andrewducker: (Default)
andrewducker ([personal profile] andrewducker) wrote2011-10-12 01:51 pm
  • Add Memory
  • Share This Entry
Entry tags:

Interesting Links for 12-10-2011

Flat | Top-Level Comments Only

[identity profile] channelpenguin.livejournal.com 2011-10-12 01:57 pm (UTC)(link)
I am glad they are finally getting round to publicising some of the negs to hormonal contraception. Over my life (personal experiencem observation and reading the research as it comes out) I have come to the conclusion that it is pretty damned evil - plain IUDs should get a lot more use/publicity - sure, they can be not without some minor issues for some people, but they don't do stuff that f*cks with your head like hormomes do, (or break like condoms do...)

[identity profile] meaningrequired.livejournal.com 2011-10-12 03:37 pm (UTC)(link)
I agree with you. 10 years ago my female GP tried to tell me that there were no side effects of the pill at all. If I had any I was imagining it. There isn't any hormonal balance which suits me, they just have different intolerable side effects.

[identity profile] alitheapipkin.livejournal.com 2011-10-12 06:07 pm (UTC)(link)
I've always been boggled by how obsessed all the GPs I've ever seen as an adult have been with trying to put me on the Pill. Not a single person I know has taken them with no side effects but if you listened to my GPs you'd think they were some sort of wonder drug that cures all ills.

[identity profile] danieldwilliam.livejournal.com 2011-10-13 08:30 am (UTC)(link)
What do you think the GP thinks makes a good prescription?
andrewducker: (Default)

[personal profile] andrewducker 2011-10-13 09:31 am (UTC)(link)
A GP shouldn't always be making a prescription. They should be offering expert advice on how a person might improve their life through the tools a GP has at their disposal, and letting the person decide, after balancing up the pros and cons, what they wish to do with their own body.

[identity profile] danieldwilliam.livejournal.com 2011-10-13 09:40 am (UTC)(link)
Valid.

I was using prescription as a short hand for offering a solution to a problem.

andrewducker: (Default)

[personal profile] andrewducker 2011-10-13 09:44 am (UTC)(link)
I think that part of the problem is that GPs see loads of people who don't want to take on the decisions or don't have a background that would allow them to understand the various factors. They therefore have a tendency to revert to telling people that "X will make things better." and brush over any negatives or qualifications to their statements, so that they can move on to the next patient.

My father is a doctor, and he says that GPs desperately want people that X didn't work for to come back and say so, but most people don't - probably because of the way they were talked to in the first place.

[identity profile] danieldwilliam.livejournal.com 2011-10-13 10:47 am (UTC)(link)
Not having the background or time to understand the various factors is probably a key difficulty in trying to shift to a more patient lead health service.

Also I think is a view that people to to the doctor to be cured and they are the experts and I feel secure if I'm told to take X. I think some people (many - most perhaps) would like the reassurance of a strongly positive prescription (in the broadest sense).

I'm an educated man from a family with a medical background and some scienctific and medical training myself. I know that I don't want to make the time to understand the subtleites of some of my health issues. I just want my GP in her authoratiative Edinburgh brogue to tell me what to do.

There is also a cost in bespoking the care patients recieve. I may post a longer winded ramble about this but I wonder how (or if) we assess if the improved care from more patient lead general consulting is worth the extra cost.

[identity profile] alitheapipkin.livejournal.com 2011-10-13 09:56 am (UTC)(link)
I wouldn't mind so much if I'd gone to the doctors asking about a problem that hormonal contraception might have been an answer to but in the worst case I experienced, the GP tried to pressure me into taking it merely because I'd presented as a sexually active young woman.

[identity profile] danieldwilliam.livejournal.com 2011-10-13 10:49 am (UTC)(link)
So you think GP's have some kind of knee jerk response or procedureal bias in favour of the Pill?

I'm wondering why that would be the case.
andrewducker: (Default)

[personal profile] andrewducker 2011-10-13 10:52 am (UTC)(link)
"Woman is sexually active. Woman not looking to get pregnant. Woman need best thing for her. Me tell woman what best solution is."

Because, apparently, most people are of the opinion that "I just want my GP in her authoratiative Edinburgh brogue to tell me what to do".

[identity profile] danieldwilliam.livejournal.com 2011-10-13 10:58 am (UTC)(link)
and I'm wondering if that's the issue, not just for the Pill but wider than that.

