don't be palmed off with drugs

[Will1985]

Who said anything about a holiday Maggot? Of course there are meetings while they are out there, but not to fill the whole day or night! While there are most certainly some interesting topics and talks at these things, I'm sure there are also some lectures which are not very useful to everyone in any sort of conference. Some individuals are known for turning up and abusing the system by signing in and then walking out (sounds like some members of the House of Lords), but that has been largely put a stop to.

The big drug reps have up to 6 figure sums of money to throw at practices over a year, which they are supposed to spend somehow. All I can say is I enjoy the massive lunches they bring for the staff when visiting

 

[bonj2]

And you know this how exactly?

because my knee isn't inflamed! I can see that, and feel it!
It just isn't swollen up or anything at all.

 

[bonj2]

Do you really believe that Drs just take backhanders off of drug companies all the time, and the main choice for prescribing the particular drug is based on how much money they can get off drug companies?

They do, in the same way that dentists benefit from giving you a filling, as they can claim off the government for each one they do. Doctors give out drugs, the government pay for it, but the drug companies benefit. So they naturally want to increase that benefit. The way of doing so is to reward doctors who give out more.

On the other hand, there are situations where Drs are charging a "referral fee" to therapists in their local area. So inadvertantly, you may have made the GP some money from a referral, and saved him some penalties (financial) from the PCT on his prescribing costs!!!!!

This won't have been the case, otherwise he wouldn't have been reluctant to do it.

BTW my wife is a physio, and she will exam your knee for £45.00

That's a bit steep, the one my mum recommended is only £30. And not saying your wife isn't, but he's very good.

 

[bonj2]

You think? So what is the week long expenses paid trip to Spain that two of my dad's colleagues are taking courtesy of a drug company this week? Doctors can still squeeze a hell of a lot out of drug companies, but often it is payment for 1 day courses and expensive books more than anything.

All too true.

Bonj - inflammation could be under the knee cap

No, the problem is not unerneath my knee-cap, the problem is on the top of my knee cap. It's the ligament that runs over the top of the knee cap that's pulled or twisted, or spasmed (not sure if a ligament can get spasmed) or something.

If you don't like the service, look elsewhere. It shouldn't matter to the GP where he refers you, but if he either has no private friends or gets a type of commission for referring you to the practice physio, that isn't so good. It takes less than 5 minutes to dictate a simple referral letter TWIMC....some GPs even charge a fee!

I know I can go elsewhere or just to a different GP in the same surgery if I want, but it isn't about that - the point I was making was that you don't always have to take the 'experts' word for it - sometimes if you know what's wrong with you and you know how it needs fixing you just need to insist that that gets done, rather than go along blindly like a sheep with whatever path they choose to lead you down.

 

[bonj2]

There's a fair chance that you have [got inflammation].

Bollocks. My knee isn't swollen at all, it looks normal, and feels normal to me, and obviously does to the GP, but probably wouldn't to a physio.
The GP has got absolutely nothing to go on. All he's got is my word, that 'my knee hurts'. I could be making it up, or have a broken knee-cap for all he knows. He's got no idea. And neither have you. But a physio would, because he knows the exact shape and workings of the skeleton, muscular system, and all ligaments and tendons, etc inside out like the back of his hand. On top of that, physios actually work with people's bodies all day every day, GPs don't, they just sit at their computer banging out prescriptions.

 

[bonj2]

They won't be going on a week long all expenses paid trip to Spain, they will be going to attend a week long educational meeting, sponsored to attend by a drug company.

Same difference...

While they are at the meeting, your dads colleagues are under absolutely no obligation to attend any functions or symposium put on by the drug company, and if the companies representative told them that the only way he could arrange for them to go was on attendance at such functions, your dads colleagues should immediately report the rep to his company and the ABPI.

If any drug company puts on an educational meeting, the content cannot be promotional, if they do promote at the meeting, your dad should immediately report them. The issue of books, if a company buys a book for someone the book should become the property of the team in which the dr/nurse works. If someone offers to buy your dad a book, he should make it clear it is for the surgery/dept in which he works, as should the rep. Otherwise report them. The regulation system only works though if people report wrong doing. If you look in the BMJ nowadays you will find a list of named and shamed drug companies following complaints to the ABPI. It's just a shame there is no mechanism for naming and shaming Drs who try and blag absurb freebies from drug companies, by the sounds of it your dads colleagues would be on it!!!

