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A demented idea



Look, enough, stop. I realise I’m at risk of sounding like a very stuck record and that recent blogs have seen me reduced to a ranting/quivering wreck but I genuinely have reached the point where I don’t know whether to laugh or cry.

This is the tipping point – the proposal that we GPs screen all at-risk patients for dementia.

In case you missed the detail, I’ll recap. Sorry to shout (something else I’ve been doing a lot in blogs lately) but it’s impossible to convey this without frothing at the mouth a bit. Here goes. We will have to assess for dementia ALL PATIENTS OVER 75 and those AGED OVER 60 WITH CVD, STROKE, PVD AND DIABETES.

Another way of saying that is we have to screen for dementia JUST ABOUT EVERYONE OVER 60. Or, if you like, JUST ABOUT EVERYONE. So, just to make that crystal clear, WE’VE GOT TO SCREEN JUST ABOUT EVERYONE FOR DEMENTIA.

As well as frothing, I am now, literally, hyperventilating. I have carpopedal spasm. It’s stpopppngingnggg mne tpypypppping  pporoprely. SSee?e?e?

Calm. It’s difficult, I know, but let’s ignore the rather obvious questions, such as, er, when do we do this dementia screening, is that, like, just after we do the exercise screening and before the annual diabetes check, or the other way round? And, er, is it really a good idea to uncover a bunch of closet dements when the memory clinics can’t cope as it is? And, um, aren’t there scientific criteria that screening is supposed to fulfil, or do they not apply in this increasingly surreal parallel universe?

Yes, ignore all those because they’re not the main point. This is. Every extra bit of work of this sort forced upon us is an implied slight on what we do already. It says that our current role is so undervalued that it can be usurped by politically driven bilge, that general practice is worthless and that we are fit only to be the puppets of Public Health.

I love being a GP but, with each latest idea, initiative and imposition, a little bit of me dies. This cannot continue. Either the GPC negotiates some sense into the contract and some pride back into the profession or we man the barricades. A demented idea? Well, go on, screen me, you bsasbtardsrdsstardds.

Dr Tony Copperfield is a GP in Essex. You can email him at tonycopperfield@hotmail.com and follow him on Twitter @DocCopperfield.