It’s Official - being a pushy patient is good for you

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Professor David Haslam, Chairman of the National Institute of Health and Care Excellence (NICE) said on 2 October 2014 that NHS patients should adopt American attitudes and become more assertive to ensure they get the treatment they need. In an interview with the Daily Telegraph he said that too many patients were not being offered medications already approved by NICE and that they should become more knowledgeable about their conditions and ask for dugs which should be prescribed for them

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  • Posted

    It seems to me that it's essential to be assertive in order to get anywhere as a patient, I've had prolapsed bowel, polyps and IBS for four years and have frightful symptoms yet in all that time my GP and indeed the two consultants that saw me, one on numerous occasions, didn't so much as mention to me, antidpasmodics, or suggest their use, also I had to wait 12 months before I was diagnosed with a full prolapse and offered surgery and prior to that I was accused by the Consultant of forcing myself to go to the loo, my schizophrenia was actively used against me and as a blanket term to prevent a full investigation into why I was needing the loo 16 to 22 times a day.  However I do feel it is a sorry situation if things are getting more like the USA as the situation out their with health care is appalling, no one gives a hoot, as I hear from American friends I chat to daily, we had an exemplary health service in the 60s and 70s and personally I would hate to see it get more cynical and underfunded than it is currently, just saying.
    • Posted

      Without getting too political all the parties seems to be offering a better NHS with extra billions - must be a general election soon?  Still we can only hope!
  • Posted

    Haha! Hope he will issue that statement in writing and signed to all of us who have become expert patients! They actually have a scheme for patients with chronic illnesses so they go on courses to learn how to manage their problems better and reduce hospitalisations. A study on the results found that patients, particularly diabetics, met with downright brick walls from healthcare professionals which took away all the advantages. GPs even disputed the dosages agreed between an expert patient and their consultant and so undersupplied them and nurses in A&E took away medication so the patients couldn't use it and then were late with handing it back to be used.

    My daughter was assertive with the consultant who said her daughter had laryngeal dysfunction which was causing her asthma (she doesn't) and was non-compliant with medication (she isn't, mum is a nurse) and wrote an action plan for admission which brought her to resus at least twice and she nearly died - but the consultant has now chucked my daughter out because of her requests for correct care. Not much loss - but the local hospital consultant admits he doesn't know what to try next. The prognosis is bleak - so we're hoping for the Brompton - but they live in Scotland.

    Communication, communication, communication!

    • Posted

      Eileen, I know exactly how you feel, I was forced to notate reams about my symptoms because the Consulrant wasn't listening and taking prejudicial attitudes to me, eventually I binned him off and asked to see a different consultant, eventually realising they just didn't like me and the new consultants attitude was clearly an attempt to silence me so I am now forced to see my GP to get a recommendation to a different hospital!!  It's madness, why can't these people just do their job?!
    • Posted

      They are paid, a lot, after all
    • Posted

      Back to the tin gods - they think they know better than the patient!  I'm very glad I have had good and listening doctors.
    • Posted

      When we lived in Germany a close friend who was training as a paediatrician told us one of the first things they were told was "Listen to the patient/patient's parent - they know their illness and the child better than you EVER will"

      Just recently I've seen a load of posts where doctors are questioning the patient's pain levels. OK, some people do lay it on a bit - but to tell me that post op or in PMR "you can't have pain because others don't" is downright rude.

    • Posted

      Can I suggest a googling of the 2014 BBC Reith lectures by Atul Gawande? This year they are called "Why doctors fail", are available online and there is a edited version in the Guardian today.

      Very apposite I think.

    • Posted

      Thanks Eileen, I'll definitely take a look at the article in the Guardian, as avid reader of Guardian particularly
    • Posted

      fiona, if you go to the Guardian fromt page for today there is a useful easy link to Dr. Gawande's first of four ) Reith lecture. You have the choice of listening or printing.  I think the title for the series is Medicine Today.
    • Posted

      Hi Eileen, first of all I am the stroppy patient. I have just received an appointment through for my DEXA scan - I asked for one and refused the aa until I had a scan to show if I needed to take the  medicine.

