Monday, July 9, 2012

NHS & Best Health Care: Good Doctor & Good Hunch!


Does having a good hunch make you a good doctor or are we all so tick-box trained that we have lost that art. Why is it then that House MD is so popular when the story line is around the “hunch” of Doctor House?

Fortunately for my friend, her GP (family physician) has managed to keep that ability.

My friend was blessed with good health all her life. She seldom sees her GP so just before last Christmas she turned up because she has been having this funny headache that the usual OTC pain killers would not shift.

She would not have gone to the doctor except the extended family was going on a skiing holiday.

She managed to get to the surgery before they close. The receptionist told her that the doctor was about to leave. She was about to get an appointment for after Christmas when her doctor came out and was surprised to see my friend.

I have always told my juniors to be on the look out for situations like this. Life is strange. Such last minute situations always seem to bring in surprises. One should always be on the look out for what patient reveal to you as a “perhaps it is not important”.

Also any patient that you have not seen for a long time deserves a thorough examination.

She was seen immediately.

So no quick prescription of a stronger pain killer and no “have a nice holiday” then.

She took a careful history and did a quick examination including a thorough neurological examination.

Nothing.

Then something strange happened. Looking back now, I did wonder if she had spent sometime at a Neuroligical Unit.

She asked my friend to count backwards from 100.

My friend could not manage at 67.

She was admitted to a regional neurological unit. A scan showed that she had a left parietal glioma. She still remembered being seen by the neurosurgeon after her scan at 11 at night:

“We are taking it out in the morning!”

The skiing was cancelled but what a story.

This first appeared as: 
Best health care: NHS GP & NHS Specialist


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2 comments:

Emily Christopher said...

That's terrible. I hope your friend will recover from this and will feel better soon enough. I just like to point out that a hunch is a hunch, I don't think it's wise to rely on that especially if you are a Doctor.

Cockroach Catcher said...

But my point is the better you are as a doctor, the better yourhunch would be and no guidline or prvotocol would be able to give you that. In golf, someone said the moreI practice the luckier I get.

For cost efficiency, hunch leads youto investigations that are 95% right.