Mirror newspaper article on hyperparathyroidism

Reading this emphasises to me the failure of the GP system in an age when medicine is complicated and requires specialised expertise and a motivation to be thorough..

When my niece changed from being an ordinary GP to a hospital frontline generalist (a sort of GP in A/E) she commented that hospital doctors seemed 'risk averse'. What she meant was they tended to make sure they weren't missing something unusual. GPs are taught to ignore the possibility of anything unusual and keep people happy. My niece said that at first this thoroughness seemed strange and then she came to understand the reason for it.

Even as a hospital doctor I was taught to go for the common things and not waste too much resources on other possibilities. We live in an age in which a high proportion of medical problems are not particularly common things. The common things got dealt with. So the GP mentality needs to go.

Unfortunately, the new government sees things the other way around and wants to pour all the money into GP.
 
Sorry I seem to be struggling cognitively today, the draft for this thread disappeared several times and then posted before I was finished. Also I manage to delete the contents of this second post several times:

'NHS doctors brushed off our condition as menopause – what we suffer from is far worse'

Today the UK Mirror newspaper ran a feature on two woman’s struggle over many years to get a diagnosis of hyperparathyroidism:

Caroline Johnstone, 61, is lifting a lid on a debilitating illness after doctors at NHS Ayrshire & Arran allegedly assumed her long-standing condition was simply the menopause. Hot flushes, 'pain all over', numerous kidney stones and severe exhaustion were among her symptoms – even her 87-year-old mother was more active than she was.
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Caroline's condition is known as 'hyperparathyroidism'. This occurs when two glands in your neck – each no bigger than a grain of rice – produce too much parathyroid hormone (PTH).

Over time, this can lead to easily broken bones, kidney stones, excessive urination and a range of other symptoms that may appear to have no clear cause. Dr Gareth Nye, a senior lecturer at Chester Medical School, told The Mirror: "Reportable symptoms are vague and are often assigned to other diseases.

"In women with the condition it is often more likely to be [linked to] menopause which ultimately means our understanding of the real numbers of patients with this disease is likely way off. Although primary hyperparathyroidism is [common] ... it is under-recognised in the general population and by health professionals.

"Current stats place this at 1-4 cases per 1,000 although this is likely an underrepresentation."
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Over a period of between seven and eight years, she claimed one particular doctor insisted they'd have to 'agree to disagree' on her condition before it was finally diagnosed in 2021. The 57-year-old told The Mirror: "Men get diagnosed quickly, and offered surgery promptly, because if a man goes to the doctor, it must be serious. For us women, it is a long frustrating and arduous battle that can span many years.

"We are fobbed off with 'lifestyle, early menopause, fibromyalgia, post menopause, CFS', and our lives are ruined... The effect of the group is that it's saved countless lives. I've had people I don't know email me from the website to thank me for the information calling it a lifeline."
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[added - sorry moderators if there are incomplete drafts lurking somewhere, please feel free to delete.]
 
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And it seems in Denmark the GP mentality is also actively being promoted by Dr Fink and co (on another thread).

Since 2008, all trainee General Practitioners (GPs) in Western Denmark have received basic training in diagnosing FSD and communicating/negotiating the diagnosis with FSD patients using The Extended Reattribution and Management (TERM) model [16, 19]. However, many GPs feel inadequate in managing the more complicated cases, especially at the early stage where the diagnosis is still uncertain and physical differential diagnoses have not been excluded.
 
I feel that GPs sometimes don't listen to the degree of severity of a patient's problems.

E.g. In this story, the GP seems to have heard "aches and pains and fatigue" vs. the patient reporting "pain all over" and severe exhaustion to the point she couldn't keep up with her 87-year-old mother.
 
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I wonder whether it's possible to calculate the money that could be saved by listening carefully early on. Another patient in the story says that she had symptoms for 25 years.

Not that money is the main concern, but it always helps to convince the beancounters that a different approach works better.
 
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