# Doctors name treatments that bring little or no benefit



## rayc (Jun 3, 2008)

The Academy of Medical Royal Colleges lists 40 treatments that bring little or no benefit to patients.

The academy says patients should always ask five key questions when seeking treatment.
Do I really need this test, treatment or procedure?
What are the risks or downsides?
What are the possible side-effects?
Are there simpler, safer options?
What will happen if I do nothing?

http://www.bbc.co.uk/news/health-37732497


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## patp (Apr 30, 2007)

I remember my vet telling me that he could order expensive tests on my dog but they would only confirm what he already knew. He was right. 
An experienced doctor often knows what is wrong. The trouble is the general public have such high expectations of their doctors now. They expect to be tested and given pills. Years ago a doctor's opinion was a revered thing. When did it all change?


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## Pudsey_Bear (Sep 25, 2008)

patp said:


> I remember my vet telling me that he could order expensive tests on my dog but they would only confirm what he already knew. He was right.
> An experienced doctor often knows what is wrong. The trouble is the general public have such high expectations of their doctors now. They expect to be tested and given pills. Years ago a doctor's opinion was a revered thing. When did it all change?


When people expected drugs at every visit, easier to just prescribe something, customer satisfaction.


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## rayc (Jun 3, 2008)

Kev_n_Liz said:


> When people expected drugs at every visit, easier to just prescribe something, customer satisfaction.


When my high blood pressure was diagnosed i was not offered any treatment other tan going directly onto drugs. Statins appear to be handed out like sweets. It is not always the patient who wants or instigates drug use but Government policy.


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## fatbuddha (Aug 7, 2006)

Kev_n_Liz said:


> When people expected drugs at every visit, easier to just prescribe something, customer satisfaction.


No - it started before then when people would go to the GP for the most simple of illnesses, when frankly they could either ignore, self treat or take their parents/grandparents advice. This led to GPs suffering long surgery lists and hence fobbing people off with pills they most likely didn't need (or buy cheaper at the local pharmacy). These long GP queues then led to these stupid people creating overloaded A&E units at hospitals.

It's not that we as a population are a lot more ill than our ancestors, it's the fact that the NHS has been offering free treatment and the population have taken advantage of it rather than manage simple problems themselves as many of our parents and grandparents did. Modern medicine has led to better diagnosis of diseases our parents etc would have died of and methods of treatment, but this is the top of the medical tree, and not the everyday situation. People should take more responsibility for their health and not keep doing "diagnosis by Google" and running to the GP for the most simple of things.

I have consulted my GP once in the last 5 years (and I'm in my 60's) and that was for something I know I needed quickly (antibiotics for an infected toe after I dropped a door on it :crying - other that that I have visited the surgery just for travel vaccinations, or a health check up that I was invited to that I felt was worthwhile and told me what I knew - there's bugger all wrong with me bar age induced aches and pains.


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## dghr272 (Jun 14, 2012)

patp said:


> ?.......When did it all change?


When us ordinary folk realised some of them get it badly wrong..........

Daughter told by GP it wasn't Meningitis, oh yeah it was, touch and go in hospital for two weeks. 
Same daughter told by GP she had PCOS, consultant later confirmed nonsense and GP was talking nonsense and couldn't / shouldn't have diagnosed this after a 10 minute consultation.
Wife told by GP she didn't have Carpal Tunnel in both wrists, surgeon later confirmed after surgery it was the worst he had ever seen.

Thankfully most get it right, moral of the story, if in doubt get referred to a specialist :grin2:

Terry


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## Pudsey_Bear (Sep 25, 2008)

One day last week I got a bad pain in my right eye, blinding headaches, pain in my right nostril, plus it was swollen, and I was suffering a pain not too far from a bad toothache, so I self medicated with painkillers and a nasal spray, nothing helped,so Sunday I went to the hospitals drop in center where they have a GP, reception ogre said I had to ring 111 to get an appointment, so I dial 111, spend 15 minutes explaining to someone who didn't speak English well at all my problem who informs me they can make an appointment with my own doctor in 48 hours, waste of time doesn't cover it.

Yesterday at 8am I rang my docs, got a telephone appointment for 10:20, spoke to someone who wasn't my doctor, who said I could visit my own doctor at 11:20, he gave me some Penicillin and a nasal anti bacterial cream to stuff up my hooter, I'm hoping by the morning I'll start to feel a bit better that I do right now.

