Healthcare or Health Service?
Up to 1800, no-one went near a doctor if they could avoid it. At best doctors might amuse the patient while nature cured the disease – the doctor’s business was to take as much of the credit and the money as possible. The best was rare. In an effort to get the money, doctors liked to pump us as full of stuff as possible, commonly in the process, as most people recognised, hastening our demise.
HealthCare
From shortly after 1800 to around the time the Berlin Wall came down, when we had problems we took them to doctors who operating on the basis of a medical model worked out whether a poison or a mutilation was needed or whether the condition was something that might pass of its own accord, or was terminal and perhaps best not make things worse, shorten a life even further, with a poison or a mutilation. For decades, the magic lay as often in not doing as in doing.
While places like Harley Street and its equivalent in most Western cities were still synonymous with doctors ripping off wealthy patients, the reward for a lot of family doctors came from being able to save a life or prevent a disfigurement. If they gouged some people it was in order to treat others for free.
This was Healthcare. Because we were often in too much pain, too confused and perhaps terrified, rather than interrogate medical staff, we and our families trusted those we sought help from to do for us what they would have done for themselves. We assumed a Duty of Care rather than insisted on consuming health products because of some God-given Right to do so.
Not all was perfect in this world, as women with breast cancer in the 1950s found out. Surgeons were increasingly at odds with well-informed women as to what they might want. And shockingly in the 1960s it became clear that in some leading American hospitals people, instead of getting what they thought was state of the art care, were in fact in research studies without being told of this.
Health Services
We entered an entirely different world after the Berlin Wall came down. Just before this, medicine, governments and pharmaceutical companies had discovered what they called risk prevention and later health promotion. Forget illness, lets talk wellness Tony Blair and George Bush, Barack Obama and David Cameron told us.
We found our bones, our breathing, our blood lipids and glucose levels, our blood pressure, our moods and all sorts of other things being screened and if there were any hints of abnormalities that might or might not give us problems in some distant future, we were invited to take a bisphosphonate, antihypertensive, hypoglycemic, statin or antidepressant.
Problems like this could be brought to us in a way that pizzas, downloads, and books from amazon can and heart attacks, strokes, fractures and psychoses can’t. Problems that might never materialise became the basis to all but force many of us to consume products (no mention of poisons here) that worked much better than traditional medical efforts to treat a heart attack, or fracture. Thickening bones (abnormally), lowering blood pressure (abnormally) or lowering lipids or glucose (abnormally) and making a perfectly balanced serotonin system highly imbalanced.
We didn’t make much progress at treating heart attacks or psychoses – which stubbornly continued to require close co-operation if we were going to get the right result.
This component of what happened in clinics or hospitals became became part of the service industry and rapidly grew larger than the Healthcare component. Who better to run these new services than professional managers who might rotate in from McDonalds or any other service company and who knew how to run things. Run – not support the most delicate thing we used to do on this earth.
Guidelines also appeared around this point – with the NICE Guidelines being among the most famous. But all Guidelines, including those drawn up by NICE, are based on a ghostwritten literature with no access to the data from the clinical trials done. Long before any politicians or media outlets got into Fake News, the literature on on-patent medicines offered and still offers the greatest concentration of Fake News on the planet.
These Guidelines laid down what doctors should be doing and our new “managers” could put a requirement to keep to Guidelines into a doctors job description, just as they might write some equivalent into the contract for an employee in McDonalds. They could (and do) get rid of any doctors who don’t put patients on hypoglycemics, antihypertensives, statins, antidepressants and other drugs – most of which the doctor wouldn’t take themselves or let any of their family take.
We moved rapidly from taking a brief course of one drug at most at any one time, in the 1980s, to taking 7 or more every single day of the year now. The human body can survive acute poisoning or a skilful mutilation relatively well but chronic and indiscriminant poisoning is another matter and life expectancy is now falling with very few people offering any good explanations as to why.
