Stories are how we communicate as humans. The Greek Myths have persisted for thousands of years. Mythology explained natural phenomena, cultural variations, traditional enmities, and friendships. I’m not going to try to write an epic for the ages here; I’m not going to wax lyrical. I am going to try to illustrate a basic tenet of great quality General Practice.
Galen came nearly a thousand years after the Greek Myths and was a physician of Greek descent in the Roman Empire. Wikipedia tells us: Galen received a comprehensive education that prepared him for a successful career as a physician and philosopher. Born in the ancient city of Pergamon (present-day Bergama, Turkey), Galen travelled extensively, exposing himself to a wide variety of medical theories and discoveries before settling in Rome, where he served prominent members of Roman society and eventually was given the position of personal physician to several emperors.
He is often credited with the the model we use today which is where the doctor takes a history, performs an examination, and then investigates further. This allows the doctor to arrive at a diagnosis, a label that allows comparison with previous patients and further allows useful predictions about what might work to help or hinder the patient’s recovery. Today we have amazing tests and scans but they are FAR MORE useful if these are used AFTER taking a good history and performing a useful clinical examination. For example, if a man has a positive pregnancy test, there is no baby; a normal x-ray of your finger tells us nothing about your headache.
Patients will often ask for an ‘everything’ test. ‘Just check me for everything, doc’, they say, cheerfully. This has many pitfalls. Firstly, to do every blood test would require taking ALL of your blood. You do need your blood to do little things, like carry oxygen around your body so you can live. It’s kind of essential. You can’t give it all away. Secondly, we hit that pregnancy test problem again. Not everyone with a positive pregnancy test is pregnant. While this is obviously easy to overcome – men don’t get pregnant – what do you do with a positive lupus anticoagulant test in an otherwise fit and healthy person? Thirdly, taking some blood might be relatively quick and painless, but what if we then need to do another test because of those results? This could be painful, dangerous, or expensive (or all three). There are lots more potential issues – which is why we recommend a great GP, with a history and clinical examination, before any testing.
There are only 5 reasons to do a test. Any test. Four of them require follow up. Let’s look at the one that doesn’t, first. Number three above, screening, is when we take perfectly healthy people and check them with a screening test, looking for disease. We ONLY need to follow this up with an appointment if the test is positive, because you were fit and healthy before the test, with no issues. Examples of these screening tests include faecal occult blood tests on your poo (when was the last time you used the word stool), mammograms, and cervical screening tests. We can send you a simple form text message if these tests are negative. Easy. Lets look at the other four cases, and we’ll use a story.
A hypothetical patient (let’s call him Hamer, to avoid any copyright issues) presents to his GP with an itchy rash. The GP takes a history and performs a clinical examination. A picture is worth a thousand words, especially with a rash, so I’ve just popped a couple of images below.
Hamer is troubled by the itch, and the diagnosis is unclear, so the GP prescribes some symptomatic treatment and takes some blood, and a swab from the itchy areas, These are sent off to the pathology lab. As an aside, pathology is pretty cool, and there’s a great podcast with Dr Travis Brown, This Pathological Life, where he uses stories to make pathology understandable to all. Check it out! Back to the rash. Now, it could be herpes. We need to rule this IN or OUT. After all, that’s a pretty important diagnosis to make. So regardless of whether the test is positive (herpes ruled IN – needing advice and treatment) or the test is negative (herpes ruled OUT – so what the hell is the rash? Is it still there?), we still need to follow this up. If the test is positive, and we treat the herpes, we may retest to confirm resolution (prognosis and monitoring). I’ve tried to make this story cover all scenarios but basically ALL tests other than screening tests NEED to be followed up with an appointment. This is a quality measure and it’s better for you. This is why PartridgeGP doesn’t suggest that you ring our awesome reception team for your test results. They are awesome at reception, not herpes.
PartridgeGP works with you to help you make your best health decisions, and we won’t back away from being your companion, guide, advisor, and sounding board through your health journey. We pride ourselves on great communication and we’re ready to share our professional skills and knowledge with you. This is only MORE important now, in the time of a global pandemic with a new vaccine on the horizon. The way forward is clear: make your appointment with us conveniently online right here – or call our friendly reception team on 82953200.
Better, for you.
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
For everyone, we believe that having a usual GP or General Practice is central to each person’s care and recommend that people with any health issues that come to the attention of other health professionals should be advised to attend their usual GP or General Practice rather than a specialised service (ie a place not providing the holistic care a specialist GP would). If they say that they don’t have a usual GP or general practice, they should be helped to find one and to actually attend it. Call PartridgeGP on 82953200 or make an appointment online here.
(Hat tip: Dr Oliver Frank)
Photo by Miguel u00c1. Padriu00f1u00e1n on Pexels.com
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If you are a great GP or a great Allied Health Professional, and you want to serve your clients or patients to the best of your ability, without worrying about all the non clinical things that get in your way, lets talk. Call Mrs Hayley Roberts on 8295 3200 and have a coffee and chat with us as to how PartridgeGP can help you to help others.