Posted by: Tony Copperfield29 August 2012
I’d just seen my fourth patient of the week complaining anxiously of persistent loose motions, and I smelt a rat. Or maybe it was faecal incontinence.
Whatever. This fourth patient I decided to interrogate because by now I was gastrointestinalled out. ‘Why the hell is everyone poo obsessed at the moment?’ I demanded. ‘Have they just renamed Basildon “Boweldon” or something?’
He caved in quickly, as you do when you have a gloved digit stuck up your rectum. ‘Haven’t you seen?’ he winced. ‘It’s been in all the papers and on the telly – bowel cancer awareness!’
Ah! It had passed me by, this particular campaign. Apparently, the Department of Health had been informing the public that one of the main symptoms of bowel cancer is ‘loose poo for three weeks or more’. A self-fulfilling prophecy then, because by this time half the nation was crapping itself.
As well it might. These campaigns may promote awareness, but they achieve a state of neurotic hypervigilance. They’re only occasional irritants, though, even if this one was particularly notable for a lack of any age-related context, meaning that the mums of kids with toddler diarrhoea weren’t sleeping as well as they should.
But hang on. Flushed with the success of its bowel cancer campaign, the DH is at it again. Its new policy of regularly dictating exactly what the worried well will be banging our doors down with continues on 8 May with a national lung cancer awareness campaign. And get this: the key message is that patients who have had a cough for three weeks or more should see their doctor. Yep. It’s that magic three weeks, again. According to the blurb, that’s consistent with NICE cancer referral guidelines. Gotcha! It can’t be. Not even in the throes of one of its more florid episodes of wild-eyed psychosis would NICE seriously suggest that cancer-phobic punters flock to their GP after just three weeks of cough.
But bugger me. There it is on page nine of the sodding cancer referral guidelines: ‘Refer urgently for CXR patients with any of the following... blah blah... unexplained or persistent (longer than three weeks)... blah blah... cough.’
Okay. It’s buried in the guidance. It’s poorly and ambiguously worded. It’s obviously the dumb-assiest thing NICE has ever said. But instead of discreetly drawing a veil over this obvious embarrassment, the DH has decided to trumpet it from the hilltops as the basis for a national campaign. Bloody excellent.
Fact: the cough of a straightforward, and usually viral, bronchitis lasts, on average – you guessed it – three weeks. In other words, this ‘awareness’ campaign takes a bog standard minor illness and turns it into a major catastrophe. That’s the DH and NICE working in perfect harmony to terrify patients and terrorise GPs.
Brilliant. Why don’t they just go the whole hog and have a huge gob on TV shouting, all day long: ‘GO! Go to your GP now! Whatever the symptom! Whatever your age! Whether or not you smoke! It could be cancer! RUN! Run for your life! For God’s sake see your GP before it’s too late! In three weeks you DIE!’
Jesus. The campaign against campaigns starts here.
Dr Tony Copperfield is a GP in Essex.