Social Capital
When in an acute medical crisis we sense a doctor is doing what they would do for their own family, and we trust them, even if things go wrong, a social capital develops.
But if in delivering a health service, a doctor puts us on some sacrament (never say poison) and we get injured and later figure she would never have taken it herself, this is a betrayal. It might make money for the service, who are relatively immune to any action we might take against them – as the O’Neill Inquest brings out – but it destroys social capital.
The world becomes a poorer place. And if doctors betray one person, it probably doesn’t get any easier to stand up for the next person. We can cope with a medicine, where some doctors are following the money or the glory in places like Harley Street, but we can’t cope with a system where the entire apparatus is geared to be indifferent to our interests. The logic of the concentration camp kicks in this case and almost all of us end up doing what we need to do to get by.
More and more of us are faced with the inexorable logic of health services who injure or kill us or people we love but whose employees – decent people – can demonstrate that everyone has kept to Guidelines and everyone has ticked all the boxes that have been put in place by managers who have rotated in from McWherever – boxes aimed minimising risks to the organization rather than look after us.
(The Germans running the concentration camp apparatus were just as well adjusted on all tests of moral and behavioural function as the American troops who liberated the camps. Just as those who operate death row facilities now are screened to ensure they are all entirely normal – and are just doing a job).
O’Neill Country
Stephen O’Neill’s death, covered over the last two months HERE, is a telling example of this.
Some years ago Onora O’Neill, from the opposite side of the religious divide in Northern Ireland to Stephen, gave the Reith lectures – a British Institution. Her subject was Trust.
She began with this:
Confucius told his disciple Tsze-kung that three things are needed for government: weapons, food and trust. If a ruler can’t hold on to all three, he should give up the weapons first and the food next. Trust should be guarded to the end: “without trust we cannot stand”.
What generates Trust? Key is our sense that the leader in this case recognises his/her Duty to go the extra mile for us and others. S/he will only ask us to go to the wall if s/he is willing to go there – first if need be.
The idea of Rights came later when government became anonymous, supported by functionaries who were regarded as ethical, if they ticked the boxes of policy dutifully, whatever the policy, and posed no risk of recognising any other duty to fellow citizens – any duty in humanity as the phrase goes.
This social capital, critical to everything, is under threat today, no where more clearly than in Health. For millennia, Religion was the primary force shaping us. For a few centuries politics and economics took over. Now health is at the centre of everything.
For a few decades in some but not all countries, Health was a place where you were treated with humanity regardless of your creed, or politics – where battles stopped while people from both sides were removed from the field of battle.
No longer. Doctors now tolerate a medical literature that has been more Fake than any other body of literature on earth, and have been doing so for decades before any of us heard of Russian bots.
If you are injured by a drug or device now, where once they were quick to recognise these injuries and champion us when we were injured, doctors like Stephen O’Neill’s doctors will walk by you, claiming to have done their duty by keeping to Guidelines.
Common Purpose
When RxISK began, some of us hoped doctors would fill adverse event forms and we might be able to build maps locating the doctors who could be trusted.
Perhaps we, or those of you filling forms, have just gone about it the wrong way but there is a very strong sense that few doctors now have the guts to put their name to an adverse event report. Without this there can be no HealthCare – simple as that.
In the absence of adverse event reports, however, health services meanwhile will run ever more smoothly – see the processes are working!
Rebuilding a sense of common purpose has to be the task for the next decade. If we don’t make progress very soon we may be doomed – ‘Tis the Season to Rebel.
See also The Pandora Hypothesis.
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Look hard and wide for doctors that practice like those who made house calls years ago and cared for you as they would their child. They’re becoming an endangered species I’m afraid. Unfortunately the pharm industry has done such a good job of poisoning the well that many Drs just don’t get it. By that I mean the harms of meds, manipulation omission of data. What it’s become -big pharma take over of medicine reminds me of ivy weaving through the bricks of a house.
