Clare Gerada: influence on UK medical practice and ME/CFS management

Ariel said:
Ah yes I forgot the ADHD comments. I thought this was interesting as she may run into trouble on dealing with autistic people this way as there is a push to changing things and talking about neurodiversity. It is just extraordinarily retrograde and wrong. I am concerned that this has a constituency.
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I'm not on twitter so can't read the comments, but it is natural for there to be an increase in ADHD diagnosis over the last several years (including the ADD type) as it used to be an exclusion criteria for autism, but in more recent years (and in the DSM 5) it is recognised that about 70% of autistic people also have a form of ADHD. So many autistic adults will seek a formal diagnosis to help them manage what can be very disabling and invasive symptoms (myself included). For the same reason, once people reach adulthood they may make different choices than their parents, who may have been reluctant to have their child given any 'label'.

Additionally, CCGs are now recognising the need and funding appropriate diagnostic and support services to manage the demand. NICE also published a fairly recent guideline on it:

https://www.nice.org.uk/guidance/ng87
 
Simbindi said:
I'm not on twitter so can't read the comments, but it is natural for there to be an increase in ADHD diagnosis over the last several years
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Her tweet was of the 'just asking questions here!' variety, should we be directing lots of people down a route that involves medication for life, etc. Her routine generally involves asking that people not be diagnosed with things, not get assistance for medical conditions, etc, because poor GPs.
 
youngscum said:
Her tweet was of the 'just asking questions here!' variety, should we be directing lots of people down a route that involves medication for life, etc. Her routine generally involves asking that people not be diagnosed with things, not get assistance for medical conditions, etc, because poor GPs.
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Getting a formal diagnosis does not involve 'medication for life'. Like any other medical problem, patients have choices after diagnosis! She is so ignorant, doesn't appear she has even bothered to read the NICE guidelines or the diagnostic criteria (which require substantial impairment of functioning).
 
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youngscum said:
Her tweet was of the 'just asking questions here!' variety, should we be directing lots of people down a route that involves medication for life, etc. Her routine generally involves asking that people not be diagnosed with things, not get assistance for medical conditions, etc, because poor GPs.
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Is she actually popular with people? It's all incredibly offputting and would seem to be at odds with how many people in the profession see themselves
 
Ariel said:
Is she actually popular with people? It's all incredibly offputting and would seem to be at odds with how many people in the profession see themselves
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She is very polarizing. I see a lot of brown-nosing mixed in with people, including some medical professionals, who are horrified at her behavior. Little in between.

Frankly I think that settles the question of why she is so obsessed with GP complaints, no doubt she has been the target of many legitimate ones over the years. She is an acerbic and downright unpleasant person, regardless of her GP skills, which appear on the same level. Also very often confidently incorrect, which normally should be quite annoying to fellow professionals.
 
Omg, I just had a scroll through her twitter feed and it's hilarious, she has pissed off a lot of people.

I suspect she has also fallen out with Greenhalgh, too - Greenhalgh is a staunch proponent of masks meanwhile Clare has been posting idiotic tweets about masks!
 
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Sarah94 said:
Omg, I just had a scroll through her twitter feed and it's hilarious, she has pissed off a lot of people.

I suspect she has also fallen out with Greenhalgh, too - Greenhalgh is a staunch proponent of masks meanwhile Clare has been posting idiotic tweets about masks!
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She's a pal of Claire Fox.

She's done a lot of moaning about mask wearing and "what have we unleashed, here?", about not being able to go shopping, or try on shoes, about not being able to go on holiday, and having to cook at home...and how dreadfully busy she is doing weekend GP surgeries. (But evidently not so busy she can't also take up the position or President of the RCGP.)
 
Interesting letter in the Guardian today in response to Gerada's piece:

I was intrigued by Dr Clare Gerada’s long read (‘In my 30 years as a GP, the profession has been horribly eroded’, 22 February). I left general practice in late 1990, a few months before Dr Gerada began her own distinguished career. The changes she so graphically describes were incipient even then. The personal, responsive and resilient service provided by a dedicated and stable workforce was already under threat.

The shift to an impersonal gig economy has been driven by inexorable consumer demand, untempered by any significant response from the profession.

It is my opinion that the General Medical Council and Royal College of General Practitioners could have done far more to retain the ethical, personal and accessible services threatened by the intrusive and bureaucratic contracts of 1990 and 2004. My profession’s weakness and possible complicity has led us to the situation we find ourselves in today.
Peter Baddeley
Painswick, Gloucestershire


In other words, 'well it's your own fault ducky.'
 
My own belief is that the introduction of student loans was a backward step. In the heady days of grants 3 of my classmates from poor working class areas went on to be well loved GPs. Many of their fellow students were similarly from poor areas, first in their family to go into higher education, with all of them wanting to "get on" but also to go back to their communities with a useful skill.
 
rvallee said:
Yeah that explains a lot. Well, some of it anyway. And her damehood is around mental health. Seems quite similar to Wessely in that regard.
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The two of them - Wessely and Gerada were Maudsley people. The place behind the a type of 'treatment' in this article: The Challenge of Providing Treatment for Children With Anorexia (undark.org)
which is worth reading because the 'manifestations story' without checking, just sticking it onto people is very familiar and comes with the similar damaging risk of actually causing the psych issues it claims to 'resolve' and certainly is an approach that would directly wreck support networks and destroy relationships and the ability of a person to be seen as a human. NO checks of harms caused, no care for them. In fact if you read what the impact of their 'selling' of that treatment was it should be disturbing to those without empathy missing. And yet the 'it's not our fault if people took it literally and used it to bully' excuses are nonsense back-covering. They changed nothing and it was just words to wash their hands of responsibility for what they actually foreseeably encouraged and I see little that they look to stop that 'misunderstanding'.

and sounds very familiar to the 'stigma' deliberately created for 'CFS' in the worst, most obvious selling misogyny and 'see only a hysterical person' video sewing bigotry I have ever seen that were by Gerada and Chalder. Old Maudsley GP training video | Science for ME (s4me.info)

I think I've seen the names involves with other areas too (addictions etc). I would like this year for us to stop being censored on talking about who these people are, what their beliefs are that they are selling, actively selling, and how they are often significantly different to the 'other mental health, genuinely do science and want to make people happier' stuff people get sold as 'not stigmatising'. There are themes, and what is actually underlying this does actually matter.

I still get chills about how they got away with creating those videos which would ensure a GP would have wide rabbit-in-headlight eyes when some poor person from a certain demographic, looking a certain way, or with a made-up slight in their notes walks in as they have been brainwashed to be told 'told confront their delusions' and from that point on they never got the basic respect of being seen as a human with a voice. What that does to an individual. WHen it was deliberately spread further afield. That those people are worth nothing, anywhere. Not to be heard, not to be looked at. People who walked in perhaps with genuine physical conditions and biological markers for other things that were encouraged by these videos and the nonsense guidelines to be refused to be tested for. It's just plain markign out of individuals by their face fits for the worst dehumanisation based on lies that were encouraged to never be allowed to be proven by the 'don't investigate' nonsense.

There is a strong theme of 'psycho-education' aimed at creating stigma and lack of support around people singled out to 'create' the dystopia I find frankly frightening by ensuring those near them 'look at them as a non-person' or 'possessed'. Let's be honest and begin using the words that are accurate to describe what they should be able to see is clearly an underlying message and mis-attitude behind how many of these things are seen and believed to be 'best dealt with'. None of which I believe was ever 'evidenced' as not harmful, studied for the potentially lifetime devastating impacts, nor even properly assessed as being useful.
 
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