research efforts of your patients, rather than continue to dictate to or dismiss them.
3.Accept that patients continue to come to you not because you are necessarily good at your job but because society has largely made it impossible to get help or medicines except through you.
4.Accept that your actions are often dictated by ghost written articles and inaccessible data, mediated through guidelines that you haven’t the guts to stand up to even when you see discrepancies.
5.Recognise that far from being founts of wisdom and compassion, you and colleagues can get quite nasty if questioned and so can be seen an obstacle to work around instead of a source of support.
6.Acknowledge that Medically Unexplained Symptoms can simply point to limitations in current knowledge; even your knowledge. It is not some euphemism for that old ‘all in the head’ psych junk.
Doctors and patients are now in a unique position to mutually engage with health issues. Doctors can nudge patients toward healthier lifestyles; guide them to personalised and effective treatments; empower to ensure patients enjoy a maximum quality of life for as long as possible; they can yet more often than not don’t. Fundamentally medicine has gone in a direction taking it away from personal care for depersonalised guidelines, notions of academic elitism and bureaucratic complexities which all simmer behind the scenes.
• in reply to
I can recommend the book ‘This is going to hurt’ I am reading this at the moment. Written by an ex-doctor...
MaisieGray• in reply to
It's interesting that you recommend the book, and you're one of many people who have, to be fair; but before buying, I read the 1 and 2 star reviews here, and was completely put off it, myself. He sounds obnoxious, and as one reviewer said, a mysogynist.
amazon.co.uk/This-Going-Hur...
• in reply toMaisieGray
Yes I’m sure it’s not to everyone’s taste. Though it does I think show a human side to a doctor
LindaC• in reply to
It looks funny - thanks1 Hey, there are so many amazing doctors - researchers have my ultimate respect - it is the plodding, abusive [because so much information is known about hypothyroidism] that there is no excuse for.
• in reply toLindaC
I wasn’t too sure about it at the start, but as time went on I saw where it was going. I think one of the main themes is to point out that doctors are in fact humans with flaws like any one else and make mistakes (bad ones they have to live with... or struggle to). I think it can be quite cathartic to come on a patient forum and rant about doctors, so I have perhaps posted this in the wrong place!!
LindaC• in reply to
Of course doctors are human... perhaps they sometimes need to remind themselves of that... err, when getting up in the morning and looking in the mirror. 
Yes, we all make mistakes... but when it's people's lives; accidents do happen, but long term shoddy treatment... nooo 
No, you posted this in just the right place... things splinter off and who knows where it can go. Thank you xox
Hi Maisie it is true there is a drive to lower antibiotic prescriptions. In our local surgery we have an information screen with impersonal instructions that anti biotics may not be given. The patient sits a trembling bundle looking anxiously at their septic toe, wondering if they are being put on the back burner especially if they are over 67.
The facts are that some generic copies may not be identical to the patented branded product. I found this out when I tried an alternative drug, and felt very ill after taking it.
The patient probably won't have built up resistance to drugs, unless they've had interrupted courses of antibiotics and have not taken the full course. If the patient is sick as part of the side effects, they will stop the drug and have to go back for a different one.
Now some practices are relying on a new bacteria test to see if you have a virus which won't need an antibiotic. These tests are not 100 percent guaranteed, as you can have a viral pneumonia which develops into a bacterial infection. If people have autoimmune problems such as diabetes the new regime is not to take any notice but to go with the government guidelines. Going to the doctor is now a pre determined interview with the drive to cut down NHS bills. People feel insecure. Not many people demand antibiotics
as to argue with their doctor might lead to them being removed from the practice.
There is no patient organisation to gain fair assessment from the doctor to prescribe rather than lose a patient for not prescribing a drug. Quality of care only exists in England and it is usually investigated after the incident concerning a relative. Not much hope there is there? We have cases of sepsis reported in the region where we lie which is shameful.
Who knows what the future holds? I look forward to hearing your views on whether the patient has any rights at all in this new era of cuts in the NHS.
