Doctors..

bulkbiker said:

As some of may know I spend some time on the ketogenic forums as well as here.
I read this today and it struck a huge note of recognition with me that I thought some of you might like to read it too.

https://www.ketogenicforums.com/t/m...ctor-and-im-not-offering-medical-advice/32723

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Thanks for posting the link @bulkbiker. An excellent post from him and he's right: they won't have the complete picture about one's personal 'engine' and it is up to us to be the engineer of our learning about diabetes or any health matter that affects us, as much as we can. GPs cannot possibly know everything about your condition (you will be very different from the next patient through the door) and after all, these days I get the impression that in some instances they are just the 'sifter', i.e. they see what they think is a problem and then pass it on to the consultants. That doesn't excuse them from making sure their diabetic patients are on the list for eye and foot checks, i.e. following basic guidelines.

bulkbiker said:

As some of may know I spend some time on the ketogenic forums as well as here.
I read this today and it struck a huge note of recognition with me that I thought some of you might like to read it too.

https://www.ketogenicforums.com/t/m...ctor-and-im-not-offering-medical-advice/32723

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I agree with the need to do your own research and the fact that doctors especially GPs may know nothing about diet and fasting etc. However what the do know, or should, is the patient's medical history. Even those experts on the forum only know what the OP has thought fit to mention. So it could be dangerous to give medical advice without knowing the full facts about the case.

Thanks for that @bulkbiker

Great article. I think the key is to take responsibility for your own health, educate yourself and find a route that works.

I’m lucky to have a supportive GP who recommends this forum, but she doesn’t have a detailed knowledge of a ketogenic diet.

Mr_Pot said:

I agree with the need to do your own research and the fact that doctors especially GPs may know nothing about diet and fasting etc. However what the do know, or should, is the patient's medical history. Even those experts on the forum only know what the OP has thought fit to mention. So it could be dangerous to give medical advice without knowing the full facts about the case.

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I agree
Also Doctors can rightly claim to be the experts in terms of general population treatment outcomes, just as we can rightly claim to be experts about our own bodiy’s responses to various interventions / challenges
Neither of those expert positions give anyone the right / understandding to tell anyone that they “must” do anything tho

bulkbiker said:

Outcomes or general population treatments a sin being told what to do by NICE?
I don't think they are experts in the outcomes...in fact only yesterday there was a piece on Radio 4 about how many people die because of medical mistreatment. mainly through GP's and Pharmacists. I think that just means tht hospitals have got better at covering their tracks..

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Not sure what your first sentance means
What they are taught is very much in the realm of x% of people exposed to intervention y will achieve outcome......
When drugs are considered ‘safe’ that is actually very misleading as no drug is 100% safe - The safety threshold for a drug ( i.e.free from major adverse events,including death, is somewhere around 98 % of the time) . Apparently the drug I had a major adverse reaction to ( Ciprofloxacin) is counted as very safe as the adverse reaction I had is “Very rare” .Im sure most people are reassured to hear that a drug is 99% safe and would see the 1% as collateral damage ( as long asits not them of course)
Add the potential for individual errors by prescribers ( eg in the area of the Nhs I woorked in there were incidents of prescriptions being both incorrectly written and wrongly read), random mar errors ( I worked with 1 family where a family member had died because the wrong organ was removed), inadequate screening ( my trust had a basic literacy and numeracy test for new staff where people had to achieve 95% to pass so nurses and doctors ( although I dont think docs always had to take the test ) could fail the Q working out an appropriate insulin dose from a provided algorithm and still pass the overall test)

bulkbiker said:

What I meant is that they could be considered experts in general population treatments but highly unlikely to be experts in the outcomes of these treatments.
I am very well aware that no drugs are 100% "safe" which is why I make such a lot of effort to remain drug free for as long as I possibly can.

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They will have been taught that at the general population level drug x will do y with patients suffering from condition a
What they wont have been taught at gp level is the nuances of how different subsections of the population / condition group will react. As doctors become more specialised within a specific area of practice and the attached level of training they will have more info but still substantial gaps when it comes to the indivicual level

bulkbiker said:

I think we are in danger of agreeing again.. as you say they are told what should happen.. what does happen (the actual outcome) may leave them a bit confused..

