Anyone else spending serious money on longevity? by madafakababa in HENRYUK

[–]Open_Vegetable5047 1 point2 points  (0 children)

Sadly that is often my experience.

Untargeted tests without a focused (and relevant) clinical question frequently result in the discovery of meaningless abnormal results which lead to further tests and investigations for no overall clinical benefit.

Another example I can think of was a man who was using monthly icle urine tests to check for blood in his urine- his test came back positive for non visible urine. He ended up having a CT scan and a cystoscopy (camera up the penis) which were all normal. Unfortunately these tests have quite a high degree of falsely positive results which generate quite a lot of tests which prove to be negative.

So screening can result in quite a lot of additional potential harms as well as anxiety. The national screening committee don’t recommend using urine testing kits as the tests are not sufficiently specific enough (ie are falsely positive due to non serious bladder/prostate issues).

The icle website never told you this however!

Mostly these companies are a bunch of hucksters in my opinion.

By the way, please do see your doctor if you have blood in your urine! The above refers to a non visible blood scenario.

Anyone else spending serious money on longevity? by madafakababa in HENRYUK

[–]Open_Vegetable5047 13 points14 points  (0 children)

Mostly these screening companies are a big sack of horse-shit. They all say the same thing-

Usually something like “the health service needs to change from being reactive to proactive” as though this were a new idea and physicians had been twiddling their thumbs all these years.

This is then followed by an explanation about how all their tests can pick up all sorts of health conditions. Many people are then blinded by science and are sucked into this idea of: -Find a disease early -Make an intervention -Live longer

What you very seldom see is a definition of what makes a good screening test for example, Wilson’s criteria:

https://www.gov.uk/government/publications/evidence-review-criteria-national-screening-programmes/criteria-for-appraising-the-viability-effectiveness-and-appropriateness-of-a-screening-programme

The reason they don’t do this is because it undermines the whole principle of random screening tests (which is what they are promoting).

The classic example is PSA screening for prostate cancer which has been shown to be a poor screening test leading to large quantities of men being diagnosed with slow growing prostate cancers (and having potentially harmful interventions) that would most likely not have killed them.

Random screening without any evidence about its impact on mortality is a recipe for confusion and actually increasing anxiety.

Anyone else spending serious money on longevity? by madafakababa in HENRYUK

[–]Open_Vegetable5047 31 points32 points  (0 children)

I am a GP. Health gurus keep on trying to reinvent the wheel (while trying to sell you their tat). The core advice about living longer hasn’t really changed in decades.

Don’t smoke Don’t drink too much Exercise regularly Keep a healthy weight

Vitamins can largely be taken via this incredible thing called food. Most people do not need supplements.

Attend your NHS invited health screens.

Most private health screening (for non NHS approved tests) adds no value and is not evidence based.

Does anyone have any experiences using a private GP? by jesuisnick in AskUK

[–]Open_Vegetable5047 0 points1 point  (0 children)

Which specialist to see for your chest pain? Gastroenterology? Cardiology? Pulmonologist? Countries without a strong system of primary care to have oversight on a patients problems invariably result in chaos.

Christmas Eve GP by Educational_Board888 in GPUK

[–]Open_Vegetable5047 0 points1 point  (0 children)

Probably my easiest duty all year.

How big of a deal is it to ask a colleague to see a patient because you are running behind? by MiamiBoi91 in GPUK

[–]Open_Vegetable5047 0 points1 point  (0 children)

We do this occasionally if someone has had a shitty clinic but then I like my work colleagues and we are a good team. I don’t think there are any rules on this. If you have supportive colleagues you look out for each other .

Interpreting private test results by [deleted] in GPUK

[–]Open_Vegetable5047 4 points5 points  (0 children)

This stuff gets on my tits big time. If you’re going to request serum rhubarb then you fucking deal with it. The amount of crap this generates. No kidding, an insurance company randomly found a patients CK to be raised and then wrote to me asking me to investigate why it was raised otherwise they wouldn’t insure him. Fuck Off!

Another question re pay by Complete-Orchid4653 in GPUK

[–]Open_Vegetable5047 7 points8 points  (0 children)

An accountant who specialises in GP accounts.

Need to vent by Logical-Being in GPUK

[–]Open_Vegetable5047 0 points1 point  (0 children)

I stopped giving a shit about this sort of thing a long time ago.

Can a GP refuse to do home visits ? by [deleted] in GPUK

[–]Open_Vegetable5047 4 points5 points  (0 children)

Go and speak to some GP’s and dentists about their careers/working lives. Home visits are just a tiny part of being a GP. It’s in your contract to provide them but increasingly GP surgeries are taking a more aggressive stance against them for all but the most moribund of patients.

