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bobspud
16th January 2013, 08:32
FFS :mad:

BBC News - Going paperless 'would save NHS billions' (http://www.bbc.co.uk/news/health-21033984)

The partners at PWC must be rolling round on the floor like a bunch of smash robots at the thought of the money that is going to come their way :mad

BA to the Stars
16th January 2013, 08:37
This could be re-cycled every year since they started NPfIT / Connecting for Health. :eyes

darmstadt
16th January 2013, 09:18
Saw this in the Guardian (http://www.guardian.co.uk/politics/2013/jan/16/paperless-nhs-medical-details-online?CMP=EMCNEWEML1355) this morning and it made me laugh. In particular this quote:


Unlike the Labour scheme, under which the Department of Health in Whitehall attempted to design a national database and ask five different organisations to build it, the current government will set out national standards for different IT systems to "talk to each other", but allow more than 200 clinical commissioning groups of GPs who will take charge of patient care from April to design and purchase their own programmes.

So they're planning on multiple systems. Knowing how government works, this isn't. Idiots...

bobspud
16th January 2013, 09:27
Saw this in the Guardian (http://www.guardian.co.uk/politics/2013/jan/16/paperless-nhs-medical-details-online?CMP=EMCNEWEML1355) this morning and it made me laugh. In particular this quote:



So they're planning on multiple systems. Knowing how government works, this isn't. Idiots...

Just fills me with rage that they still don't know that they can't do this stuff...

If I was Cameron at the moment I would have the health secretary in my office by 10 and out again to start their new career serving hamburgers by 5 past...

I just finished working for a very old government department that had stuff dating back to pre 1800 its all stored on parchment in climate controlled buildings. We had the usual list of muppets in to tell us about storage and none of them could get their head around the fact that the storage technology that they would specify would need to be capable of keeping data safe for 100's of years not 8. I doubt these idiots have thought about this either... Oh lets put it all on IBM Sans that will be completely out of date by 2030 despite most of the population needing their data safe until at least 2050 with posthumous stuff stored for longer...

filthy1980
16th January 2013, 09:52
the problems with the National NHS database start well before you even get to technology, when you have different trusts treating the same patient in different ways then is pretty impossible to build a system that caters for all these variables

DoH first tasks should be get consensus how how to treat certain illnesses, get it right on paper before you introduce a computer into the equation

bobspud
16th January 2013, 10:04
the problems with the National NHS database start well before you even get to technology, when you have different trusts treating the same patient in different ways then is pretty impossible to build a system that caters for all these variables

DoH first tasks should be get consensus how how to treat certain illnesses, get it right on paper before you introduce a computer into the equation

^ This

Always surprised me that the government didn't take one hospital and perfect the blueprint for running it end to end, then role it out like any other Starbucks or McDonald's or data centre, saying this is how you run the hospital with one set of standards. Then as you adopt changes you do the same. Target the one Hospital then role out the change... Its not rocket science.

Letting trusts think that they are clever or different is the biggest mistake...

Its the fact that every nurse or doctor seems to think that they are doing something that no one else can do...

Mich the Tester
16th January 2013, 10:08
^ This

Always surprised me that the government didn't take one hospital and perfect the blueprint for running it end to end, then role it out like any other Starbucks or McDonald's or data centre, saying this is how you run the hospital with one set of standards. Then as you adopt changes you do the same. Target the one Hospital then role out the change... Its not rocket science.

Letting trusts think that they are clever or different is the biggest mistake...

Its the fact that every nurse or doctor seems to think that they are doing something that no one else can do...

Umm, is standardisation really the way forward? You have to be pretty damn certain that the standards you apply are right, because if they aren't then everybody ends up screwing it all up and you'll have no successful examples to follow.

I don't think the comparison with Starbucks or MacD really holds water; healthcare is quite a lot more complex than making coffee or hamburgers.

AtW
16th January 2013, 10:18
healthcare is quite a lot more complex than making coffee or hamburgers.

Why is it so hard to have a web interface to a central database that will contain patient records?

filthy1980
16th January 2013, 10:20
Umm, is standardisation really the way forward? You have to be pretty damn certain that the standards you apply are right, because if they aren't then everybody ends up screwing it all up and you'll have no successful examples to follow.

