Monday, November 19, 2007

My Tears Dry On Their Own

Ranting ahead, and a few housekeeping notes.

Doing a bit of extra curricular reading, I came across a few posts by MonkeyGirl. I apologise for the lack of link at the mo', but my server is flailing... I'll rectify as soon as. The gist runs around a story of a patient dying in an ED after being 'underdiagnosed'. The problems are bilateral - it seems the patient was known to the Department, and had a reputation for being non-compliant, and a drug seeker. (This is how I understand it, and I apologise if I have mis-represented anyone, specifically the Girl Simian). On t'other side, it seems that this ED did not offer a particularly high standard of care to anyone, and has subsequently been down-sized, or closed or something. MG's point centred on the family of the unfortunately dead patient suing for $45m. If I understood, she considers this... taking the piss?

It has provoked some polemic.

This is an old problem, and one unlikely to go away. While a system exists that can be abused - e.g free or subsidised healthcare, for e.g drugs - people will abuse it. People's sense of entitlement seems all too often to find ways to overpower their sense of responsibility, both personal and collective.

I think this is particularly true of the UK. People aren't keen to consider their own 'emergency' in the context of others'. And why should they?

Rationing. That's why.

And people have very different ideas as to what constitutes an emergency for them, as opposed to others.

Yes, I know this is sweeping generalisation. I think that's kindof the point.

As medical professionals, nursing professionals, paramedics, whatever, we seem to have our natural cynicism nurtured and enhanced by our exposure to certain types of people. But if we dare to openly suggest that some people allow themselves to be 'legitimately' classed as ill by the state, allow themselves to slide into a sick role because it might be an easy option, we are pilloried.

Of course there are many folks out there whose lives are ruined by chronic conditions, the effects of which are difficult to see, hard to comprehend, even to so-called experts; but there are equally people out there who make use of the system to live of the state, or feed a drug habit.

We, I mean I, am not suggesting that they are one and the same. But some people allow themselves to become medicalised

And if you have spent years feigning illness, or exaggerating your symptoms to get a quick fix, or a warm bed for the night, or time off work, it makes it a bit harder to take you seriously when you really are ill.

I note that critics of the medical profession have rarely had to deal with manipulative, 'professional' patients; have rarely tried to reason with people who feel that their own unhappiness must be the fault of some internal locus, that absolves them from blame - this ranges from the obese patient who blames all their troubles on some mysterious glandular / hormonal conspiracy, to the man who's bad back prevents him working, but not enjoying leisure time with his mates, to the patient with the unexplainable headaches who chooses your ED over the two nearer his home address, for equally inexplicable reasons.

I don't see the same criticism labelled at banks when they give you a poor credit rating for constantly being overdrawn and defaulting on all your loan payments.

But maybe I'm not looking hard enough.

For every genuine patient, with a seemingly 'dodgy' story and/or collection of symptoms, there's at least one who's motives are not pure. There seem to me to be few other professions that have to spend so much time trying to tell one from t'other.

Cynicism seems almost inevitable; we are human too, are we not. And if we vent from time to time, please don't tell us to get out of medicine, unless you've walked a few miles in our shoes.


I would be sincerely grateful if the press would fuck off, and stop writing ill informed pieces about doctor's pay, posing as factual articles.
The idea that medical salaries have gone up at the expense of patient care is ludicrous. The Government felt that doctors, and specifically Consultants and GPs were not doing enough work and should therefore pay them for the work they did. This, it seemed would equate to large savings. If it seemed fair to pay people for the work they do when you thought that meant a pay cut, how is it now unfair when you discover they actually do more work that you thought, and in fact this has meant a pay rise. This suggests that before now, these doctors were doing that work without due financial recompense. You cannot announce a deal to pay people for what they do, only to try and renege because it transpires these guys and gals work far harder than you realised.

And particularly not when it is MPs doing the carping; a bunch of useless bastards who vote on their own pay increase. (Which is never below inflation, as far as I can see. Oh, and they don't have restrictions on what other jobs they can have... but private medicine is to be discouraged?)

I am a simple Shroom; maybe I've missed the point. But I still remember the glee on one the face of one of my old Bosses, when he submitted his work pattern, as instructed by 'the management' and calculated that he was owed 9 months compensatory rest.

Why should medical professionals not be paid at a level commensurate with e.g lawyers, or dare I say it, bankers?

But mostly, I'd like the press to fuck off.

I've added a Reciprocity list to the blog. If you've linked me, and I haven't already, I'll link you. I hope this isn't bad blog etiquette; if so I apologise. If you don't wanna be associated with my rantings, let me know.

And, I have decided. You must all now go out and buy Astral Weeks, by Van Morrison.


Do it.

You won't regret it. (Seriously)

No comments: