Safety first or last?

Someone seems to have stuck a stick of dynamite up my GP’s backside and blasted him into the 21st century. Last month, out of the blue, the receptionist told Adam, that they now have a website through which we can now order my prescriptions and book appointments, without having to phone. I checked it out with total excitement, yes, my world has become that limited, and when I read the leader page, my excitement grew. There was my dream, access to my personal files. It didn’t last long, as it turns out it is up to each GP individually to decide if they want to open our notes this way or not, mine has chosen the not. I had also hoped that I might be able to request a phone call, since clearly I don’t need appointments, but no luck there either. On the good side, we can at least put in the prescription requests.

Then yesterday morning, the phone rang, it was a call from my doctor, well not quite, it was from the surgery number. There was this woman who introduced herself as the practise pharmacist. I wasn’t even sure that the practise employed a cleaner, far less something as posh as a pharmacist, so I was somewhat shocked. No, I’m not implying the building is dirty, it’s just I wouldn’t have been surprised to discover the receptionists were also the cleaners. Anyway, the pharmacist was calling to check that I was taking the correct dose of one of my drugs. There was an error in the dosage on her screen which I had spotted on the pack when it arrived here. Because I knew what I should have been taking, I had ignored it, but she sounded as though she was more than a little concerned and told me that I must only ever take one puff twice a day, not the two on the label. It was clear from the quantities we had been ordering that that was in fact, what I was already doing. It set me thinking about who is supposed to check what, as accidents can undoubtedly happen, we are all human after all. This one, surprised me, though, as I have been on that inhaler now for well over two years, and it has been supplied by at least two different chemists. The original prescription had been requested by my consultant, my doctor then wrote it up, and it has been in the hands of several pharmacists, but suddenly, out of the blue, one stopped and checked it that bit more closely, what happened to all the others?

We automatically assume when a drug arrives in our hands, that we have the right drug, with the right dosage instruction written clearly on it. I have never once, looked further than that. I’ve never checked online to see what the recommended dosage is, or questioned anything about any drug when first prescribed. I suspect, the same can be said for all of us, we assume, we expect and we believe that it is always correct. I know that in the past on two separate occasions a chemist has refused to fill one of my prescriptions, without first talking to my doctor. On both occasions, it has been the same thing, the very high dosage of steroids that I at times need for flares. They both wanted to double check them, as the dosage is off the scale for most people. That, I believed until yesterday, was the safeguard, the pharmacist. This time, I was lucky, when I started taking it, I remembered what my consultant had said about it, and how to take it, so I knew. That was pure luck, as normally, I remember nothing and by now I could have been taking a double daily dose for nearly 2 years. It appears that all our medications safety relies on, is luck. Is that really a good thing to work with, just luck.

Lately, we are being repeatedly told that if you can’t get an appointment with you doctor, and your condition is minor, to consult your local pharmacists. The TV ads portray this well-educated person, just a step below our own GP’s, who’s knowledge is vast and that we can trust, trust to prescribe us the correct treatment for what ails us. Long long before those ads appeared, in fact, for a lot of my adult life, that is exactly what I have done, for anything not serious enough for a doctor’s attention. I’ve watched them filling prescriptions, two of them side by side, apparently checking all is correct. I have even seen some, flicking through drug manuals, I thought to check dosages or any detail, they were uncertain about. For 2 years, my prescription has been in the hands of what must be dozens of these professionals, yet only now, one spots the error? Why?

In this case, there was no danger, but it could have been a very different story. There are a million and one drugs out there that could have killed me long ago, some of which I am actually still on. It has made my realise that maybe, just maybe, that in the future it might just be worth checking ourselves, something that these days, it’s easy to do. At our fingertips, is the exact same information those well paid professional use daily. Putting in one more check as we start yet another new drug, might just save us problems in the future.

 

Please read my blog from 2 years ago today – 17/03/2014 – Still longing

I used to think that when I grew up I would know the answer to everything and that my life would flow smoothly as I would have nothing left to learn. It’s amazing just how wrong a child can be and how far from even scrapping the surface I am from actually knowing anything. All of us have a million questions daily, some small, some amazingly big, but in our minds at the second they appear they feel just the same. I never got the chance to do so many things in my life that I wanted to do, not because anything really stopped me but more because life just took over, time pasts and somehow those things just became unimportant. The places I wanted to go, the……

 

 

 

 

 

Lets change the system

I have thought a lot over the last few days and the more I think about the more I want to restructure the care of the chronically ill by the NHS. I can’t talk at all for other medical system but my idea could work anywhere I guess. There is one major issue with our care and that is the damage that is done to us by just making a visit to a hospital or to a surgery. We are locked into the now old fashioned routine that we have to be seen face to face with the doctor we are consulting with and I can see no reason why that has to be. Unless a doctor needs to actually examine you I don’t understand why a consultation can’t be done by skype.

Think back say the last 10 times you have been to see a doctor, any doctor, how many of those 10 times did you wasted time and money traveling to see them and they didn’t lay even one figure on you, you told them what was wrong and they wrote a prescription or referred you on, or worse still smiled and said right I will see you in a year, after you having sat in the waiting room for over an hour. The result of that visit if you have a chronic illness is always, regardless of what was said, you are exhausted and take days for the physical effects, your health dips, the opposite of what I hope all doctors want to achieve. Isn’t it about time that they all entered the 21st century and were the patient has a web cam, which I am guessing the majority do these days, that all consultations are completed on line, should an examination be required it could then be arranged for a trip to their clinic. I expect though that at least 90% wouldn’t have to see anyone. I also expect that the result would be a savings for the Doctors on the time it takes to do there clinics as well and saving costs as well.

I know I would be happy myself to never attend a hospital ever again and a few minutes on line would be perfect. From the point of the NHS I bet that the waiting list would go down as more people could be spoken to daily than it is possible to see face to face, not to mention less transport cost as well. I have heard of a similar system being used for those who live in remote locations, why then can’t it be done for those who also have problems with mobility and health that reacts badly to exertion also be treated in the same way. For years now I have managed to more than cope with not seeing my GP, but just talking to him on the phone, why should it be any different when it comes to hospital consultants. First visits I can see that yes a doctor would want you to be there, as it is normal for some sort of examination, but for follow ups it is a case of normally talking and talking only. The consultant themselves could suggest a phone or skype follow up instead of a clinic visit, so they would be setting it up with those they feel would benefit from it. I am sure that the cost of transporting one patient to the hospital for one visit, would cover the cost of one web cam, the savings would be from then on.

The world is changing, the technology is there and is cheap, and the health benefits I think would also be huge. I was at the hospital on Friday, it is now Monday and I am still not completely back to how I was, but if my consultation had been on web cam, well I would now be fine. I see nothing but a win win situation and I can’t understand why it isn’t happening now.