I don't think the comparison with Starbucks or MacD really holds water; healthcare is quite a lot more complex than making coffee or hamburgers.


you'd think so but in my experience of receiving health care from doctors and nurses their training is often a case of "symptom A+B+C = Diagnosis X" "symptom A+B+F = Diagnosis Y"

i'm no techie but at the basic level you can build systems to do that, in fact they already have with NHS Direct

Mich the Tester
16th January 2013, 10:20
Why is it so hard to have a web interface to a central database that will contain patient records?

It isn't, but that's a different matter; the poster suggested standardising the way hospitals are run and suggested that part of the problem is different doctors and nurses working in different ways; I think that diverse approaches are more likely to lead to progress than standardisation.

EternalOptimist
16th January 2013, 10:21
the NIHS

not invented here service

mudskipper
16th January 2013, 10:34
<whinge>

Got underactive thyroid and am permanently knackered - proper knackered.

Been on meds for 3 months now, with little improvement. Did lots of research, and printed off academically rigorous stuff from endo journals showing that although the accepted normal range (in the UK) for TSH (thyroid stimulating hormone) is 0.5 - 5 (apparently based on 97.5% of the population), 95% of the population have TSH < 2.5, and the median value is < 1.5. Tried to use this to argue that, with a TSH of 3, I may not yet have reached the optimal levels, and that we should aim to treat the symptoms, not the numbers, at least until I am either feeling better, or values closer to the median. Doc's attitude was 'computer says no' - her flowchart says that once TSH < 5, I am cured.

Anyway, point of whinge is that many GPs are indeed treating according to a standard model with no real interest in tailoring to an individual patient's needs. At least in McDonald's I can get my burger without gherkins.

</whinge>

vetran
16th January 2013, 10:36
Umm, is standardisation really the way forward? You have to be pretty damn certain that the standards you apply are right, because if they aren't then everybody ends up screwing it all up and you'll have no successful examples to follow.

I don't think the comparison with Starbucks or MacD really holds water; healthcare is quite a lot more complex than making coffee or hamburgers.

Booking bed's, appointments, meeting / operating rooms is pretty standard.

They aren't even doing this right, its a bit like turning up at NASA and being presented with cold water & milk when you are offered coffee. You know you don't want to go up in their rockets.

Its not rocket science they just try to make it look like that.

I have turned up a couple of times to have machine X attached to me for 24 hours, an appointment I waited for 2 months, I turn up on time, wait the usual 90 minutes after my appointment and find that they are out of machine X or its faulty. This experience is fairly common as far as I can tell.

Once I can get an 'urgent' appointment in 7 days, turn up on time and be seen on time ,yes I know doctors are busy, appointments can vary etc. but if I'm having to queue in a regular surgery to have a standard 7.5 min review it should be on time give or take 15 minutes not 4 hours.

We aren't talking about anything clever its resource scheduling and patient manipulation, a Hotel booking system would do most of it. Add a CRM system and you have half the problem solved.

I think people are over thinking most of the problems, I'm assuming BUPA & so on have a suitable tool just as US (and other nations) hospitals do. Buy one of their systems off the shelf and turn off the invoice issuing part.

Mich the Tester
16th January 2013, 10:37
<whinge>

Got underactive thyroid and am permanently knackered - proper knackered.

Been on meds for 3 months now, with little improvement. Did lots of research, and printed off academically rigorous stuff from endo journals showing that although the accepted normal range (in the UK) for TSH (thyroid stimulating hormone) is 0.5 - 5 (apparently based on 97.5% of the population), 95% of the population have TSH < 2.5, and the median value is < 1.5. Tried to use this to argue that, with a TSH of 3, I may not yet have reached the optimal levels, and that we should aim to treat the symptoms, not the numbers, at least until I am either feeling better, or values closer to the median. Doc's attitude was 'computer says no' - her flowchart says that once TSH < 5, I am cured.

Anyway, point of whinge is that many GPs are indeed treating according to a standard model with no real interest in tailoring to an individual patient's needs. At least in McDonald's I can get my burger without gherkins.

</whinge>

I can sympathise, but the crux is in the term 'many GPs'. Indeed, in any organisation most people in the same job will do that job in a similar way, BUT, by standardising you can discourage the few who will try to do things differently and thereby possibly lead improvements to how the job is done.

minestrone
16th January 2013, 10:38
Doctors love people who turn up with print outs from the web, 15 minutes on google equals a medical degree don't you know.

bobspud
16th January 2013, 10:39
Umm, is standardisation really the way forward? You have to be pretty damn certain that the standards you apply are right, because if they aren't then everybody ends up screwing it all up and you'll have no successful examples to follow.

