Everybody was telling me there was nothing wrong

Alvin

Alvin

Senior Member (Voting Rights)
Compared to many other diseases, diagnosing a brain tumour is fairly straightforward. Promptly detecting it comes down to being concerned enough about the early symptoms – which range from fatigue to seizures to personality change – to get an image of the brain. Either the tumour is there, or it isn’t.

But in 2016, the Brain Tumour Charity released a report on the treatment of brain tumour patients in the United Kingdom. It found that almost one in three of them had visited a doctor more than five times before receiving their diagnosis. Nearly a quarter weren’t diagnosed for more than a year.

Women, as well as low-income patients, experienced longer delays. They were more likely than men to see 10 or more months pass between their first visit to a doctor and diagnosis –and to have made more than five visits to a doctor prior to diagnosis.

One 39-year-old woman quoted in the report recalled: “One of the GPs I saw actually made fun of me, saying ‘what did I think my headaches were, a brain tumour?’ I had to request a referral to neurology. I went back repeated times to be given antidepressants, sleep charts, analgesia, etc. No one took me seriously.”
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http://www.bbc.com/future/story/20180523-how-gender-bias-affects-your-healthcare
 
Patients know their individual stories, but doctors must surely be aware and feel some shame/embarrassment/stupidity when they've brushed patients off repeatedly only to eventually find there was a real problem after all. To discover that their own attitude has caused needless pain, suffering and even death.

So, even if they are reluctant to take responsibility for their own mistakes for fear of damaging their career, they must know that IAPT will make these problems more likely to happen and less easy to put right.

Why are they not speaking out? Does the pain and suffering of their patients matter so little?
 
Merged thread

Spotted this in a tweet by Derya Unutmaz today, and don't think the article has been shared here?

Maya Dusenbery: "Everybody was telling me there was nothing wrong"
Women are more likely to wait longer for a health diagnosis and to be told it’s ‘all in their heads’. That can be lethal: diagnostic errors cause 40,000-80,000 deaths in the US alone.

 
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I'm reminded of this awful story from a few years ago:
https://www.theatlantic.com/health/archive/2015/10/emergency-room-wait-times-sexism/410515/

As we loaded into the ambulance, here’s what we didn’t know: Rachel had an ovarian cyst, a fairly common thing. But it had grown, undetected, until it was so large that it finally weighed her ovary down, twisting the fallopian tube like you’d wring out a sponge. This is called ovarian torsion, and it creates the kind of organ-failure pain few people experience and live to tell about.

“Ovarian torsion represents a true surgical emergency,” says an article in the medical journal Case Reports in Emergency Medicine. “High clinical suspicion is important. … Ramifications include ovarian loss, intra-abdominal infection, sepsis, and even death.” The best chance of salvaging a torsed ovary is surgery within eight hours of when the pain starts.
[...]
I knew which end of the spectrum we were on. Rachel was nearly crucified with pain, her arms gripping the metal rails blanched-knuckle tight. I flagged down the first nurse I could.

“My wife,” I said. “I’ve never seen her like this. Something’s wrong, you have to see her.”

“She’ll have to wait her turn,” she said. Other nurses’ reactions ranged from dismissive to condescending. “You’re just feeling a little pain, honey,” one of them told Rachel, all but patting her head.

We didn’t know her ovary was dying, calling out in the starkest language the body has. I saw only the way Rachel’s whole face twisted with the pain.
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It isn't just women. In 1972 my uncle was not doing well, I can't remember exactly what happened but other people kept telling the family how bad he was but he never seemed that bad when he was around us. His doctor said it was depression and finally told my Dad to have a word with him "or it would become entrenched and he would never get better" Reluctantly, my Dad did this though even at the time I felt he needed more investigation, not people having a word with him.

Then he saw a locum GP who sent him for tests - an incurable brain tumour. My father never got over his guilt.
 
What does this paragraph mean?

Women, as well as low-income patients, experienced longer delays. They were more likely than men to see 10 or more months pass between their first visit to a doctor and diagnosis –and to have made more than five visits to a doctor prior to diagnosis.
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  1. Women as well as low-income men?
  2. Non low-income women, plus low-income men and women?
  3. Men who have low income are not men?
I find this poor grouping to be very unhelpful in trying to sort out what she is trying to say. Is it a pure gender bias phenomenon, or a gender plus class phenomenon, or a person 'not like a doctor' phenomenon, a mix, or what?

What is the ratio of doctor to patient ratio in areas of low-income compared to other income groups? Are the help seeking behaviours the same for both genders? The same for for different groups? Are there differences in the performance of female and male doctors? Does the doctor's socio-economic background make a difference?

These questions matter in how to see where the problems lie and how they can be challenged.
 
