Rethink Health - April 2011

News through the GoodHealthKeeping lens

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What to Ask of Your Doctor

My neighbour at a recent lunch is chair of his doctor's Patient Participation Group in Leicester. They are concerned how the new purchasing arrangements will affect their very small practice who want just to doctor, not to manage. I sympathised, but was reminded how much a practice like that can achieve without buying anything. I suggested a few new items for his next agenda.

Appointments

The most valuable offer doctors can make is flexible access to their time. An appointment system can easily become the opposite - don't let it. A doctor can offer a generous block of time twice daily by appointment, but finish the session with a non-appointment spell and guarantee to see everyone who arrives before a certain deadline. A larger practice can run this session alongside the appointments, so that two doctors are available to be seen on different terms.

My experience of doing this (starting at 7am, to catch people on the way to work) is that they appreciate and do not abuse it. In particular, they do not request home visits as the only way to get the doctor on a particular day. More especially, night visit requests become rare and appropriate. And simple ailments do not get so much chance to grow into major problems!

Advice

Don't press your doctor for a prescription, or any particular escalation of your medical care. If you see him (her) reach for the prescription pad as you enter the door - less easy to spot in the computer age - then say you don't want a prescription for the sake of it - just advice.

Be careful what you ask. You can probably cope with a cough, for instance, without medical advice but if it persists or keeps returning, then make that clear in your request. You don't need a bottle of cough medicine but a bit of detective work, and perhaps some tests. The doctor may ignore your request, which is vexing, but is not to blame if you don't make it sufficiently clear in the first place.

Commonly in my experience, people solve a persistent problem using a complementary medicine of which doctors may not approve. If so, you naturally wish to share the good news with your GP. How do you best do this without arousing any prejudice or antagonism?

I recommend you consult him for his advice about - say - osteopathy. Do this even though you have already had it, and it has worked for you. Thank him for it (whatever it is) and mark your calendar six months ahead. When that comes up write your GP a short letter - just a couple of paragraphs. Thank him for his wise advice to try osteopathy (or whatever) and express your delight at both the result and his open-minded and progressive approach. 

This may strike you as slightly dishonest, but so is prejudice. The GP will not remember what advice he gave, but will appreciate the compliment. He doesn't get much fan mail. He's much more likely to remember and recommend that treatment in future, to someone else.

Participation

It's never easy to know what form of action helps your practice most. Here are some suggestions.

A Practice Open Day every quarter is very valuable. Everyone meets on more friendly terms, over a healthy buffet lunch, and you can request certain topics for discussion. A valuable kind of event is a health master-class, in which people ask general questions - doing it in public rules out the more personal kind! That leads off a general response and discussion which may wander across a lot of related territory. The doctor acting as "master" learns as much as the assembled patients, and is nudged towards a more health-based way of thinking. Knowing about disease is all very well, but most people don't want to acquire diseases and would like to know how to avoid them. This is not ground doctors are very good at, and open discussion encourages them to improve.

An e-newsletter and Website are valuable media. It can flag forthcoming events and carry features by patients and practice staff. It can offer seasonal advice, such as avoiding colds or hay fever. It can allay fears, about radioactive iodine for example, and give simple and safe counter-remedies. For instance, two tablets daily of kelp would saturate your body with iodine and stop you absorbing any radio-iodine that did come your way. And if it didn't, no harm would be done. A few people may actually feel better, if they were hard up for iodine without knowing it!

In any case, don't get bogged down in the policy of the moment. These things pass. Outflank them. Look beyond to a more permanent horizon, health itself, and press for that - it makes life so much simpler!

Alcohol and Cancer

Every Friday morning, without fail! - a hot topic from the weekly medical press makes headlines. This was today's.

The main cause of cancer is a poor grip on your body's organisation, which has many potential causes. Dissipation is well up the list. There are however plenty of people who enjoy a glass of decent wine or beer with their healthy meals, and they don't drop like flies. HM Forces are notorious drinkers but their camaraderie and risky jobs seem to concentrate their minds on survival. 

Be wary of cheap brews, and spirits of any kind, by all means. But don't miss out on precious minerals, available from vine fruits among other things. Malnutrition may drag you down long before cancer gets a grip!