Zero Tolerance

Oh thank you so much Mrs Hewitt.

Our esteemed Health Minister says that patients offering abuse or violence to NHS staff will be met with a policy of zero tolerance and fined up to £1000 a throw. Those at the front door of the NHS in Practices or in A&E confront abuse on a daily basis. In A&E sadly violence is also commonplace, often fueled by booze and frustration at long waits.

BUT, with so much of the Departments current rhetoric being about patients rights: to choose, not to wait, to have unlicensed treatments; to have both instant access and prebookable appointments at times of your choice with whomever you want, to name but a few..... this ramps up expectations of what can be delivered.

THEN people rightly come to expect these things can be delivered, everywhere, all the time. And when this is not the case a few, a merciful few, get a bit narked, and are wont to take it out on the first person the come across...usually the Casualty Nurse or the GP receptionist.

So I'm off the army surplus store to invest in a stock of tin hats for our valiant staff, 'cos now it's been on Radio 4 we are bound to have an army of Clive Horrobin's queuing up to do us all an injury.

Them pills off the telly

There has been a trend emerging, ever since Pfizer launched Viagra as it happens, for drug companies to bypass professionals and direct market to the public. They do this not using tradiitonal marketing-- I believe direct marketing of presciption only medicines in the UK may still be banned if not frowned upon-- but in the form of "breaking news" stories. This means we now regularly get consultations of the sort I had yesterday afternoon.

A pleasant Jill Archer type lady came in to enquire, among other things, what I thought about "those pills off the telly"?

Having missed the news bulletein the night before I asked which ones they were.

Mrs A: I'm not sure, something to do with cholesterol I think?

Dr J: I see, and which channel was this?

Mrs A: ITV I think.

Dr J: So which programme was it on?

Mrs A: Definitely the News.... three or four weeks ago I think it was.

Dr J: and you can't remember the name of them at all?

*Mrs A shakes her head*

Five minutes later and after fruitless earch of the ITN website, which when searched for "Cholesterol" listed news items none less than 6 months old and all unhelpful, we agreed she would try to find out a little more about them and get back to me.

As a rule of thumb, most "pills off the telly" fall into three broad categories;

Those that have been around for ages which are now "dangerous" (i.e.the industry has a newer, more expensive replacement that they can supply at a premium).

Those that have been around two or three years the are "potentially life saving" (or not selling as well as we had hoped).

Those that are freely available elsewhere and "definitely life saving" (but not licenced for use in the UK because significant questions remain about either their safety profile or effectiveness).

In amongst these there are occasional true advances and new treatments that deserve the fanfare, but they are in dangfer of being drowned out by the background noise of constant hype for less worthy also rans.

So next time you need to enquire abut "pills off the telly, please try to remember the name.

Snow

The move to Borsetshire has been a great success already, even if I don't have a story to tell today. You see before, in the Real World, whenever we have more than a heavy frost, on the first day after the precipitation roads are closed or gridlocked.

Now I'm in radioland, even though I had to scrape a full 4mm thickness of white powdery stuff from the big red bus before the school run, everything went like clockwork. If anything despite the extra 5 minutes spent scooping (me) and chucking the worlds smallest snowballs (them) we managed to pick up all the other kids on the school run, drop off at normal time, and I still got to surgery 5 mins early.

Must be all the motorway standard bridleways they have here in Ambridge ;-)

*witness the undignified sight of a grown man thumbing his nose at the controller of Radio 4*

Just because you're paranoid....

I'm starting to think my surgery is bugged by the controller of Radio 4.

Two days ago I had a difficult consultation with a man bereft after the murder of his ex-wife and subsequent jailing of her killer after the predictable protracted legal hiatus. The knowledge that her killer is now being held for life in prison has, unsurprisingly, failed to bring his family any closure. They have in effect put grief on hold all through the build up to the court case, and have variously had to relive the events of their loved one's final hours in the glare of public scrutiny in open court. Counsellors for this sort of thing, if they exist at all, are not available in our locality and so the family are muddling through with mutual support and antidepressants.

And today on Today third or fourth lead item on the news.... families of murder victims to be allowed a say in court on the impact of their loss, betwen verdict and sentencing. Too late for this family, and too little to provide true closure (if such a thing is ever possible), but as they say otherwhere, It ain't nothin'.

And since they seem to have me under surveillance I have decided to turn the tables. For some time I have been worriting about posting these stories and preserving confidentiality so here's the thing.... I am moving the surgery to Borsetshire, perhaps even to Ambridge. Hence forth these pages will be populated with Grundys, Archers, Aldridges and Sterlings, to name a few. Any resemblance of the stories here to those fictional entities is of course intended merely for illustration and not as a reflection of the unfolding "Everyday story of Country Folk".

Oh, and I expect soon to be innundated by the malnourished elderly and brain tumour sufferers if the news continues to exert it's strange influence in this consulting room!

Dr J

Weirdness

Another of those serendipitous pieces of weirdness ocurred today.

This afternoon Radio 4 had a play about a celebrated case of an 18th Century Doctor (female masquerading as male) caught out after marrying a woman, who was "outed" in a pamphlet written by Henry Fielding.

Surgery started just after the play ended. First patient in was seeking to register his change of gender in order to get married to his long term partner, decades after adopting his male gender identity.

There are days when I wonder if someone "up-there" is having a laugh.