Posted by: Tony Copperfield2 July 2014
Expletive deleted hell. We’re still down from the punch in the face that was Jeremy Hunt threatening to name and shame GPs who ‘fail to spot cancer’, only for the Royal College of Pathologists to wade in with a kick in the head too.
Politicians and pathologists are entitled to their opinion, I guess, so long as the public understand that one group specialises in not actually dealing with live people and the other talks as though it’s braindead.
The fact is, as anyone who’s spent even the briefest time working in general practice knows, cancer diagnosis is unbelievably complex, difficult and nuanced - but we’re so downtrodden and depressed that it’s hard to summon the energy to explain this to those who simply wish to beat us into submission. But there is one obvious point we should ram home.
Whether or not you think the politicians and pathologists are unbalanced, their argument certainly is.
Because any talk about cancer diagnosis has to factor in the opposite – non-cancer diagnosis. This is actually the larger part of our work. For every patient we see who ends up having cancer, we see at least 10 other who are worried they have it, but don’t. These patients are dealt with properly by us with the time-honoured history and examination, followed by judicious tests when necessary. We resolve patient anxiety, avoid unnecessary investigation, reduce waiting times at the hospital and save the NHS money.
This isn’t easy and is prone to human error - but we see it as our core role and we bear the associated risk as part of the job. You can’t even start to ‘judge’ cancer diagnosis without taking account of non-cancer diagnosis. If you don’t, then the obvious response (as many have already pointed out) is for GPs to refer absolutely everything. We’d never miss a cancer, so we’d never be named - but we would be shamed for destroying the NHS.
At least, that’s what I’ve always thought – that a week of action where we really do open the floodgates would be counterproductive, as it would harm patients and screw the health service. After this, though, I’m starting to think differently.
Our role is undervalued because it’s not understood. Bringing the NHS to its knees for a week would focus the minds of politicians, pathologists and headline writers – and maybe we should accept the collateral damage as an unfortunate necessity. Let’s do it. Let’s give them expletive deleted hell.
Dr Tony Copperfield is a GP in Essex. You follow him on Twitter @DocCopperfield