Rebecca Smith : a service to British Medicine

There are a lot of coughs and colds around at the moment and so, once again, we are in the middle of the annual great antibiotic fight.
Rebecca Smith, the medical editor of the Daily Telegraph, has poured fuel on the fire of the general public’s eccentric views on medicine with her recent article entitled:
Stop giving antibiotics for colds, doctors told.
(Daily Telegraph)
I approached the article with anger. Rebecca, I am sure you meant well but, for the record, neither you nor Alan Johnson is in a position to “TELL” doctors what they can or cannot prescribe.
Then I came to the comments under the article.
I take it all back. Rebecca Smith has performed a valuable service for, amongst the sensible comments, there is the most glorious torrent of tosh from the lunatic fringe of the general public.
I quote from only a handful (verbatim, no corrections) of the comments. You, dear reader, must decide who is mad and who is sane. I could not possible comment - but would be interested to hear your views:
...GP's just cannot wait for the next moron with a cold to request inappropriate antibiotics. Like me they lie awake in eager anticipation of the tomorrow mornings tsunami of snotty brats & expectorant geriatrics. Actually, I was thinking of filling a wheelbarrow with amoxicillin & leaving it in my waiting room. This would free up more time to spend my undeserved & outrageous pay rise on a very expensive golf course...If you want to understand better the pressures family doctors are under during the “bad cold” season, pick the maddest ten comments, and then imagine having to listen to the writer in person for twenty minutes.
...YES, we have created superbugs with the overuse/misuse of antibiotics. we need to allow our immune systems to fight the viruses, then if we have leftover infections, THATS when we go see a doctor about antibiotics. taking antibiotics too often weakens our immune systems. antibiotics are for the bacterial infections left over from fighting viruses. they by themselves do NOTHING to fight viruses...
...Medical scientists including myself have been developing a safe alternative to antibiotics in the form of non-ionic silver-charged water which inactivates most viruses and bacteria. When ingested orally the silver atoms act only as a catalyst in the body (human and animal) and are excreted unchanged since even hydrochloric acid cannot dissolve silver...
...I have rarely given my children antibiotics. We treat colds mostly with raw honey, vitamin C, rest and plenty of water. They are rarely sick. My 12 year old only has missed one day of school so far. My youngest caight pink eye recently, I treated him with a homeopathic remedy and he was back in school after being out only one day and nobody else in the family caught it. My girl had a bladder infection a few months ago and we treated her with cranberry juice and chamomile tea. Everybody id fine...
...It is true a virus won't respond to an antibiotic, but the secondary infections of bacteria WILL, and many times if left untreated by a stubborn doctor will lead to pneumonia and death, usually in immune challenged patients like asthma as I have. AND, yes that did happen to me and I nearly did not escape death. It took 6000 dollars of hi tech antibiotic to finally beat it...
...Good Dr.'s know better than to over-prescribe antibiotics. That's all that needs to be said. Keep the Gov't and corporate bean counters out of health care decisions and life will be better for all of us....
...In a 5 month period of time one child was on a series of 7 anti-biotics. At my pleading before they went there, they agreed to see an alternative/pharmicst/naturapathic doctor. He immediately removed all anti-biotics and steriods, along with all sugar and wheat products. Natural herbs and supplements along with vitamins and a diet of fresh fruits, vegetables and yogart. Fevers disappeared over night and within a few days of the changes the improvement was startaling. Their health has been good now for two years. They continue on the diet and herbs and supplements and allowed a small sugar and wheat back into their diet. No fevers, minor colds, no ear infections or sore throats........no anti-biotics. They now have a pediatric homeopathic MD. I could go on to share the harmful effects on my elderly mother from anti-biotics as well as...
...If you have to take a anti-biotic, take a pro-biotic to balance it out and keep your gut healthy. I take Primal Defense by Garden of Life...
..Its disturbing to read comments from Doctors who blame so called "patient pressure" for the reason they prescribe antibiotics when they don't need them. I can't imagine what kind of spineless coward would fall to such pressure from a patient...
...As usual, Brown's government is trying to blame doctors for MRSA and C. Diff. What they should be blaming is their own policies of hospital overcrowding and flogging off hospital cleaning services to the lowest bidder...
