Patients deserve to be treated – not treated like they’re daft
I was on a set of scales in a nurse’s office, which is a fairly humiliating place to be at the best of times. However, if you have type 1 autoimmune diabetes, as I have had since the age of two, weight monitoring is necessary. What happened next was not necessary. The nurse started aggressively jabbing their finger at the number: “See?
Can you see that? It is X. Can you see that? Look at it. Look. It is X.” Of course l could see it. I may have disabilities, but I don’t suffer from a visual impairment of any kind.
By now, you’ll probably have worked out that the number was fairly awful. It shocked and embarrassed me. But not as much as my treatment in that office. Now 20lb (and counting) lighter, I’m still angry. You could say “But you’ve lost 20lb, so it clearly worked.” Nope. It was the number – not the nurse – that catalysed a change in my diet. The humiliation I was subjected to? That just made me furious.
Wait, I thought: having been all but abandoned by the NHS, this is what I get? This? And then: is that the aim? To put patients off? If it is, people like me are going to get sick and they’re going to require expensive hospital treatment down the line. But we’ll park that, because this encounter – and my reaction – raises an important point about the NHS crisis: it is changing the relationship between patients and clinicians. It can’t help but do that.
Let me be clear: I am not in any way suggesting that any of this is the clinicians’ fault. On the contrary. Most, if not all, of them are probably horrified by a situation that has been created by the government’s persistent refusal to properly fund the NHS, which in principle is an admirable and cost-effective means of delivering mass healthcare. The government has refused to train sufficient staff. It has wasted money on bad contracts. All of this is leavened with a dash of good old-fashioned incompetence and the refusal to take responsibility for its failings.
It should also be said that most clinicians wouldn’t dream of putting their patients in the situation I was put in. But the feeling of abandonment people with long-term health conditions experience is real. I’m supposed to be under a consultant at Whipps Cross Hospital. However, I’ve written before about not having had a proper hospital appointment in years, partly as a result of Covid. Trying to book one when cancellation is all but inevitable now feels pointless.
I’ve also covered the difficulties diabetics face in securing their regular health checks – just 36 per cent received the checks they were supposed to have during 2020-2022, according to Diabetes UK. I’m lucky in that I have a first-rate GP, but the support that used to be there has otherwise ebbed away. It is naive to pretend that this isn’t going to have an impact.
The government has refused to train sufficient staff. It has wasted money on bad contracts. All of this is leavened with a dash of good old-fashioned incompetence and the refusal to take responsibility
Prior to the pandemic, most people will probably have taken the view that the doctor or the nurse is the expert. Their attitude will have been something like “I’m going to listen carefully to what you say and I’m probably going to act on it in the knowledge that it will in all likelihood be in my best interests.”
Now? Now it’s more like “Hey stranger! What’s this you’re saying? I’m getting this wrong? OK, well the thing is, I’ve been managing this on my own for a long time without much input from you. My blood results look OK, and you don’t know me, my body, or the challenges my condition imposes upon it. This is the first time we’ve met. We’ll probably never see each other again. From the way you’re talking, I’m not sure that you’ve had the time to look at my notes. So I’ll take what you say under advisement because I do know my own body.”
Now, how about we talk about all that new kit that’s out there. Is any of it relevant to me? Could it help me handle this? Can we sort this out, because neither you nor I know if and when another appointment will be forthcoming. That matters too. The Independent carried a report this week about the development of an artificial pancreas. Fab idea. As a child with a life made up of
needles, I would have been cock-a-hoop at seeing that. It looks like the next best thing to a cure. Revolutionary? Maybe.
Trouble is, my control is probably too good to make me eligible (it’s pricey kit). I can’t even get anyone to talk to me about the (much cheaper) electrode and app system for blood sugar monitoring. So I’m languishing as a human pin cushion, and I’m likely to remain so, even with better options available.
Needless to say, I’m now disciplined enough to put up with the sort of treatment I was subjected to on the scales. There is, however, a way to address and perhaps to resolve this.
One of the best things I read last year was a paper by Caitriona Cox and Zoe Fritz, a pair of doctors from Cambridge University. They called for an end to belittling language on the part of the medical profession, in a paper published in the British Medical Journal. In it, they diagnosed the problem, discussed the symptoms, and put forward a treatment pathway. For this invaluable service, they were shamefully portrayed as “woke medics” by a tabloid newspaper.
But they were right, and are all the more so today. Their work should be filed under the heading “essential reading”.
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