Should we do as we are told?

[sanguine]

That's is exactly why I would recommend that you follow your doctor's instructions - you don't know enough statistics to realize that your anecdotes carry no weight, and I doubt that you have the statistical knowledge to make an educated decision about which drugs are best. Your doctor, on the other hand, acts on instructions made by people who do have that knowledge.

You mean instructions from government departments who base their 'knowledge' on what pharmaceutical companies tell them, the latter driven by the purely altruistic objective of wanting to help people?

Following Zand's comment, my wife also has experience of people who have been prescribed drugs which have clear contra-indications with drugs they were already on. The GP was so focused on writing another prescription he didn't even check the case notes. So much for knowledge. Is it any wonder we question their advice?

As for statistics, how much do you need to know to resolve the dilemma of 'GP says eat more carbs', result BGs go up; and pragmatic verifiable and repeatable direct experience of many on here which shows the exact opposite?

 

[Spiker]

This topic skates close to the thin ice of the site's posting rules.

I would say, no, never ignore a doctor or other health care professional. Never. I would say it is acceptable to disagree with them, but only after you have heard out their arguments and evidence, put your own arguments and evidence, and then heard what they have to say in rebuttal. I would also say, if you do disagree with them, it's best to tell them that you are going to follow different advice than theirs. That's a sticky point as depending on their personality, it can affect the quality of care and support you get. But in an ideal world, tell them.

From personal experience, about half of the times when I think they are wrong and I am right, on further discussions it turns out they at least have a point.

 

[Syd]

In what circumstances should we ignore our Drs and other HCPs advice? If ever? Or should we always do as we are told?

We should not ignore the advice of the doctors or other healthcare professionals even if we do not decide to follow that advice.

We should make informed decisions on all the facts, and in doing so we should consider very carefully the advice given by the doctors.

To ignore out of hand the advice of professional men and women is impolite and stupid in equal measure.

 

[Spiker]

Oh, so I asked for Metformin on the advice of a complete stranger on this forum. Was that wrong? My GP would not have given it to me if I hadn't asked.

Getting advice from an external source (forum, friend, taxi driver, clairvoyant vision) and then running it by your HCP is not the same as ignoring your HCP. There's nothing wrong with running it by them. They can [often] venture a very sensible opinion on a proposal that just didn't occur to them in relation to your care.

 

[sanguine]

This topic skates close to the thin ice of the site's posting rules.

I was probably getting a bit OTT, apologies.

Most people on this forum are already more of a questioning nature than the mainstream - that's why we're here and a small minority. It can be difficult though having a sensible discussion with the GP when all he seems to be interested in is ticking another prescription box. I'm refusing the statins he prescribed and explained my reasons to the DN when I saw her. I'm seeing one of the senior partners in the practice when I have my next review and hopefully will have the chance for a more reasoned conversation.

 

[Totto]

My GP said he wanted me to start ACE inhibitors when I was first diagnosed. When I understood what this was I said: Are you out of your mind? My BP is already low enough to cause me to almost faint several times a week!
He didn't insist on them once I pointed out to him my latest BP had been 105 over 55.

 

[zand]

I never had a problem with following advice from HCPs until I had a few chest infections when I was in my 20s. I was always given the usual spiel about it being a virus and viruses not responding to antibiotics. This was a half truth, because when I had a virus, I nearly always developed a bacterial infection too and this was what made me feel lousy and filled my upper respiratory tract with khaki coloured phlegm tinged with blood. I was always told antibiotics wouldn't help....then one day, usual thing happened, I was ill, same symptoms, but due to go to Paris for a long weekend the following weekend....and guess what?...the doctor gave me antibiotics and they worked and I got better in time for my trip.

So how can I respect or believe them when the truth is often hidden? If he had said 'you have a virus and bacterial infection, but I would rather not give you antibiotics because you are young and fit and will get over it and be fine in a couple of weeks and we need to be careful not to overuse antibiotics as they will become less effective,' I may have had more respect for him. If he had helped with advice on my immune system I would have had even more respect for him. Those awful posters in the doctors' waiting rooms about antibiotics not treating viruses remained there until the swine flu epidemic that wasn't. Then of course they were foisting antivirals on everyone.

 

[Opalshards]

Well I am a bit of a rebel I suppose 3 years ago my Doc prescribed Statins knowing I was already suffering from muscular problems. I read the information about the medication and they went in the bin. Same with the Metformin in March. Seeing my pharmacist wanted me to check in on a regular basis it worried me. Why would I opt to have stomach problems? So no I don't take advice, I find out what the hell they are foisting on me. And make an informed choice. It is my body and nobody has rights over it but me.
Although it did make me re-think my lifestyle, hence the forum and a different way of eating. If only to prove to the (EXPERTS) they are wrong. Shouldn't they be giving diabetics nutritional advice instead of throwing medication at the problem?

 

[zand]

Well I am a bit of a rebel I suppose 3 years ago my Doc prescribed Statins knowing I was already suffering from muscular problems. I read the information about the medication and they went in the bin. Same with the Metformin in March. Seeing my pharmacist wanted me to check in on a regular basis it worried me. Why would I opt to have stomach problems? So no I don't take advice, I find out what the hell they are foisting on me. And make an informed choice. It is my body and nobody has rights over it but me.
Although it did make me re-think my lifestyle, hence the forum and a different way of eating. If only to prove to the (EXPERTS) they are wrong. Shouldn't they be giving diabetics nutritional advice instead of throwing medication at the problem?