...Whenever I have a cold I dance around a tree three times, look up to the sky and say McBean, McBean, McBean, the cold usually goes within a few days. I recommend this remedy rather than attend your local GP lottery...
...This article overlooks a very serious overuse of antibiotics, and that's the use of massive amounts of them in animal feed and via direct administration...
...Now I know why I had to practically beg a doctor for antibiotics yesterday! After four weeks of investing in self- medication to alleviate every type of cold symptom, plus coughs, sore throats, pains in ears & swollen glands; decided to admit defeat & accept something stronger was required, if this infection was to be 'killed'! A trip to the docs was now called for...... My husband has been suffering for nine weeks with similar probs. The doctor made no attempt to listen to how long I'd been living with 'cold syptoms' or what they were, just say the word 'Cold' & the doc. knows what the system is... Cursary check of ears, throat & temperature, stethoscope on the back & immediately he launched into 'It's a virus etc.' but I was too tired to listen or accept this...
...The level of understanding about antibiotics in the general public is hideously low. Here in America I am constantly asked by lay people for antibiotics to treat viruses and common ailments that antibiotics wouldn't affect. If I refuse, then I'm a "bad, heartless doctor"....
Every experienced family doctor in Britain has met all of these correspondents. On a bad day, you might see half a dozen of them.
Now you can share them with us and perhaps then you will understand why doctors can never win.
Labels: bad colds, strong antibiotics









39 Comments:
Like it or not, MPs *are* in a position to, if not exactly tell, then strongly direct what doctors prescribe. MPs, via the taxpayer, pay your wages.
As you say, GPs cannot win. That's because you are not in a fucking competition. Listen to your patients and prescribe as you feel appropriate within the bounds set by your paymasters. GPs have prostituted themselves to the State and done very nicely by it. Now do what you are told and shut up whining 'the plebs don't get it!'
there is nothing that a good drop of rum won't cure apart from getting your head removed.
or by the way cookie you are a twat.
john gibson
Dr C, I thought you'd have been spoiling us today with your take on Lana Williams' attempt to badmouth GPs:
http://blogs.guardian.co.uk/joepublic/2008/01/gps_are_crying_wolf.html
Especially considering her recent attitude toward the ever-helpful amdsweb:
http://www.admissionsforum.net/viewtopic.php?t=2391&start=15
Do you think the Dean of Queen Mary medical school should have words with her? Do you think she should be GMC reported for defamation?
Get ye back to DNUK and catch up with the gossip!
Jesus Cookie. Who pissed on your breakfast this morning?
Yes Cookie you are mad, there are treatments for Paranoia get some help,
Stu.
Oh aye, Spider_monkey has ants in her pants alright. It's a real shame when promising youngsters turn nasty. They do themselves no favours. Peraps she's not getting any right now, and wants to take it out on GPs and adamsweb
I suppose Cookie you are the same one who posted about auto-euthenising the poor psychiatrically ill boy David in the good doctors diary to conserve funds for more "deserving patients"? You are a cleft of the lowest order, but at least your the most honest NuLabour drone I've ever had the misfortune to read.
Doc,
Please, please tell me you made up the "...Whenever I have a cold I dance around a tree three times,..." comment yourself as a deliberate plant or I swear I'll cry at the shear prospect of this idiot voting.
Yours was one of the first blogs I ever read, temping in the NHS for excellent doctors under misanthropic sadists and trolls; it is good news that your back, though its a pity the ministerial pickings are so slim this time...
Please, please tell me you made up the "...Whenever I have a cold I dance around a tree three times,..." comment yourself as a deliberate plant or I swear I'll cry at the shear prospect of this idiot voting.
+++++
No, I did not make it up.
Please please please read the comments under the article yourself. It is the most wonderfully entertaining 10 minutes
John
Dr John Crippen
Dr C, I thought you'd have been spoiling us today with your take on Lana Williams' attempt to badmouth GPs:
http://blogs.guardian.co.uk/joepublic/2008/01/gps_are_crying_wolf.html
Especially considering her recent attitude toward the ever-helpful amdsweb:
http://www.admissionsforum.net/viewtopic.php?t=2391&start=15
Do you think the Dean of Queen Mary medical school should have words with her? Do you think she should be GMC reported for defamation?