Luther Blissett said:
I find this poor grouping to be very unhelpful in trying to sort out what she is trying to say. Is it a pure gender bias phenomenon, or a gender plus class phenomenon, or a person 'not like a doctor' phenomenon, a mix, or what?
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I suspect they did two different analyses one with men and women and a different one looking for correlations with income so they may not have explored the relationship. Then the journalist combines these in a single sentence. It would be interesting to know what else they looked at (say age and sex of doctor).
 
Mithriel said:
It isn't just women. In 1972 my uncle was not doing well, I can't remember exactly what happened but other people kept telling the family how bad he was but he never seemed that bad when he was around us. His doctor said it was depression and finally told my Dad to have a word with him "or it would become entrenched and he would never get better" Reluctantly, my Dad did this though even at the time I felt he needed more investigation, not people having a word with him.

Then he saw a locum GP who sent him for tests - an incurable brain tumour. My father never got over his guilt.
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I think these stories are far too common. My father new someone who was told he had stress headaches but it was too late when it turned out to be a brain tumor.

Doctors are encouraged to dismiss patients these days as the worried well. I don't know what the motivations have been in the past but there seems to be a consistent pattern of doctors ignoring symptoms.
 
Adrian said:
I don't know what the motivations have been in the past but there seems to be a consistent pattern of doctors ignoring symptoms.
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Personally, I think the health service and the medical profession are being manoeuvred into a way of working and thinking that achieves several aims :

1) Lowering people's expectations.
2) Treating symptoms only, rather than properly investigating - it saves money. A headache, for example, can be caused by anything from mild dehydration right up to brain tumours. Doctors will assume the cheapest thing they can think of is the right explanation, if they can get away with it.
3) Blaming the patient's mental health - it's cheaper still.
4) If a few thousand people are lost along the way due to not being treated, well there are plenty more where they came from.
5) The "important" people have private insurance.
6) When the NHS ends up privatised completely, these patterns of working will increase shareholder's profits.
 
Arnie Pye said:
1) Lowering people's expectations.
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I think most doctors want to help their patients

Arnie Pye said:
2) Treating symptoms only, rather than properly investigating - it saves money. A headache, for example, can be caused by anything from mild dehydration right up to brain tumours. Doctors will assume the cheapest thing they can think of is the right explanation, if they can get away with it.
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I suspect most doctors want to think they are doing a good job.

Arnie Pye said:
3) Blaming the patient's mental health - it's cheaper still.
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I don't think this is about cost, its about hubris, from what they are taught mental is common hence they would diagnose it commonly

Arnie Pye said:
6) When the NHS ends up privatised completely, these patterns of working will increase shareholder's profits.
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Yes this is the real risk, medicine for profit means bad treatment as a slave to the almighty dollar.
 
@Alvin

My beliefs, thoughts and feelings about doctors have developed as a result of the treatment I've received personally. I have realised a few times that I will never see eye to eye on the subject of doctors with people who are happy with their treatment.
 
Arnie Pye said:
@Alvin

My beliefs, thoughts and feelings about doctors have developed as a result of the treatment I've received personally. I have realised a few times that I will never see eye to eye on the subject of doctors with people who are happy with their treatment.
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Mine have as well, most seem to want to help patients even if they are inept to do so. And i have met many who are useless or addicted to anchoring bias
As for profit over people thats another kettle of fish, the bean counters would murder their own mothers for an extra dollar.

That may be a bit harsh, they probably have some standards, which are worth at least two dollars...
 
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While I believe that most doctor's are generally trying to do their best, there is little doubt in my mind that the politics about and within the NHS are often counter productive to patient care.

I have seen happen in companies where certain sections are deliberately managed to fail, so that a new system or regime can be brought in, I wonder if that's also the case with the NHS.

Like the DWP policies that were designed to deny benefits and encourage people to take out private health insurance/income replacement policies. I wonder if something similar is happening with healthcare.

Even doctors who want to help have to work within the system and if something is slightly outside the norm their hands are often tied. I've been on the receiving end of this a few times. It has limited meds I can try and has also limited tests the doctor is allowed to run.

The NHS is an important part of politics in the UK, but I don't want to break forum rules with politics, so I'll stop there.

Moderators - if this is too political feel free to remove.
 
Invisible Woman said:
While I believe that most doctor's are generally trying to do their best, there is little doubt in my mind that the politics about and within the NHS are often counter productive to patient care.

I have seen happen in companies where certain sections are deliberately managed to fail, so that a new system or regime can be brought in, I wonder if that's also the case with the NHS.

Like the DWP policies that were designed to deny benefits and encourage people to take out private health insurance/income replacement policies. I wonder if something similar is happening with healthcare.

Even doctors who want to help have to work within the system and if something is slightly outside the norm their hands are often tied. I've been on the receiving end of this a few times. It has limited meds I can try and has also limited tests the doctor is allowed to run.

The NHS is an important part of politics in the UK, but I don't want to break forum rules with politics, so I'll stop there.
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Since i'm in Canada i've dealt with a different system so i can't comment on the vagaries of your system, but it does not sound good :(
 
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