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Can your GP really diagnose in 10 minutes? | Mother Distracted

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Wednesday, 17 June 2015

Can your GP really diagnose in 10 minutes?

Now I appreciate that we are lucky to have the NHS.  I also appreciate that many of my medical ailments are comparatively minor and that many GPs are working all the hours God sends (albeit for what could be considered a very generous salary) and do their best to help us.

An apple a day doesn't always keep the doctor away
But, here's the thing.

In my local surgery we are allocated 10 minutes per appointment and I fail to see how a comprehensive diagnosis can possibly be made in that time.  I spend more time waiting to see I doctor than I do in front of them. Ignoring the logistical problem of keeping everybody happy and ensuring medical emergencies get priority treatment, let me give you an example of what I'm talking about.

I have been variously diagnosed with TMJ (Temporomandibular Joint syndrome), Bruxism (teeth grinding), bleeding gums, Early Onset Hearing Loss and Vulvodynia.  Add to the mix lower back pain and anxiety. My life is occasionally a series of trips to the doctors - each generally futile because a GP will treat the symptoms you present at the time without considering the overall picture.

For example, go to the doctors with gynaecological problems and I can guarantee you will be treated for i) thrush, ii) water infection or if you are my age iii) vaginal dryness.  It's as if there are literally only 3 choices.  Now it may well be that, for most women, these are likely to be the main contenders but what if they're not?

And that, to me is the crux of the matter.

I have been reading about Fibromyalgia lately - happening to come across some excellent blog posts on the topic and it's curious that every single one of my symptoms could be the result of this.

Fibromyalgia is a long term condition that causes pain all over the body. The NHS says that "the exact cause of fibromyalgia is unknown, but it's thought to be related to abnormal levels of certain chemicals in the brain and changes in the way the central nervous system (brain, spinal cord and nerves) processes pain messages carried around the body. It's also suggested that some people are more likely to develop fibromyalgia because of genes inherited from their parents."

But I know that unless I go to my GP and directly ask the question "could I have Fibromyalgia", there is practically zero chance that anybody would make the link between my symptoms and start to address the potential cause.

Constantly treating the symptoms without addressing the cause must be costing the NHS millions, not least in the amount of antibiotics and antidepressants that are dished out.  Is it any wonder so many of us are turning to Dr Google?  There is obviously a lot of incorrect and potentially dangerous medical information online, but as our obsession for googling all things medical grows, we are reaching a place where the patients consider themselves much better informed than their doctors - which must make a doctor's life even more difficult and may be putting some of us at risk.

There is no obvious answer to this problem.  We need a root and branch change to the way we think about medicine and its place our health.  We surely cannot go on with a situation where the sum total of a doctor's advice is "put a bit of cream on it" (oh yes, I've heard that one a few times).

I suspect that the future of medical care in the UK may well involve compulsory medical insurance and private medical care.

But perhaps a rethink about how we manage doctors appointments is in order.  And some division of labour so that there are medical specialists in particular areas in each practice - my first suggestion would be paediatrics, closely followed by gynaecology! Let's staff up practices to cover practical appointment times e.g. up to 7 pm at night.

Having spent 20 years in Law I can say that law firms have had to look at their business models and many have had to drag themselves kicking and screaming into the 21st century.  Better communication (both internally and with clients), a clearer understanding of the needs of their clients and designing services to anticipate and meet those needs have been critical for those firms who have survived.

It's time for our doctors' surgeries to start thinking the same way.

If more comprehensive and accurate diagnoses are not made at an early stage, then all that will happen is that chronic conditions will need to be treated at greater time and expense in our hospitals. Get the diagnosis right in the first place (or earlier on) and the number of appointments requested will probably decrease, freeing up time for treating more medical emergencies or offering more specialist care.

Otherwise, we'll all just carry on diagnosing ourselves and putting up with aches and pains that maybe, just maybe, could have been dispensed with months, even years ago.
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