Get ye back to DNUK and catch up with the gossip!
Thursday, January 10, 2008 8:48:00 PM
++++++++++++++
I really have not been following the blogosphere for a while. I will check this out
John
Dr John Crippen
Oh no. Are we back to slagging patients off? The 'poor doctor under siege from idiots' whine is getting SO old.
And the 'doctors won't be told' comment was funny- when you consider how easily doctors have been fooled into swallowing the IAIYH crap about ME/CFS for example, a lot of which has come from 'official' sources, including the NICE guidelines- about to face legal challenge. Or the "computer says tell patient off for being a greedy lard guzzling pig- even if they're not" instructions from the government that brings in some nice cash with each box ticked...
Why does this happen? You are ill, the doctor says it is a virus. So you don't take antibiotics, because they are for bacteria. After a couple of weeks you are not better. Then sometimes the Dr gives you antibiotics.
ISTR that happening to me/my family a couple of times. Maybe I remember it wrong.
K
Last time I had antibiotics was after my c-section 11 months ago...7 weeks worth of antibiotics because of infection and I simply got worse.
In the end,I asked them to send off a swab to find out what exactly was going on,asked him wha alternative things i could do at home (he suggested salt water baths) and within a week was feeling better.Turns out my infection was "anaerobic" and they got the meication wrong :/
I dont blame them though,I blame myself for not getting clued up about what was going on in my body.
I saw my doctor MORE over those 7 weeks than I had done in 3 years!
I feel sorry for the doctors.They always get bad press :(
"BACK" to slagging patients off?
I think not!
GPs are currently being blamed for causing C. Diff and MRSA by prescribing too many antibiotics for bad colds.
You have NO IDEA of the pressure we are put under to prescribe inappropriately.
I am not slagging patients off. I am drawing your attention to an article written by someone else which has attract comments some of which typify the kind of intellectual approach with which we have to deal every day.
Remember, as doctors we want to please people; we are human; so when someone wants a treatment that we know is inappropriate, it can be difficult.
John
Dr John Crippen
Are they blaming MRSA and C. Diff on the GP's?
I've read too many stories about NHS trusts keeping patients in hallways, taking the wheels off the trollies and calling it a "bed admission", and (I can't believe this one) turning over sheets between patients instead of washing them.
These practices seem more likely to give us the outbreaks you see in hospitals.
........arf
Arf
I'm no microbiologist, but the popular perception is that, whilst MRSA & C diff (& norovirus &..) may be spread by the things you suggest, it is overprescibing by hospital juniors and GPs that has created these monsters in the first place.
Scientist
Dr Crippen
"I am drawing your attention to an article written by someone else which has attract comments some of which typify the kind of intellectual approach with which we have to deal every day."
Yeah but.
Firstly you call the comments 'mad'. Which means nothing. I looked through the comments- exactly what was 'mad' about them?
Secondly, 'intellectual approach' is not the issue here - and you shouldn't have made it so. People go to you because they have a problem. They might be wrong in what they assume about the illness (not always- many GP's knowledge about ME/CFS being much less than patients, a case in point) but it's not 'mad' 'intellectually wanting' patients we're talking about here. It's people with health concerns who want them addressed.
You're constructing people who might challenge you as mad and stupid and annoying.
One of the big problems with your blog has been that sort of treatment of people like patients and other health professionals.
But this points to another, bigger issue: why is trust in doctor expertise waning amongst the general population (as it appears to be even just from your own claims about patients coming to you asking for 'inappropriate treatment')?
One of the potentially most far-reaching grave diagnostic errors of medical practice has been that of 'psychosomatic illness', in all its forms. These diagnoses are not based on sound science, and trap the patient in a cycle of contempt by doctors and refusal to investigate the prodromal condition or even subsequent conditions, with far too often a subsequent progression into severe illness and sometimes premature death (I'm not just talking about ME/CFS here).