I don't think the comparison with Starbucks or MacD really holds water; healthcare is quite a lot more complex than making coffee or hamburgers.

No it is not. At the root of it is a set of workflows that end in a cure, containment or a death. They are many more workflows than making coffee I admit. but if you have cancer in Scotland or Surrey it should not make a difference.

Diagnose
Discuss options
Treat
monitor
discharge the patient or retreat
Handle palliative care
Discharge a body :(

Letting 50 different trusts handle that process in their own way is ludicrous. Letting them think that they and only they need a patient system and that it should be custom to their own ways of doing things is a massive mistake. I am sure that there are hundreds of admin staff that would say but my ways better than that because I designed it. but its those guys that need to be shown a door...

vetran
16th January 2013, 10:40
I think that diverse approaches are more likely to lead to progress than standardisation.

Once you have > 80% of the throughput being dealt with efficiently then you can go off and do clever things with the outliers, until then you need to standardise.

Currently 80% of the organisation is screwed up.

Mich the Tester
16th January 2013, 10:41
No it is not. At the root of it is a set of workflows that end in a cure, containment or a death. They are many more workflows than making coffee I admit. but if you have cancer in Scotland or Surrey it should not make a difference.

Diagnose
Discuss options
Treat
monitor
discharge the patient or retreat
Handle palliative care
Discharge a body :(

Letting 50 different trusts handle that process in their own way is ludicrous. Letting them think that they and only they need a patient system and that it should be custom to their own ways of doing things is a massive mistake. I am sure that there are hundreds of admin staff that would say but my ways better than that because I designed it. but its those guys that need to be shown a door...

I'm not talking about admin staff but medical staff; they need the space to use the brains they've trained during the years of very expensive education they've been given.

vetran
16th January 2013, 10:43
I'm not talking about admin staff but medical staff; they need the space to use the brains they've trained during the years of very expensive education they've been given.

yes give them that by virtue of having a stable & predictable framework to work within.

Only great artists fare well in chaos.

mudskipper
16th January 2013, 10:51
Doctors love people who turn up with print outs from the web, 15 minutes on google equals a medical degree don't you know.

I appreciate that, but I think it's fair to say that a GP is unlikely to be up to date on the research on every patient's different condition, and, when the patient has gone to the trouble to find some mainstream research that they'd like to discuss, the GP could at least do the courtesy of explaining why she disagrees.

I think the problem is that you can find evidence to support just about any view, but in this case I was trying to find out what the reference range meant, and it's clear that 95% of people have a lower TSH than me. If she doesn't think that getting me to a place where 95% of people are may give me a chance of feeling better, I'd like to understand why. FWIW, if I was in the USA, my values would not be considered normal - they have a much lower upper limit. Things are rarely black and white, and they should be prepared to discuss stuff. :(

formant
16th January 2013, 10:57
Doctors love people who turn up with print outs from the web, 15 minutes on google equals a medical degree don't you know.

Unfortunately a medical degree also doesn't equal common sense.

<I have a whinge, too>
About a year and a half ago my other half was "diagnosed" with high blood pressure (solely based on two readings), no other physical indications or symptoms. Funnily enough he only ever had high blood pressure at the doctor's office, not when measured at the gym. But it was a stressful time in his life so he accepted that maybe there was something to it. They ran various tests and there were never any physical causes found for the alleged high blood pressure - he was in excellent shape. They put him on meds and as all this co-incided with our house-purchase, this messed up his chances of getting Critical Illness cover. Great. Anyway, he's been on the meds ever since and more recently started feeling faint and actually fainting on several occasions, along with other textbook symptoms of low blood pressure. Went to the doctor, blood pressure taken, reading was high again. Doctor wants to prescribe a higher dose of the meds, not interested in his actual symptoms. OH asks about White Coat Hypertension - doctor ignores it. He goes home, borrows blood pressure monitor from neighbour and starts recording his own readings -all ranging between low and perfect. Back to the doctor with said readings - "Oh I'm glad you did that, I'd have upped your meds and that would have been pretty dangerous *insert girly giggle*". So finally she admitted it must be White Coat Hypertension, after over a year on the meds (now off them entirely) and after this misdiagnosis preventing him from getting insurance. So from the start there was nothing wrong with him, but because they went by nothing other than the reading and completely ignored the symptoms and other explanations, he's had to go through all this hassle and it's consequences.

