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| hellkat |
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hellkat
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Joined: 12 Jul 2004
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 Posted: 11:47 - 17 Aug 2022  Post subject: |
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Further heads up:
There is the possibility of the NHS considering "patient-initiated follow-up outpatient appointments".
So the deal would be:
You go for an initial OP appt, and if they don't give you a follow-up (which basically would only be if they think you are sick enough to need one), you will then have to ask for another one yourself - presumably when you feel the need to go again - or still feel like shite after a certain amount of (presently unspecified) time.
Apparently, they think it might save the NHS a fortune in wasted appointments. 
____________________
Not nearly as interesting in real life. |
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| Irezumi |
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Irezumi
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Joined: 07 Dec 2019
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Posted: 16:17 - 17 Aug 2022  Post subject: |
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| M.C wrote: | That can work both ways, my experience of the NHS is they say whatever to get you to go away, and it's about 'managing resources' rather than (it feels like) the best level of care or what's best for the patient. |
Yeah that happens, and I know I have been guilty of doing it too. A million reasons as to why but ultimately falls under 'because we're all human'. Poor excuse I know but different patients come with all different personal and social issues that we have a duty of care to deal with. I'm assuming everyone reading this has a normal IQ with a relatively normal life so are unlikely to see this stuff.
People I see can have significantly low IQ's with or without learning difficulties, societal problems such as being recently released from prison, can turn up with what may well be abusive partners, be drunk or on drugs, not speak English and the interpreter has cancelled last minute + any other random thing you can think of. Hard to deal with everyone within 30 minutes making decisions on whether to escalate these things with the ethical and responsibility issues this entails, and include doing notes on it all! Sometimes the referrals are just completely inappropriate and I will see the patient so we haven't wasted their time completely even though I know after 1 minute I need to refer them back to GP or a different service. Normally they are screened by admin but some get through, I will carry out appropriate investigations to make sure my assumption is correct and back up why I am referring back/onwards.
| M.C wrote: | For example a physio told me I might have a bulged disc (I think he used slipped but whatevs), then told me not to get a scan as I'll bankrupt the NHS. |
If that is the reason they have given you then it is very poor. Imaging is way overused and not indicated in many cases, even some where you would think it is, based on current evidence though it shouldn't be. For example, patient is 70 and turns up with bad knee, has worsened over time, presents symptomatically as Osteoarthritis. Will imaging change how I treat that patient assuming I have ruled out any red flags? Absolutely not. For your disc issue, if there were no significant neurological deficits tested then keeping mobilising and strengthening would be a more suitable starting point, imaging only needed if further issues etc.
Message given to the population by government is to have more imaging, this is an unnecessary waste of time and resources, should be specified. Clinicians are bad for this as well as it means they can pass patient onto someone else/placate them. Have I done this before? Definitely, and I will probably do it again at some point. Also, being exposed to radiation is bad, don't do it.[/quote]
| M.C wrote: | I also know someone who died not that long ago, because the NHS didn't want to repair a leaky heart valve, then when they were subsequently diagnosed with kidney cancer (that took a while), they had trouble coming round from the biopsy and couldn't have the kidney op'. |
This is a problem which afflicts us all in that way we always remember the bad stuff. Can we remember all the cars that I saw on my ride the other day, absolutely not. Can we remember the guy who pulled a daft u-turn in front of us? Yep, and we will tell anyone we see probably for the next 5 years. Does it means it's acceptable? Definitely not, but it happens.
Ultimately communication and psychology plays a lot in healthcare and it's really complex, and often where the problems are. I often see patients and do absolutely nothing in a session apart from listen to them really. The following session is when I get reports of some of the best improvements. 
P.S. this is my last long post conveying my experience of healthcare. |
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| M.C |
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M.C
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Joined: 29 Sep 2015
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| Posted: 17:32 - 17 Aug 2022 Post subject: |
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| Irezumi wrote: | If that is the reason they have given you then it is very poor. Imaging is way overused and not indicated in many cases, even some where you would think it is, based on current evidence though it shouldn't be. For example, patient is 70 and turns up with bad knee, has worsened over time, presents symptomatically as Osteoarthritis. Will imaging change how I treat that patient assuming I have ruled out any red flags? Absolutely not. For your disc issue, if there were no significant neurological deficits tested then keeping mobilising and strengthening would be a more suitable starting point, imaging only needed if further issues etc.
Message given to the population by government is to have more imaging, this is an unnecessary waste of time and resources, should be specified. Clinicians are bad for this as well as it means they can pass patient onto someone else/placate them. Have I done this before? Definitely, and I will probably do it again at some point. Also, being exposed to radiation is bad, don't do it. |
I mean it was an MRI scan, and it was done by a private company for the NHS in 2 weeks, then it was a 6 months to see the NHS consultant (obviously the bit the NHS want to avoid). I think patients want to know what's going on with their body, even if it doesn't change the course of action.
How is it preferable to keep someone in the dark, then further down the road when they get really bad presumably then offer a scan, then maybe surgery.
IMO it's a f**ked up attitude to healthcare, understanding what's going on now and taking steps to address it, rather than waiting for people to deteriorate would be best for the patient (the anecdote I gave re the heart issue highlights this attitude).
| Irezumi wrote: | This is a problem which afflicts us all in that way we always remember the bad stuff. Can we remember all the cars that I saw on my ride the other day, absolutely not. Can we remember the guy who pulled a daft u-turn in front of us? Yep, and we will tell anyone we see probably for the next 5 years. Does it means it's acceptable? Definitely not, but it happens.
Ultimately communication and psychology plays a lot in healthcare and it's really complex, and often where the problems are. I often see patients and do absolutely nothing in a session apart from listen to them really. The following session is when I get reports of some of the best improvements. |
I mean death does kind of stay with you  It isn't just one case, I could cite loads just within my family and friends group, where they died or nearly died due to poor care.
Also that person did have people 'batting' for her, I genuinely feel sorry for elderly people that are alone, or maybe don't have a partner who's together enough to fight their corner.
The fact a theme of this topic is fighting for (a proper level of) healthcare, and/or the best treatment shows something is very wrong with the NHS. |
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| recman |
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recman
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Robby
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to v or not to v
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Ariel Badger
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recman
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Ariel Badger
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Old Thread Alert!
The last post was made 1 year, 245 days ago. Instead of replying here, would creating a new thread be more useful? |
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