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Has the hospital run out of steroids?



Pardon me while I cathart. If I don’t get this down in a column I might have to resort to random physical violence.

Here’s what happened. A couple of weeks ago, my partner Dr A saw patient B with rotator cuff syndrome and told her to make an appointment with Dr C – correct, Dr Copperfield.  Because in our practice, I’m the one blessed with joint injection superpowers, apparently.

Somewhat inconveniently, between patient B’s consultation with Dr A and her booked appointment with Dr C, she jumps from ABC to CVA, ending up in hospital with a stroke.

So now the inconvenience of a sore shoulder is somewhat overshadowed by the catastrophe of a hemiparesis. Or so you’d think. But, while she’s still an inpatient on the stroke unit, she, or someone, happens to mention to the ward staff her booked appointment with me.

Guess what happened next? Actually, don’t bother – even in your wildest nightmares you’d never work it out.

I receive a message to phone someone on the stroke unit. ‘I’m sorry Mrs B won’t be able to attend her appointment with you this afternoon,’ she tells me. ‘I forgot to book her transport. Can I rearrange it for a couple of days’ time?’

Yes. While. She. Is. Still. An. In. Patient.

There’s a pause while I pick myself up off the floor. It’s true. The plan is to transport this very sick lady from the stroke unit – which is situated, correct, in a hospital which, correct, is full of rheumatologists who, correct, spend half their lives sticking needles in joints – to an appointment with me so that, without any current knowledge of or responsibility for her care, I can inject her subacromial space before she is carted back whence she came.

The only word I can articulate at this point is a strangled: ‘Why?’

‘I think it’s because,’ explains stroke-unit person, ‘we don’t have any of the appropriate injection in the hospital.’ Of course not. No way would a hospital have injectable steroids. Obviously, as an austerity measure, the rheumatologists are using normal saline.

So, naturally, at this point, I go a bit mental. It does the trick, though. I know this because of the post script.

A couple of days later, my partner receives a cryptic message from our receptionist: ‘Call from hospital – they need to speak to you about Mrs B’s groin infection.’

It turns out that ‘groin infection’ is actually a Chinese-whispered version of ‘joint injection’. Apparently, the hos doc is going to inject the joint, which is good, but wants us to suggest what with, which isn’t.

To two particular types of reader digesting this story, I’d say this: if you’re a CCG evangelist looking to cut expensive intra-hospital referrals, thinking, ‘Hey – this is the way forward,’ no it bloody isn’t.  

And if you’re the lady who responded to one of my blogs asking if I made this stuff up – well, you couldn’t, could you?

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