Yeah, I don't have a whole lot of faith in GPs. Some may be good, but some are really a bit on the ignorant side.
So I'm not surprised people come along with Google diagnoses.

</whinge>

Robinho
16th January 2013, 10:57
It isn't, but that's a different matter; the poster suggested standardising the way hospitals are run and suggested that part of the problem is different doctors and nurses working in different ways; I think that diverse approaches are more likely to lead to progress than standardisation.

This is why a government enforced monopoly on health is bad.

minestrone
16th January 2013, 10:58
I appreciate that, but I think it's fair to say that a GP is unlikely to be up to date on the research on every patient's different condition, and, when the patient has gone to the trouble to find some mainstream research that they'd like to discuss, the GP could at least do the courtesy of explaining why she disagrees.

I think the problem is that you can find evidence to support just about any view, but in this case I was trying to find out what the reference range meant, and it's clear that 95% of people have a lower TSH than me. If she doesn't think that getting me to a place where 95% of people are may give me a chance of feeling better, I'd like to understand why. FWIW, if I was in the USA, my values would not be considered normal - they have a much lower upper limit. Things are rarely black and white, and they should be prepared to discuss stuff. :(


Well you sound like you know what is wrong with you, just get the pills off the web as well and save the NHS the time and the money.

bobspud
16th January 2013, 11:01
I'm not talking about admin staff but medical staff; they need the space to use the brains they've trained during the years of very expensive education they've been given.

For every fantastic genius there are at least a dozen normal guys going through the motions.

Bupa seems to do well and have some of the top brains. I wonder if they let everyone do things their own way...

Mich the Tester
16th January 2013, 11:05
This is why a government enforced monopoly on health is bad.
Firstly, NHS is not a government enforced monopoly; it's the biggest provider by far, but there are private providers for most care in the UK.

Secondly, in your ideal world of privatised healthcare what actually happens is that an oligopoly of big insurers, trained in Bizzinezz Studies and Marketing tell doctors and nurses who are trained in medicine how to do their jobs and fook it up just as royally as governments while overcharging customers for the pleasure.

Mich the Tester
16th January 2013, 11:06
For every fantastic genius there are at least a dozen normal guys going through the motions.

Bupa seems to do well and have some of the top brains. I wonder if they let everyone do things their own way...

Well, if you've paid the money to hire the best, you don't necessarily need to tell them how to do their jobs.

mudskipper
16th January 2013, 11:08
Well you sound like you know what is wrong with you, just get the pills off the web as well and save the NHS the time and the money.

The point is that I still feel like tulipe. So, my thyroid is cured, but my symptoms remain. Either a) my thyroid is not completely cured, or b) there's something else wrong as well that causes similar symptoms to hypothyroidism, or c) I'm making it up / a hypochondriac.

By refusing to entertain a) or b), the doctor's default position must be c. It's this kind of arrogance that means people enter the surgery with printouts from google.

vetran
16th January 2013, 11:10
Well you sound like you know what is wrong with you, just get the pills off the web as well and save the NHS the time and the money.


Sorry Minestrone You sound like some managers I have worked for they thought only they knew the 'right' way and blustered similarly. Pride cometh before a disbarment?

If the patient researches carefully and presents information respectfully they may well change the doctor (or other experts mind), I have frequently collected data and had it corrected by a competent user because they mention an obscure use case which changes the solution completely.

Mich the Tester
16th January 2013, 11:11
The point is that I still feel like tulipe. So, my thyroid is cured, but my symptoms remain. Either a) my thyroid is not completely cured, or b) there's something else wrong as well that causes similar symptoms to hypothyroidism, or c) I'm making it up / a hypochondriac.

By refusing to entertain a) or b), the doctor's default position must be c. It's this kind of arrogance that means people enter the surgery with printouts from google.

Or that your condition requires more observation; one problem is that doctors spend a lot of their time dealing with thicko's and don't believe they can explain what they're trying to do; you need to ask him what his approach is going to be and be fair, if he needs to give it some time and see if it improves in a few weeks then you have to give it a chance. Lots of people go to the doctor with complaints that spontaneously go away and somehow the doc has to filter that out.

Robinho
16th January 2013, 11:12
Firstly, NHS is not a government enforced monopoly; it's the biggest provider by far, but there are private providers for most care in the UK.