When patients are faced with doctors who actually believe in this 'psychogenic illness'- while the patients' bodies show all the evidence otherwise- confidence in the doctor's abilities wanes. This sort of problem might explain at least some of the more challenging of doctors by patients (there are other reasons also)
With the advent of doctor blogs- we've seen some pretty horrendnous behaviour towards patients in recent years. The 'bad, stupid patient' construction is excrutiating. I had hoped your sojourn had made you a kinder, gentler Dr Crippen, and that you perhaps had learned that there are far more productive and useful ways to construct patients in your narratives that acknowledges their dignity as human beings, while also learning doctors are not omnipotent, do not know everything about health, and can learn an awful lot from other members of society, even the person sitting in front of them asking for their help.
"I've read too many stories about NHS trusts keeping patients in hallways, taking the wheels off the trollies and calling it a "bed admission", and (I can't believe this one) turning over sheets between patients instead of washing them."
I believe that. I have seen worse at my hospital. They are forcing us to put patients in closets, day rooms, and won't even give us a chance to clean it because they are afraid of breaching targets.
They forced me to admit a patient into an abandoned room where the tiles had caved in months ago and rain was leaking into basins on the floor. I refused and got called into the office and whilst I was there they put the patient into that room.
We also run out of linen pretty regularly and cannot get a hold of any. One day we snuck across to the ward next door and stole all of their's which wasn't much. We made one ladies bed up with pillowcases only and pads because it was all we could get a hold of.
Who are these people? I'd have to have a lot worse than a cold before I tried to get an appointment to see a GP. Fortunately I enjoy excellent health. I put it down to the wonder that is beer.
All very important and interesting but the thing that gets me is...'We treat colds mostly with raw honey, vitamin C, rest and plenty of water' - RAW HONEY? What other kind is there? How do you cook it?
...Whenever I have a cold I dance around a tree three times, look up to the sky and say McBean, McBean, McBean, the cold usually goes within a few days. I recommend this remedy rather than attend your local GP lottery...
Sounds like very sensible advice to me, do much the same myself - I certainly wouldn't dream of pestering my GP over a bloody cold! Mind you, the incantation that I use contains rather more "robust" terms. :-)
Actually Tomrat - I thought the "Dance round the tree" comment, whilst bizarre to say the least, not a bad one at all - as he (she?) said "my cold *usually* goes away in a few days" well of course it does......
My GP told me that he can treat a cold and it should then clear up in about 7 days, or he can leave it alone, but if so, it will take maybe as much as a week to clear up!
:-)
Steve
Scribbler said..
All very important and interesting but the thing that gets me is...'We treat colds mostly with raw honey, vitamin C, rest and plenty of water' - RAW HONEY? What other kind is there? How do you cook it?
You know, I wonder the same thing when the news says something like "The beach was covered with raw sewage"
What is raw sewage please? calling it raw suggests that someone out there is cooking the stuff! then it would not be raw - well that's what goes through my mind every time
Shall I get my coat?
Steve
...Whenever I have a cold I dance around a tree three times, look up to the sky and say McBean, McBean, McBean, the cold usually goes within a few days. I recommend this remedy rather than attend your local GP lottery...
******
Well, I took this comment as a quite sensible effort to show us that just about whatever crazy remedy you take for a cold, it is a self-limiting problem and will go away in a few days, regardless. i.e., (in case the above wasn't clear enough) I don't think that commenter actually does those crazy things, but rather was poking fun at the way people brag about their crazy remedies and how they got rid of their colds within a few days... quite a good comment, I thought.
For the record, when I have a cold I avoid the doctor and try to take foods that are thought to have healthful qualities, like ginger, various herbs and spices in food, honey (just regular honey), dark green veggies, things containing Vit. C, etc... maybe it just gives me a psychological boost, I don't know. I hope this approach doesn't sound TOO crazy to you... but never mind, I like it anyway...
We used this approach, plus Vit. E and C that I bought cheaply, *in addition to* all doctor-supplied remedies (anti-virals, daily Vit. B12 injections at the clinic, etc.) recently when my husband had shingles. I really made us feel better to know that we were doing everything we could both on the medical front and on the nutrition front. Luckily the shingles attack passed quickly with no major problems.
It's nice to see you back!
Ah yes, the "colloidal silver" panacea.
Check out the "blue man" here
http://msnbcmedia2.msn.com/j/msnbc/Components/Video/080107/tdy_snyderman_blue_080107.300w.jpg
to see a lovely side effect.
