26 July 2009

Bad news: We are all going to die

It must be true because Karol Sikora says so. He says so in an excellent article which you can read here. Not a great supporter of socialised medicine, Karol Sikora does at least support the values of good general practice and calls for the return of Drs Finlay and Cameron. For once he is right. We are all going to die and we do need good GPs.

If the government had got less involved in the management of individual patients with possible 'flu and had left it all to the judgement of GPs Dr Grumble thinks the public would have been a lot better off. And if the powers-that-be hadn't wound the populace up and created all this hysteria the GPs might just have been able to cope. Most important of all the patients with 'flu-like illnesses would have had decent doctors diagnosing their problems accurately instead of window cleaners. Getting the Tamiflu out is not the important thing here. What is important is finding amongst the worried-well and those with flu-like symptoms those who really have meningitis or pneumonia or pyelonephritis or malaria or typhoid or one of the 101 other things in the differential diagnosis of influenza. How many will be misdiagnosed by window cleaners and given Tamiflu when what they really need is an antibiotic? We shall never know. But it certainly seems possible that the government's untested 'flu line is killing more people than it is saving.

Mrs Grumble who used to be a GP says there was no alternative. Dr Grumble is not so sure. He is sure Dr Finlay would have coped somehow. As it happens Dr Grumble has had two Dr Finlays who have worked for him quite recently. He asked if patients remarked on their name. Only if they are of a certain age was the unkind retort.

So, for those too young to know, Dr Finlay was the creation of the author A J Cronin who was himself a doctor. The books spawned a television series which Dr Grumble remembers seeing as a child. The best stories were early in the series and were written by Cronin himself. They always had a medical story line which challenged the diagnostic skills of any watching doctor. As the story evolved clues to the diagnosis gradually emerged and it would become increasingly apparent that the local village of Tannochbrae was suddenly in the grip of some terrifying and incurable infectious disease. Does that sound familiar?


DHS said...

Good general practice is a wonderful thing, and I wish we had it. A young lady presented to our A&E, sent in by her GP, having had 4 days of flu-like symptoms, for some oseltamivir.

Never mind that oseltamivir is not approved for that partiular indication, she ended up having a urinary tract infection!

Dr Grumble said...

I'm afraid we had the very same thing (except it was pyelonephritis) after a young lady, Australian actually, made the mistake of phoning one of the government's help lines instead of seeing a GP.

Anonymous said...

He is one of the three that let the
Lybian free. Lord Sikora or should it be Lord Karol.