Yes it is, everyone is forced to pay for the NHS.


Secondly, in your ideal world of privatised healthcare what actually happens is that an oligopoly of big insurers, trained in Bizzinezz Studies and Marketing tell doctors and nurses who are trained in medicine how to do their jobs and fook it up just as royally as governments while overcharging customers for the pleasure.

/tinHat

Project Monkey
16th January 2013, 11:13
Why is it so hard to have a web interface to a central database that will contain patient records?

...because nobody will agree what they want the interface to do and what data they want to hold. Everyone has different and conflicting requirements and since the NHS is a deluded pseudo democracy, finding leadership capable of making and implementing decisions is all but impossible.

Mich the Tester
16th January 2013, 11:13
Yes it is, everyone is forced to pay for the NHS.



/tinHat

Yes, but that doesn't make it a ' monopoly' ; yes, a near monopoly but you have other choices for healthcare. And as for paying with your taxes, you'd better learn to live with tax; just like death, it won't go away.

Mich the Tester
16th January 2013, 11:15
/tinHat

Yes, keep your tin hat on while I listen to the first hand accounts of doctors and nurses working in a recently privatised healthcare system.

Robinho
16th January 2013, 11:15
Yes, but that doesn't make it a ' monopoly'

Oh you're just being arsey about the definition.

Mich the Tester
16th January 2013, 11:17
Oh you're just being arsey about the definition.

No, you have a choice as to where you purchase healthcare.

Project Monkey
16th January 2013, 11:20
No it is not. At the root of it is a set of workflows that end in a cure, containment or a death. They are many more workflows than making coffee I admit. but if you have cancer in Scotland or Surrey it should not make a difference.

Diagnose
Discuss options
Treat
monitor
discharge the patient or retreat
Handle palliative care
Discharge a body :(

Letting 50 different trusts handle that process in their own way is ludicrous. Letting them think that they and only they need a patient system and that it should be custom to their own ways of doing things is a massive mistake. I am sure that there are hundreds of admin staff that would say but my ways better than that because I designed it. but its those guys that need to be shown a door...

sounds like a new methodology to me.

Robinho
16th January 2013, 11:20
Yes, keep your tin hat on while I listen to the first hand accounts of doctors and nurses working in a recently privatised healthcare system.

Ahh anecdotes.

Tbh i never said anything about full on privatising healthcare anyway.

You should be able to opt out of the NHS and not have to pay your share of tax that goes towards it.

mudskipper
16th January 2013, 11:22
What's with the 'Virgin Healthcare' thing? A lot of our local NHS community hospital services are now being provided by Virgin.

Robinho
16th January 2013, 11:23
No, you have a choice as to where you purchase healthcare.

No you don't, you have to purchase the NHS.

You could choose another provider, but you have to purchase the former.

Mich the Tester
16th January 2013, 11:27
No you don't, you have to purchase the NHS.

You could choose another provider, but you have to purchase the former.
Fine, because I quite like the idea that someone who can't afford the huge premiums I pay for health insurance gets treated nonetheless because I consider his life to be just as valuable as my own.

minestrone
16th January 2013, 11:28
Unfortunately a medical degree also doesn't equal common sense.

<I have a whinge, too>
About a year and a half ago my other half was "diagnosed" with high blood pressure (solely based on two readings), no other physical indications or symptoms. Funnily enough he only ever had high blood pressure at the doctor's office, not when measured at the gym. But it was a stressful time in his life so he accepted that maybe there was something to it. They ran various tests and there were never any physical causes found for the alleged high blood pressure - he was in excellent shape. They put him on meds and as all this co-incided with our house-purchase, this messed up his chances of getting Critical Illness cover. Great. Anyway, he's been on the meds ever since and more recently started feeling faint and actually fainting on several occasions, along with other textbook symptoms of low blood pressure. Went to the doctor, blood pressure taken, reading was high again. Doctor wants to prescribe a higher dose of the meds, not interested in his actual symptoms. OH asks about White Coat Hypertension - doctor ignores it. He goes home, borrows blood pressure monitor from neighbour and starts recording his own readings -all ranging between low and perfect. Back to the doctor with said readings - "Oh I'm glad you did that, I'd have upped your meds and that would have been pretty dangerous *insert girly giggle*". So finally she admitted it must be White Coat Hypertension, after over a year on the meds (now off them entirely) and after this misdiagnosis preventing him from getting insurance. So from the start there was nothing wrong with him, but because they went by nothing other than the reading and completely ignored the symptoms and other explanations, he's had to go through all this hassle and it's consequences.

