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Can we trust

....the doctor ?

Female
Cassis  Female  Cambridgeshire 2-Oct-2019 01:41 Message #4755616
Listening to the recent reports of women's heart attacks being misdiagnosed and leading to unnecessary deaths, it got me thinking about how many conditions can be overlooked, or put down to something else, just because the patient doesn't fit the popular norm for a particular condition. That's scary.

I've had that happen to me with serious consequences (meaning "clinical death" on the most serious occasion) 4 separate times, because I didn't fit the usual patient profile.

Have any of you been a victim of this? Shouldn't this be rectified as immediately as possible? If so, how?
Female
RAACH84  Female  Buckinghamshire 2-Oct-2019 09:09 Message #4755640
I’m sure doctors make many mistakes because diagnosis can be almost impossible. Doctors are a lot more knowledgeable and professional than in the past but are also under much more scrutiny.
Female
Ilsmileforu  Female  Durham 2-Oct-2019 09:11 Message #4755642
I have had an experience a few months ago.
One emergency Doctor made a decision after doing lot's of tests ,then told me his opinion, which I agreed with.
The next morning a Doctor who did no tests decided I had not got the medical condition after reading the tests the other Doctor had done.
They could try listening to the Patient, instead of not doing any tests.
Male
Neros1954  Male  Devon 2-Oct-2019 10:32 Message #4755649
We need to trust our doctors and it's worth finding one we have confidence in. A lot of friends i've heard complain about their doctors diagnosis have already looked on Google and decided what they have before asking the doctor.
Female
wonderoushen  Female  Gwynedd 2-Oct-2019 11:17 Message #4755659
After menopause women no longer have the protective effects of oestrogen and are as vulnerable to heart attacks as men. I used to find that any problem I had between my waist and my knees was always assumed to be reproductive and if not that then psychological in origin, I used to have really bad IBS and it was often ignored in favour of a reproductive system ailment. I had a grumbling appendix for years, possibly from childhood which was undiagnosed, despite numerous visits to the doctor, I think it was A-typical smptoms that stumped many doctors, but to not even refer me on for further tests? When I had an ectopic pregnancy and had emergency surgery for that they checked my appendix which they said they did routinely if they had your abdomen open, because its much easier to remove it if it looks bad, which they did on me, as they said they were amazed that I wasn't having symptoms already and another 6 months and I would of been in again for more emergency surgery. The ectopic pregnancy was misdiagnosed by the on call GP, in those days it was one from my own surgery rather than a locum, initially he refused to come out twice and had to be told by the ambulance service to come out to me, when he arrived he was steaming drunk, said I had a bladder infection and left a handful of painkillers on the mantle piece and he'd send my normal GP to me in the morning. She took one look at me went white and called an ambulance. I turned out that I was lucky not to have died as I was bleeding internally and having convulsions from blood running under my lungs.

Ever since then I've been very careful in who I see as a GP and the last few have been ones I trust with the exception of most of them when I was at uni, there were two of them who were of any use, the others would either prescribe penecillin when I'm allergic to it, didn't believe anyone was allergic and would take any reference to it off my notes. There was another who would say he'd refer you on to someone else and not write letters and another who thought anti-depressants were something you could take the odd one or two of when you felt bad. The student nurse would routinely put people on anti-depressants when they weren't needed, it was a running joke that you went to her with a cold and came out with anti-depressants. The local hospitals were so used to the general crapness of our GP's that if you ended up in A&E with something that should of been treated by a GP or refered on, that they'd ask no further questions about why you were there and had been untreated for so long.
Male
brisinger  Male  Lancashire 2-Oct-2019 12:25 Message #4755668
I find that is a person already has a medical condition they have a tendency to "blame" it on that. It's happened to me a number of times. On a number of occasions recently I've caught them out blaming things on LO's Alzheimer's. Just now A&E Dr's were so keen to blame symptoms on Alzheimer's that they discharged her only for it to carry on an her ending up in a level 4 coma.

I had it myself when they have been keen to blame it on my epilepsy.
Female
NoSaint  Female  Devon 2-Oct-2019 14:39 Message #4755694
There is a tendency to blame medical conditions on a present illness or smoking or obesity. they will choose the most obvious causes first.
Female
JustLyn  Female  Cheshire 2-Oct-2019 15:44 Message #4755702
I have worked for GPs since 1999 and have little faith in them.

On the other hand, they mostly have only 10 minutes per appointment and patients' expect a full body scan for a lot of things. If a GP is seeing mundane coughs and colds over and over again that shouldn't even be going the doctor, then by time they are running 30 minutes behind, it is difficult to "see" little things that might stand out.

In the past, I have been told by GPs to stop checking for diabetes because it means they have more diabetes to look after. Even my health care assistant once asked me if the lead GP (then) knew how to check blood pressures because he always got a lower reading than all the rest of us.

From blood letters and low status, doctors, have propelled to very high status, in my opinion, beyond what is humanly possible. The public, we, expect an exact science and guarantees every test tells us what we want to know in our instant gratification society.

