Re "So wait a minute, you want doctors to prescribe antibiotics for every cough and ear ache that comes in the door?
Hey, that's a great idea! Oh, hang on, didn't we used to do that? Oh yes, and that's what caused MRSA...
Idiot."
Er NO not at all
I want poor people (using the NHS), folk too far away from a private GP etc, to be able to see a GP THE VERY SAME DAY when they are in agony as for instance the most extreme cases of ear ache can be
I do not think it is appropriate to wait 3 days to see a GP if you are in so much pain that you cannot sleep, and you therefore struggle to do your job
This is basic humanity as per the entire rest of the Western world
AND
I want some consistency so that similar conditions get similar response whether you see an NHS GP or a private one
Now extreme ear ache from private GP you get Clarithomycin and Gentisone (hope I've spelt that right I'm not a medic and don't pretend to be) where as similar presentation to an NHS GP tends to be come back next week if it still hurts (normally in the cases I know about it does) , and when you go back you get a cheaper antibiotic as Clarithomycin seems too expensive for the NHS?
Now I do not want to be the arbiter of what the best response from the doctor should be in these cases, I just observe that on a fairly large sample of friends and family the average response from the medic is along those lines
A cynic would imagine its just cos the NHS is penny pinching
I just want some fucking consistency, so the poor people get what the folk seeing the private medics get, and both get the best advice - whatever that is?
I really do not see how you can defend lack of access to a medic when you are in extreme agony especially when you are in another part of the country to your home GP
Earache maybe minor to the average GP, when it's dominating your existence, and stopping you sleeping it sure feels more important than that
As a simple example of a common condition where the NHS is way behind the private and rest of the world in its response
No I do not want over prescribing, and no I do not want to define what best practise prescriptions should be, I simply want fair access to good quality care, especially in parts of the country where there is no competition to the NHS
MRSA is more to do with 110 % bed occupancy and fucking dirt and shit allover the walls
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Clarithro and gent might be apt for an external ear infection; gentisone drops certainly wouldn't do any good fr a middle ear infection; both present wth earache. So it is possible that different treatment is as a result of different diagnoses, albeit with the same symptoms.
As a cynic, I might observe that private medicine is more inclined to panda to what the patient wants - and this often means giving abx where they are not indicated... after all the patient wants / expects them, and is paying...
so if they don't "pay" ( and that's the fucking problem with the NHS they think they are offering a "free" service, thanks for making it very plain why we have to have competition!) you should wallow in your own shit be called a "fat bastard" by staff like the patient in Birmingham, be ignored, expected to give up weeks of your life because staff are too lazy to "panda" to YOUR needs, get some of the worst care in Europe, and die all because its a free service and we shouldn't expect anything from your or it?
You people live in Disneyland................
so which is better, paying for a private service and being given a treatment that you don't need, or being treated through the NHS and not being given something you don't need?
re "so which is better, paying for a private service and being given a treatment that you don't need, or being treated through the NHS and not being given something you don't need?"
er on the whole I find it impossible to access a doctor via the nhs so I just about always end up paying, whether I am given good advice by the private GP I am not qualified to comment, but their advice is routinely different to that handed out by the nhs
and yep I have been left weeks without treatment by the nhs in this kind of silly cycle, ended up costing the nhs a fucking fortune, and the consultant muttered something along the lines of "if only the stupid tossers had given you antibiotics 3 weeks ago"
so how do you think i feel?
NHS GPs are caught in a bit of a dilemma. Regarding ear infections we are told that only 1 in 20 benefit from antibiotics - so don't treat routinely with these drugs. It's only a 5 days course and cost pennies but if we do treat routinely we are "bad" Drs - unless of course the 1 in 20 who does gets worse goes to hospital and then gets the response that you did from the consultant! Always easy to be treating retrospectively!
So with ear infections we are told DONT treat the majority to help the 1 in 20, but with statins we are told we are bad Drs if we dont treat 100 patients for 10 years continuously in order to benefit about 3 of those patients!
Can't win! Unless you're a private GP when can treat according to need and to patient wishes - winner all around!
One thing that will definitely increase if NuLabour get their way with polyclinics is private General Practice.
"MRSA is more to do with 110 % bed occupancy and fucking dirt and shit allover the walls"
Hmm. I agree 110% bed occupancy etc etc ain't good for your health, but blaming the origins of MRSA on it? I don't think so.
Have a quick butchers at http://en.wikipedia.org/wiki/Antibiotic_resistance
Unfortunately use antibiotics and bacteria find a way to survive, and resistence follows. If only 1 in 20 with earache benefit from Abs a decision has to be made whether to prescribe. It sounds cruel for the 1in 20 who may benefit and the key is to find ways of acturately diagnosing those 1 in 20. Look at the situation in China - antibiotics are available over the counter to anyone and now first line and second line antibiotics are useless. To make matters worse the drugs companies are finding it difficult to come up with new antibiotics - I can think of only 2 new ones in the past 10 years.
Re "If only 1 in 20 with earache benefit from Abs a decision has to be made whether to prescribe. It sounds cruel for the 1in 20 who may benefit and the key is to find ways of acturately diagnosing those 1 in 20"
are these figures from the UK? are we sure lots of the patients didnt just go somewhere else to get their pills after being told no by the 1st doc?
in my own lifetime earache never clears up until I get antibiotics, it always just gets worse, I know this from experience of having had it every few years most of my life, does this make me a special case? or not one of the 19 in 20?
the other thing is the marked difference in approaches to ear ache in other countries
in other European nations GPs often do some physical interventions which in the UK is normally only done by ENT folk
again I dont comment on which is the best approach, I simply point out that its obvious the UK is in the minority of GP opinion on this matter in the world
put words in your mouth
theres no fucking room from the constant barage of ill informed shit
youre a right fucking charlie
"the other thing is the marked difference in approaches to ear ache in other countries
in other European nations GPs often do some physical interventions which in the UK is normally only done by ENT folk
again I dont comment on which is the best approach, I simply point out that its obvious the UK is in the minority of GP opinion on this matter in the world"
Most of this research seems to originate from the Netherlands, and in fact in the UK our 'routine' use of antibiotics for earache is much higher than in Holland, Germany or the Scandanavian countries.
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