Yeah, I don't have a whole lot of faith in GPs. Some may be good, but some are really a bit on the ignorant side.
So I'm not surprised people come along with Google diagnoses.

</whinge>

Whatever you say Gentile.

Robinho
16th January 2013, 11:28
Fine, because I quite like the idea that someone who can't afford the huge premiums I pay for health insurance gets treated nonetheless because I consider his life to be just as valuable as my own.

Then donate money to charity.

Edit: Actually that's not a bad idea, the gov could let other companies fairly compete with the NHS, and when it gets adequately small, sell it off as a charity.

Mich the Tester
16th January 2013, 11:30
Then donate money to charity.

I do, but too many people don't.

Robinho
16th January 2013, 11:34
I do, but too many people don't.

And that justifies theft? :confused:

One would hope that if the government didn't forcefully tax and spend our money people would be a bit more willing to donate, both because they have more money and also because their would be more need.

formant
16th January 2013, 11:35
Whatever you say Gentile.

You actually still think I'm Gentile?

Goodness that gal must've left an impression around here. I regret I wasn't around then to witness that.

I still know f-all about .NET, btw.

Mich the Tester
16th January 2013, 11:39
And that justifies theft? :confused:



Yes I'm sure you are confused; the moral justification for tax and public healthcare is a bit more complex than a simple and fallacious theft-charity dichotomy that defines tax as theft.

formant
16th January 2013, 11:45
...because nobody will agree what they want the interface to do and what data they want to hold. Everyone has different and conflicting requirements and since the NHS is a deluded pseudo democracy, finding leadership capable of making and implementing decisions is all but impossible.

Actually, it's also because with the payment by results system introduced in 2004, trusts are essentially in competition with each other. They don't want their data out there for fear it'll make them less competitive.

(Current ClientCo amongst many many other things also does clinical coding software and is involved in digitising NHS medical records, pathways, etc. trust by trust to at least in theory make the data available. In practice, what I said there as well as a number of other factors would still mean that this data will not actually be shared.)

Robinho
16th January 2013, 11:47
Yes I'm sure you are confused; the moral justification for tax and public healthcare is a bit more complex than a simple and fallacious theft-charity dichotomy that defines tax as theft.

No it isn't. Healthcare is a commodity, just like a car, an ipad, or food.

bobspud
16th January 2013, 12:02
I still know f-all about .NET, btw.

Neither did she :p

formant
16th January 2013, 12:06
Neither did she :p

How's she with Python, Perl and Regular Expressions? Any degrees in Linguistics by any chance? Would love to find someone to subcontract to. Would really help me with going LTD and add substitution clauses to my contracts. ;)

Mich the Tester
16th January 2013, 12:08
No it isn't. Healthcare is a commodity, just like a car, an ipad, or food.

Yeah, sure. So if someone with an infectious disease isn't being treated but is infecting the rest of us, we'll just leave him to it.

Robinho
16th January 2013, 12:13
Yeah, sure. So if someone with an infectious disease isn't being treated but is infecting the rest of us, we'll just leave him to it.

I'm not sure how reflective of the issue this example is. Nice straw clutching tough.

minestrone
16th January 2013, 14:00
I appreciate that, but I think it's fair to say that a GP is unlikely to be up to date on the research on every patient's different condition, and, when the patient has gone to the trouble to find some mainstream research that they'd like to discuss, the GP could at least do the courtesy of explaining why she disagrees.

I think the problem is that you can find evidence to support just about any view, but in this case I was trying to find out what the reference range meant, and it's clear that 95% of people have a lower TSH than me. If she doesn't think that getting me to a place where 95% of people are may give me a chance of feeling better, I'd like to understand why. FWIW, if I was in the USA, my values would not be considered normal - they have a much lower upper limit. Things are rarely black and white, and they should be prepared to discuss stuff. :(

So you thought your 15 minutes of foogling trumps 5 years at medical school, 2 years in hospital wards and a further year as a trainee GP?

formant
16th January 2013, 14:14
So you thought your 15 minutes of foogling trumps 5 years at medical school, 2 years in hospital wards and a further year as a trainee GP?