MaisieGray• in reply to
Hidden I can read virtually nothing on the screen in either of my Drs' surgeries as the admin staff seem to have no grasp that you can't simply transfer an ordinary densely typed document on to a screen that is 8/9 feet high on the wall and expect it to be legible; so there may or may not be something similar here, I don't know. But I wonder if screens in Drs' surgeries are perhaps the ultimate in subtle passive:agressive patient bullying. Having said that, I'm not sure that a patient reasonably arguing their corner for any med, is, or should be, at risk of being de-registered - yet - but I do think you're right to be concerned about the likely and continuing denuding of patients' rights. I've always been pro-NHS and pro-Drs, and remain so, but I've had a number of experiences these past two days that have reminded me, well, have almost browbeaten me with the fact that the delivery of the service is almost wholly dependent now on systems, and more importantly, on gatekeepers to those systems. And that often, those gatekeepers aren't intellectually or psychologically up to the job, which makes the problem even worse than it might otherwise be. Therefore patients are as much at their mercy, as they are at that of their Drs, and perhaps even more so; and I believe it is largely hidden from the GPs, and is insidious in its nature and effect.
Hi,
I like your reference to "gatekeepers". I have seen it in other government bodies-education and welfare - and agree that they usually aren't intellectually, psychologically and I'll add, experienced enough, to do the job.
Yes, it's a recognised personality type although of course it can be played out in various guises - the adoring PA to the Alpha male Boss being one such traditional example - but as you've identified, aren't necessarily now only in 'support' roles where they can at least be circumnavigated. If it's a system, or data, or decision, that they are gate keeping, supported by perfectly valid security or hierarchical protocols, you can't manipulate an accidental meeting with the computer in the lift, as you might if they are gate keeping their Manager, say.
• in reply toMaisieGray
It's telephone consultations that I hate. Not quite as impersonal as computers but...
MaisieGray• in reply to
I've never had a phone consult myself, but as I'm getting progressively more hard of hearing, and hate phone conversations in any case because you don't have the important visual cues of face to face talking, I'm sure they're a nightmare.
• in reply toMaisieGray
My hearing is OK, but I have very little confidence and hate confrontation, especially when talking to a stranger on the phone.
Yet our surgery seems to rely on telephone consultations with doctors. I probably haven't seen one, as such, for a couple of years.
MaisieGray• in reply to
That must make physical examinations a trifle challenging, doing them over the phone .... sorry for the black humour, but more seriously, how can talking "invisibly" on the phone, make for good doctoring. At least if they skyped or whatever is the more current platform, they can see our palor & how dreadful we look, or how we've developed a stress-related tic, and so on. Surely any time saving is at least in part, offset by repeat appointments at the surgery, to visually investigate symptoms reported on the phone?
• in reply toMaisieGray
"That must make physical examinations a trifle challenging, doing them over the phone"
LOLOL!!! 
• in reply toMaisieGray
I think it's because blood tests have mostly taken the place of physical examinations in problems such as thyroid. Although our surgery uses nurse practitioners and pharmacists for most of the "Routine" hands on stuff.
If they took any notice of how we looked, perhaps thyroid treatment would be better. It’s actually very informative that they regard telephone consultations as appropriate
LindaC• in reply to
WoW - really! Eek, that's a bit scary! xox
Apologies also, if I seemed confrontational - as you are you, I am me - and nothing on this planet offends me, so I don't see anything as such in what I say. Take care and be well
• in reply toMaisieGray
One consultation I had was with a doctor who sounded like Doc Martin on a bad day! He told me I was "Confused" and wouldn't listen to my feeble hypo attempts to explain what I was trying to say!
LindaC• in reply to
WHAT!? I'd have [metaphorically] had his 'plums on a skewer'! Appalling!
• in reply toMaisieGray
The doctors used to be in the driving seat with personal relationships with their patients. Now people have to be more flexible and may see a doctor who has no bedside manner, and has no empathy. Also as you say the system is over riding the doctors knowledge in prescribing, and each decision he makes is now based on cost.
We are now back in the eighteenth century with a few leeches and a flea in the ear where nothing is prescribed and we are now part of the survival of the fittest philosophy. That's why visiting the doctor is stressful with these e mail messages which are hard on the eyes , telling us we are not likely to get anything except a kick up the behind. Ha!
