Re: Helen Salisbury: The gaps in our knowledge: FIlling the gaps ...
Dear Editor
I was deeply dismayed to read Helen Salisbury’s article ‘the gaps in our knowledge’ about medically unexplained symptoms – and especially in context the of training junior doctors (1). I note that Dr Salisbury uses only two references. Please may I draw attention to the e–letter responses to her second reference (2).
Please may also I draw attention to the 2017 BMJ feature on medically unexplained symptoms – and the large collection of responses there too including some of my own (3).
I and fellow campaigners have, for several years, been actively trying to engage the medical profession – and especially GPs – with the issue we are seeing very clear evidence of: that of patients being made ill by medicines believed by prescribers to be ‘safe and effective’ and ‘non-addictive’ and the fact that ‘effects’ of these (medicines ‘taken as prescribed’) are being further medicated - leading on to all manner of other problems and polypharmacy. Patient experiences (of the effects of the medicines) are being disbelieved by doctors as ‘medically unexplained’, as I initially wrote about, as an ‘Outsider’s observation’ in 2016 (4). As described in a previous BMJ response we have gone on to gather and put together patient evidence, drawn from a large collection written testimony submitted by patients to the Scottish and Welsh Parliaments: “The aetiology of the huge burden of 'medically unexplained symptoms' experienced can be clearly seen in the published patient testimony, analysed in this report” 2018 (5) (6).
The BJGP has also published a number of my responses to various further articles about medically unexplained symptoms, such as this ‘Unexplained physical symptoms: What is being missed?” (7): “Doctors, psychiatrists, psychologists and therapists are clearly being actively trained to believe that their patients are ‘somatising’…. in fact, many are actually suffering the serious physical effects of commonly prescribed ‘safe and effective’ (sic) ‘antidepressant’ medicines, which (effects) are therefore remaining dangerously unrecognised by prescribers – with serious consequences.”
Patient experience from our own report (Guy A, Brown M, Lewis S, Reid S, Epsley K, Cope D, et al. The Patient Voice: an analysis of personal accounts of prescribed drug dependence and withdrawal submitted to petitions in Scotland and Wales. : All Party Parliamentary Group for Prescribed Drug Dependence; 2018) (6) is quoted and formally referenced (Ref 109) in the Public Health England Review report published September 2019 (8).
Please may I urge Dr Helen Salisbury and her colleagues to NOT train doctors to ‘not know’! And instead to really start to explore what is really happening to far too many people: being made very ill by ‘medicine’. Please see this ‘Patient Journey’ Infographic – and perhaps use it in your training for doctors? (9).
(If you need this infographic in a different format, please email mmarionbrown@gmail.com )
Rapid Response:
Re: Helen Salisbury: The gaps in our knowledge: FIlling the gaps ...
Dear Editor
I was deeply dismayed to read Helen Salisbury’s article ‘the gaps in our knowledge’ about medically unexplained symptoms – and especially in context the of training junior doctors (1). I note that Dr Salisbury uses only two references. Please may I draw attention to the e–letter responses to her second reference (2).
Please may also I draw attention to the 2017 BMJ feature on medically unexplained symptoms – and the large collection of responses there too including some of my own (3).
I and fellow campaigners have, for several years, been actively trying to engage the medical profession – and especially GPs – with the issue we are seeing very clear evidence of: that of patients being made ill by medicines believed by prescribers to be ‘safe and effective’ and ‘non-addictive’ and the fact that ‘effects’ of these (medicines ‘taken as prescribed’) are being further medicated - leading on to all manner of other problems and polypharmacy. Patient experiences (of the effects of the medicines) are being disbelieved by doctors as ‘medically unexplained’, as I initially wrote about, as an ‘Outsider’s observation’ in 2016 (4). As described in a previous BMJ response we have gone on to gather and put together patient evidence, drawn from a large collection written testimony submitted by patients to the Scottish and Welsh Parliaments: “The aetiology of the huge burden of 'medically unexplained symptoms' experienced can be clearly seen in the published patient testimony, analysed in this report” 2018 (5) (6).
The BJGP has also published a number of my responses to various further articles about medically unexplained symptoms, such as this ‘Unexplained physical symptoms: What is being missed?” (7): “Doctors, psychiatrists, psychologists and therapists are clearly being actively trained to believe that their patients are ‘somatising’…. in fact, many are actually suffering the serious physical effects of commonly prescribed ‘safe and effective’ (sic) ‘antidepressant’ medicines, which (effects) are therefore remaining dangerously unrecognised by prescribers – with serious consequences.”
Patient experience from our own report (Guy A, Brown M, Lewis S, Reid S, Epsley K, Cope D, et al. The Patient Voice: an analysis of personal accounts of prescribed drug dependence and withdrawal submitted to petitions in Scotland and Wales. : All Party Parliamentary Group for Prescribed Drug Dependence; 2018) (6) is quoted and formally referenced (Ref 109) in the Public Health England Review report published September 2019 (8).
Please may I urge Dr Helen Salisbury and her colleagues to NOT train doctors to ‘not know’! And instead to really start to explore what is really happening to far too many people: being made very ill by ‘medicine’. Please see this ‘Patient Journey’ Infographic – and perhaps use it in your training for doctors? (9).
(If you need this infographic in a different format, please email mmarionbrown@gmail.com )
(1) https://bjgp.org/content/67/661/363
(2) https://bjgp.org/content/67/656/106/tab-e-letters
(3) https://www.bmj.com/content/356/bmj.j268/rapid-responses
(4) https://www.madinamerica.com/2016/12/outsiders-observation/
(5) https://www.bmj.com/content/356/bmj.j268/rr-18
(6) http://prescribeddrug.org/wp-content/uploads/2018/10/Voice-of-the-Patien...
(7) https://bjgp.org/content/unexplained-physical-symptoms-what-being-missed
(8) https://assets.publishing.service.gov.uk/government/uploads/system/uploa...
(9) https://www.hgi.org.uk/sites/default/files/hgi/Marions%20infographic_for...
Competing interests: No competing interests