Ah, so because the GP went through the standard educational path for their profession, as patients we should completely disregard all our physical symptoms once we're told things are fine. Because they're the experts, they must be right. Who are we to question that?

Sure.

minestrone
16th January 2013, 14:24
Ah, so because the GP went through the standard educational path for their profession, as patients we should completely disregard all our physical symptoms once we're told things are fine. Because they're the experts, they must be right. Who are we to question that?

Sure.

It is cretins like yourself that have seen measles cases spike in the last few years.

vetran
16th January 2013, 14:30
So you thought your 15 minutes of foogling trumps 5 years at medical school, 2 years in hospital wards and a further year as a trainee GP?

No but its a great way to get the symptoms described, also a little humility is always useful when trying to identify a root cause. Its annoying when users set up solutions that fall to pieces and they ask us to fix (our expertise and decades of education are obviously waste so when we said do it this way we didn't know what we were talking about) but we JFDI and do not consider ourselves above them.

So far we have a huge organisation that cannot get to appointments all the time, cannot effectively process feeding and regular maintenance properly saying 'Its too complicated mere mortals cannot understand the process'. I hear that all the time. Guess what? most people don't understand their own process and the higher up the tree they are the more arrogant they get about it.

We have had anecdotal evidence that GP's do misdiagnose (in a very serious way) every medical expert I have had take my blood pressure has seemed to be aware of the white coat effect.

mudskipper
16th January 2013, 14:31
So you thought your 15 minutes of foogling trumps 5 years at medical school, 2 years in hospital wards and a further year as a trainee GP?

Tradesmen must love you -

"You need a new boiler, Mr Minestrone. And a hot water tank too"

"Sure, just let me find my check book."

minestrone
16th January 2013, 14:35
People self diagnosing on the web is like fat people going shopping when they are starving.

vetran
16th January 2013, 14:59
It is cretins like yourself that have seen measles cases spike in the last few years.

No its failing to deal with public & substantiated challenge by a health professional, who was more highly qualified than most GP's, he put forward what seemed a reasonable argument against what was a cost reduction project.

The project was using a poorly tested vaccine COMBINATION. By a government that later handled things like Bird Flu vaccines so successfully (we found out that the supplier was a mate of the ministers and most vaccines were useless).

There appeared to be a credible link between evidence of infection probably caused by the vaccine and a debilitating disease that none of the highly qualified medical experts could cure or explain.

Was Dr. Andrew Wakefield Right After All? | Vactruth.com (http://vactruth.com/2012/01/13/andrew-wakefield-autism/)

The response to his objections was to run him out of town and remove the single injections.

Parents panicked and removed their children from the vaccination, private organisations imported incorrect single vaccines and helped the issue, I don't remember these companies later being closed for gross misconduct by BMA / NHS as they should have.

I suspect there is a link between MMR and autism just because they were so desperate to bury it, will it be the 90's Thalidomide scandal?

Will we be burning the bodies in fields as we did with the BSE farce - directly caused by the government.

My children had the MMR jab because the single jabs were made unavailable, they would have had the single jabs if I had the choice.

minestrone
16th January 2013, 15:13
No its failing to deal with public & substantiated challenge by a health professional, who was more highly qualified than most GP's, he put forward what seemed a reasonable argument against what was a cost reduction project.

The project was using a poorly tested vaccine COMBINATION. By a government that later handled things like Bird Flu vaccines so successfully (we found out that the supplier was a mate of the ministers and most vaccines were useless).

There appeared to be a credible link between evidence of infection probably caused by the vaccine and a debilitating disease that none of the highly qualified medical experts could cure or explain.

Was Dr. Andrew Wakefield Right After All? | Vactruth.com (http://vactruth.com/2012/01/13/andrew-wakefield-autism/)

The response to his objections was to run him out of town and remove the single injections.

Parents panicked and removed their children from the vaccination, private organisations imported incorrect single vaccines and helped the issue, I don't remember these companies later being closed for gross misconduct by BMA / NHS as they should have.

I suspect there is a link between MMR and autism just because they were so desperate to bury it, will it be the 90's Thalidomide scandal?

Will we be burning the bodies in fields as we did with the BSE farce - directly caused by the government.

My children had the MMR jab because the single jabs were made unavailable, they would have had the single jabs if I had the choice.

He was a fruit bat who bribed children to give blood samples at a birthday party and made up claims against a drug that was and has been proven to be safe based on his research done on 12 patients.