MaisieGray• in reply to
We have a GP in the practise who is fantastic, very intelligent, very knowledgeable, always willing to chat about medical or scientific issues - he generally runs 2 hrs late as his norm - and is appropriately cynical about CCGs and bureaucracy etc. Consequently appointments with him are rarer than hen's teeth. Yet in my experience he is as unlikely to give you what you'd like, as his partners. I once asked him for Low Dose Naltrexone and although he's prescribed naltrexone in his work with drug abusers, he refused LDN for my hypothyroidism. More widely, when I Chaired formal panels to hear patient complaints against GPs, in my role as a Non-Exec Director with the HA, I saw that sometimes there might be evidence of dire professional practise but interestingly, the patient's complaint was solely about the GP's poor bedside manner. For myself, I've always favoured excellence over niceness, although having both would be perfect. I think doctoring is a poisoned chalice and I don't envy them their jobs one bit, but I think the present system definitely facilitates, and even encourages the poor ones in continuing to be poor Drs, whilst preventing the good ones from delivering a good service to their patients - and if that's not the definition of a lose:lose situation I don't know what is! 😊
I think we're in a situation that I'm sure has happened in schools, and I've seen happen in my volunteering work, too.
There's this huge emphasis on consistency and guidelines, but it doesn't really consider quality, and ends up pulling everyone down to the level of basic competency. It means excellent doctors, like excellent teachers, are really restricted in what they can do. And I guess this happens because people are afraid a few less skilled individuals will run wild and deliver a poor service.
I think doctors are really deskilled from where they were a generation or so ago. A lot of their job is paper pushing and just carrying out the scripted appointment they have no choice but to act out.
I agree with you, and I'd say it's probably rife in every profession TBH nowadays. I was an NVQ chief External Verifier in my own profession, and saw evidence of what you describe during every centre visit I made. Depressing and frightening in equal measure. I believe that the human race has a great capacity for invention and having great ideas about things, and an even greater capacity for applying those great ideas in a way that ultimately destroys the intended benefit and in many cases creates opposing dis-benefits in their stead.
• in reply toMaisieGray
Ha - the idea of the GP's job as a poisoned chalice - is enough to cancel future appointments.
MaisieGray• in reply to
Ha Ha
holyshedballs• in reply to
hawii60 an interesting article from MaisieGrey and some interesting replies including yours. I would just like to add to yours that the GMC tells doctors that they shouldn't remove patients from their practice because they complain about them. I personally would include respectfully challenging a doctor's wrong or illogical statements. The GMC say:
"You should not end a professional relationship with a patient solely because of a complaint the patient has made about you or your team, or because of the resource implications of the patient’s care or treatment.Before you end a professional relationship with a patient you should:
a warn the patient that you are considering ending the relationship
b do what you can to restore the professional relationship
c explore alternatives to ending the professional relationship
d discuss the situation with an experienced colleague or your employer or contracting body
and you must be satisfied that your reason for wanting to end the relationship is fair and does not discriminate against the patient (see paragraph 59 of Good medical practice)".
gmc-uk.org/-/media/document...
I think that if members of this forum and patients in general know this, then we can be more confident in the surgery. We should always be assertive but not moving into aggressive and then the doctor has no come back or reason to "de-list"us.
With regard to guidelines, there is case law to say that
>guidelines should not take the place of a doctors skill and knowledge, (Pfizer v Secretary of State for Health1999)
>guidelines should be followed unless there is a good reason not to (Ali v LB Newham 2012. Following a course of action supported by a responsible body of medical opinion that is contrary to a guideline is a good reason not follow a guideline.
Rv Thanet 2014 said that There is no explicit statutory obligation upon CCGs (or, indeed, NHS England), however, to comply with the “regulation 5” type of advice or guidance, which includes clinical guidelines published by NICE.
That is regulation 5 of The National Institute for Health and Care Excellence (Constitution and Functions) and the Health and Social Care Information Centre (Functions) Regulations 2013
Experts guide the courts as to whether there is a responsible body of opinion which would have adopted the same course of action as the doctor concerned, regardless of whether or not the doctor followed guidelines forward-me.org.uk/Letters/L...
NICE guidance does not override the individual responsibility of health professionals to make appropriate decisions according to the circumstances of the individual patient in consultation with the patient and/or their guardian/carer. forward-me.org.uk/Letters/L...
