Makes you wonder whose side those researchers they have these days are on, doesn’t it? Particularly when they come up with findings that suggest that not only do cortisone injections for osteoarthritic knees not work, they may make matters worse. It was there, in the BMJ. Yeah, I know. But still.
It also makes you wonder where common sense has gone in medicine. I give loads of knee injections, and most of my patients swear by it. Some even swear during it.
Besides, they’ve made the schoolboy error of taking a very patient-centric view. There are two sides to any intervention, and by stupidly focusing solely on patient benefit, they have completely overlooked the benefits to the GP. Specifically:
By focusing solely on patient benefit, they’ve completely overlooked the benefits to the GP
1 These are really easy consultations, as they don’t require any intellectual activity whatsoever.
2 The injection gives the illusion that we are actually doing something, which makes a nice change from the delusion that we are actually doing something (eg: dishing out statins to patients who won’t take them to prevent something that wouldn’t have happened anyway).
3 We get paid for doing them.
Take this away from us, and what do we have to offer patients?
Research (that again) suggests that standard oral analgesics are ineffective/potentially dangerous, waits for physio are beyond average life expectancy, and TKRs are only available to those who are paragons of health virtue and most of these patients aren’t (try weighing them) otherwise they probably wouldn’t have such bad OA in the first place.
It’s EBM gone mad and they’re just spoiling it for the rest of us. Why don’t they do something useful instead, and meta-analyse the hell out of the Government’s suggestion that we should be visiting residential homes every week?
That workload can only increase, on account of a lot of untreated arthritis. In the meantime, let’s give those so-called researchers an injection of common sense. Or doesn’t it work?
Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at http://www.pulsetoday.co.uk/views/copperfield or follow him on Twitter @doccopperfield