This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

A wake-up call for everyone in medicine

Dr Charlotte Alexander 

It’s been a strange time. It’s been interesting to see how the medical community has reacted to an unknown pathogen, but mostly it’s been a lesson in humility, as for once in modernity, science has no answers.

We have supportive measures, true, but if the most technologically sophisticated and expensive field of medicine - ICU - can only confer a 50% survival rate, then it cannot be regarded as a solution.

We have stood in awe watching our ICU and respiratory colleagues grind it out in hellishly hot PPE, hoping that the strain of their efforts may just make a difference. Sadly, in many cases they were simply bearing witness to the inevitable.

It’s been a lesson in humility, as science has no answers

Then, there are the many medical professionals - and GPs - who have lost their lives in the line of duty. The stakes have always been high in medicine - the pressure, the litigation, the possibility of error, but I don’t think anyone thought they would lose their life. The role of the Government and Public Health England in this can’t be overstated. I don’t intend to expand on this now - you all know it, suffice to say their approach has been deadly.

Paradoxically, at this exact moment of chaos and uncertainty, doctors and nurses have been idolised. At times, it has felt like you can’t move for SHOs or GPs offering well-meaning advice in public, only for it later to be proved wrong. I can’t help feeling this was a bit unwise - we shouldn’t fall into the trap of thinking a bit of knowledge is the same as evidence.

We should try to hold onto some of the things that we’ve learnt. For me, the limitations of the ’treatment approach’ have never been starker. Prevention and care seem to offer the most value and GPs, quite frankly, are the best at it.

As my very poorly-controlled type two diabetic patient said to me recently: ‘It is all short-sighted this giving medicine to the diabetic. It’s like giving alcohol to an alcoholic, innit?’ Quite.

Dr Charlotte Alexander is a GP in Surrey

Rate this article  (3.33 average user rating)

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

Readers' comments (8)

  • I agree. A wake up call. To also the humility of all those complaining and demanding patients, the same that never covered their mouths when they coughed into our faces to prove their argument for antibiotics. I think we also have learnt what value, truth and dedication mean.

    Unsuitable or offensive? Report this comment


    Unsuitable or offensive? Report this comment

  • The wake up call will be when lack of health services hits the middle classes.
    Currently the funding mechanism for primary care is relatively generous to the needs of the the fit and well patients in affluent areas vs those with multi morbidity in poor areas.

    Unsuitable or offensive? Report this comment

  • Epidemiology should be treated like homeopathy.

    Unsuitable or offensive? Report this comment

  • Prevention does not save money in the long run, it actually ends up costing more. We’ve been recycling this fallacy for decades and still can’t seem to realise it, despite ongoing increases in the costs of funding the NHS.
    I am NOT saying prevention is bad (prevention is good and I support it), what I am saying is that is does not save money for the health system.

    Unsuitable or offensive? Report this comment

  • Thank you Charlotte - yes totally agree. We need To promote safe and effective self care strategies along with more work on the dangers of over-diagnosis

    Unsuitable or offensive? Report this comment

  • The clapping has stopped now and people have gone back to dropping litter on the UK's beaches. What has become abundantly clear in the last few months is that consumerist medicine as promoted by the government and royal colleges is unsustainable and offers little when faced with the resurgence of infectious disease and higher mortality.

    Unsuitable or offensive? Report this comment

  • Story of Rip-Van-Winkle. When they, if ever, wake up to realize that the world has changed beyond recognition and they are now a misfit in it, would push them back to slumber.

    Unsuitable or offensive? Report this comment

Have your say