GP's operate a production line for their consultations in an environment where most cases are straightforward, resources are tight and most patients aren't up for a more challenging interaction.

GP's therefore end up with way of working that solves 90% of 90% of the problems they encounter with reasonable efficiency.
andrewducker: (Default)

[personal profile] andrewducker 2011-10-13 11:00 am (UTC)(link)
Yup, definitely. Their heuristic works perfectly a lot of the time, and then leaves some people feeling unhappy and pressured.

It works less well on some issues than others - I've bumped into a fair number of women who complain that they were put on the pill, their concerns weren't listened to, and they were consistently told that the problems they were having didn't really exist. Because the process doesn't seem to deal well with individual variation, and hormonal variation seems to be much more common than most people (including doctors) believe it is.

[identity profile] danieldwilliam.livejournal.com 2011-10-13 02:39 pm (UTC)(link)
The Pill seems to be a bit of an issue for this kind of tick and bash patient processing.

I say seems - I wonder if it that unusual a problem.
andrewducker: (Default)

[personal profile] andrewducker 2011-10-13 02:48 pm (UTC)(link)
I suspect it's a problem with anything that has varying effects depending on the person taking it*. I also suspect that The Pill is the most widely used of these drugs.


*Because people I know on psychiatric medication have similar issues sometimes.

[identity profile] danieldwilliam.livejournal.com 2011-10-13 02:51 pm (UTC)(link)
Because people I know on psychiatric medication have similar issues sometimes.

Me also (sigh).

[identity profile] alitheapipkin.livejournal.com 2011-10-13 11:12 am (UTC)(link)
To be fair, this particular GP was part of a university medical practice - maybe she was very biased in favour of the Pill because she saw lots of young female students having unwanted pregnancies or at least pregnancies scares. But I was a 23 yr old postgrad with no history of either presenting with a bladder infection and she basically told me it was a miracle I'd never been pregnant because I wasn't on it!

Maybe I'm just an overeducated awkward person but I find doctors who tell me what to do mostly patronising. I went for a prescription for antibiotics not a lecture about contraception from someone who wasn't any more informed about it than I was.

[identity profile] danieldwilliam.livejournal.com 2011-10-13 02:35 pm (UTC)(link)
- maybe she was very biased in favour of the Pill because she saw lots of young female students having unwanted pregnancies or at least pregnancies scares

Yeah - I think this is a specific example of where my thinking on GP production lines generally has got to today. it sounds like it was too difficult / time consuming / expensive to treat you as you and not (mistakenly) as one of a class of people who had identical issues and could be treated in an identical way.

Maybe I'm just an overeducated awkward person but I find doctors who tell me what to do mostly patronising.

I am nothing if not over educated but I quite like the idea of being told what to do by a doctor, especially when I know in my heart of hearts I agree with them.

[identity profile] alitheapipkin.livejournal.com 2011-10-13 03:58 pm (UTC)(link)
Maybe the agreeing in your heart of hearts is the crucial bit here - in my heart of hearts I have a possibly irrational hatred of the idea of messing with my hormones. Also I don't think the Pill is necessarily a safer contraception method than properly used barrier methods and get annoyed because I think doctors generally overstate its effectiveness and understate the possible side effects (http://www.contraceptivetechnology.org/table.html backs me up on this - perfect use of condoms* is more effective than typical use of the Pill). Doctors never seem to be very keen on pointing out how many things can reduce the effectiveness of the Pill, like having a dodgy stomach or taking OTC cold & flu remedies, never mind the number of prescribed antibiotics that stop it working.

*I realise that isn't a like for like comparison but perfect use of condoms isn't that hard to get right if you and your partner are careful.

Sorry, pet rant ;) Fortunately for me, my partner has had a vasectomy so I get to avoid the issue these days.

[identity profile] nineveh-uk.livejournal.com 2011-10-13 09:18 am (UTC)(link)
Ditto. They're good for some people with specific needs, but they are not a cure-all!

[identity profile] danieldwilliam.livejournal.com 2011-10-13 08:53 am (UTC)(link)
Limited sympathy for the folks phoning in to a radio programme.

More sympathy for the woman working in the bar who appears to have tried really hard at her job in order to win an incentive.
Flat | Top-Level Comments Only