I don't want to slag off the 111 service, as I used it in Scotland earlier this year when I had toothache and they got me into a local dentist the next morning, but they do need to up their game a bit, and employ people who can understand English & that people ring for help not to waste time, also what is the point of a drop in center if you can't drop in and see someone.


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## rayc (Jun 3, 2008)

fatbuddha said:


> No - it started before then when people would go to the GP for the most simple of illnesses, when frankly they could either ignore, self treat or take their parents/grandparents advice.


When your Grandparents were in their 60's a blood pressure of 160/120 was considered ok for their age. Governments and drug companies have rewritten those rules and even invented a new category of pre-hypertension. It lead to millions of Americans suddenly, overnight, having hypertension when the day before they were blissfully unaware.
We are constantly informed that as we age we should have checks for any number of diseases and as we are over 65 get the flu jab. Is it the people who are driving these 'advances'? A year or so ago practices were being funded to carry out dementia tests on their patients, even those who showed no signs of it.


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## Penquin (Oct 15, 2007)

The 111 service has one commendable feature c/w the previous NHS Direct scheme (which MrsW worked for for 5 years as a very senior nurse advisor), it is CHEAP TO RUN.

Government policy has dictated cuts in expenditure and that has meant a cut in service however hard those providing the service resisted it......

Previously NHS Direct had available a team of nurse advisors in every region - when MrsW was in Exeter she was one of a team of 4 there with others in Ringwood and Bristol as well as links to lots of others available so calls needing such advice would hopefully be responded to by a call back within minutes (although at peak times it was slower).

Now, the number of nurse advisors is miniscule and the answers come from computers via medically untrained people.

Enough said.....

Some of the treatment being cut are very sensible - wrist fractures in children are often "bends" rather than breaks (greenstick fractures) and recover within a few days or a couple of weeks - plastering them for 6 weeks leads them to muscle wastage and subsequent delays before full fitness is resumed.....

So there are some sensible things being suggested......

Dave


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## TeamRienza (Sep 21, 2010)

A point raised by fatbudda prompted my memory of an article that I recently read.

He mentioned he had consulted his GP once in 5 years. I came across this item in a newspaper recently,

http://www.dailymail.co.uk/news/art...-insurance-d-struck-GP-hadn-t-five-years.html

Allowing for the fact that it is in the newspaper and a jolly good story, there does seem to be some truth in it. There is a direct response from the insurers. In the light of that it might be worth investigating further if you enjoy rude health and have not visited a GP for over 5 years and live in England (no mention of the other U.K. Countries).

Davy


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## erneboy (Feb 8, 2007)

That's just insane, but not surprising.


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## Penquin (Oct 15, 2007)

I can verify that the story has factually correct content - one of my daughters is a GP and the deregistration is not in their hands - it is in the hands of some bureaucrat way above the surgery level who looks at the returns and deletes those that have not been seen, they are usually sent a letter apparently, but if they have moved......

We once had the problem of being called to a very old lady who had suffered an MI (in the loo) and was not capable of being brought back. The local Doctors were unwilling to come out as she did not appear to be registered with them......

The Police were called in (suspicious death?) and we were not allowed to leave for nearly 3 hours, it turned out she had not seen a Doctor in 30 years..... and her records had never been computerised, so although she was still (on the books) it was only as a paper entry and that took a long time to locate.

So, if you have not seen a Doctor in 5 years do make sure that you are still registered.....

Dave


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## Pudsey_Bear (Sep 25, 2008)

I should point out I'm all in favour of the 111,but it has to be something usable, not just a number to be fobbed of with, I didn't know it but I met up with one of the lads on Owners a few weeks ago, and I think he said his wife (ex nurse) worked for them, maybe I should have rung him/her, my 2nd wife was also a senior sister back in the 80s did A&E too.


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## patp (Apr 30, 2007)

One of my old GP's had a marvellous way of deciding if you really needed attention.


I had collapsed at the bottom of our stairs. It was 4am. Called husband to come help and told him to call GP (which is what we did then). GP listened to husband's description of symptoms (excessive bleeding) then asked if he could speak to me. I could not stand up so I crawled across the floor to the phone and duly spoke to the doctor. His response was "take a couple of aspirin (!) and go to bed - I will call round in the morning".