I took my cat three years ago for what I thought was an abscess on her lower jaw. The vet put her under cleaned it up did and X-ray which showed a mass and she resected this aggressively into the jaw bones little and sent a biopsy. Came back as a particularly bad cancer. Prediction was kitty’s demise in about 3 months. I had kitty morphine ready to go and got the hospice mindset in gear but Kitty did fabulous. So stoped the meds (she seemed to not like the pain med) and she hasn’t had a drop of Medicine in 3 years no labs or tests. She did well with a small surgery and antibiotic for 7 days. She gets her soft food and well she’s happy running around herself doing fine. Docs still amazed. Less is more in most cases.
Merry Christmas to all.
Our pets these days in general get more person-centred care from Vets than we do in hospitals.
D
It seems like we understand the concept of less is more with animals.
Talking of China, I’ve read many times:
“Historically, a Chinese Medicine doctor was paid a retainer to keep their patients healthy. If a patient became sick, the doctor would not be paid until the patient’s health returned.”
https://xhistoryunveiledx.wordpress.com/2014/10/13/doctors-paying-patients-in-ancient-china/
Beware of wolves dressed in sheep’s clothing ~ They are everywhere!
There is good and bad in every profession and some Docs like to give the impression that they care.
Some make their patients very ill so that they can generate $$$ out of the vulnerable.
They do:
unnecessary tests upon tests + dish out meds upon meds = unfavourable health outcomes (induced diseases)
Some are sadists and get their kicks out of watching healthy people get sick, under their ‘masked disguise’ of ‘so called caring!’
The vulnerable are tricked into believing that those who care are doing so much to benefit their patient when they are doing more harm than good and placing their patients through unnecessary RISKS!
Is the model of medicine today fooling and deceiving a lot of people?
Are we just another number and once we end up in the wrong hands, lost in the vacuum of a futile system?
Should there not be quotas and guidelines on how much tests and procedures should be done on patients?
If you end up in the wrong hands, your good health will surely be compromised or cut short.
Vulnerable patients believe the more tests and procedures you do = better health outcomes. Not necessarily so!
Who has the right to put us through so much harm and unnecessary risks?
BEWARE OF THE WOLF IN SHEEP’S CLOTHING ~ Little Red Riding Hood is in for a very rude SHOCK!
Fake news+ bad medicine + flawed literature +some fake politicians + some docs who wear false masks = all play their role in deceiving the majority
Lessons To Learn From Little Red Riding Hood
So when Little Red Riding Hood reached the cottage, she entered and went to Grandma’s bedside. “My! What big eyes you have, Grandma!” she said in surprise. “All the better to see you with, my dear!” replied the wolf. “My! What big ears you have, Grandma!” said Little Red Riding Hood. “All the better to hear you with, my dear!” said the wolf. “What big teeth you have, Grandma!” said Little Red Riding Hood. “All the better to eat you with!” growled the wolf pouncing on her. Little Red Riding Hood screamed and the woodcutters in the forest came running to the cottage.
It would be wonderful if we had benevolent souls watching out for us, especially when we are dealing with WOLVES IN SHEEP’S CLOTHING!
(Please post this response instead of the other.)
It’s been about 1.5 years since I last visited the doctors because of my kindling reaction to a reinstatement of an SSRI. I still suffer from awful symptoms. I’m getting on with life as best as I can.
But it still keeps me awake at night. Not the symptoms, although they make it uncomfortable at times. But the injustice of it all. That keeps me awake. It’s now Christmas. I had my adverse reaction on The 17th off December 2017. Worst 6 days of my life. almost died and then another 1.5 years off work complete with around 20 different symptoms coming and going, new ones appearing, old ones leaving then coming back and so fourth and now I’m in debt.
The worst feeling is nobody cares, doctors don’t have time or even believe what happened. It’s very lonely. I have support from friends and family, but I really need proper help both medically to help investigate things and emotionally as it has effected me. There isn’t a day I don’t think about what happened, not a single day. I’ve tired to move on despite it all but it’s hard.
