What medicine are you really getting?

October 30, 2008 by  
Filed under Drugs & Medication, Health

When you visit the doctor you have an entirely reasonable assumption that they will treat the condition that you are consulting them for. This may involve giving you medication, and again you a right to assume that what you are given will be effective. However, disturbing new evidence from the USA has found that many doctors routinely prescribe placebo treatment instead of ‘real’ drugs.

Now, as my readers know, I am not a fan of wholesale medication but I do think if you are being given a placebo you should be told about it. In my childhood, it was actually not that uncommon either as then most doctors also had their own dispensaries and had a variety of standard bottles of jollop for various ills. My mother was a cleaner for our own doctor and she soon realised that the making up of the various remedies for stomach ache, sore throat, coughs and colds were basically all the same but each was a different colour and had more or less sugar in them. I can see the point in them, often such minor illnesses cure themselves and being given treatment increases confidence and that you will soon be well.

However, in the USA, 58% of doctors surveyed said it was ethical and acceptable to prescribe vitamins, sugar pills, painkillers, saline injections, or even antibiotics instead of the medical treatment the patient might expect. They also admitted that they don’t inform the patients of what they are giving them and regularly give placebos, but without ever mentioning the word. Over 1200 doctors were surveyed and they most routinely prescribed standard painkillers that the patient could buy in a pharmacy, or vitamin pills in a different bottle. A staggering 46% of doctors said that at least two to three times a month they recommended a treatment (placebo) primarily to promote patient expectations. They apparently usually tell the patient that they were being given a “potentially beneficial medicine or treatment not typically used for their condition.”

Well, yes. If you go to your doctor for a condition that manifests with lethargy and tiredness and you are given a vitamin, I can see how it might help, but wouldn’t it be simpler to at least have a discussion about diet and lifestyle? I know placebos are helpful and have a place, but the fact it is so common and widespread concerns me because are the doctors saying these people don’t need medical treatment but they are getting the consultation fee and payment for their ‘treatment’ so that makes it all right?

A significant proportion of the doctors surveyed were rheumatologists and prescribing placebos to people who are often in a great deal of pain seems to me to be admitting that you don’t have an adequate treatment – so why not say so and look outside the box to the complementary medicine field which often has greater success with particular ailments than the medical profession do?

The moral of this story? Always ask what you are being prescribed and what it is going to do for you. Doctors may prescribe placebos without informing you, but they are not going to do so if you ask for chapter and verse on what you are getting.

MRSA – Don’t depend on your doctor

May 9, 2008 by  
Filed under Health, Wellness

We tend to put a lot of faith in our doctors, we believe they know they more than we do and have access to greater information and resources. All of which can be true, but I would like to return you to one of the basic principles of good health: you are your own best first resource, certainly in terms of your everyday well-being. The better you take care of yourself, the better able you are to monitor potential illnesses by being aware of the warning signs and paying attention to good old fashioned virtues like getting enough sleep, eating and drinking sensibly, taking regular exercise and finally, and most importantly, not ignoring basic rules of hygiene.

MRSA is now a real problem for all of us, and I was horrified to read that in a recent survey an amazing 1 in 5 GPs admitted that they had poor knowledge of the MRSA superbug and how to treat it. This is not because they are too busy to read the information they are being given, because the other staggering statistic that emerged was that 62% of doctors had not received any information on what to do if they suspected somebody had the bug. As a woman with a long memory, I looked up an item I wrote about four years ago where it was reported on 04 November 2004 that more than one million NHS staff were to get MRSA prevention training, presumably they haven’t got round to the poor old GP’s yet.

As MRSA is usually passed on by human contact, often from our hands, there is the most simple of preventive acts you can take. Supermarket shelves now offer a number of different anti-bacterial and anti-microbial sprays and gels for you to carry with you – and they are a good second stage of protection, but the first is to be totally vigilant about washing your hands. Not just after using the bathroom, but always before you have any contact with food or drink. One of most common ways to pick up a bug is from using a handrail on a staircase in a public area such as the underground, on a bus or in a theatre – most people either hold on as they walk up and down, or just touch it lightly for extra balance and security. That is where bugs can be passed – not by direct contact with someone else but the indirect contact from the skin of the hands.

It’s not rocket science, it’s what we were taught as children, but regularly and thoroughly washing your hands it could help prevent you being affected by a very unpleasant bug indeed.

Can’t get a doctors appointment?

October 21, 2007 by  
Filed under Childrens Health, Health

I don’t know about your surgery, but mine operates an appointment only system and it can take several days to get one, and up to 30 minutes hanging on the phone to actually get to speak to the receptionist at all. That may be about to change as The Health Minister, Lord Ara Darzi, has proposed a three year plan where he wants more than 50 per cent of practices in England to extend their opening hours.

The Health Minister is also proposing to set up 150 large, GP-led practices that will be open seven days a week, from 8am to 8pm. They will be situated in easily accessible locations offering a range of services including walk-in services. He said funding would be available but if existing practices refused to open extended hours other providers would be commissioned. Can’t quite imagine what ‘other providers’ means; is he thinking of setting up freelance surgeries, rather like the ‘walk in’ doctors you can consult at mainline stations in London? Except they are all private and although you can see a doctor immediately, you usually want to see your bank manager afterwards.

It sounds a bit confused to me, as he is also saying there will be an increasing proportion of the NHS payments made to GP practices but that these are going to be linked to their success in attracting patients. So they want the doctors to have more flexible hours, offer the ability to book advance appointments and be able to see a GP within 48 hours – none of which they can manage with their existing patient lists in my area – but they are expected to do it only if they also have an increase in patient numbers. Paying them more to attract new patients doesn’t exactly help the existing ones does it?