4. Medical surfing

More patients nowadays are coming to discuss with me their medical conditions and needs aided by information they have gleaned from the internet. This source has amongst the younger generation displaced the much venerated newspaper cuttings favoured by older people.

It is certainly admirable to show such resourcefulness and I personally find it enriching to engage with well-motivated patients. The caveat is of course the quality, if not the veracity and integrity, of these sites. Watching Sky News recently, I was reminded by its partner CBS about the hazards of surfing the internet for medical information, advice and treatment. It is therefore worthwhile to bear in mind some simple advice that CBS highlighted, namely

1. If a product claims to cure cancer, click out.

2. Beware of phrases like”scientific breakthrough” and products claiming to be “natural” and therefore safe.

3. Beware of anecdotal information from testimonials or blogs.

4. Check out the medical credentials of so-called “experts”.

CBS mentions as its fifth point sites like WebMD that are reviewed by health professionals. While such sites add broad and international perspectives, some American and foreign medical practices differ from ours not so much in the motivation, rationale or cultural context but by nature of the political control over our health system. I have therefore included only the BMA, NHS and NICE links. Present-day British GPs are performance-monitored by and paid according to QOF (quality and outcomes framework) target points, so there is little room for innovative approach. Moreover, a draft government enforcement policy document is expected to result in the ultimate restriction on GPs who will have to prove they comply with NICE guidelines or face the possibility of suspension, prosecution or closure of their practice. Another major constraint is of course funding and GPs have to stay within budgets assigned to them by the PCT.

As many of my patients appreciate, I believe such interference with professional decisions risks compromising the ethical advocacy of patients’ best interests and run counter to the principles of advancement and pioneering excellence.

For these and various other reasons, the PPG is critically important for ensuring that the highest standards of care are maintained. I believe there is no substitute for a frank and personal discussion with your own doctor. With thirty years of very varied medical experience, I can safely say that the strength of British general practice has been the unique continuity of care and personal rapport. Indeed, I have patients spanning four generations! Such is the deep sense of fulfillment and privilege I enjoy as a traditional family doctor and long may this special quality continue!

Dr Khong





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