This site is intended for health professionals only

At the heart of general practice since 1960

Finding fault with the system

One of the regular things that Jobbing Doctors look at is balancing risks and benefits. We generally have to do this on behalf of our patients and it can be a difficult judgement call to make.

By The Jobbing Doctor

One of the regular things that Jobbing Doctors look at is balancing risks and benefits. We generally have to do this on behalf of our patients and it can be a difficult judgement call to make.

It is, of course, impossible to get it right every time and not investigating someone who turns out to have cancer is a nightmare that most of us have. The most difficult one for me is the early diagnosis of colon cancer. I can think of three cases in 30 years where I wished I made a different judgement.

I think that General Practitioners get this balance right a surprisingly high number of times and we rarely get any credit or understanding about the people that we don't refer for tests who end up not having significant diagnosis. You just need to look at the way that the mainstream media deals with mistakes to realise the problem.

We approach the same problem with Swine Flu. There are a huge number of anxieties that I have in relation to the way this has been dealt with. Firstly, we had dire progostications from the Chief Medical Officer talking about 65,000 deaths from this illness. This led to a few horrendous days of screeching headlines. This was faulty progostication.

Secondly, we had the National Flu pandemic line. This was set up with the mistaken belief that swine flu was easy and accurate to diagnose and anyone with a computer, an algorithm and GCSE English could diagnose it. Our experience was that the rates of false positive and false negative diagnoses were enormous and each incorrect diagnosis (which outnumbered the true diagnosis by a factor of 5:1) push up the number of cases to a scientifically useless level. This was faulty diagnosis.

Thirdly, we had the prescriptions of Tamiflu and Relenza. This was borne of a wish to ‘do something' and so the general public could get their prescription for these expensive and largely useless compounds. I have never prescribed it myself and remain unconvinced of its efficacy. Some patients complained of its side effects, so we had to stop it anyway. A useless treatment based on inadequate diagnosis. Poor medicine all round. This is an example of faulty treatment.

So now we face the rolling out of the swine flu immunisation. There is the usual attendant publicity, laced again with stories of people who have suffered genuine illness as a result of swine flu. The Government have managed to get all their ducks in a line and we have all the experts saying the same things: very important, serious illness, dire consequences, can't be too careful etc etc. These are, unfortunately, doctors and nurses and managers who have not lifted a stethoscope or wiped a bottom for decades.

We are being exhorted to tow the party line and get on and give it as the Department knows best.

The problem here is two-fold. Firstly and with the evidence of our eyes, we have seen serious issues of faulty prognostication, faulty diagnosis and faulty treatment. Who is to say that we won't get faulty prevention? Many of have significant doubts about all these areas in swine flu.

Secondly, we have all been so thoroughly undermined and undervalued in the past few years that we are not particularly persuaded to follow the party's diktat and do what we are told. We can be belligerent, awkward and independent-minded if we so choose. We are also scientifically trained to assess the problem and determine the risks and benefits.

I am far from convinced that the case for the vaccine has been made.

The Jobbing Doctor

Rate this article 

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Have your say