Monday 5 June 2023

Opinion: Getting good medical outcomes is a fight to be heard - II

Up against the system

When I wrote last week that my NHS rating is a 6 on a scale of 0 – 10, a series of conversations with users of the service and most especially, my personal experience highlighted issues I have overlooked rather than pursued.

Blog - Opinion: Getting good medical outcomes is a fight to be heard - I

There are organisational inefficiencies that consequently impact the patient at the point of contact and the bureaucracy demands those who people the establishment that they need more time to address issues and where they do, they should be more attentive.

In some cases, those who choose to address ineffective processes that result in poor outcomes are deemed, termed, and labelled difficult and troublesome. The person's suffering is forgotten as the Hippocratic oath of service becomes a perfunctory recitation without heart or mind involved. The patient is a customer on a fast-moving conveyor belt to the exit than to wellness.

Organisational failings that fail us

In my other blog, I talked of when I had to relay my medical record to a doctor because my file was not available to check my notes for the consultation. It would appear, every patient that visited on that day, if they were not as clued in and read up on their condition would have received attention below par.

I have high praise for the department that has taken on my case for almost 8 years, but they are not perfect and not all the consultants I have met give due heed to the wider issues of who the person they are seeing is and I can understand their limitations. However, one has to question how with that knowledge of who was attending for the day the essential documentation was not provided to the consultants for review and understanding as they met their patients.

It might have been a one-off situation, but I have the feeling there is a rot that pervades the system that is seething and creeping almost unaware to those with the responsibility to ensure things work better for the desired outcomes of their patients.

Seeing but not perceiving

Then, it was the lassitude that greeted my need for treatment of a co-morbidity condition that they knew of for more than two years, but never sought to address until I challenged the thinking in the department. You could almost feel they were more ready to express sympathy after your demise in the knowledge you were one less problem to deal with than face the complexity of the person-problem conundrum.

When they advocated for the change of my drug regime for a new medication, the consultant inelegantly let slip that the decision was being made on a cost basis as my medication was still under patent protection. This was reinforced with a contrived neurological test as I did mention absences in thought that could be side effects on my memory, much of which I had compensated for as I noticed changes in how I remember things, especially in the short-term memory space.

The struggle of outlay over outcome

The new medication was a hellish 7-week experience that they were keen to fix me to after the second week which I thought was too short a period to understand its effects. I dare say, one of the side effects that was on a label you could tear off from the packaging included sudden death. Each day, I recorded every funny symptom from tingling in my extremities, to insomnia and nausea – those were the prominent ones.

I walked into the department with 42 pages of side effects recorded for each of the 42 days and demanded I be put back on my old medication that I had tolerated well for over 8 years. The year after this sordid experiment, there were generics of my medication available, and I have been on those since then.

Obviously, there is a cost to medical provision, and I cannot ignore the towering cost of the 12-week medication for treating the co-morbidity 7 years ago with new drugs for which I am grateful, but it is never comfortable to be in the hearing of cost rather comfort and outlay rather than outcomes.

Being there but not with me

It was my last consultation that inspired these blogs as my doctor’s notes created on the day of my visit or thereabouts get sent to both my GP and me. Now, after that consultation, I was given a survey to fill in about attending the consultation that day. After receiving the note, I would like to review my earlier commending comments.

This is for the simple reason that I discussed a number of issues with the consultant that should have superseded the talk we had 6 months ago. On review, there is little of what we discussed in the new note, I can also put it down to either the consultant being distracted or inattentive. That conclusion is easy to arrive at as when he said he had refilled my prescription, it was one of two medications that he prescribed, and I had to return the next day for the other medication.

The notes can be consequential

Doctor’s notes might hold no particular significance as a simple administrative process, but when one is engaging with the system and some decisions are predicated on what the doctor’s perspective is of you and your situation, there can be no room for error or variance between how you describe yourself and your doctor's observations. I can only wonder what it would take to rectify this without creating a crisis of confidence and trust within that team of medical personnel.

Indeed, I do make demands on the NHS for better outcomes which have much room for improvement, but there are only so many things you can overlook before you realise something radical is needed to ensure you do not become a mere conveyor belt statistic.

It is a fight to be heard and listened to, beyond which you hope that they would respond and act on the situation, with your interests to heart and in your favour.

No comments:

Post a Comment

Comments are accepted if in context are polite and hopefully without expletives and should show a name, anonymous, would not do. Thanks.