Dealing with medical professionals

RE: Dealing with medical professionals

Lazy Bee — Thu, 11 Jan 2018 08:43:48 GMT

Some years ago I had to call out our GP one night to see our elder boy with crippling bellyache, she decided I should take him into the childrens ward at our local hospital for observation. Jenny requested a sheet of writing paper (& envelope) for me to take a referral letter in with me, in large capital letters across the top of the letter I saw Jenny had written "Julian's father is our veterinary surgeon".

I spent the rest of the night in the children's ward taking tea and buttered toast with the Sister and her Nurses - who were all clients! Oh, and after 36hrs TLC we got Julian back good as new.

Further Good News - just over 3 weeks ago - I had a Christmas present from the NHS in the form of a new right hip. From my first consultation with one of our G.P.s, through the practice's senior Physio (2 more consultations), referral to the same surgeon who did my wife's THR 8yrs ago, then 3&1/2 days in the ROH Birmingham - every option was discussed, every treatment/medication explained. Yes, they knew I'm a retired Vet, but to be honest it didn't seem to make much difference one way or the other, and I can't think of anything that could have improved my experience.

RE: Dealing with medical professionals

Sarah McGurk — Fri, 15 Dec 2017 22:37:36 GMT

Glad to hear you are receiving such excellent care Julian.

[quote user="Clare Tapsfield-Wright"]

I do not blame the neurologists for their different diagnoses , there is no definitive test. I am just appalled that one medic would speak about a colleague in such a manner to a patient even if he disagreed with them.

[/quote]I don’t currently have a high opinion of my local neurology in-patient department and hope I never have to go back in. I concluded mine was as appalling as I had thought when one of her colleagues admitted she was ‘tactless’ and one of the nurses told me I shouldn’t let the way I’d been treated put me off coming back as lots of people were only diagnosed on their second, third or fourth time through. I was shocked that they were willing to speak about their colleague that way and they weren’t nearly as rude as yours!

I now have a new neurologist thank goodness, but only after my husband pointed out to my GP that ’we wouldn’t send a dog home in that state.’ I’m still wondering if I should complain, but if I have to go back, there’s no guarantee I won’t get her again.

RE: Dealing with medical professionals

Julian Earl — Fri, 15 Dec 2017 17:53:28 GMT

In recent years I have received fabulous treatment from the NHS and specifically from my wonderful neurosurgeon at Hull Royal Infirmary. I worship the ground he walks on for what he has sone, mostly in 2012 but also at the post-operative follow-ups. Every time that I go I receive a thothorough history-examination and he always asks me and my wife for that matter, how we want to proceed. I have a programmed shunt in my head to control the drainage of fluid and he asks me if I want to change the pressure-setting at which fluid drains. This affects my physical function and dexterity, plus causes headaches if it is wrong. But Gerry never adjusts the setting without discussing it first and in January I will ask him to increase the setting to 200mmHg to try and obtain even further improvements. He will do this based on my request and current history. That is usually done immediately with some electro-magnetic magic and the press of a few buttons. I have no complaints at all there. He treats me like a fellow-professional which is nice as well!

We met him at a charity event as well so I told his wife how wonderful he had been. She said, "Don't tell him that will you?! But I did and he just laughed and credited his colleagues. A wonderful chap like I say!

RE: Dealing with medical professionals

Anthony Todd — Fri, 15 Dec 2017 16:12:58 GMT

Thanks, just wondered whether they'd spray local and say "hold very still with your mouth wide open" or something...

Doctors IME seen to have no idea that patients are sentient......

RE: Dealing with medical professionals

Gillian Mostyn — Fri, 15 Dec 2017 13:09:11 GMT

[quote user="Anthony Todd"]Tell us what happened then.[/quote]

Not sure what you want me to say really. Ate some chicken at a restaurant on a Saturday night, felt a sharp pain immediately after swallowing, retched and brought up some blood. Pain and discomfort on swallowing for next 2 days but could eat fine. Went to hospital 7pm Monday evening (after work) and had x-rays, was a differing of opinions so had to wait to see surgical SHO. (No ENT surgeon on call.) He palpated, checks rads and passed a nasal endoscope. (unpleasant!) He was convinced the radiodense area immediately next to my larynx was normal cartilage, plus there wasn't any excessive soft tissue swelling. Sent home...pain resolved after another 3 days or so. Assume small oesophageal scratch I guess.

