There is a picture circulating on medical Twitter (that’s one thing – doctors love Twitter, many post incessantly) of a coffee mug that says, “Don’t confuse your Google search with my medical degree …”.
I get it. A little knowledge is a dangerous thing, and all of that. Easy online access to medical information means that we civilians often get the wrong end of the line.
But really, it is reminiscent of the bad old days of paternalistic medicine. It goes very much, ‘Don’t worry about the details, sir / madam. Doctor knows best. ‘ That kind of energy.
I know it’s a joke But do you know that we can all see what you are saying – that you are not just writing to your GP colleagues?
The same goes for all those family doctors who seem so glowing under the recent decree of the NHS England that they should offer face-to-face appointments when a patient requests one.
Agitprop approach: Front pages of GP magazine Pulse. In February Pulse ran a front page with the words, in poison-pen-letter style, How the Media Created an Anti-GP Storm
Pretty sensible one might think. But not so, say numerous general practitioners on social media.
Given the hysteria, you’d think they’d been ordered to do something horrific – not just return to a way of working that was more like it was before Covid.
For the past nine months, this newspaper has warned of the damage caused by the shift to remote consultation. These measures were put in place at the start of the pandemic for obvious reasons, but have inexplicably remained in place since then. Crowds of patients – I’ve never seen a mailbag like this – have spoken out in favor of being excluded.
Doctors themselves have argued in the Mail on Sunday that the system in which patients are screened by phone or online before they receive a personal consultation is deeply flawed, even dangerous.
But a hardcore minority of general practitioners appear to be on their heels. You are not told. They will continue to do what they want – visit patients in person “when necessary”.
And in many cases, this will undoubtedly work fine.
But we know that there are pockets where the situation is dire for patients.
There seems to be a widespread reluctance to acknowledge or accept that some in their ranks deserve criticism. Instead, they say they are the victims: a creaky, over-the-top system (that’s true, but more on that later) and a media-staged witch hunt that is completely wrong.
A family doctor wrote on Twitter: “Hospitals to collapse in May 2020 = clap for the NHS. May 2021 #TeamGP threatened with collapse = blow on the GPs. ‘
Patients in droves – I’ve never seen a mailbag like this – have spoken out in favor of being excluded, writes Barney Calman (pictured)
Another warned: “Please stop the politically driven hate campaign. Many of us have resigned after a wave of attacks and abuse from parts of the press and the public. Soon none of us will be there anymore. ‘
And one more thing: “Dear patients. The reason you find it difficult to get an appointment with a family doctor isn’t because we’re lazy, work shy, afraid of getting Covid, refusing personal appointments, or any of the other damn reasons reported in the right-wing hate brochures. The reason is … there are too few general practitioners, house nurses and insufficient funding. Next time you have trouble getting an appointment, don’t blame us. Blame the government for which you voted. ‘
He got hundreds of shares and likes, mostly from doctors.
Occasionally a civilian takes the courage to post something in one of these rant threads like: Wait a minute, my practice has been sealed since March 2020.
Undoubtedly, for each of them there are dozens more patients who read and think in silence – how can I put it politely: how uncomfortable are these general practitioners.
That bothers me. Doesn’t it bother the family doctors? Maybe they didn’t think about it.
The hysteria is led by the British Medical Association and the rebellious family doctor magazine Pulse.
In February, Pulse ran a front page with the words, in poison pen letter style, How the Media Created an Anti-GP Storm.
The June issue contained a sign in a GP operating room window that read Normal Services Resumed – with “resumed” crossed out and “imposed” scrawled next to it.
This agitprop approach is not only misleading, but also inappropriate given the suffering of patients and general practitioners.
A GP’s assessment of a patient should begin the moment they walk into the consulting room, says Barney Calman (file photo)
And Kate Mansey’s story shows so very clearly why these objectors not only think wrong, but – unwittingly or not – risk their lives.
Of course, one could say, well, even if she had been examined the doctor might have come to the same conclusion. Abdominal pain is a pretty nondescript symptom.
But severe central stomach pain that eventually radiates into the right lower abdomen – as Kate’s brilliant 111 operator aptly put it, the right iliac fossa – is a tell-tale sign, if not the definitive symptom of appendicitis.
I know that thanks, uh, Google. Should someone say Kate’s medical degree GP?
If that hadn’t been convincing, the weeks of incessant vomiting and explosive diarrhea should have been pretty good indicators that something was seriously wrong.
As Kate herself said, she hardly recognized herself in the mirror – she looked so sick.
The GP’s assessment of a patient should begin the moment he enters the consulting room: the way the patient walks, the color of his skin and eyes, his general behavior – all of these contribute to the diagnosis.
So yeah, given all that, Kate’s GP could still mistake her ruptured appendix for a gastrointestinal virus, or maybe they realized she needed an urgent operation.
But that’s the thing, we’ll never know now.
It looks like the trust that existed between Kate and her family doctor has been irrevocably broken because her family doctors can’t possibly say, hand on heart, they did everything they could to help her.
It’s a story we keep seeing.
And that’s the tragedy of what’s happening right now – or at least another tragic outcome.
Some tweets were really worrying as the GPs were clearly in need. Horrible, but … they still tweet many, many times a day, writes Barney Calman (file photo)
Nobody is under the illusion that the pre-Covid situation was perfect. Thousands of general practitioners were already lacking in primary care, while the number of patients has risen rapidly. But in most of the letters we received, readers said the same thing: They were all completely satisfied with their surgery by March 2020.
As already mentioned, the new online eConsult system is also causing problems. Amid this chaos, GPs report they are on the verge of the inflow of email forms. Patients bombard their doctors with mundane questions – “Should I eat a plant-based diet” was a new favorite – all of which must be read in full so that nothing is overlooked.
As one family doctor I know said he didn’t sign up to work in a call center. Many find working remotely unsettling for fear of missing out. So I find the reluctance to return to the old methods doubly astonishing.
Some tweets were really worrying as the GPs were clearly in need. Terrible, but … they still tweet many, many times a day. Sometimes every hour. Surely doctors should know how psychologically harmful heavy use of social media is?
And let me remind you again: your patients are likely to read what you write.
My tip: log out. The best thing to do is delete the app.
It will be difficult to resolve this chaos. And worrying all the time about what’s happening on Twitter only makes it harder.