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1850: Why does everyone have a UTI at the moment?

That's the burning question preoccupying Copperfield today.

There I was, going through my morning post, wondering whether the day would provide the surreal (the patient who brought me a loaf of sliced bread - white – as a thankyou gift) or the spectacular (the patient who had a stroke before my very eyes), but knowing that, being a Monday, it would probably just be the mundane (sore throat/unseemly fight over antibiotics), when I spot this, a casualty note.

‘Diagnosis ?TIA ?UTI' That would be a UTIA, then.

The fact is, everyone is Essex seems to have a UTI at the moment. Whether they turn up at A&E with unilateral weakness, chest pain or the ‘I've still got that sore throat and the sodding GP won't give me antibiotics' scenario, they each receive, as an added bonus, the diagnosis of ‘UTI' to accompany whatever else they're misdiagnosed with.

My theory, which I expounded over a post-post coffee, is that hospital doctors are plain stupid.

‘They obviously don't realise,' I announced, to the assembled throng, ‘that loads of people turn up positive but irrelevant findings on urinalysis. Especially if they're ill or feverish.'

‘No, no, it's not that,' said my senior partner, who is even more burnt-out and cynical than me, if that's possible. ‘They're just gaming. It counts as an extra episode of care. It's an income generator.'

Surely not? Quite apart from the ethical concerns, I doubt you could train casualty doctors to be consistent in their approach.

So there we have it. The thought in my head as I start my surgery and await the surreal, or the spectacular, or the mundane, is that I'd much prefer the hospital doctors to be stupid because the alternative is that they're manipulative. I bet it wasn't like that 50 years ago.

Copperfield