A decade ago, I used to refer about half of the patients who presented to me with breast lumps immediately to breast clinic, now I refer a hundred per cent.
Patients complaining of chest pain, unless barn door cardiac pain, would have had blood tests and an ECG before being referred to cardiology. Now anybody who even mentions pain above the diaphragm on exertion is referred to the rapid access chest pain clinic without delay.
During my GP registrar year I once asked a GP in my training practice how to organise a blood test for a child. ‘Oh we don’t do blood tests for children in primary care,’ came the response. A couple of decades later and I’m arranging blood tests for kids most days.
So what has changed? A recent study of how complaints impact on NHS doctors highlighted that patients are being put at risk by being prescribed unnecessary drugs and having needless investigations, due to GPs’ concerns about a complaint.
This would allow us to practice sensible, realistic medicine not the defensive variety
In the past there seemed to be an unwritten agreement between doctor and patient that by and large doctors do their best for patients and when things go wrong it is due to genuine human error not a deliberate desire to cause harm by the doctor.
This unwritten agreement seems to have been gradually eroded, as those in power, seemingly fully signed up to the ‘divide and rule’ principle, continue to sow suspicion and discontent with abound.
A combination of successive governments’ rubbishing of the medical profession and the proliferation of avaricious personal injury solicitors has led us to where we are now.
It’s not so much the fear of being sued; as we know, most complaints are either vexatious or driven by greed and go nowhere. It’s the time and stress spent dealing with them we wish to avoid.
I’m pretty confident I’d halve my prescribing, investigations and referrals if the Damocles sword of a potential complaint for the slightest of errors was removed from above my head. I’m sure many other doctors feel the same.
Full crown indemnity for GPs and fixed compensation packages for genuinely wronged patients would, overnight, take away the persistent low level knot of anxiety in the pit of our stomachs the current medicolegal minefield brings and allow us to practice sensible, realistic medicine not the defensive variety.
Result: less demand on secondary care and a better NHS.
There you are Jeremy, another good idea for free for you. Don’t say I didn’t try.
Dr David Turner is a GP in west London