People or patients?

The BMJ have got a good personal view written by Emeritus Professor Michael Oliver. It’s entitled “Let’s not turn elderly people into patients” and is based on the Prof’s own experience of healthcare.

I suspect there are a fair amount of doctors both in hospitals and general practice who sometimes talk, over coffee, about whether or not their medication does any good at all and in fact just does harm – or maybe I just associate with medics who are as cynical as I am. The trouble is that this attitude may be cynical, but is often correct. All medicines have side effects. Medication used for preventing cardiovascular disease is increasingly commonly used in more people – especially, as the Prof says, in older people, 75+ - yet the margin of possible benefit may be small. Sure, if people want to take medicines and have been properly and fairly advised about them, fine. But all too often, standardised protocols are applied with such rigour that the person’s opinions about their options aren’t highly prioritised.

I doubt that there has ever been a golden age in medicine, but the current obsession with clinical guidelines, and the GP contract and hospital targets which prioritise political targets over clinical ones are dreadful. What is worse is that the medical “profession” seems to have given up objecting and has more or less accepted them.

Margaret McCartney’s Blog

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A forum on healthcare policy and professional issues, by Glasgow-based GP and FT Weekend columnist Margaret McCartney.