As I age, I do find my tendency to impatience, petulance and rage is dissipating. Take the other evening, after England’s footy defeat to Italy: thanks to my new-found maturity, this time – unlike four years ago – I refrained from burning my Panini Official Licensed World Cup sticker album.
Nonetheless, I do still sometimes find myself obsessing and exploding over minutiae. My current preoccupation is dementia ‘screening bloods’. You know, the B12, folate, TFT, yada yada hoops that we have to jump through for QOF, and to get anyone seen at the memory clinic.
It’s a massive waste of time and resources: has anyone, ever, in the entire history of dementia, found that checking these bloods significantly contributed anything other than delay, confusion and QOF points? After all, the outcomes are either:
a) Normal, in which case the patient says, ‘Great, so, I haven’t got Alzheimer’s’ and I have to enter into a protracted and contorted explanation that the blood test isn’t actually to check for Alzheimer’s, despite the fact that I’m having this conversation, remember, with someone who probably has. And that’s not easy, or terribly worthwhile.
b) Abnormal, in which case the treatment of their folate/B12/thyroid/whatever deficiency makes absolutely no difference to their condition other than to falsely raise hopes that I’ve found a cure and to delay the referral they really do need.
I absolutely guarantee that there will be no evidence out there to back up this stupid ritual of screening bloods in dementia patients, though I can equally guarantee that I haven’t checked that out on account of the fact that I can’t be arsed.
Maybe you’ll email me with anecdotal claims of patients with myxoedema madness that you’ve cured. More likely you’ll be in touch telling me to calm down, that in a world where we’ve got issues with recruitment, pay, AQP, private takeovers and such like, dementia blood screening is something that shouldn’t agitate me and that I should just forget about.
Forget it? You’ll be wanting to check my bloods next. And that really winds me up. Pass me those matches.
Dr Tony Copperfield is a GP in Essex. You follow him on Twitter @DocCopperfield.
20 December 2021
21 September 2021