I agree with you on statins. I have refused them several times.
I would just like to say that not everyone gets the side effects listed on the leaflet for the drugs. I have just started taking Metformin (9th day today) and I haven't had any stomach cramps at all yet.
I agree that changing lifestyle is really important and can sometimes stop the need for drugs, so this has to be a sensible step.

 

[hanadr]

I would say that blind obedience to Healthcare professionals is dangerous. Anyone with a chronic health issue, should learn everything he or she can about it. Use reliable sources. The level of information you can access depends a lot on the kind and level of education you have. Some of us can read and evaluate scientific papers. some don't have that skill.
Although I believe most HCPs have the best interests of their patients at heart, they may be out of date on their knowledge or simply not have enough. They also may not really understand what they've learned by rote.
If you have reservations about an HCPs advice, ask for explanations. If none are forthcomingg be suspicious. If they don't make sense, Likewise!
If still unhappy, ask on this forum. there are plenty of members here with YEARS of experience and many with medical or science training.
Someone else on this thread has mentioned anecdote as unreliable. remember, not all advice is based on real science. If someone tries to convince you of something against your instincts, ask to be shown the evidence.
Hana

 

[Danny Prince]

To be fair i don't think they give you advice/information for the fun of it

 

[Pat McCann]

On the advice of my NHS dietitian I stuck to a high fibre diet for three years. During that time I developed mysterious abdominal pains. I ended up in consultation with a consultant after a series of tests including colon, stomach invasions by cameras and probes. He advised me to chuck the high fibre diet and take a "little of what you fancy" and a large dose of common sense. So I firmly believe that the guy (on this forum) who said "Moderation in everything including moderation" is absolutely right. Consult with doctors, consultants, specialists or whatever they like to call themselves all you like but lay a thick cloak of credibility over everything they tell you. Remember it is doctors who control the health service despite the fact that doctors are the greatest opponents of the health service in the UK (according to Bevan - architect of the National Health Service) so their first priority is their salary package - not the welfare of the patient.

 

[Pat McCann]

Why is Diabetes UK advocating the use of this "free" meter and "free" test strips which will actually cost the customer £100. After I got my free meter I get my test strips on the NHS and the meter gives me a continuous record of any changes that occur in my condition for free. Why pay £100 for something I can get for very little effort and no money?

 

[Spiker]

Why is Diabetes UK advocating the use of this "free" meter and "free" test strips which will actually cost the customer £100. After I got my free meter I get my test strips on the NHS and the meter gives me a continuous record of any changes that occur in my condition for free. Why pay £100 for something I can get for very little effort and no money?

If it's the programme I think you are talking about, it's a DCUK programme not a DUK programme, and it's for Type 2s - who don't usually get meter strips on prescription. But maybe post a link to what you are talking about.

Sent from the Diabetes Forum App

 

[Indy51]

Of course you should trust your HCPs:

http://www.dailymail.co.uk/news/art...given-incorrect-drugs-jumps-9-six-months.html

 

[zand]

Remember it is doctors who control the health service despite the fact that doctors are the greatest opponents of the health service in the UK (according to Bevan - architect of the National Health Service) so their first priority is their salary package - not the welfare of the patient.

The clue is in the name - National health service. They deal in numbers, bulk numbers, the nation, before thinking of the needs of an individual. We are all individuals and can sometimes be let down by the 'numbers' approach.

 

[Spiker]

Remember it is doctors who control the health service despite the fact that doctors are the greatest opponents of the health service in the UK (according to Bevan - architect of the National Health Service) so their first priority is their salary package - not the welfare of the patient.

The doctors who opposed Bevan are all long dead. A completely different generation of doctors have grown up with the NHS being a given. There are a relatively tiny number of private doctors left in the UK who have the economic incentives that existed before the NHS, and even these have to compete with an NHS that is free at the point of use. I think this argument is misplaced.

 

[Spiker]

Of course you should trust your HCPs:

http://www.dailymail.co.uk/news/art...given-incorrect-drugs-jumps-9-six-months.html

This shock horror report from Daily Mail Island ought to be balanced against equivalent statistics for people who are harmed by self diagnosis, ignoring an NHS diagnosis or prescription, or by following a non-medical diagnosis. However there are never any balanced statistics on Daily Mail Island.

Long after Bevan's doctor opponents are dead, the Daily Mail continues to wage unremitting war on the NHS.

 

[Brunneria]

We do know our own bodies best - providing we are observant enough to notice the clues they give us. No doctor can do that in a 5 or 10 minute surgery appointment.

However, a doctor has FAR more experience at observing individual clues and putting them into their diagnostic framework and a career's worth of experience (if they have kept up with new developments in the field).

I think the NHS has several severe blind spots. Individual staff within the NHS vary tremendously.

My own experience is that I have had brilliant or useless advice from doctors and nurses, usually depending on their interest level, capacity to communicate, and degree of NHS 'institutionalisation'.

And I don't take ANYONE'S advice without checking it out. Then I make an informed decision.

Likewise, I hope no one takes MY advice without doing the same!

 

[Brunneria]

Oh, and I think that Type 2s and pre-diabetics are in a luxuriously different position from Type 1s.

If someone tells me that I will die, unpleasantly and quite quickly, if I don't do what I am told, then I probably knuckle down.

If someone tells me that I should adjust my eating and exercise more, but i have no way of gauging the effect of that advice (because they didn't issue me with a blood glucose meter), then I am free to exercise a great deal more independent interpretation!