I still have a few symptoms left that have made my life less than ideal. But I’m working and trying my best. I have a lot of anger inside me, I feel like I want to fight them, make some noise but don’t know where to begin or where to turn.
To this day I have nerve pain in my neck, vision issues such as depth problems. Playing computer games is hard as my eyes have a delay in tracking objects. Raining in my ears (tinnitus), my hands feel weak and I get spasams in my fingers. Sometimes my fingers get so stiff and tingly they feel like wooden hands. It’s an odd sensation to describe.
I believe I had a form ot cervical dystopia as my neck muscle seized up for a full year: it felt like toffee being stretched, pulling my neck had the weirdest sensation. Months after that I started getting tingling skin around my neck and now for nearly 2 years my neck skin felt like it was sandpaper, like a burning feeling. I can’t stand how weird and awful it feels when I’m lying down but I’m learning to live with it. There’s more.
I could write a massive list of symptoms I’ve experienced on and off these past couple of years but it would be a massive post.
The one one I experienced was Akathasia which I had no idea what it was. At the time. I will never forget how awful I was going through that. 2 years later and I’m still deeply hurt by what the doctors did to me. I don’t think I’ll ever get over it.
I have a lot of hate, resentment about how I trusted doctors. I carry that with me everyday . I should really see someone about that as it has poisoned my soul a little. I’ve moved to Camden in London so I’m trying to find a support group or therapist who I can talk to about what I went through and continue to go through. But I have no idea who to turn to as I need someone who understands what these drugs can really do. Nothing can help with the symptoms. But ironically I need to see a therapist to help me deal with what happened because of the meds.
The SSRI almost destroyed my life, I had a great career as a VFX artist working on movies. I’m lucky enough to be back doing that. But I still have problems that I fight with daily.
I honestly can’t believe my life has been efffected in the way, if I had never went to the doctors about anxiety all those years ago, I would be fine. Ironically I’m not anxious anymore but what I’m left with is much worse.
Reply
Shaun,
Am sorry to read all you have been through with this. Just wanted to respond to say that you are not alone, if that is any kind of small comfort at all. I took an SSRI for many years and I can relate to some of what you describe.
There is a lot about antidepressants and withdrawal which just isn’t being spoken about, a lot of people go through a private hell trying to come off and deal with the after effects, it can be very hard to find words to describe this experience to others. It can be life changing.
I’m not sure if it’s still going but there used to be a support service in Camden for those withdrawing from antidepressants and Benzodiazepines called REST. Are you familiar with it at all? It’s not a service I’ve used myself but I think they may be able to offer some peer support. I believe the lady behind it is called Melanie Davis if you wanted to look into it further.
There is also survivingantidepressants.org which you may have used before? Can be useful for connecting with others who share an understanding of these issues.
I can relate to the anger and injustice you speak of, It’s astounding how hurt we have been by something which was supposed to help.. Wishing you well
Sarah
This post, at the opening of a new decade, is incredibly important.
What made things change after 1987?
Discuss———————
Why do GPs when presented with a RxISK Report after a patient experiences an ADR:-
(a) roll their eyes and say ‘what’s all this about, we’ve got yellow cards for this’
(b) shuffle uncomfortably in their chair and say ‘I really don’t have time for this’
(c) snarl, ‘please don’t get involved with all this nonsense, it will do you no good’ implying that ‘you are being brainwashed by a load of self interested loonies and I will make a note of your records that you have lost the plot, so if you bring any of this up with my colleagues, they’ll have their blocking response ready for you. And there’s an end to it.’
Tick all those a’s, b’s or c’s that apply.
Has ANYONE ever managed to elicit a warm hearted, open-minded, genuinely reasonable interested response from a GP when tentatively or even in a gung-ho manner, proffering a RxISK Report?
