Illness behaviour
BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.333.7570.709-a (Published 28 September 2006) Cite this as: BMJ 2006;333:709All rapid responses
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I would make Dr Barraclough's article compulsory reading for all
doctors if I thought it would do any good.
Unfortunately, his nightmare future vision of the government NHS
£billions going down the plughole while patients flit around on buck-
passing trips to Radiology is already reality in at least some hospitals.
Or they would flit if the hospital could work out how to deliver them to
us.
Once mention is made, no matter by whom, of conditions such as
aneurysm, DVT, PE etc, then it becomes the job of radiology to prove it's
absence, generally very expensively, and independent of clinical
likelihood or the rarity of a positive diagnosis. It has to be done while
the patient is in hospital, despite the advent of proven practices such as
out patient s/c LMWH, and the 'blame' for all those wasted bed days is
heaped upon unfortunate scanner staff who endure abuse and incessant phone
calls.
Massive hospital deficits are not to be wondered at and, in the
absence of an imminent election, are very unlikely to be corrected save by
stripping out the assets (the odd ready built hospital, for instance) to a
ravening private sector with friends in high places.
Oh dear! Our Chief Executive has just jumped ship out to PCT
Commissioning Land, and he should know, so it looks like hard times ahead
for the DGH.
Competing interests:
I work in a Radiology Department where patients do indeed spend much of their lives
Competing interests: No competing interests
Fear drives the herds
Sir: There is nothing like financial ruin to motivate an otherwise
sensible individual. Having lost autonomy to the extent that we have
NICE, which really should be NICO (O for ordinariness), clinical acumen is
irrelevant. How is an individual clinician supposed to argue his corner
against a system designed for blame. The easy and obvious answer is take
no risks, keep one's head down and never cause conflict. The result is a
terribly expensive mechanised service that delivers print-outs as opposed
to reasoned diagnoses. The personal is drowned, the private is crowned
and the technocrats are gowned. So Sir Manager now what?
Competing interests:
None declared
Competing interests: No competing interests