I do think it is something Artificial Intelligence has to offer because such a system can go through so many potential algorithms, but we will likely always need a human eye to pick out the obscure where experience and gut feeling can go off at a tangent.

When I worked for an out of hours service we used what used to be known as an "expert" computer system where we had to ask, sometime, the most idiotic questions but it was good in a way because it forced professionals, who might be tempted to cut corners. Nurses who do "advanced practice" are trained to follow protocols, but GPs have more prerogative to short cut those and make a medical decision which unfortunately, in my opinion, gives SOME of them a bit too much power and leeway to be more arrogant than skilful.

I don't agree with patients knowing the answer always either, though we have to respect now we have expert patients which are great, because we negotiate how to proceed. The problem patients are the mystical ones who get off on the wrong track and I keep insisting something is causing something when it is not related at all.

Of course it is right to dismiss the obvious first, as diagnosing is usually a process of elimination rather than the other way round. The NHS spends a fortune testing things we know are going to be normal, but we have to exclude the obvious and not assume otherwise.

You have to remember that a dozen things can all cause the same symptoms.

Even though I am not medically trained, I am often picking things up inadvertently such as abnormal full blood counts on a routine test for something, then the patient might have zero symptoms at that point and have leukaemia, or one today sadly, lung and prostate cancer.
Male
tumbleweed  Male  Gloucestershire 2-Oct-2019 15:55 Message #4755704
I don't want to be too critical of them....but...

There's always a 'but'.....there are mistakes made unfortunately...Not just the Doctors, but hospitals and all....

In general they try to do the best I think...but some are pretty stubborn and headstrong...They know best...they won't listen to you...various things...

In the last few years my health has deteriorated fairly badly, so I have been a part of the 'system' ( Dr's and hospitals ) more than I would normally be....Without them, I wouldn't be alive now, but I've also had a fair share of issues with them...I had to go through Oxford PALS twice and Gloucester PALS as well. ( PALS - Patient Advisory Liaison Service )

One of the annoying things with Doctors appointments is you only get 10 minutes with ours...You can sometimes book a double, but I feel I need a treble at least at times...The doctor who initially got me to hospital, has unfortunately had to leave as she became very ill herself...hope she is ok...so when I've seen a Doctor in the last year or so, it has sometimes been locums...I haven't got a regular one at the moment, as I've been seeing the Heart Nurse and the hospitals.....The one I saw a few weeks ago, it was the first time seeing her....She was annoyed that I had too many things for her to deal with...not heart related, as that is being dealt with elsewhere...but a leg problem amongst other things...Although I came away with a blood form and an x-ray form, which was good, I didn't get time for any of the other things....so they are still unanswered...
Male
terry  Male  West Yorkshire 2-Oct-2019 20:56 Message #4755751
I'm torn with this, doctors at hospitals have saved both my son's and my ex wife's lives, for which I am eternally grateful; it falls apart a bit when I go and because I freely admit to having smoked from age 15 and despite numerous attempts to, am unlikely to stop; they seem to lose interest in checking for what may be wrong and put any illness I have down to bad eating habits or smoking. I sometimes wonder if it's more a difference between GP's and hospital doctors? Once you're in the 'system' most people I've spoken to are happy with their treatment, it's getting into the 'system' seems to be the difficult bit.
Female
eurostar  Female  Merseyside 2-Oct-2019 21:01 Message #4755753
I was misdiagnosed by a doctor but went by my gut instinct and went to the practice nurse a week later, she diagnosed correctly and saved my life...
even now ten years later its the practice nurse for me every time...…our doctors change that often all they see is a computer screen of past symptons….practice nurse knows me.and knows the once or twice a year I go is because I need medication that cannot be bought over the counter
Female
Cautious1954  Female  Berkshire 2-Oct-2019 22:17 Message #4755774
I trust my own doctor as I’ve known him for years but I worry about some of the hospital doctors who don’t look old enough to have had any experience.
Female
Cassis  Female  Cambridgeshire 2-Oct-2019 22:41 Message #4755786
Doctors are human and thus fallible, but there's a difference in misdiagnosis through noone's fault and misdiagnosis when the doctor has failed to consider all possibilities and test appropriately for them.

I raised this question on the back of current statistics that show how many women are misdiagnosed and suffer fatal heart attacks, starkly more than the figures for men. Health experts admit that a lot of the blame lies with the fact that a) women are not seen as at risk in the way men are, and b) when women present with symptoms that would raise alarm bells, and thus correct tests and treatment in men, they are far less likely to be correctly diagnosed and treated than are men.

I think misdiagnoses in various illnesses happens when doctors conform too rigidly to the templates given, and/or are dismissive when they arrogantly assume they "know" more than they do. For example, Brisinger is right in saying that too much emphasis is placed on existing conditions, as it is on the ageing process. Doctors also form personal opinions of a patient that colour their diagnoses, etc etc.