Oh come off it. You don't think the drugs companies are going to pay for it if it's completely impartial do you?
Two things spring to mind: one, it's to 'educate' on how important a particular chemical is, when the only actual product to contain that chemical is made by the company putting it on, but they're 'educating' about the chemical, not the product - but which they know can only be bought in drugs form off them; also, the drugs companies have got very clever ways of getting round all the rules of non-promotion with technicalities. Probably both actually.

 

[ChrisKH]

To be fair to the doctor, he's probably not a knee expert and is trying remedies to see if they alleviate a problem that may be temporary. If you had tried these and then returned with the same problem he would probably refer you to a specialist. If you aren't interested in drugs try a good physio.

Either way if it doesn't resolve itself, present yourself back at the doctor and ask to see a specialist. What appears to be a non-inflammatory twinge now may not seem serious but it could be the onset of something more serious (and less easy to treat). I'm a living example who used to get a slight twinge in the knee but only when walking up stairs two or three at a time. I left it of course and didn't see a specialist for two years.

Alternatively, you may just be a hypochondriac with a slightly strained knee. In which case take a couple of Ibuprofen and rest the knee. Isn't that what the doctor said?

 

[bonj2]

1. Thourough examination...and yes it is possible to do a good knee exam in a 10min appt.

Hmmm... yes, it should be. But I think the GP didn't have the necessary knowledge to do it, whereas the physio probably would, because even though the doctor probably should know, he's got a bit rusty, whereas the physio actually does this sort of thing every day.

2. Agree about a referral to Physio and explore options regarding NHS (usually long waiting time) and private (quicker) an emphasis here due to Bonj enjoying regular sport.

Yep, agreed...

3. Offer a solution for some relief from the pain in the interim period...and in this case I do agree that despite Bonj claiming that there is "no infalmmation" a good NSAID such as Diclofenac would be indicated (unless contraindicated by concurrent health problems or allergies) would be the best course.
Perhaps it would be best to request an alternative GP next time.

Nope. I don't need pain relief, because it isn't really that painful - it's just a twinge more than anything, but it needs sorting because it's wrong compared to my other knee.

 

[bonj2]

Just think, if you'd just listened to an expert and taken the tablets, your knee could be all better by now.

Yeah but i'd have more drugs knocking about my system propping me up, which I don't want. I've always been brought up to recognise that you should only take prescriptions when absolutely necessary, because if you take them willy nilly every time there's anything wrong wtih you then your body will grow to rely on them, rather than building its own defences.

 

[bonj2]

To be fair to the doctor, he's probably not a knee expert and is trying remedies to see if they alleviate a problem that may be temporary. If you had tried these and then returned with the same problem he would probably refer you to a specialist. If you aren't interested in drugs try a good physio.

Alternatively, you may just be a hypochondriac with a slightly strained knee. In which case take a couple of Ibuprofen and rest the knee. Isn't that what the doctor said?

You don't get it do you. Can't any of you lot see any benefit in not reaching for the drugs everytime there's something vaguely wrong with you?

 

[bonj2]

To be fair to the doctor, he's probably not a knee expert and is trying remedies to see if they alleviate

Sorry - no, I don't want to have things tried out on me, if I'm going down that road I'll want paying for it thank you very much.

 

[bonj2]

Well there you go then.

How many different types of drugs have you got in your bathroom cabinet? Well there you go then.

 

[andyoxon]

because my knee isn't inflamed! I can see that, and feel it!
It just isn't swollen up or anything at all.

bonj, you can have internal inflammation without it being visible externally. eg. arthritis, intestinal...etc. Often inflammation is a response to injury of some sort...

 

[bonj2]

Well there you go then.

Sometimes taking drugs for a week is the best solution.

If it's the choice between that and arguing with a GP, not taking the drugs, insisting on a physio appointment and thus wasting their resources, carrying on making your knee worse in the mean time, to be told by the physio that you need to go back to your GP for some anti-inflammatories, then I think the decision is clear.

Well, if the physio tries to tell me to go back to the GP for drugs, then I'll just go to the physio my mum recommended and pay, but he won't. That's not what occurs to him. His job is to fix people, and that's what he does. It's not his job to understand the effects of various chemicals, so that doesn't occur to him - his knowledge is of how the skeleton, muscles, tendons and ligaments all fit together and move, how they should move, and how to manipulate them back into the right place if they're strained or whatever.

 

[bonj2]

None. Your point?

That there is a disadvantage to taking lots of prescription drugs!