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Incompetent medical professionals

ringi said:
Assuming I understand the biology correctly, the reason for high BG has no effect on how an eye doctor will examine or treat an eye condition.
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But the cause of the retinal damage is the high blood glucose. Should one not get the blood glucose normalised if they expect to fix a diabetic eye problem? Not doing so is like trying to rebuild a burnt-down city while the arsonist is still on the lam.
 
Firstly, i understand that doctors in a number of countries these days are required to undergoing continuing medical education (CME) or some form if valudation that each us keeping up to date. I have read about these facts in the various websites of some countrie's medical regulation boards.
The record of each doctor of attendence at approved CME courses each has has to reach a certain minimum number of allocated 'points' in order that the doctor can continue to be re-registered over a certain time interval. There is usually a compulsory requirement that a refresher in resuscitation instruction is undertaken.
Problems i have read about these systems are:
the doctor can just chose any course even though they may be quite knowledgeable about it. And thus not address any deficiences in knowledge or skills. So an opthalmologist might asume they know all about diabetes from their training 10 years ago and choose not to refresh their knowledge.
I get the impression though that medical boards are now requiring their registrants to demonstrate that the CME courses they attend no longer overlap too much in content and skill relearning. Similarly specialty colleges might be doing the same.
And there is also the issue the drug companies often bankroll the costs of many CME activities and they will try possibly to influence the content of the talks on offer. And a drug company can choose not to fund a CME course whuch it sees as irrelevant to its interests or threatening them.
There have been attempts to do inspections of doctors' surgeries, of their practice standards etc under accreditation schemes, in order to give patients some guidance abiut the quality of a particular medical service but this does not automatically ensure the quality of the dictor, nurse and staff within the practice.
Having said this there are many postive feedback reports of a qualitative nature from patients surveys abiut doctors in Oz at least but there has been scathing criticism from the public and doctors about the medical biard of Oz in recent times. And much mire undercurrent if criticism of another HCP regulation body here.
The more thorny question is about what is refered to ( in UK, mainly) as revalidation.
My understanding iof this is that the actual doctor is examined periodically on what the medical board and speciality colleges deem is an appropriate set of knowledge and skills.

As one might imagine, this has met with a great deal of resistance from doctors and the formulation of appropriate examinations has been the source of ridicule and contention.

However arguments ensue that at present the only way that a doctor's knowledge, skills, manner etc can be remediated is when an issue becomes before the country's, States,, county's medical regulation board through a lodged complaint. Complaints can range from minir to allegations of extreme negligence and 'malconduct)
And this raises the question if why should things have to reach this stage before something is done? And can validation processes help to alert to, minimise and prevent disaster in rhe future? And also reduce suffering and large legal and procedural costs?

Many possible reasons exist fir the status quo:
the applicability and effectiveness if current laws about medical regulation;,
the fact that medical boards in some countiry's are still dominated in numbers and thus voting power by doctors ( the UK's GMC i gather is an exception, but I bow to anyone who has more knowledge and understanding of the process in UK) and doctors sometimes have been noted to close ranks of some issues to do with colleagues;
the apparent failure of the validation process to gain more traction ( but again i may be out of date on this)!,;
a natural tendency for some patients to not wish to confront their doctor or report him or her, or who feel the reporting process to a medical board is too overwhelming.

I hope the above provides some background to the problems that patients and authorities face when it comes to the ongoing quality, knowledge, behaviour and skills of doctors, in particular, and HCPs in general.
 
A high bsl may affect the focussing of light by the lenses of the eyes and give an inaccuarte reading of visual acuity and fom that a prescription for spectacles may be less than helpful.
This is what my ophthalmologist explains as his reason for unfailingly asks me each appointment about how my diabetes control and HBAIC etc have been like before starting an eye examination.
 
Daibell said:
Yes, worrying but so common. I'm a LADA still diagnosed as T2 due to similar ignorance. I always say I'm insulin dependent rather than giving a type as that is really what matters and tells any hospital that you may go hypo etc and need to manage your own meds. So far all the consultants and hospitals I've used have been good about this even if they know little about diabetes or types.
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I have a similar problem-we cannot get type-tested in my health authority so because I'm overweight and over-40 its assumed I'm Type 2 but never been confirmed so I just say insulin dependent too x
 
Unite said:
My experience with medical professionals is not good.Recent diabetic review with practice nurse was horrendous. She was determined to stop me testing blood glucose levels.She said my control was excellent and immediately cancelled my test strips. She implied I was addicted to testing!! I have been testing for 13 years and consider this vital to my control along with strenuous exercise and diet
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WOW! how can any nurse call herself a professional when she takes away an essential part of any diabetic's health regime! I am so much luckier with the nurses at my G.P. they managed to get me 3 types of strips as I have 3 machines ( my first, the upgraded one from the same company and a free one via an email offer)! Ssssshhhhh......don't tell anyone-please!
 
It's terrifying isn't it? I had a cracker with a new GP a few months back, went with problems with my foot - nothing to do with my diabetes (corns between my toes and an unhappy tattoo on the top of my foot due to me being allergic to red tattoo ink), he immediately assumed neuropathy, wouldn't listen to me about the red ink, so I left with a referral to podiatry, a leaflet on foot care and thought that was it. Later that day he called me as he had looked through my medical history and it had to be neuropathy, I ended up hanging up on him as I'd had my fill of him by this point. Then came the super patronising letter a week later 'I was impressed by your medical knowledge of your condition yadda yadda' well, I have only been living with it for 25 years, probably longer than you have been walking the earth! I read said letter, laughed and filed it under 'B' for bin as funnily enough my foot had settled right down again and I had seen a chiropodist to have the corns dealt with. THEN the absolute cracker of a letter appeared about another week later - an invite to a Type 2 group consultation! Excellent, but I have been Type 1 for 25 years...Straight out of med school, all the gear and no idea sprung to mind. I was tempted to attend said clinic just to play Devil's advocate but was called the day before to be told it had been cancelled.