We are worrying about global warning, naturally enough. But shouldn’t we be even more worried about the mass infiltration of our minds and bodies by poisons (sacraments) delivered by trusted minions duped into so doing by a terrifying power. We will never cope intelligently with global warming challenges if we can’t think straight. We will never care about each other if we are drowning in sickness ourselves. It is tempting to feel smug satisfaction about being one of the elite, one of those ‘in the know’ having discovered Mad in America and RxISK.org. But it’s not very edifying, just to hug the knowledge to ourselves. But how the hell do we get that knowledge universally accepted in time? So many of us have tried and tried. Perhaps we can’t. Perhaps the end of the civilisation pre 1987 is here, and only little pockets of us, up on high hillsides, will survive to remember one day how things once were. The rest will be zombies. Maybe this is destiny. Maybe we’ve passed the running point, and all is lost. Maybe now all that’s left is the possibly of a miracle. Who believes in miracles these days?
I do.
Serafina, I’ve had two very caring responses to a Rxisk report. One went so far as to talk to the chair of her department, but both ultimately said they could not get in touch with Rxisk. It would require a release of information which I would gladly sign, but reaching out to Rxisk seems to be stepping too far outside what these doctors are routinely expected to do. Both of them decided to focus on helping me in more immediate ways but at the time I resented them for not getting involved. Since that time I’ve learned to accept this as the way it is, and like you, I believe it’ll take a miracle.
Reminds me of doing ‘lines’ in detention at school…write some ‘wise’ person’s words of wisdom over and over until it’s meaningless – then forget all about it. But all the same sincerely kudos G J B for outing yet again what is well known to still go on in medicine.
Re: Pathways to independence: towards producing and using trustworthy evidence
Re: Pathways to independence: towards producing and using trustworthy evidence Joel Lexchin, Helen Macdonald, Barbara Mintzes, Cynthia Pearson, et al. 367:doi 10.1136/bmj.l6576
I completely agree with the points and issues raised. I am a consultant breast radiologist working in the NHS for the last 9 years. The NHS prides itself in being one of the few medical institutions in the world free from any financial incentives to the healthcare providers directly from the patients. Having worked in other medical settings, I know this system works well for the patient and doctors alike, keeping the public trust in doctors high.
To uphold NHS principles, it is crucial to obtain trustworthy medical evidence free from commercial and sponsor bias. For that to be possible, direct industry sponsored research to test new equipment and drugs should be stopped with separation of those who make products (with clear financial gains) and those who evaluate it. Often the medical stalwarts involved in industry-sponsored research are the same persons who are actively involved in contributing to key guidelines as ‘experts’ by speaking in national and international meetings. I can speak that from personal experience as recently I was asked to help in an industry sponsored research to test a new equipment, in which the data was completely held by the industry and the chief investigator had significant contribution to decision making which effects protocols throughout the country. I refused to take part. I also know from personal experience that all ‘breast screening’ guidelines in this country are made by people who work in the screening set up with clear gains from screening to continue, even though resources are scarce and are taken away from genuine symptomatic women who wait for weeks to be seen by a breast radiologist. There is never a healthy debate about the pros and cons of screening healthy women for breast cancer in national meetings. We are in an age of over diagnosis, over treatment and turning healthy people into patients.
There are few steps that could be taken. Firstly, there should be a strict universal policy to have a clear display of conflict of interests before any presentations/ published materials with key findings, especially those that could influence public and medical opinion. Secondly, experts involved in drafting guidelines on a particular topic should not have financial or non-financial gains from the outcome of those guidelines. Thirdly, industries interested in testing new equipment/drugs should contribute to a public body, from where there should be blinded allocation to a research team for an non-biased testing of these new equipment/ drugs. There should be no direct contact between industry and healthcare providers.
Competing interests: No competing interests
17 December 2019
Gaurav J Bansal
consultant radiologist
Cardiff and vale UHB, UK
27/12/2019 Radio4 Today 5pm On antidepressants
https://www.bbc.co.uk/programmes/m000cn11 (On SOUNDS now)
Both episodes on SOUNDS – todays episode is A follow up to the series on antidepressant withdrawal -by Sarah Vine John Read and Roger Whittaker -ist episode shown 11th March 2109
Anti-depressants: How hard is it to get off them?