I still cannot believe that people are still arguing that MMR is not safe.

vetran
16th January 2013, 15:53
He was a fruit bat who bribed children to give blood samples at a birthday party and made up claims against a drug that was and has been proven to be safe based on his research done on 12 patients.

I still cannot believe that people are still arguing that MMR is not safe.

what proven safe after being tested on 12 patients? seriously though there are side effects to every drug we need to know that and assume the worst then prove otherwise. Medically AIUI there is little advantage to the combined jab, its just convenience and risk of misuse.


It was a cost saving exercise, they blackened his name instantly, they pulled the choice of single vaccines etc. It smelt dreadfully.

---------------------------


I can't believe that people believed X-Rays were safe for so long, now nobody takes X-Ray's. When I was a kid I got one every time I went to the dentist or hospital. Of course evidence gathered over a mere hundred years suggests X-Ray's are a bit dodgy when mis-used. The experts in the medical profession have only just restricted it?

http://www.liv.ac.uk/media/livacuk/radiation/pdf/X_ray_Safety.pdf

Just how safe are X-rays at the dentist? | Mail Online (http://www.dailymail.co.uk/health/article-1284843/Just-safe-X-rays-dentist.html)


If you ask a dentist if its necessary to have an x-ray, he/she will always say YES!! and will also say "the quantity of radiation used if very small and is harmless" - yes, I have had this said to me more than once. If you try to argue they dont like it and become like doctors who are questioned about the efficacy of any medicine. Neither like to have their opinions questioned.

Seems Dentists are just as arrogant.

----------------------

These guys probably did their research at the local McDonalds

Half of drugs prescribed in France useless or dangerous, say two specialists | World news | The Guardian (http://www.guardian.co.uk/world/2012/sep/14/french-doctors-drugs-useless-dangerous)

again & again stories like these surface across the world and it seems that the medical profession is less than organised. And of course

Foreign doctors who lack words for compassion | Mail Online (http://www.dailymail.co.uk/debate/article-2129554/Foreign-doctors-lack-words-compassion.html)

so that suggests the all knowing medical professionals are not exactly in touch with patients needs.

minestrone
16th January 2013, 15:57
He said it was unsafe after a trial of 12 patients.

vetran
16th January 2013, 16:04
He said it was unsafe after a trial of 12 patients.

I read it correctly was just trying to inject some humour. He may have been a fruit bat but he was a highly qualified & respected fruit bat when he said it.

my other points?

formant
16th January 2013, 19:08
It is cretins like yourself that have seen measles cases spike in the last few years.

As it stands, I happen to be a big fan of vaccinations. You seem to be confusing valid circumstantial scepticism with questioning decades of sound research and development. I don't even do much of the latter in my own specialism, let alone someone else's.

minestrone
16th January 2013, 23:18
As it stands, I happen to be a big fan of vaccinations.

Good for you.

I'm sorry I cannot give you a prescription pad though, if it were up to me you would be first in line for it.

I would honestly forget you have not got to the top level of your school, gone through 5 years of medical school, 100 hour weeks on wards, nor the trainee role, RGCP validation or revalidation.

You are the expert here, not me.

formant
17th January 2013, 07:36
Good for you.

I'm sorry I cannot give you a prescription pad though, if it were up to me you would be first in line for it.

I would honestly forget you have not got to the top level of your school, gone through 5 years of medical school, 100 hour weeks on wards, nor the trainee role, RGCP validation or revalidation.

You are the expert here, not me.

You sound like you really wanted to make it into medicine but didn't and since put the profession on a pedestal.

I've gotten to the top level of my class, had no interest in medicine, went through more degrees and more years of education than your average GP to specialise in something else, and yet somehow I don't get my panties tied in a knot when some layperson second guesses my work. Nah, I consider the their input, see what I can do, and if not explain elaborately why what they think works doesn't.

You also seem to assume that completing the mandatory training for your profession guarantees that you'll be a flawless practitioner.

So, do you actually hold the view that all anecdotal as well as proven stories of medical malpractice or negligence out there must by default be made up?

mudskipper
17th January 2013, 08:26
You sound like you really wanted to make it into medicine but didn't and since put the profession on a pedestal.


His missus is a GP. It's quite sweet really. :)

formant
17th January 2013, 08:32
His missus is a GP. It's quite sweet really. :)

That explains a lot. :rollin: