Twitter threads on why most GP's won't suggest low carb

[rosco 2]

My GP at my appt of diagnosis when I requested a meter and the goodies, said the local commissioners do not fund these because people don’t know how to use them. Another example of one size fits all. Problem is if patient a is judged to be competent to apply sense /knowledge but patient b is considered unable, the effluent hits the moving object if a & b compare outcomes. So! Hallelujah! We can refuse everyone T2 and save loadsamoney. Result.

 

[Guzzler]

Colour me bias but I think all newly diagnosed Pre Ds, T2s, T1s and anyone on the metabolic dysfunction scale should be given a prescription to join this site. This is because I view education as one of the most important treatments but this education would have to include HCPs so this could turn out to be a very 'interesting' forum

 

[rosco 2]

HCPs in my area of speciality really did have to be up to speed on research, thought, practices. Early days of HIV meant people like me in major London hospitals which specialised in HIV came across a variety of issues, self medications, bathtub remedies that no scientific journal, let alone the management would condone. No matter, people’s lives were under threat and they - and we - took whatever strategies as possibly worth a try. Some were pretty hit and hope. As a registered nurse I could not express opinions on a site such as this if I could possibly be identified or used my position to persuade others to my POV. Now I am retired, no longer on the register...I can do whatever my conscience allows! Happy days.

I would have read a site such as this though because I would have recognised the level of experience and expertise.

 

[brassyblonde900]

My GP at my appt of diagnosis when I requested a meter and the goodies, said the local commissioners do not fund these because people don’t know how to use them. Another example of one size fits all. Problem is if patient a is judged to be competent to apply sense /knowledge but patient b is considered unable, the effluent hits the moving object if a & b compare outcomes. So! Hallelujah! We can refuse everyone T2 and save loadsamoney. Result.

If only they are saving money.
80% of the so called "money spent treating T2DM peeps, is spent on treating complications and only 20% is spent on preventing said complications.
Its blindingly obvious the whole lot of them, wherever the decision on funding is being made, are in an advanced state of an affliction characterised by "Penny-wise-Pound-foolish" as its main symptom.

 

[Guzzler]

If only they are saving money.
80% of the so called "money spent treating T2DM peeps, is spent on treating complications and only 20% is spent on preventing said complications.
Its blindingly obvious the whole lot of them, wherever the decision on funding is being made, are in an advanced state of an affliction characterised by "Penny-wise-Pound-foolish" as its main symptom.

Yes, you have to speculate to accumulate.

 

[rosco 2]

Ok. Reality check time here. NHS budgets were apportioned on a year by year basis. No 5 year plan or anything useful like that. So people like me had to balance the book. Few excuses accepted. Now in GP surgeries they have income streams depending on various factors but the expenditure on services directly impacts upon GPs. So saving money on prescribing, no matter that in the long term money would be saved, quality of life improved, the here and now nature of public funding is about concrete stuff, not the might bes. Add on to that mix the political cess pit that is currently in vogue and you and me are pretty stuffed in some ways.

 

[rosco 2]

Yes, you have to speculate to accumulate.

No, in health care that is not true. If you don’t supply a service, you save money. It’s irrelevant whether nor not people benefit. That’s a speculative, long term possible outcome and managers are into balancing budgets, saving money. Nothing else.

 

[Guzzler]

No, in health care that is not true. If you don’t supply a service, you save money. It’s irrelevant whether nor not people benefit. That’s a speculative, long term possible outcome and managers are into balancing budgets, saving money. Nothing else.

Forgive me, you speculate money on, let's say education, and the long term benefit should be twofold. Improved health outcomes thereby saving real £s on fewer dialysis chairs, orthopaedic surgeons fees etc etc and then there is the saving to the economy from fewer days lost at work, a higher income to the treasury etc.
This, surely, is 'the' best business model?

 

[Mr_Pot]

If you agree it works for so many why shouldn’t gps use lchf as a routine thing for their patients without complicating factors and save the specialist dietitians for those more complex cases.

I agree, but from what my DN, a low carb enthusiast, told me it would seem that the idea of not eating sugar is accepted by patients as reasonable but not eating bread, potatoes, rice etc. is treated as a joke, a ludicrous idea. As for recommending eating fat, she dare not even go there for fear of being thought a witch. The only hope is for the media to change the attitude of the general public, I am not going to hold my breath!

 

[Guzzler]

As an aside. Those of us of a certain age will remember how the government tried to educate the general public about HIV/AIDS with the 'Don't die of ignorance' ads on TV. These ads became a real talking point at the time. They worked in that they taught people to be more cautious however they also fed into the stigma surrounding those unfortunate enough to contract the illness.