Healthcare professionals really shouldn't assume things, it's people's lives they are playing with. Can't remember who mentioned it above, but a nurse cancelling testing strips? I would go wild!
 
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A quick referral to a good podiatry service is not a bad outcome.

Did you put in a formal complaint as otherwise they will not improve?
 
ringi said:
A quick referral to a good podiatry service is not a bad outcome.

Did you put in a formal complaint as otherwise they will not improve?
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I'm still waiting on the referral to podiatry to come through, not holding my breath if truth be told, but I am not particularly worried about my feet, other than the occasional irritation of my tattoo they are both grand. It's about the only part of me that's not falling apart! :wacky:

I did put in a complaint about him after the Type 2 clinic invitation, one of the other GP's at the practice gave me a call to get all the details and I was assured he is no longer at that practice, exact words were 'He's long gone' :)
 
I would almost welcome ignorance. Had a letter from surgery asking me to contact them for bloods and review appointment. When is my appointment? 30th October for nurse appointment. And she is useless and doesn’t even carry out all checks she should. Don’t know if boiling blood changes the results
 
As a newly diagnosed T2 diabetic I have to say these continual sub par experiences with medical professionals are really worrying. What I really don't get it why so much of the medical profession is so ignorant? Diabetes is a growing issue, with severe health implications if not treated properly. As a GP why wouldn't it be one of the things you made sure you were well educated on?
 
Karenchq said:
I went to a new eye doctor and was/am furious with the lack of knowledge about diabetes care. I made sure to specifically state that I am a type 1 diabetic and ask to see a doctor who has significant experience with diabetic patients. The quack didn't even know the difference between type 1 and type 2 and insisted that I was a type 2 based on my age and that taking or not taking insulin had nothing to do with type 1 or type 2.
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My daughter aged 16 had this very same question on her recent double science GCSE? My sister, an A & E cosultant sent me her lipid profile so I could comment. These guys live in silo s but if their silo is labelled 'eyes' you'd expect that a disease causing a large amount of eye problems would be better known....
 
SarahEN said:
As a newly diagnosed T2 diabetic I have to say these continual sub par experiences with medical professionals are really worrying. What I really don't get it why so much of the medical profession is so ignorant? Diabetes is a growing issue, with severe health implications if not treated properly. As a GP why wouldn't it be one of the things you made sure you were well educated on?
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A GP is by definition a General Practitioner and that means Jack of All Trades and Master of None. I exaggerate a bit and GPs are good for an initial problem investigation ready for the expert to handle. They have to handle a ridiculously wide range of medical issues and facts. Some GPs specialise in certain areas but my two 'specialist' diabetes GPs knew next to nothing about diabetes
 
This all teminds me of a spychological phenomenon called Dunning-Kruger Effect. Everyone is susceptible to it. Basically the less informed about a subject you are, the more confident you are to discuss and offer opinions about said subject. So a HCP professional may be well trained in a particular area of health but have little knowledge about diabetes, but Dunning Kruger makes them think they are knowledgeable enough to discuss it.
 
Antechinus said:
This all teminds me of a spychological phenomenon called Dunning-Kruger Effect. Everyone is susceptible to it. Basically the less informed about a subject you are, the more confident you are to discuss and offer opinions about said subject. So a HCP professional may be well trained in a particular area of health but have little knowledge about diabetes, but Dunning Kruger makes them think they are knowledgeable enough to discuss it.
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Ha. Yes thats my boss / employer. Its quite a prevalent phenomenonenom and pervades forums too. .
 
ChrissiStar said:
I'm still waiting on the referral to podiatry to come through, not holding my breath if truth be told, but I am not particularly worried about my feet, other than the occasional irritation of my tattoo they are both grand. It's about the only part of me that's not falling apart! :wacky:

I did put in a complaint about him after the Type 2 clinic invitation, one of the other GP's at the practice gave me a call to get all the details and I was assured he is no longer at that practice, exact words were 'He's long gone' :)
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The podiatrists I have been sent to see have had three unsuccessful attempts to sort my nail problem on a big toe. I am still using Gehwol and having to cut it myself.
D.
 
Locally at least for me, my local NHS surgery (and associated GP's) are relatively useless in any instance. The perceived lack of knowledge and ability is astounding and am guessing they must have been a delight at a student doctor level (i assume they even completed it lol).
 
Antechinus said:
This all teminds me of a spychological phenomenon called Dunning-Kruger Effect. Everyone is susceptible to it. Basically the less informed about a subject you are, the more confident you are to discuss and offer opinions about said subject. So a HCP professional may be well trained in a particular area of health but have little knowledge about diabetes, but Dunning Kruger makes them think they are knowledgeable enough to discuss it.
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Strange effect, but shouldn't really be the case, one should be feeding back into ones store of knowledge on any given subject and then modify one's view of our knowledge base.

In electrical engineering it's known as negative feedback.
It's in a similar way proper science proceeds.

This is a problem for any form of fundamentalism.

We see it occurring with pharma and food choices, where clearly food fundamentalists would have us eat stuff that puts up blood glucose.
"Eat to meter", is the right kind of feedback.
D.
 
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