See here for article:
http://www.foxnews.com/story/0,2933,317564,00.html
Recently a student nurse had a coughing fit in front of some relatives. They promptly told her that she shouldn't be a work as she would be spreading MRSA all over the patients on the ward. Having spoken to them myself, I thought that I had diffused the situation. Today in my in-tray, a complaint from said relatives about the standard of care on the ward. Well actually a complaint about the fact that the patient only had two pillows and was made to walk to the toilet. I have to answer this within the next two days and then will have to have a meeting with the unit manager. The same unit manager (no clinical background at all) who just last week refused to let me have any agency staff and wants to introduce a "quota" system for linen. I continue to fill out the IR1s to complain about staffing levels but am fairly sure that they just end up filed in the bin.
Dino Nurse can I use your post on my Blog?
Okay signed in now. My whole blog is about the intentional short staffing on the wards and why that is the sole reason for crappy nursing care.
http://militantmedicalnurse.blogspot.com/
I am currently compiling as many of these stories as I can because I know it is just not my trust.
Dr. Crippen I apologize for the hijack and hope I'm not out of line. I just wanted to grab Dino Nurse as she is here.
I saw and experienced the pressure GPs are under from patients to prescribe antibiotics this morning. I had a surgery all to myself this morning, my first as a 5th year med student.
One patient, who'd had a cough for a week was determined to get some antibiotics, I tried to explain that it was probably viral but they were having none of it. The doctor came in and tried to explain exactly the same thing but found it very difficult.
They went away empty handed in the end but they were far from happy about it.
I had a horrible run of colds before Christmas, accompanied by infected sinuses, dark phlegm going down and coming up - horrible. Luckily my dentist prescribed amoxywhatsit for an abscess and lo I was cured of the horrors too.
Mind you, I've still got a persistent dry cough: any advice gratefully..
stop the ace inhibitors, and start a PPI
here's an outrageous thought but, why doesn't the government instead of bullying doctors and nurses, spend a little money and teach the general public about their own health, that a cold is most likely a virus, that not everything that happens to you requires a GP.
But that would be too sensible wouldn't it?
But what about when GPs prescribe antibitoics that are clearly not needed. I had to ring my surgery last year and ask why the chemist had shoved a box of trimethoprim through my door when the result of the urine culture had clearly said antibiotic therapy not indicated unless septic. Response was "Dr says take them so you don't get sick". I told her to tell "Dr" that he'd had the results for 10 days before doing anything and so if I was going to get sick, it would have happened by now.
This was the same Dr that then made me make an appointment to discuss my blood results, as my HB was 11. I told him that was perfctly normal for me, and that the only reason he had called me in was to get more QoF points (he instsed on taking weight and BP). He spluttered and said nothing!!
I assumed the dancing round trees comment was someone taking the piss out of the others.
given the length of time it takes from illness onset, giving it a while to go away on its own, giving up and trying to get to see a doc, fighting the good fight against the stroppy receptionist, long wait for appointment, by the time I'm in front of the GP the likelihood is I do need an antibiotic
i know ive left chest "infection" for a few months and it goes within two days of starting antibiotics, so ive done my bit for trying to avoid the pills
docs are on a loosing battle cos access is so poor in much of the country that people really do need a prescription cos waiting another long wait to see doc again if it doesnt clear up is not viable
John, it seems that nurses aren't the only ones running wild with patients and having their own clinics these days - even the unqualified can have a 'surgery'as The Little Medic tells us above:
'I had a surgery all to myself this morning, my first as a 5th year med student.'
Something must be done to protect patients from this dangerous pretender. Perhaps a nurse practitioner could sit in and supervise him, at least then someone qualified to provide health care would be in the room.
I've found that a hefty allergic reaction to an antibiotic is a good way to reduce their use!! I would have gone to the doctor in the past with bad throat etc. Now I go to bed with lots of drinks! Seems Grandma may have been right :)
i have a stone which keeps away tigers! anyone want to buy it? anyone? It really works , i have never been attacked by any tigers
I particularly enjoyed the blue man / colloidal silver story. FWIW, the comment about probiotics with antibiotics to reduce associated diarrhoea, even unto c.diff is gaining some evidential support.
Post a Comment
Subscribe to Post Comments [Atom]
Links to this post:
Create a Link
<< Home