Let's not turn elderly people into patients

doi:10.1136/bmj.b873

Published 3 March 2009, doi:10.1136/bmj.b873
Cite this as: BMJ 2009;338:b873

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Let’s not turn elderly people into patients

Michael Oliver, professor emeritus of cardiology, University of Edinburgh

michaeloliver@mac.com

The first 150 words of the full text of this article appear below.

Many older people, often retired, are summoned by their generalpractitioner for an annual health check. They may feel reasonablywell, but the NHS does not always permit such euphoria. Theymay be told that they have hypertension or diabetes or highcholesterol concentrations; that they are obese; that they taketoo little exercise, eat unhealthily, and drink too much. Thequality and outcomes framework (QoF), the scheme that rewardsNHS general practitioners for good performance, awards points,with related payments, for each documentation. Many of thesepatients are told to have more investigations. Eventually, mostare started on pills. Few seem to be considered not at riskfor something. Thus, of those who thought themselves healthy,a number will return home as patients. And they may be scaredand no longer comfortably aging.

What kind of medicine is this? It is politics taking preferenceover professionalism, obsession with government . . . [Full text of this article]

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This article has been cited by other articles:

Buskens, E. (2009). Wanted: age adjusted outcomes. BMJ 338: b1309-b1309 [Full text]
Gooderham, P. (2009). On disobeying NICE guidance. BMJ 338: b1198-b1198 [Full text]
Witham, M. D (2009). Better evidence is the answer. BMJ 338: b1199-b1199 [Full text]
Oliver, D. (2009). Older people are undertreated as much as they are overtreated. BMJ 338: b1200-b1200 [Full text]

Rapid Responses:

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NICE and QoF: Mark W Couldrick
bmj.com, 4 Mar 2009 [Full text]
Another wrong target?: Peter Gooderham
bmj.com, 4 Mar 2009 [Full text]
What, exactly, is the role of the doctor?: James D Gubb
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Extrapolation of Evidence gained in younger patients to the elderly.: Ailbe Beirne
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Academic peer pressure: O James Sherifi
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Failure of Evidence Based Medicine: Harry Rogers
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Economies of scale: Joan McClusky
bmj.com, 5 Mar 2009 [Full text]
'Healthy eating' is making us ill: Barry A Groves
bmj.com, 6 Mar 2009 [Full text]
Leadership: James A Cave
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A cultural: Owen P Dempsey
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Every man has his particular way of being in good health. Emanuel Kant: Joachim P Sturmberg
bmj.com, 7 Mar 2009 [Full text]
Older patients get undertreated as often as they get over-treated: David Oliver
bmj.com, 7 Mar 2009 [Full text]
Beware of Polypharmacy in the Elderly: Hugh Mann
bmj.com, 8 Mar 2009 [Full text]
Better evidence is the answer: Miles D Witham
bmj.com, 8 Mar 2009 [Full text]
A Failure of 'Common' Sense.: Philip M Dainty
bmj.com, 8 Mar 2009 [Full text]
Helping elderly individuals to understand the aging process.: Les O. Simpson
bmj.com, 9 Mar 2009 [Full text]
It's the patient's decision: Graeme Mackenzie
bmj.com, 10 Mar 2009 [Full text]
Impact of Polypharmacy on senior citizens: Ediriweera Desapriya
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Supporting for these inappropriate interventions may be weaker than it seems.: C Kevin Connolly
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Not in my neck of the woods, anyway.: Julian Moore
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..and increased insurance premiums: Beena J Raschkes, et al.
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Healthy vs. frailty in elderly people: Angel J. Romero-Cabrera, et al.
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Exception reporting and QOF: Dougal J Jeffries
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Aspirin and the elderly: Brian P Halliday, et al.
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