Just as an aside, I got a phone call 10 days later from a different hospital doctor, asking how I was. Apparently it is routine to review all radiographs, and at the review the ENT consultant felt there was indeed an abnormality...!!! When I reassured her that I was AOK she said she'd get back to me. Still waiting....3 months later!

RE: Dealing with medical professionals

Bob Russell — Fri, 15 Dec 2017 11:33:01 GMT

I am not sure that many medics appreciate the fact that we have ultrasound, X-rays and access to CT and MRI.

Actually we do 'proper' medicine and many of us do it quite well on the limited budgets available to us!

I really have avoided contact with my GP as it interferes with my day but I do have considerable respect for him. Last time we discussed why he was not allowed carpet in the waiting room as it is now very echo'y!

RE: Dealing with medical professionals

Julian Earl — Fri, 15 Dec 2017 10:03:31 GMT

[quote user="Wren"]I do find that a lot of doctors are flabbergasted at the level of medicine we practice.[/quote]

One doctor asked his colleague how we diagnosed pneumonia? His colleague suggested that vets have sthoscopes just like doctors do!I kept quiet!

RE: Dealing with medical professionals

Julian Earl — Fri, 15 Dec 2017 09:58:11 GMT

[quote user="Julie Innes"]that lots of exciting developments coming faster in the canine world,[/quote]

Seven times faster at a guess?

RE: Dealing with medical professionals

Anthony Todd — Fri, 15 Dec 2017 09:15:30 GMT

[quote user="Gillian Mostyn"]I recently had some x-rays to check if I had a chicken bone stuck in my oesophagus.[/quote]

Tell us what happened then. [no axe to grind, just interested]

Might help someone dealing with an oesphageal FB?

RE: Dealing with medical professionals

Gillian Mostyn — Fri, 15 Dec 2017 08:15:10 GMT

I recently had some x-rays to check if I had a chicken bone stuck in my oesophagus. The radiographer and registrar thought I did, so referred me to the surgical SHO on duty that night. Apparently he looked at the rads and disagreed, and asked that I wait in A+E to see him. The nurse on duty came to tell me, sighed, and said something along the lines of "the SHO disagrees with them, but I'd put more faith in what the registrar thinks than in him to be honest." I was dumbfounded at her attitude. I couldn't believe that anyone would discuss their colleague so negatively.

When the SHO examined me I found him to be knowledgeable, kind and, in the end, correct. He went through the rads with me, discussed how everybody can have different calcification of the thyroid and cricoid cartilages and he was sure what everyone else was seeing was a normal variation. At no point did I tell him I am a vet. I have to say he was one of the loveliest, and most thorough, doctors I have seen.

Unfortunately I was left wondering whether the fact that he was a black African, with a very strong and sometimes difficult to understand accent, had any bearing on the opinion of his colleagues. I hope not.

RE: Dealing with medical professionals

Clare Tapsfield-Wright — Fri, 15 Dec 2017 08:01:34 GMT

I have some lesions on MRI and neurological deficits but the diagnosis is still under debate. I’m no worse over the past year and I wouldn’t be opting for radical treatment regimes at present so I am playing it by ear.

RE: Dealing with medical professionals

Sarah McGurk — Fri, 15 Dec 2017 07:31:38 GMT

[quote user="Clare Tapsfield-Wright"]

I have seen three neurologists now about my weird neurological condition , the first one diagnosed MS but the second and third have their doubts about the diagnosis. The second one commented that the first consultant who I saw through my private medical insurance might have been too hasty making the diagnosis because he “ has a large villa in Cyprus to maintain “ !!!

[/quote] Well I’m currently in the Norwegian health system, but the doctors seem almost pathologically averse to even considering a diagnosis of MS without specific MRI lesions, yet my understanding is the current guidelines that are in use were only brought in to allow a standardised diagnostic model for lab use (presumably for testing new treatments). There is other information that states that 5% of MS patients have no visible lesions.

So it doesn’t surprise me that your private doctor made the diagnosis. I had considered going for a second opinion as I get the impression the hospital doctors just saw me as a unit and when they’d put me through a few standard tests, decided to spit me out of the system. I was told they «had no suspicion of neurological illness» which was frankly ludicrous. The fact that even diseases as well accepted as Parkinson’s can’t always be picked up using any of the current diagnostic tests seems to be ignored as way too inconvenient to contemplate.

