Quacktitioner Alert (6)

Quacktitioner tales are flooding in. Do keep them coming. I shall continue to highlight the worst ones.

This from a NHS BLOG DOCTOR commentator:

"Whilst at a meeting yesterday, I got a phone call from my wife, who had been rushed to hospital by her optician. Over the last few weeks, she has been having problems with her eye - migraines and over sensitivity to light. She decided to have an eye test in the UK, as it is considerably easier than having one in French (we recently moved to parts foreign) and we have had this trip planned for some time. Her optician noticed some retinal damage that was serious enough to be immediately sent to an eye emergency department. Indeed, so urgent that she suggested my wife didn't go home first - but go straight to the hospital in a taxi.

Upon arriving at the hospital, she was told quite bluntly by a nurse quacktitioner that she should see her GP, it might not be very serious and even if she was referred to see an eye doctor, she would be waiting a long time.

The nurse's 'advice' was based on two tests - how my wife's pupil reacted to light and whether she could follow the nurse’s finger with her eyes.

• She did not look into my wife's eye to check the retina.
• She wouldn't arrange an appointment with a specialist,
• She would not refer my wife to a doctor of any kind, despite the optician advising my wife (who did look at her retina) it was the worst case she had seen and would probably result in an urgent operation.
  

Effectively, the nurse didn't know what the problem was, didn't know what caused it, didn't know what treatment she should have, didn't know how seriously it should be taken, whether any long-term irreparable damage was present or indeed whether anything could be done in the meantime to prevent any further damage.

Obviously, the quacktitioner didn't have 'retina damage' next to one of her check-boxes, or in her list of 'what tests to do given symptoms'. So we have paid for a private consultation to be carried out tomorrow, by the very same consultant that works in the department my wife was sent to, but was not allowed to see. I don't expect my wife to have an operation the next day. I also don't expect my wife to even see a consultant the next day. But I certainly don't expect my wife to be told to go home by an under-qualified quacktitioner who hasn't even examined her."

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Yes, I have had the same experience, as have many of my partners. The local eye department is front-ended by nurses. They do not have the training or the experience to examine the back of an eye. This examination is called fundoscopy. It takes years to become competent at it. Nurses cannot do it, so they do not think it is necessary. We send patients with urgent eye problems further afield now to ensure they see a doctor who is trained in ophthalmology.

What is this?

Opticians are good at fundoscopy. They do it a dozen times a day. It would be fair to say, and no disrespect to opticians, that sometimes they over-react to minor abnormailities, but nonetheless they perform a valuable screening service. They are, for example, perfectly capable of picking up detached retina. Early diagnosis of a detached retina means the eyesight can be saved. Look at the picture above. Did you spot that it is a retinal detachment? Why not? You have had as much training in retinal pathology as the average nurse

No doctor in his right mind ignores the worries of a experienced optician.

As always, nurse-specialists do not know what they do not know.

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Original story from AJD - home page here