Tuesday, January 6, 2015

To clarify

You must have noticed it, haven't you? The words that were uttered in black humour, with a wink and a dash, words which were said in closed quarters at the end of a busy day, words which came forth over the nth pint...it's all quite openly spoken now. It's the patient..or rather the fault of them. Their fault they waste doctors time, nurses time, ED time..inappropriate, awful, wastage of precious time of healthcare professionals. Trivial issues brought forward..how dare they ask for help.

And it opens a Pandora's box, doesn't it? We have all seen the patients we deem are unsuitable, the drunks we have encountered in ED queues, the ones who forgot their prescriptions and needed better planning- but in a system which treats millions- the question has to be what proportion of that are what we term as "time wasters". We ask, no, demand that the public should look after their health better and bother us less, yet how many times have we followed the mantra of regular exercise and the healthy diet we are so quick to profess? As a Diabetologist, I look at HCPs everywhere and can only say this...practicing what you preach ain't easy, so why be so quick with the judgements? Some of the recent Twitter exchanges have been uncomfortable..challenge is good but with respect too, right?

It's a difficult argument and there are many fold reasons why the system is creaking but from my own perspective, blaming patients ain't gonna quite help. Making people feel guilty about coming to see a healthcare professional ain't the way ahead in my book. I have recently been to ED and yes, I have seen folks who perhaps could have gone "elsewhere" but how is it their fault that we have so many avenues to access when ill? How is it their fault if 111 follows an algorithm and goes down the risk averse route to send them to to ED? How is it their fault that the out of hours GP is too swamped and has a waiting time of 6 hours to see them? Blame anyone, blame ourselves for not being adult enough to work together, blame leaders for never quite getting out of their silos, blame politicians for not being honest with the overall situation, blame anyone but don't make people feel guilty about seeing us.

I write this with a bit of sadness after recently seeing an elderly lady who tried to stay away from GPs and hospitals while trying to manage her COPD. She said she didn't want to bother her overworked doctors, she said she had read a blog which said patients needed to self manage better. You know what? The message maybe the right one, but that is not the patient we are trying to educate, this is the wrong message gone to the wrong person. What do we call her now? Stupid for not understanding the message of the article? Or kind for trying her best to help out her poor doctor?

I urge all to be careful with the rhetoric. It's easy to shift the blame, easy to blame all...let's leave the patient out of this one, shall we? Today, categorically, via my blog, let me be crystal clear. As a Consultant in Diabetes and Endocrinology who works across organisations, any patient who is under my care, I do NOT want you to feel guilty about contacting me. I do NOT want you to feel you are disturbing my peace by asking me a question which may keep you safe. I do NOT want you to go without your insulin if you have lost your pen and then worry about disturbing the overworked doctor. If you want help, ask...an email or text is easier to do rather than you being admitted in ketoacidosis. If it is within my power, I will help. I cannot speak for anyone else, I certainly can't speak for GPs who are far busier than me but I can certainly speak for myself. If you are stuck, call me, email me, leave a message with our administration staff, I will help to the best of my ability.

Let me end with a disclaimer too. This isn't a blog lecturing others, this isn't a swipe at those once-motivated individuals who feel so beaten by the system that they have now turned part of their ire against patients. This is to simply establish one thing publicly for patients under MY care. I don't want anyone admitted because they felt I needed a bit of respite. If it's an inappropriate request, I will point it out with humour and a smile. In 2015, I am trying my best to be more mellow and smile a bit more.
As the saying goes..everyone is going through something you don't know much about..and no one speaks on my behalf when they want you to "go away". Amen

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