Obviously the ability to get to the phone was critical to his assessment of my need to be seen immediately or not!


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## Penquin (Oct 15, 2007)

That reminds me about the plumber who received a phone call late one evening from his GP as he had a serious burst pipe....

The plumber listened carefully and then advised;

"put 2 aspirin in to the tank, if it is not better in the morning call me then" and put the phone down......"

apocryphal, but it makes me smile..... :wink2:

Dave


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## aldra (Jul 2, 2009)

Well I visited our doctor for at least two years

Trying to tell them that I could hardly walk, was in severe pain at times, and felt I was turning to stone

Blood tests, more blood tests and yet more blood tests and no result so maybe I was imagine it 

One docter even hinted it could be psychosomatic 

But when my joints flared up I couldn't physically get to a docter

Finally demanded they refer me to a specialist

Alleluia, I have a diagnosis,I'm not imagining severe pain, I'm not imagining that I can't walk at times

I can't, and someone really knows I can't 

But the GPs seem really reluctant to refer 

Thank God Albert found his way to Christies 

This is one cancer hospital that is magnificent

Ring at anytime, a problem straight in

And a help line always managed

Sandra


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## Spacerunner (Mar 18, 2006)

I was under the impression that GPs and/or surgeries were laid extra for managing chronic conditions. These would include hypertension, diabetes, high cholesterol etc. So it's a nice little earner for border line cases to be put on medication rather than be advised on lifestyle.
Like a previous poster I was put straight onto medication for high blood pressure with no word of advice on self help. And, of course, once you're on hypertension medication you only stop the tablet at your peril as your body becomes reliant on the pills.


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## rayc (Jun 3, 2008)

fatbuddha said:


> People should take more responsibility for their health and not keep doing "diagnosis by Google" and running to the GP for the most simple of things.


Interesting as I have just read this April 2016 article which says "Patients will be urged to "self-manage" conditions on the internet and see nurses and pharmacists instead of doctors as part of a major shake-up of GP practices announced today"

http://www.independent.co.uk/life-s...ed-to-self-manage-conditions-on-a6993461.html

I have also read that many pharmacies will close due to a cut in NHS funding
http://www.itv.com/news/2016-10-20/...pharmacies-could-close-as-funding-is-slashed/


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## aldra (Jul 2, 2009)

And sometimes they need to google

Because 10 min with the doctor doesn't always do it 

So many cancer diagnosis are missed 

Sometimes you need to sit there and demand they take seriously what you are saying 

When my psoriasis was spreading I was told it was a typical sweat rash, tried to tell them it was shedding skin and I was sure it was psoriasis, Id had psorisis for 20 yrs+
Prescribed ointment for a sweat rash, it nearly skinned me, 

Oops they said

But then they didn't have to put up with the pain or the mess left behind

Not saying that they are always wrong but best to have a good idea of the problem when you consult them and be prepared to challenge, and if you are wrong so be it, if they are wrong well that's a whole new ball game 

No they may not like google but it may just encourage them to think beyond the prescription pad 

Sandra


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## rayc (Jun 3, 2008)

rayc said:


> When my high blood pressure was diagnosed i was not offered any treatment other tan going directly onto drugs. Statins appear to be handed out like sweets. It is not always the patient who wants or instigates drug use but Government policy.


I have read the complete list of 40 recommendations. One is " You should only be considered for medication to treat blood pressure, prevent heart disease or strokes if you have other risk factors."

I wonder if my last 14 years on blood pressure tablets would be replicated if I was diagnosed under that criteria. there are some other interesting ones such as "Unless you are at risk of prostate cancer due to family history, screening does not lead to a longer life."
"The Academy has previously estimated £2bn a year is wasted on useless medicines, operations and tests. It will later publish a full list of up to 150 treatments it believes should be reconsidered."
http://www.cityam.com/252096/some-40-nhs-treatments-you-could-get-prescribed-dont-help


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## Pudsey_Bear (Sep 25, 2008)

patp said:


> One of my old GP's had a marvellous way of deciding if you really needed attention.
> 
> I had collapsed at the bottom of our stairs. It was 4am. Called husband to come help and told him to call GP (which is what we did then). GP listened to husband's description of symptoms (excessive bleeding) then asked if he could speak to me. I could not stand up so I crawled across the floor to the phone and duly spoke to the doctor. His response was "take a couple of aspirin (!) and go to bed - I will call round in the morning".
> 
> Obviously the ability to get to the phone was critical to his assessment of my need to be seen immediately or not!