Fast forward to today and the rates of people seeking treatments for STDs like gonnoreah, chlamydia and syphilis are steadily rising (according to a programme on BBC I viewed a couple of years ago). It seems that the generation post HIV scare need some educating, no?

 

[rosco 2]

Guzzler, perhaps I have not been clear in my posts. There is a world of difference i. how I, a nurse regarded health spending and how a budget holding beaurocrat manager regarded the money. Budget holders, non clinicians, don’t / cannot think long term gains or outcomes because their appraisals are partially dependent upon coming in under budget. We know Monday spent on health promotion should be money well spent in the long term but the NHS is not allowed long term planning.

 

[rosco 2]

I agree, but from what my DN, a low carb enthusiast, told me it would seem that the idea of not eating sugar is accepted by patients as reasonable but not eating bread, potatoes, rice etc. is treated as a joke, a ludicrous idea. As for recommending eating fat, she dare not even go there for fear of being thought a witch. The only hope is for the media to change the attitude of the general public, I am not going to hold my breath!

Agree. Someone who comes from a culture that is accustomed and dependent upon carbs...rice, pasta, cassava, yam, potatoes, corn, whatever, is not going to be filled with joy and bonhomie when advised their cuisine of preference will make them very unwell.

 

[Guzzler]

Guzzler, perhaps I have not been clear in my posts. There is a world of difference i. how I, a nurse regarded health spending and how a budget holding beaurocrat manager regarded the money. Budget holders, non clinicians, don’t / cannot think long term gains or outcomes because their appraisals are partially dependent upon coming in under budget. We know Monday spent on health promotion should be money well spent in the long term but the NHS is not allowed long term planning.

It is in general a nuanced problem needing a multi pronged approach, I agree with you. We could discuss this topic ad infinitum and meanwhile someone somewhere is recovering from amputation (and likely being told it was their own fault) that middle managers and number crunchers cannot fathom. It really is such a sad state of affairs but that does not mean we should shy away from the necessary task of what amounts to a complete overhaul of the system.

 

[rosco 2]

Ah, sexually transmitted infections. People now assume that just everything is treatable. Until antibiotic resistance really does become a global reality which may not be far off. Plus people are ignorant, afraid of shame, stigma, disclosure issues, gender, education or lack of it, selfishness, power discrepancies, abuse etc etc. “They won’t fit me” I heard time and time again. Erm, guys, condoms will go on your head they are that stretchy...

Humans are filled with excuses and lies, deceptions. Especially when they want to have a sh@g.

Edited by Mod

 

[Guzzler]

Ah, sexually transmitted infections. People now assume that just everything is treatable. Until antibiotic resistance really does become a global reality which may not be far off. Plus people are ignorant, afraid of shame, stigma, disclosure issues, gender, education or lack of it, selfishness, power discrepancies, abuse etc etc. “They won’t fit me” I heard time and time again. Erm, guys, condoms will go on your head they are that stretchy...

Humans are filled with excuses and lies, deceptions. Especially when they want to have a sh@g.

I didn't think I should give you a funny for this comment but it came across that way. (Is that a mod I can hear padding his/her way to their tech...

Mod edit of quoted post

 

[rosco 2]

Hahaha, I am considering going for the record of number of mod corrected posts. I wonder just how many members of this site are that sensitive? Working in sexual health, I think I have heard pretty much everything. Butt plug anyone? Good for those metformin or xylitol moments

 

[rosco 2]

Oh, go on, spoil me, give me a funny!

 

[Guzzler]

I actually laughed out loud, thank you.

 

[Jaylee]

Hahaha, I am considering going for the record of number of mod corrected posts. I wonder just how many members of this site are that sensitive? Working in sexual health, I think I have heard pretty much everything. Butt plug anyone? Good for those metformin or xylitol moments

I'm pretty rock & roll. But, used a condom during encounters.. My mum was ahead of her time with the whole perental life skill thang in the 80s what with me being a heterosexual needle user..

But this is where we start going down the route of thread derailment..

@Guzzler you can hear a mod. Cranking it up to "11."

 

[Oldvatr]

Ah, sexually transmitted infections. People now assume that just everything is treatable. Until antibiotic resistance really does become a global reality which may not be far off. Plus people are ignorant, afraid of shame, stigma, disclosure issues, gender, education or lack of it, selfishness, power discrepancies, abuse etc etc. “They won’t fit me” I heard time and time again. Erm, guys, condoms will go on your head they are that stretchy...

Humans are filled with excuses and lies, deceptions. Especially when they want to have a sh@g.

They almost fill a bath before they burst = memories of schooldays when only barbers sold them.

Quote edited by Mod