Does Peppa Pig encourage inappropriate use of primary care resources?

It is a pity that Dr Bell should see fit to write, and the BMJ to publish, such an ad hominem (or rather, ad ursum) attack on Dr Brown Bear [1], who, far from being unfit to practice, is one of the last truly general physicians, with a practice extending across the barriers of species divides. While accepting that Dr Bell may have been thoroughly and repetitively inculcated in the theory of porcine medicine by her daughter, surely she must acknowledge that the art of medicine must be learned at the bedside, or in this case, in the sty. What experience has she in porcine medicine that she feels able to criticise such an experienced practitioner as Dr Brown Bear? Let she who is without porcine medicine experience refrain from throwing stones at those who have! And can the BMJ, which piques itself on its peer review processes, explain how this severe criticism of a hard-working Bear by such an inexperienced author was allowed to reach the printed page?

References
1. Bell C. Does Peppa Pig encourage inappropriate use of primary care resources? BMJ 2017; 359: j5397

I applaud Dr Gray's important research. However, I think that it would have been important to assess how this behaviour extends to other similar and yet substantially more diverse populations, such as for example Ben and Holly's Little Kingdom, with its mix of Elves and Royal Fairies.

I do tend to agree with the observations and conclusions put forward by Dr Bell, and also find the rich information from the 'rapid responses' to be suitably pragmatic and quite the learning experience one would expect of the BMJ and those who contribute to it.

However, I feel that one potential option to at least partially address this unwarranted use of healthcare has been somewhat overlooked. I propose an educational exchange scheme between qualified GPs, specifically in this case allowing Dr Brown Bear, and Doc Martin to swap roles for a fixed period of time - let's suggest 10 full episodes (including the Christmas special) as a starting point, though I'd be open to suggestion about the optimum length of such a Knowledge Transfer Activity. I feel that both practitioners would find such an exchange a career-threatening... sorry, career-enhancing experience, and it would definitely allow the Pig family, and their relatives and associates, to view a different side to primary care services.

Since my own children are now just beyond The Dratted Peppa Pig Phase, I would like to clarify that this suggestion is in no way borne out by a desire on my part to see Peppa and friends, for once, actually uncomfortable with their otherwise-idyllic existence.

I found Dr. Bell’s paper on the possible influence of Dr. Brown Bear on inappropriate use of primary care physicians both amusing and deep.

As the father of a 3-year-old girl I would like to bring into the discussion a positive example of how hospitals, diseases and the role of healthcare professionals can be effectively explained to toddlers in a realistic but understandable way, without resorting to magic or sugar-coated scenarios. I am referring to an episode of Curious George titled “Curious George goes to the hospital” that was originally written and illustrated in 1966. My daughter has asked me to read this bedtime story almost every day for the past year and a half, so I can confidently claim to know it well.

The story starts when Curious George inadvertently ingests a piece of a jigsaw puzzle and develops belly pain. His “parent” the Man with the yellow hat calls Dr. Baker, who promptly goes to Curious George’s home to examine him and states that he would need to go to the hospital for further testing. There, they obtain a barium swallow and discover that the piece of the puzzle is stuck in the lower esophagus. George is then brought to the admitting office, where nurses check his vitals and collect demographic information, then he’s admitted to the children’s ward.

He shares the room with several other young patients, including: Dave, who’s getting a blood transfusion (maybe for leukemia?); Steve, who fractured his leg and is moving around in a wheel-chair; Betsy, who is admitted because she is very sad and doesn’t smile anymore (maybe a major depressive episode?). The next day George is brought to the OR for a gastroscopy with Dr. Baker. After waking up he’s very cranky (maybe the effect of anesthesia?) and nurses advise to let him sleep until the next day. When George is finally back on his feet, he starts to entertain all the kids in the pediatric ward with all sorts of mischiefs and even performs a puppet show.

The children all cheer and even Betsy “smiles a little”. The climax is when he steals Steve’s wheel-chair and runs down the ramp to the floor below, where lots of doctors and nurses are busy showing the mayor around the hospital. George crashes right in the middle of the lunch carts and it’s immediately chaos with food thrown all over the place and everybody shouting and yelling at him. All of a sudden, their attention is captured by happy laughter coming from above: it’s Betsy, laughing and cheering out loud. Then, the mayor starts laughing and everybody follows. The mayor praises George for making Betsy smile again and she comes downstairs to comfort George because he feels sad and guilty for what he has done. The story ends with a nice nurse giving George the piece of the puzzle that Dr. Baker had recovered the day before from his stomach.

The message that in my opinion this story so effectively delivers, is that you can explain to young children what hospitals are, what doctors and nurses do and even what serious diseases are, in a way that is both realistic and amusing and teaches them how a good healthcare system should work.