      I have reduced the Pred to 12.5 after 6 weeks on 15mg and I am ok but not brilliant,have some pain in my hips but no stiffness.

      Anyway enough about me. If your granddaughter has bad asthma, then get her to the Brompton. They run 10 asthma clinics a week and the waiting time when we were referred 4 years ago was 11 days! My son had a life threatening attack because the house officer did not follow the instructions of the senior reg and give IV steriods so my son's SATs got down to 85% and he ended up on IV aminophlyn in HDU.

      The team at the Brompton are fantastic and look for causes of asthma - my son's triggers are house dust mites, viral infection and grass pollen. We have a treatment plan and have not been in hospital since he started under the care of the Brompton. Prof Bush and the team are fantastic. Have a look at the hospital's website under childhood asthma.

  • Posted

    Can someone tell Prof Haslam that most patients only get 10 minutes with their GP and many GPs will not deal with more than one issue per appointment (no idea where they trained to come up with this nonsense). The difference between the UK's National Health Service and the American insurance model is vast. It is not a matter of being assertive, in the UK it is more a matter of 'beggars can't be choosers'. I assume many people who use this site are either paying for their treatment or are insured. They should say if they are in the UK and are NHS patients as this might account for many of their medication and treatment difficulties. 
    • Posted

      "I assume many people who use this site are either paying for their treatment or are insured."

      You assume wrongly: I think you will find that there are several of both USA and UK patients and, as far as I know, all the UK patients are NHS patients. There are one or two who have themselves paid to see a rheumatologist privately when they had problems with GPs or a rheumy who wouldn't listen. One lady I know was covered by company private health insurance but the others were added to their rheumatologist's NHS list after the first consultation which is a common practice by good consultants.

      Both US members and NHS members have difficulty getting correct treatment for PMR. In both cases it is usually lack of knowledge on the part of a GP about PMR that causes the initial problem - and then it compounds. I had 5 years of no pred PMR because the GP I usually saw didn't know PMR can occur without raised bloods and the clinical picture is paramount. When I saw a different GP in the practice she knew all about that. I hadn't seen her before as she was part time and had been on maternity leave. That's why I often suggest seeing a different member of your practice - it can make a big difference even with a 10 min appointment. For many of the US patients too the system is not so different - as anyone who has had to use medicaid or the free clinics will attest. If you have no money in the USA you are far worse off than someone in the UK, however poor the service at your local GP may be.

      They aren't "trained to come up with this nonsense" - it is managers who run the practices attempting to make more appointments available. Unsuccessfully it would appear. Some doctors happily spend a bit longer with the patient who needs it - and profit because the patient only comes once not having to come repeatedly to get an answer. To a great extent it is a result of patients demanding an appointment and that it should be on time. Here, also a state run system, I have to turn up and wait my turn as do the rest of the patients - I can find anything from walking straight in to waiting an hour and a half. No one cares, we know when it needs more than 10 mins we will get it too. We also have small co-pays for everything other than seeing the GP - a 15 euro fee dissuades people turning up at A&E for a plaster for a cut or because they have a cold. You are exempt these if you have a small income so, again, no-one is denied treatment when it is necessary on finance grounds.

  • Posted

    Can someone tell Prof Haslam that most patients only get 10 minutes with their GP and many GPs will not deal with more than one issue per appointment (no idea where they trained to come up with this nonsense). The difference between the UK's National Health Service and the American insurance model is vast. It is not a matter of being assertive, in the UK it is more a matter of 'beggars can't be choosers'. I assume many people who use this site are either paying for their treatment or are insured. They should say if they are in the UK and are NHS patients as this might account for many of their medication and treatment difficulties. 
    • Posted

      I will echo EileenH's comments.  Few of us here have any kind of private insurance, certainly not me. In more than 15 years since PMR was symptomatic, although the initial diagnosis was difficult to obtain due to preconceptions among male doctors at that time, the care and attention I have received since gives me little cause for complaint.

      My medical history is now a complicated one and although I have moved home, areas and GP's in that time I am still satisfied with my care and the routine attention I get.

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