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Dont get excited!
They are mostly taught what happens with the majority of the population, they are taught some bits of what can happen to the smaller % individuals to whome the whole population metric fails to apply, what they arent taught (partly /probably because no-one knows) is how to identify the minority group, what is likely to work for them (again at a general level) and the specifics of what will work for whome within that group

In case we think the general public are keeping themselves well informed, I overheard this in the waiting room at my retinopathy scan yesterday. Diabetic 1: "Are you still injecting yourself?"
Diabetic 2: "Yes, I think it is supposed to help the tablets - or something."

My young GP and endo advocate diet as a solution to diabetes as much as pills. They are not nutritionists so refer me to one.
Who are more openminded than they were. Rewinding 5yrs and my old-fashioned 2 dieticians were useless.

So doctors are no diet expert. Diet experts are hit and miss. Is it any surprise patients go it alone?

I hear loads of rubbish too. Mostly from wives listening to other fish wives to cook for their partner. No sugar and then cruisifying their partner for craving it more. Extra potato, rice and pasta to fill them up

Thank you for posting this. While we all know that there are a handful of HCPs who are members here even they will admit that nutrition is not in their remit of expertise and for the majority of us who are not medically trained the knowledge that we (at whatever level) is garnered from our own experience, research and from reading and listening to others with this condition. I learned very quickly, at diagnosis, that my DNs advice about nutrition was flawed and that my GP was uninterested. Ergo I had to research but many people do not for a myriad of reasons and for some who depend on blind faith or trust the outcomes can be very poor indeed.
It was evident to me before I joined this forum that a quarter of a million members could not possibly all be HCPs and having been a member of two other 'self help/support' groups I knew that not everyone would be an expert in the field, however, I have seen here new members arriving and anticipating qualified medical help so we sometimes have to immediately make that clear.

What worries me is that any poster here is pretty much an exceptionnin a huge population.....its the huge population I worry about... the ones that totally believe that they can jyst totally rely upon nhs and meds and carry on with not really giving a ****...

I just worry about the masses...

Guzzler said:

Thank you for posting this. While we all know that there are a handful of HCPs who are members here even they will admit that nutrition is not in their remit of expertise and for the majority of us who are not medically trained the knowledge that we (at whatever level) is garnered from our own experience, research and from reading and listening to others with this condition. I learned very quickly, at diagnosis, that my DNs advice about nutrition was flawed and that my GP was uninterested. Ergo I had to research but many people do not for a myriad of reasons and for some who depend on blind faith or trust the outcomes can be very poor indeed.
It was evident to me before I joined this forum that a quarter of a million members could not possibly all be HCPs and having been a member of two other 'self help/support' groups I knew that not everyone would be an expert in the field, however, I have seen here new members arriving and anticipating qualified medical help so we sometimes have to immediately make that clear.

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Many leave as believe forums are hearsay only.
Nhs's failings cannot be plugged up with forums without some medical support. At least this one has some.

ickihun said:

Many leave as believe forums are hearsay only.
Nhs's failings cannot be plugged up with forums without some medical support. At least this one has some.

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I think that the medical support we get here is in the form of knowledge rather than that which we, in general terms, get from the NHS regarding Diabetes generally and diet in specific terms. Here we get access to newly published data on research, anecdotal evidence of side effects of drugs and the efficacy of some drugs, and we get get emotional support which imo should be near the top of the list of tick boxes that seem to be the norm for practitioners these days. Instead we are given little information and a prescription and told to come back in 3/6 months.
To get back to the OP and the comments, in an ideal world we would not need forums such as DCUK but this is not an ideal world so we in effect have to advocate for ourselves. I find it empowering but some other people may find themselves overwhelmed and the lack of medical support means that these forums are necessary. The question lies in when and whether to temper every post/thread with the statement of medical qualification that may 'put off' newbies.

Hi. The motto I live by is “the meek don’t inherit the medical world “. I view this excellent forum as another source of empowerment, providing invaluable support, and knowledge based on the members’ experience and their direction to articles/other relevant sites and resources. This, combined with “traditional” medical input, form distinct but integral components of health care, which together enable me to be proactive in the management of my condition. Cheers Leeanne