RE: Dealing with medical professionals

Robin Grimmer — Thu, 14 Dec 2017 18:44:41 GMT

Two of the thickest clients I had were a husband and wife pair of GPs. Their ignorance was shocking!

RE: Dealing with medical professionals

Martin Atkinson — Thu, 14 Dec 2017 18:16:01 GMT

[quote user="Sammy82"]

[quote user="Julie Innes"]

I understand that it's probably not feasible to give treatment options to patients, but I was always surprised at the lack of discussion/ explanation of the plan, even when you ask.

[/quote]

I asked why, and her answer was seriously "because the consultant said so". They could have send the cleaner to tell me that! Very reluctantly she said he was under the 10% line. On further questions of pros and cons she said that induction increases the risk of needing a section, leaving it increases the risk for stillbirth. And left me like that. No statistics, no support in making a decision.

[/quote]Did you volunteer the information that you are a vet Sammy? I repeat what I said before but got pilloried for it. Yes there is a time issue but I do feel that some medical staff feel they're wasting their breath because most people ask dumb questions and wouldn't understand what they're talking about so they don't bother. Once they realise your level of knowledge I've found they are lot more accommodating and almost relieved to have someone to talk to on equal terms.

For the person who did rip me off a strip for saying this before my answer is: I will try to give all my clients all the relevant information but you can soon tell when it's waste of time and all they want to know is: 'how long she got doc'?, and 'how much is it going to cost'?!

RE: Dealing with medical professionals

Anthony Todd — Thu, 14 Dec 2017 13:16:55 GMT

[quote user="Robin Grimmer"]This applies to vets too![/quote]

A very switched on lab. tech. at Penn took her cat to a vet in Philadelphia for some sort of problem.

The vet reached for an injection and prepared to inject .

Tech said "What's that ?

Vet said, slowly and with emphasis "It's med-i-cine"

Tech: "[sigh] But what for?"

Vet: [even more slowly and a bit louder] "to make the cat better"

Steam was still issuing from said tech's ear canals some hours later....

I was there!

RE: Dealing with medical professionals

Clare Tapsfield-Wright — Thu, 14 Dec 2017 12:10:32 GMT

RE: Dealing with medical professionals

Sammy82 — Thu, 14 Dec 2017 11:50:47 GMT

[quote user="Julie Innes"]

I understand that it's probably not feasible to give treatment options to patients, but I was always surprised at the lack of discussion/ explanation of the plan, even when you ask.

[/quote]

Yes I felt the same when I had my son. A registrar (first and only doctor I met through my pregnancy and birth) came to tell me after a scan that I needed to be induced, there is a leaflet, see you Monday. I knew he was measuring a bit small but nothing was ever said about induction before. I asked why, and her answer was seriously "because the consultant said so". They could have send the cleaner to tell me that! Very reluctantly she said he was under the 10% line. On further questions of pros and cons she said that induction increases the risk of needing a section, leaving it increases the risk for stillbirth. And left me like that. No statistics, no support in making a decision. The leaflet contained as much information as you would find in the headlines of a medical textbook and no info about risks/pros and cons. The midwives on the other hand were very helpful and happy to discuss things on a professional level, and so are most GPs I have met. Thankfully all went smooth and very fast and we have a happy 8 month old .

RE: Dealing with medical professionals

Bob Russell — Thu, 14 Dec 2017 11:17:12 GMT

The reality is that the NHS treats us as numbers a lot of the time. Individual clinicians thankfully often do not.

It is probably more efficient to interact as little with patients as they slow things down!

My wife hates the NHS because the service she received in Thailand was far more user friendly. It did, however come with a price tag albeit amazing value.

RE: Dealing with medical professionals

Martin Atkinson — Thu, 14 Dec 2017 09:51:42 GMT

[quote user="Julie Innes"]And we have never, to my knowledge, been given treatment options- just "this-is-what-we-are-going-to-do". So it's not always easy for patients to ask/ challenge, especially if they are feeling rotten.[/quote]One reason I still pay a fortune for private medical insurance for myself and my family, the difference in attitude and exchange of information is night and day.