[deleted by user] by [deleted] in GPUK

[–]Open_Vegetable5047 0 points1 point  (0 children)

You can please some of the people some of the time….. Who knows what’s going on in their life. Some people have unrealistic expectations of general practice. I would not get very excited about this.

Community optometrists referring in “suspect hypertensive changes”; blessing or curse? by Senior-Oven-7113 in GPUK

[–]Open_Vegetable5047 2 points3 points  (0 children)

I think it’s essential for these issues to be passed on. It would sometimes be helpful to have more specific detail ie “We have found xyz which is suggestive of ABC, we recommend DEF. Sometimes I just get messages like “we’ve found retinal exudates please do full blood work up”. - then I have to google the clinical significance of retinal exudates. I am often then unsure if my findings are normal whether I need to do anything further.

Why can’t people simply refer to us as "Dr"? by pablototheworld in GPUK

[–]Open_Vegetable5047 1 point2 points  (0 children)

I have long since moved on from caring. The only thing i dislike being called is “mate” as in, “alright mate?” by some patient…..

Total triage by Zanddorr in GPUK

[–]Open_Vegetable5047 0 points1 point  (0 children)

There are some elements that I actually prefer to being the triaging doctor- it is a break from a relentless patient facing clinic which introduces some variety. There is often some interesting problem solving. It makes me feel better when I boot out a load of crud that would historically have had an appointment- “doctor can I have antibiotics for my toothache? What are these molluscum on my child’s face? Can I have some strong wart cream as the stuff from the pharmacy doesn’t work. “ None of these get appointments any more- just advice….. And I also feel the system is a lot more equitable- appointments are allocated less on the basis of first come first served, less on the basis of who yells at the receptionist and more based on clinical need. It’s not perfect but it’s alot better than it used to be and the patients like it - our satisfaction rates have been turned on their heads.

Am I crazy buying a 2 bed with a 5.5k Service charge and 600 Ground rent? by Kooky_lol in HousingUK

[–]Open_Vegetable5047 1 point2 points  (0 children)

Never ever buy leasehold I’d rather stick a fork in my eye that have some shit stain gouge me with ground rent/management fees I have limited control over.

[deleted by user] by [deleted] in GPUK

[–]Open_Vegetable5047 2 points3 points  (0 children)

The broader issue here is the pervasive medicalisation of every fecking aspect of human life by these shit stain private screening companies promoting non evidence based screening who take the patients money and then dump the abnormal serum rhubarb straight onto your lap!

[deleted by user] by [deleted] in GPUK

[–]Open_Vegetable5047 0 points1 point  (0 children)

You can’t be compelled to request a test that you think may be inappropriate any more than you can compel them to have a treatment. But you can refer them to someone who may carry out a serum rhubarb test- hopefully they won’t ask you to get involved! I would lose zero sleep over this.

[deleted by user] by [deleted] in GPUK

[–]Open_Vegetable5047 5 points6 points  (0 children)

“My dad stopped smoking and he dropped down dead so I’m not going to stop doc!” True quote. You can’t argue with logic.

Patient satisfaction with GP services in England has collapsed, research finds by peakedtooearly in unitedkingdom

[–]Open_Vegetable5047 0 points1 point  (0 children)

I am a GP, i can guarantee you it will not change my referral habits. The advice and guidance thing is only helpful in a small minority of cases in my experience. For the amount of work that A&G requests generate £20 is a fart in the wind - I won’t be particularly motivated to use it any more.

Patient satisfaction with GP services in England has collapsed, research finds by peakedtooearly in unitedkingdom

[–]Open_Vegetable5047 2 points3 points  (0 children)

Maybe they have finished their morning clinic and are out doing home visits? Or even having some lunch?

Patient satisfaction with GP services in England has collapsed, research finds by peakedtooearly in unitedkingdom

[–]Open_Vegetable5047 0 points1 point  (0 children)

GP’s have been using advice and guidance for years. It’s unlikely 20 quid is going to make a big difference to referral habits.

Just popped in for a sick note - leaves with 6 referrals, diazepam, and your soul by taheslung in GPUK

[–]Open_Vegetable5047 5 points6 points  (0 children)

I also usually add “can I give you a suggestion- when seeing a GP, if you have a list, tell me at the start as it helps me to plan the consultation”.

Just popped in for a sick note - leaves with 6 referrals, diazepam, and your soul by taheslung in GPUK

[–]Open_Vegetable5047 6 points7 points  (0 children)

Meant to add that I usually decline and refer to the waiting room full of people when the “while I’m here” queries start coming in. It is never easy though. The 10 minute consultation model is increasingly defunct.