For PM, Sarah Vine investigates the experience of withdrawing from anti-depressants
Release date:11 March 2019
What do we need to do to have our voices heard, if many are sceptical?
We have been creating an awareness before all this information came out and all concerned refused to listen. :'(
The below alcohol and drug related deaths of celebrities is not coincidental!
https://www.drugs.com/celebrity_deaths.html
There are no more excuses for health professionals to be unmindful that medicine (s) toxicities combined with other medicines, alcohol, opioids and herbal medicines, can be very fatal.
I am also very aware that any of these celebrities could have ingested a flawed batch of medicine(s).
Of course, the truth will never be revealed because it will cause a very big embarrassment and uneasiness to those who believe that everything is ROBUST when it comes to:
Research (flawed information)
Flawed Manufacturing
Unscrupulous business (corruption)
Cover up’s /lies
Perhaps, Serafina is correct in suggesting that miracles do happen in the end.
The quote by Mahtma Gandhi rings so true!
“First the ignore you,
then they laugh at you,
then they fight you.
Then you win.”
I don’t believe we hug the knowledge to ourselves, Serafina.
Some, just plead ignorance and treat us like imbeciles.
Sadly, it is too late when something unforeseen happens.
It is all over the internet for all to see/hear.
Yes, I believe that BIG DRASTIC CHANGES are inevitable.
There should be no more EXCUSES for unethical and immoral practices.
Some time ago I looked up the reporting figures on the MHRA website and calculated an estimate of how often GPs in the UK report ADRs to the MHRA. It turned out that they were averaging around twice in their careers. That was when the reporting figures were easy to find, I don’t think they are now, well they weren’t the last time I looked. And yet doctors seem to pretend that they’re fulfilling this essential task. I thought at the time that the average probably reflected a few stalwarts religiously doing their duty while the rest did nothing, and am not at all surprised to read here that “there is a very strong sense that few doctors now have the guts to put their name to an adverse event report”. When I suggested to one consultant that he should report my ADR he replied – ‘they’d be down on me like a ton of bricks’. I should have asked who ‘they’ were. I got the impression that he meant the hospital management, but I can’t be sure.
YOU ARE HERE:HOMENEWS
GP clinical judgement leads to 20% fewer referrals than NEWS score, finds study
22 January 2020 By Isobel Sims, Costanza Pearce
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Madhumita Murgia, European Technology Correspondent YESTERDAY17
A drug molecule invented entirely by artificial intelligence is set to enter human clinical trials for the first time, marking a critical milestone for the role of machine learning in medicine.
The new compound, which has been designed to treat patients with obsessive-compulsive disorder, was developed by Oxford-based AI start-up Exscientia in collaboration with the Japanese pharmaceutical firm Sumitomo Dainippon Pharma
The breakthrough comes at a time when investors are pouring billions of dollars into companies that are accelerating drug development using AI.
So far, machine learning algorithms, combined with troves of patient data, have been used to successfully expand the number and types of patients who can benefit from existing medicines. But the invention of entirely new drugs by AI that are both clinically safe and effective in humans has been harder to achieve.
Exscientia’s AI platform used a suite of algorithms to decide on the best chemical structure for the new compound, which is known as DSP-1181 and is targeted at a specific receptor in the brain involved in OCD. Together the algorithms were able to generate tens of millions of potential molecules, sift through the candidates and make a decision about which ones to synthesise and test.
“The AI can learn faster than conventional approaches, so we had to make and test only 350 compounds, a fifth of the normal number of compound candidates, which is record-breaking productivity,” said Andrew Hopkins, chief executive of the start-up and a molecular biophysicist. “The algorithms . . . can be applied to any drug targets, against a huge range of diseases in oncology, cardiovascular and rare diseases.”