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Topic: 18 months of hell followed by relief!
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Leo Enticknap
Film God
Posts: 7474
From: Loma Linda, CA
Registered: Jul 2000
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posted 04-29-2015 11:44 AM
My experience with the British National Health Service (both as a patient and what I've heard from several doctors in my family) is that there are some things it does supremely well, but if the issue you have is an unusual one, it can really be a lottery. If you see someone who knows about it and is interested in it, you're in excellent hands. But if you encounter someone who isn't and/or doesn't, then basically you're buggered.
In 1993, aged 20 and otherwise in perfect health (apart from having recovered from a minor stomach bug about 2 weeks previously), I began to feel tingling/weakness in my legs which, a couple of days later, had got so bad I could hardly stand. My GP told me that I'd probably pulled something (in both legs?!), and to rest for a couple of days and it would go away. It didn't. Then I went to casualty, where the doctor gave me a preliminary examination and opined that I'd got a sports injury, despite my telling him that I didn't do any sports. When I made a fuss and insisted on further examination, he did a reflex test, which rang an alarm bell (there weren't any), and then a whole load of further and irrelevant tests, based on what I now know was his suspicion that I had multiple sclerosis.
That night, in hospital, my mother called my uncle, a neurologist at a hospital 150 miles away, and described the symptoms. Simply from the description over the phone, he guessed correctly what I had - Guillain-Barré syndrome (GBS). It's a nasty, rare and little understood disease that causes temporary paralysis, starting in the feet and working its way up. Most people recover completely from it, but it kills around 2% of those who get it because it affects their heart and/or lungs before doctors can figure out what the problem is and put them on a ventilator.
This guess was passed to the houseman (newly qualified doctor, who in fact was a woman!) on my ward, who ordered the tests needed to confirm it, which they did. If starting the treatment for it had been left another 2-3 days, I could have died.
What enabled my uncle to guess what I had correctly and instantly was my having had the stomach bug two weeks earlier. Campylobacter is a well known trigger for GBS - well-known if you have decades of experience treating this sort of thing and keeping up with your reading, that is. I told both my GP and the casualty (emergency room) doctors this, but they didn't get the significance.
About a decade later a family friend had excruciating stomach pains which his local hospital spent 18 months investigating (they suspected cancer, extreme allergies, you name it), before he finally got an x-ray technician who knew how to take the pictures properly, revealing plain simple gallstones. One minor operation later, problem solved.
But on the other side of the coin, the NHS is known as a world leader for treating more common issues, e.g. some cancers and artificial limb installations, both in terms of cost and patient outcome. About a year before I emigrated I had a sebaceous cyst removed from the side of my head at the local hospital (Carl - you'll know the one - think Wigginton Road!). Everything was extremely quick and efficient - I was in and out in an hour and a half, it was all done under local anesthetic and I was back at work that afternoon.
It seems to me that the issue is basically the same one as we've been talking about in troubleshooting faults in projection booth equipment. Most medical professionals can diagnose and treat the common things very well, but to deal with the more unusual ones, you need to be at the top of your game, have a lot of experience under your belt, or both.
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Leo Enticknap
Film God
Posts: 7474
From: Loma Linda, CA
Registered: Jul 2000
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posted 04-29-2015 04:45 PM
To be fair, GPs and casualty doctors see a helluva lot of hypochondriacs, malingerers and people who, only a generation ago, would have just treated themselves for more minor things. This probably causes them to develop a hardened, cynical attitude, the end result of which is the never-ending stream of "'My GP told me to go home and take an aspirin, cut out the fags,* booze and kebabs and get some exercise', said mum of 6 who died in agony of cancer three days later" stories that the Daily Wail delights in printing. For every 99 people who show up at the surgery, that's the correct prescription, which makes it harder to spot the 100th who actually does have something seriously wrong.
* In British English slang = cigarettes
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Frank Cox
Film God
Posts: 2234
From: Melville Saskatchewan Canada
Registered: Apr 2011
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posted 04-29-2015 05:00 PM
We have the same issue here, where a whole ton of people who don't really need to be there are sitting in the doctors' offices and hospital emergency rooms every day.
I believe that a lot of these people are simply lonely and are looking for someone to pay attention to them (or them and their kids, or whatever). Since we have universal medicare here, it doesn't cost them anything directly to go and see a doctor for the even minor or nonexistent complaints.
We can feel sorry for these people, but the unfortunate reality is that they are costing the taxpayer major money for what amounts to nothing at all.
I think the solution is what I call the $20 medical system, where you pay $20 each time you see a doctor, whether a general practitioner or a brain surgeon. That would act as a disincentive for people who have nothing actually wrong with them and are actually abusing the system, plus it would add a revenue source that doesn't exist right now though that's not the primary objective.
If you aren't $20 worth of sick, you aren't sick.
Some exceptions might have to be made for people with chronic conditions, but that would have to be strictly limited to prevent undermining the intent of the system.
My humble opinion. ![[Big Grin]](biggrin.gif)
My wife does get a bit frustrated with me sometimes, though, since my theory of medical care is that if there are no visible bullet holes, I'm fine.
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Leo Enticknap
Film God
Posts: 7474
From: Loma Linda, CA
Registered: Jul 2000
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posted 04-29-2015 06:06 PM
That's the system we have on my health insurance here: it's called a co-pay, and it varies from very little for serious, could-happen-to-anyone problems to quite a lot for elective, non-essential treatments. The British NHS is the same as the Canadian system - everything "free at the point of delivery". In fact, just before I left, one brave politician suggested that a co-pay system might help to cut down on time wasters, but was shouted down by the argument that it would deter the poor but genuinely ill from seeking help. Of course the truth lies somewhere in between those two positions.
As for the "visible bullet holes" approach to medicine, my aunt (hospital psychiatrist) often says that the National Health Service should more accurately be called the National Illness Service, because (apart from breast and cervical cancer screening for women above a certain age) it does not do preventative medicine whatsoever: you only have any contact with the system if you have a bullet hole (real or imagined) that needs patching up. In contrast, here I am required to have an annual check-up as a condition of my insurance policy. This includes a blood sample analysis for various things and the usual weight/blood pressure type readings. Last year's revealed that my blood pressure was a little higher than it should be, and on the basis of the blood analysis I was advised to reduce my salt intake. I suspect that if the European state-run healthcare systems did more of this sort of thing, it would at least pay for itself in savings in treating people for major problems that weren't caught when they were still minor ones.
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