The case of Montgomery v Lanarkshire Health Board 2015 Made it clear that the patient arrives at a decision about their health after the doctor has explained all the options and all the risks and benefits of each option. The GMC back this up in their consent Code of Practice Consent: patients and doctors making decisions together. gmc-uk.org/-/media/document...
So if a doctor says, as they have done to me, "I have to follow guidelines" you can tell then that it is not true and you can report them if they don't change their ways. Like I did. And I wasn't delisted either!!
• in reply toholyshedballs
Hi holyshedballs - you were right to put your point of view and report your doctor if you felt they had failed in their duty of care. Although guidelines are available to government departments, there are no guide lines concerning patient/doctor relationships in pamphlets for the public in the waiting area.
It is difficult for many patients if they have been diagnosed properly and have label stuck on them. It is often when a patient bursts into tears, as they have not received any emotional support, or knowledge how their condition will improve over time or how side effects might affect them. Confrontation when you are ill is too stressful - once you have received a negative response or facial expression when the facts don't
fit you lose confidence. It is hard to repair the relationship.
Gossip from reception and attitude can be picked up by the patient if they ask too many questions or get over emotional.
Now practices are closing down in rural areas, it is hard to find another one - so just seeing another doctor in the practice might be the only option. I have had to fight for tests - and have had to fight to stay in the oncology system, but having expressed my wish to stay, within the recommended period with three monthly checks, it has paid off as I have had further incidences which have now been checked and treated. The onus is now on the patient to monitor their own progress and make sure they go back - whereas before, the doctor was more in charge of follow up procedures.
Thank you for the valuable information concerning the doctor/patient relationship.
holyshedballs• in reply to
I've been there my self; totally exasperated at what doctors have told me.
I also felt that I was so fatigued that I couldn't challenge the doctor. Everything I did was a mission.
It was only when I looked up Good Medical Practice and realised just how far from it my doctor was that I realised I should be different in the consulting room.
That gave me the energy to take matters further.
Knowledge is power it really is and the more power patients have the more confident they will be in the consulting room. I suppose I'm lucky in a way that my job entails matching people against various legal standards and taking action to require an upgrade in their actions. I applied that same approach with my doctor.
I explained calmly that
they don't have to follow guidance if there is a good reason not to,
there is an alternative body of medical opinion to support what I wanted
there is case law to support what I wanted
I would take formal action if necessary.
As patients we do have to take care of our selves and the way the NHS is going we will have to fight for our health.
I know how fatigued forum members are so I'm trying to get my information out to members so that they don't have to spend precious energy re-inventing the wheel.
it helps a lot to know what is right and gives that extra boost when in the consulting room. As I said, KNOWLEDGE IS POWER. This can easily translate into physical power. You may feel pumped up, spurned on, etc with that feeling of justice running through your veins and that can see you through your doctors visit.
• in reply toholyshedballs
Most people do not know how to ask questions - with cuts legal information is not relevant to the practices. They are compliant with directives to cut down prescriptions but with certain therapy alternatives, there are long waiting lists which means that many people suffer needlessly. Even with referrals, there is pressure for children to be re routed back again to the GP and not go to hospital.
More friendly specialist checks would be helpful in local clinics rather than in hospitals with car parking and travel problems with mothers and children with no car having to pay for transport to hospitals with lengthy waits and upset children.
Thank goodness there are people like you who dare to win the argument.
I protested I had double pneumonia several times and needed an antibiotic but only when the bacteria blood test would he accept I could have a prescription.
The new blood test is not 100 percent fool proof - cardiac endocarditis, bacterial infection round the heart valve, may not show up in blood tests. This is worrying as I you have a family history of these problems it makes no difference - the test is the test of to be or not to be!
Animals are using up to 80% of all antibiotic in the west. In the east they don't use them but something entirely natural but of course nobody wants to know as these are not profit making. It cost hundred of thousand to find another new antibiotic and takes years, as there is little money in it for the Big Pharma to do so, guess what there aren't any new versions.
MaisieGray• in reply to
I think pharmaceutical research and development runs in to £millions, if not more. When you say animals are the greatest (and thereby, unwitting) consumer of antibiotics, I'm assuming that refers to the farming industry's practises rather than domestic pets? In which case of course, apart from the abuse routinely suffered by the animals, what they consume goes into the humans who directly consume them as foodstuffs, and presumably also through the consumption of NDT.
