I don’t know how you make a living, doc

One of my patients often tells me that she used to say to my predecessor, “I don’t know how you make a living, doc, cause I’m never sick.”

Things changed when she was diagnosed with a TIA and we found an irregular heartbeat. She now often expresses her gratitude for the care available, close to home.

Like so often in life, we only value something when we perceive a need for it. Emeritus Professor Max Kamien recently reminded me of this when he quoted James Dickinson in a comment on this blog post.

Dickinson, a professor in family medicine, used to work in the Federal Department of Health. He said that health policy is devised by young, healthy, non-medical advisers who do not have a need for a personal GP and instead use impersonal walk-in practices.

They often regard these experiences as being substandard medical practice. As a result, he said, they do not understand the multiple tasks required for good quality general practice and do not perceive its relevance.

This could perhaps explain the incomprehensible decisions that often come out of the department, such as defunding ECGs in general practice (a test which was crucial in the diagnosis and management of my patient).

I sometimes wonder, is it worthwhile spending more time and effort on educating policy-makers in the department of health?