[quote user="Julie Innes"]

And we discovered from my mum's notes after her death that the doctors had decided she was DNR, without ever discussing it with us. (I would have agreed, dad wouldn't)

I think the difference is partly to do with the fact that it seems virtually impossible to sue doctors, and relatively easy to sue us! I had a friend who was a solicitor defending medical claims, and she said very few of them ever resulted in much, as to be struck off doctors had to have done something maliciously or on purpose, mistakes were recognised to happen.

[/quote]After my mother died in the night from a coronary thrombosis I mentioned to my GP and dentist that she had gone to see her GP the previous day with jaw pain but he'd said it was neuralgia and gave her amitriptyline. Both said facial pain in someone of her age with a history of heart disease should have been referred urgently to a coronary care unit. Even worse amitriptyline is contraindicated in coronary heart disease and could have exacerbated it. If she had been treated promptly and correctly she might have survived

I complained to the GMC and requested a copy of the doctor's notes but they were scribbled in hand writing and said she'd complained about ear ache so I didn't think it was worth taking it further. I didn't want the doctor disciplined, just for him to realise his standard of care was far from ideal.

RE: Dealing with medical professionals

Julie Innes — Thu, 14 Dec 2017 08:52:58 GMT

I understand that it's probably not feasible to give treatment options to patients, but I was always surprised at the lack of discussion/ explanation of the plan, even when you ask.

For example when my dad had his heart attack and they were putting stents in I asked about the risks, but they wouldn't tell me, just that he needed them. I knew that, I just wanted to know how worried I should be about him!

And we discovered from my mum's notes after her death that the doctors had decided she was DNR, without ever discussing it with us. (I would have agreed, dad wouldn't)

RE: Dealing with medical professionals

Robin Grimmer — Thu, 14 Dec 2017 07:56:55 GMT

[quote user="Nicola M"]

[quote user="Julie Innes"]

we have never, to my knowledge, been given treatment options- just "this-is-what-we-are-going-to-do".

[/quote]

Although to be fair sometimes people just want to be told ’this is what we’re going to do’ by someone experienced rather than being given a list of treatment options without a plan!

[/quote]

This applies to vets too!

RE: Dealing with medical professionals

Nicola Cole — Wed, 13 Dec 2017 23:43:17 GMT

[quote user="Julie Innes"]

we have never, to my knowledge, been given treatment options- just "this-is-what-we-are-going-to-do".

[/quote]

Although to be fair sometimes people just want to be told ’this is what we’re going to do’ by someone experienced rather than being given a list of treatment options without a plan!

RE: Dealing with medical professionals

mariette asselbergs — Tue, 12 Dec 2017 19:13:46 GMT

Here is another example of this: This week i get a letter from my GP which says "According to our record you are due for a blood test". "It is important that you attend for these tests as we require this to enable us to monitor your condition and to ensure you are receiving appropriate treatment".

Go to the hospital, they have out request on their system.

No clue what the bloodtest is for, which condition my GP wants to monitor, and I am not presently on treatment from them.

I should of course have called the GP, but I didn't, went to the hospital instead, (a lovely walk through the snow by the way), but they didn't have me on the system and had no idea what to test. Tried to call the GP who was busy and could not answer them.

Turns out, they had picked up that I was a bit anaemic at the end of my chemo, and they wanted to test for folic acid deficiency, in order to supplement me with folic acid tablets. These are actually contraindicated when you have cancer because they promote cell division.... I am sure I am no longer anaemic and politely declined the blood test.

Do we treat our clients like morons in this way?

RE: Dealing with medical professionals

Julie Innes — Tue, 12 Dec 2017 17:48:23 GMT

I've also found when relatives have been in hospital, actually getting to speak to a doctor can be a challenge in itself! Often a nurse appears and announces they are just going to do x or y, so there's no chance to ask the doctor why or what for! And we have never, to my knowledge, been given treatment options- just "this-is-what-we-are-going-to-do". So it's not always easy for patients to ask/ challenge, especially if they are feeling rotten.

RE: Dealing with medical professionals

Gillian Mostyn — Tue, 12 Dec 2017 16:08:08 GMT

[quote user="Martin Atkinson"]I suspect that most doctors realise they are wasting their breath explaining stuff which the patient won't understand anyway[/quote]

Is this really your opinion Martin? Is this your own approach with your clients?

You never fail to amaze me.