I would have moved surgeries the next day, what a pratt.


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## Pudsey_Bear (Sep 25, 2008)

Innit great to be getting old just as the NHS decides to really strangle the services WE paid for.


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## patp (Apr 30, 2007)

I refused to see him after that and he "retired" soon after. Could have killed me with the Aspirin advice.


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## Penquin (Oct 15, 2007)

patp said:


> I refused to see him after that and he "retired" soon after. Could have killed me with the Aspirin advice.


IMO you would have been wise to complain to the Surgery about his lack of care and also to the GMC - his actions were, I suspect, a breach of his requirements as a Doctor......

At least he has retired, so others are unlikely to be cast aside in the same way, but he obviously did not consider you as worthy of any exertion on his behalf.....

Disgraceful,

Dave


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## patp (Apr 30, 2007)

Yes, I suppose I should have at least complained. Brought up in the fifties we revered doctors (and teachers and policemen) so don't have the mindset to fight the system. Things don't improve though is we are too complacent. 


After the same practice were rubbish at managing Chris's medication after his heart attack we changed to one in a nearby large village. The difference is stark. Our new practice attracts dedicated professionals while the old practice struggles to keep staff.


Does anyone know what is going on with hospitals and GP's when prescribing medication? Chris was prescribed Frusemide (my, possibly veterinary, name for the diuretic) by the hospital after his heart attack. They told him to go and get it from his GP who would have his notes. Several phone calls later, over several days, and with a very sick husband, I had to make an emergency appointment for him to be seen in order to get him the medication the hospital had prescribed. 
Why did the hospital not send him to their pharmacy to pick up the drug? The GP practice kept saying they had not received his notes and so could not give him the medication. Is the hospital saving money by sending sick patients home without the drugs they need?
It turned out the notes were sitting in our GP's in tray, in spite of categorical denials to the contrary. Another reason why we changed practice.


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## Penquin (Oct 15, 2007)

I believe Frusemide is now called Furosemide

(information from my ambulance background checked with the nursing sister sat beside me.....

This is the Patient Information Leaflet for the 40 mg tablets.

Hope that helps, same drug, new name.....

Dave


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## aldra (Jul 2, 2009)

I take it

Without it I struggle with water retained close to my lungs

Not on my lower limbs 

Always did

But now with an aortic valve replacement I need a bit of help
Sandra


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## patp (Apr 30, 2007)

Thanks Dave and Aldra. Frusemide is the same drug but for dogs and it was the name I could remember from by vet nursing days. Good job I am not treating him lol!
Chris doesn't need it now but he really needed it just after his heart attack. He could not walk across the room to sit next to the hospital consultant without assistance but he still got sent home without it! I just wondered why they did not send him to the hospital pharmacy instead of leaving him at the mercy of his notes making it to the GP. And why don't they send notes electronically? They are couriered over so I was told.


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## Penquin (Oct 15, 2007)

I am surprised he did not receive a TOP (Take Out Pack) as that is the normal procedure AFAIK with sufficient for 4 - 5 days, so that a GP visit CAN be arranged.

From what my daughter tells me such a bridge is even more important now as it may be up to 3 weeks before you can get an appointment for a NAMED GP, although of course after a hospital discharge, a named GP is not essential, any of the practice will do ftb.

Even a locum would be able t prescribe say a 7 days supply just to tide over after the TOP has been finished. The only possible explanation is if he was discharged AFTER the Hospital Pharmacy had closed since these do not count as "Emergency medication" but merely routine....... Many Pharmacies only work until about 1900 and outside those hours it requires the prescription to be marked "Urgent" by the Doctor....... The same applies to those given by GP's - if marked "Urgent" then they can be dispensed out of normal hours.... but obviously the cost to the NHS is much greater.

Why courier? That way it is clear that they HAVE been delivered, electronic is still in it's infancy as sending does not equal successful delivery - wrong e-mail, wrong spelling or whatever - mistakes are made and although they may APPEAR to have been sent successfully, there is no guarantee that they have actually been received by the correct person...... That could be disastrous.....

Dave


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