I've definitely fallen victim to not looking like someone is supposed to look when suffering a certain illness, or not having the usual blanket indicators that would mean further investigation. I won't bore you with my personal details of the illnesses but in one case I didn't get correct treatment for 18months because I am slim and patients suffering from that are "always overweight"; another time a treatable (by antibiotics) infection eventually put me into septic shock and multi organ failure because I "didn't have an above normal temperature, and I looked well enough", so swabs, blood tests etc were refused me.

It seems to me, as in the cases of women and heart attacks, a more individual and more wholistic approach is needed and doctors should perhaps be taught more along these lines at medical school. There is also that very British thing of deference to doctors in any event.
Female
Aely  Female  Hampshire 3-Oct-2019 20:14 Message #4755994
Well, there was the locum who , when I described the stiff neck, blinding headache, period of unconsciousness and vomiting , said he didn't do home visits, said the hangover would pass and told me to give him 2 aspirin and stop him sitting in the draught which caused the stiff neck. And there was me thinking it might be something serious!

My husband had a burst aneurism in his brain.

2 aspirin would have killed him. I only had paracetamol so he survived, but it took 3 weeks before he collapsed in a major fit, got to hospital, stayed 6 weeks, had 2 operations - and brain damage.

Female
Cassis  Female  Cambridgeshire 4-Oct-2019 01:44 Message #4756059
I doubt the doctor would have been so blasé if it had been their spouse, Aely!
Male
brisinger  Male  Lancashire 4-Oct-2019 14:37 Message #4756137
I sometimes wonder if it's more a difference between GP's and hospital doctors?

Sadly I don't think it is. Because I have epilepsy they assume it's connected to that unless it is glaringly obvious otherwise. I am now finding the same happens with my Mum now that she has been diagnosed with Alzheimer's. It always seems to be a "worsening of the Alzheimer's" they blame it on first and foremost despite it is very common for Alzheimer's patients being more susceptible to UTI infections if they are not caught early. They usually cause the patient to act out of character. The final straw for me was when they wouldn't listen and she was rushed in in a Level 2 coma.
Female
JustLyn  Female  Cheshire 6-Oct-2019 11:57 Message #4756493
Let me give you an example of why I would not trust every GP. Not all, but than I would like to admit. Some are very conscientious and it isn't pro rata medical knowledge and training, it's about personality, a bit like government really.

This is just an example using cytology tests, smear testing on women.

Until 2004, GPs were paid for smear tests for example, there was not the same structure as there is now, so GPs are not financially as in control of how they get paid for doing smear tests on women. The first GP I ever worked for used to blackmail certain patients who needed certain drugs, that they would not get their tablets if they did not have their smear test. This was on women as young as age 16 at that time, but the GP earned extra money whether the person was in the right age group or not. The patient, by the way, had not gone in with any gynae symptoms, it might have been ear ache.

I began to get concerned as I gained more experience, when women came to se me for a smear, and I would ask why, as in those days they did not need to be invited and be actually due one. They often had gone to see a GP with symptoms of something higher up, maybe a stomach problem, or could even be ovarian cancer, but the GP (s) would fob them off by saying,
"Go and see the nurse for a smear, and if it is normal, then I am sure everything is OK"
They (the GPs, quite a few of them) would not ask the patient to be followed up, and the normal result would be falsely reassuring that nothing was wrong.
I asked a few women, what did they think I was checking here, and some not that familiar with the body would say "Well, everything?".
They often had such faith in the important smear test, that they overestimated exactly what was being checked and then be puzzled why they might have such bad symptoms when the result was normal.

It's dangerous. NO GP should be expected to be perfect and never make a mistake, they are human, BUT some might be very clever and have passed their medical degrees, but just cannot wait to get the patient out of the door.

To be fair, some might be burned out, broken, struggling themselves, but others just like the status and £90,000 ish a year and are bad doctors.

You can also have "good" doctors that are bad because they say yes t everything the patient asks for even if the drug is addictive or has horrible side effects. Patients often think these GPs are wonderful, but then we find it is easier for such doctors to not argue or take the time to explain.
These are examples of this:
Prescribing opiates for other than terminal cancers.
Prescribing benzodiazepines such as Valium other than maybe a recent bereavement.
Requesting walking sticks and wheelchairs often to people who need to be more active and gain better mobility, not sink into doing less and less.

In fact it's why, as much as I abhor the abuse in the current disability assessment system, it should be given to GPs either.
Female
JustLyn  Female  Cheshire 6-Oct-2019 12:02 Message #4756494
...should NOT be given to GP's either.
Male
MrQuiet  Male  Northamptonshire 6-Oct-2019 12:27 Message #4756497
Good post JustLyn. A lot of people thought family GPS could give independent assessments but that would not be possible of course. Appreciate all the medical detail.
Female
Minnie-the-Minx  Female  Hertfordshire 6-Oct-2019 14:45 Message #4756524
I trust the doctor with my health just about as much as I trust a garage mechanic working on my car.
Female
Cautious1954  Female  Berkshire 6-Oct-2019 16:03 Message #4756540
Nice one JustLyn.


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