• in reply toMaisieGray
Exactly.
holyshedballs• in reply to
Farmers and vets use antibiotics for 2 main reasons. For those animals reared intensively like hens, chickens, pigs and some cattle (especially in the US) disease spreads from animal to animal like wildfire so there is an animal health reason to use antibiotics.
The UK has more free range style cattle and pig operations. Remember those mini Nissan huts in the country side? They are pig houses.
A well known side effect of antibiotic use is growth promotion, so some meat animals are given antibiotics to promote excessive growth. In the case of chickens (as opposed to hens who lay eggs) they often weigh more than their young bones can cope with, rupturing their gastrocnemius tendons, causing them great pain. The faster growth means that chickens are harvested at 7/8 weeks. To reach the same weight naturally would take a chicken another 4/5 weeks increasing the cost by 30% or more. Some cattle and some pigs are also given antibiotics as growth promoters but not as "endemic" as poultry.
The farmer or vet is supposed to withdraw the antibiotics around 2 weeks before harvesting/slaughtering so it doesn't enter the food chain. Vets from the State Veterinary Service now Animal Health at DEFRA used to sample meat for residues. I'm not sure who samples or if that occurs now. The Veterinary Medicines Directorate has figures on actual use of antibiotics. I cant find any stats on residue sampling.
There are also concerns about the antibiotics escaping into the environment via faeces and urine.
Leaving the EU will put pressure on famers and super markets to lower welfare standards, but the government has said that we will maintain them. The US is lobbying hard for the government to accept their meat that is produced with on average 5 times the amount of antibiotics that the UK uses plus the Bovine SomatoTropin injected in to cows to force them to produce more milk than their udders can cope with plus their GM foods that are illegal in the EU. I'm buying local organic free range meat milk and eggs when I can.
saveourantibiotics.org/medi...
The bucolic imagery of pigs living out their lives in the fresh air outdoors, is not the reality for most of the poor creatures. "Most pigs, including those born outdoors, are put into indoor accommodation for growing/finishing after weaning. Only three percent of pigs will spend their entire lives outdoors." Source RSPCA.
Re cattle, "it's estimated that around 15-20% of dairy cows in the UK never go outside and more and more herds have only limited access to grazing". Source FreeRangeDairy. Even Waitrose and Marks & Spencer, who insist on better standards than many supermarkets, nevertheless only guarantee that their cows have grazed outside for at least 100 days a year - that's up to 265 days of the year stood inside on concrete floors in slurry.
• in reply toholyshedballs
I realize the facts about farming I was brought up on one. Thank you
MaisieGray• in reply to
My post was in response to holyshedballs' comments beginning "The UK has more free range style cattle and pig operations...."
Great points. Cradle to grave healthcare, and all points in between. Both the cause and the solution lie with, and beyond the NHS of course - taking Education for instance, we used to have cookery/domestic science taught to girls and carpentry taught to boys, and there were sports fields and lessons, for both. So setting aside the gender issue, we were taught nutrition, how to cook good food from scratch, and how to be active and "do/make things"; we had a number of lessons every week, allowing us to participate in the full range of PE - and all this was taken away to be replaced by who knows what, currently, is included in the curriculum. But way beyond aspects such as that, and as you make reference to, poor health can be a function of social disease; not only the dependency culture whereby people break themselves and expect others to fix them, or in some other way to take responsibility for their lives; but the impact of how western society functions more generally, its values and priorities.
it would be interesting to know just how many weeks of a medical degree are given to nutrition.
Next to none, apparently: bbc.co.uk/news/health-43504125
You may be interested in the following website. Dr Carl Pfeiffer was an excellent physician in America who pioneered the connection between brain chemistry and minerals and vitamins. Dr Walsh who trained under him now continues his work. I haven't read Dr Walsh's books as yet but Carl Pfeiffer's book on Zinc and other Micronutrients (which is now very old) was one of the most comprehensive yet simple books that I have ever read. Every sentence had a new insight and he never generalised. He was an excellent observer and seemed humble enough to keep learning. walshinstitute.org Dr Walsh and his team come to other countries and train doctors and medical professionals in this process.
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