Why should you care?
I am off to vacation...
Time for a break.
Off for two weeks on a well-earned rest in Ireland.
We’ll crank up again in early July but in the meantime, give a care for Why can’t I find a family doctor, Gerard Farrell’s memos from the front-line of health care and in Newfoundland and Labrador.
Just start with this bit of the column whose title I stole for this one:
We live in a very transactional world. Even in healthcare these days, the models we hear about are mostly transactional at their core. Practitioners are not there to see you, the holistic and inclusive “you”, they are there to see the problem with which you present. The ankle bone is not connected to the knee bone in today’s practice of medicine. “Just the facts, ma’am,” no idle chatter.
Or, at least, that is what you are being fed from Governments and Departments. They like transactional medicine because it is the kind they have the best chance of providing. They might be able to find a warm body with some kind of qualifications to work at a walk in clinic that they operate (so they can say they are doing something). Trying to find you a full time Family Doctor who will come to know you and your family, your wants, desires, aspirations and goals; the things you don’t now and may never want to be part of your care. The kind of person who knows there is something wrong with you when they see you in the office chair before you say anything, and who cares enough to ask what it is that is wrong. Governments don’t want that.
“You should care about these issues because they are your issues,” he writes a bit later on in the same commentary.
That’s the theme of all Gerard has written.
He helps you understand what is happening in plain English.
Give him a care and a comment.
He could use the feedback.
You can use his insights.
BREAKING NEWS: According to the Atlantic article in APRIL, AI outperformed hundreds of doctors in its ability to diagnose complex problems, at the dismay of the doctors. Apparently FDA has not approved any AI for this but many hospitals are using it anyway. many doctors are using it as a tool to improve their own analysis it seems. This study was published in SCIENCE. Of course AI can still get a lot wrong, but seems doctors get more wrong. Seems the technology is rapidly improving, for good and bad, unless there is good "oversight" . Seems similar with MFs the MOU etc, lack of good oversight, so lots of blunders.
Good morning Ed
1. Have a good vacation. Hope you have a good well deserved break. Haven't been there, but it's an important part of the history, and culture of Nfld. As I had explored the strategic use of Churchill River to make Labrador "Greener than Ireland" can you report back on how green Ireland is, as to scenery but also green energy, especially wind energy. Why not post a piece from Ireland, if you could do that?
2. I know this doctor, Farrell. I don't think his writing reflects his true values. He is on oncologist who may have had burn out from seeing so many patients have poor outcomes from cancer, and transitioned to help cancer patients who had no GP. His services were both very helpful with my wife's Stage 4 colon cancer, in the early stages in 2018, and also discouraging;
On the negative side, he is of the opinion that others with no medical training are ignorant, can't know important sources, from junk sources, so labels such inquiries with the phrase "Oh, you got that from Dr Google"
His suggestion that my wife should stay on aggressive potent blood thinners, possibly for life, and to ignore the adverse affects and symptoms we reported to him. My wife transitioned to much less severe oral blood thinners, weeks after, refusing the very potent ones, and the oral one only for several weeks post surgeries, and now long on only 81 mg low dose aspirin per day, and that needed, not related to cancer, but a mild Factor V blood condition that she inherited , genetic, that slightly increases her platelets. Her platelets stays at a near perfect normal level.
His statement that I would "kill my wife" to question or encourage her to discontinue the aggressive blood thinners was the worst I ever encountered, and we both had raised voices through that session. I had become aware, that the top cancer hospitals in the USA had been transitioning away from that aggressive type (and costing about 3000 dollar a year, to the oral pill once a day, at 1/4 the cost , and preformed better with less side effects.
He agreed that patients were not monitored much, given meds, sent home and little follow up on med effects for weeks or months. I offered to pay him to make house calls to monitor and see for himself the adverse effects on RR, HR, BP etc and he declined my suggestion.
He has made no contact with us now for the last 5 years, as to whether my wife is alive or dead, (very much alive and healthy, no evidence of cancer for almost 4 years , after 6 major surgeries from 2018 to 2022). This success likely only a 5 % chance as to survival and quality of life for now a 76 year old, who walks about 4-5 km per day.
I will read his piece as you suggested. I took his good points with the bad of our experience. My wife's original GP discouraged her from getting a colon scope, until a year or more after my wife requested it. By then cancer had spread to lymph nodes and two other organs, the liver and the spleen, Stage 4B > Prognosis 12 months to live if no treatments and 3 to 5 year with treatments. We have never heard from her since, to see if my wife lived or died.
Dr Farrell was a useful bridge and was very helpful at times, seemed wanting more time with patients as he implies in his writing, but seems to think to think others know nothing. He raised the question of her CEA level. When we inquired more he deflected from that topic. That simple blood test, It turns out, her CEA is a better predictor of recurrence and growth of her tumours than any scan, whether CT, MRI of PET. We found that out from the top USA cancer hospital in Texas : MD Anderson, where we made 3 trips and her third surgery done there, all at our expense, and found out that what then proposed here, was a procedure outdated 15 years prior , likely would have failed !!! I wish Dr Farrell well for what he did that was beneficial then, as his services were both good and not so much on some others things. He stated that all USA facilities were only money making. Partly true, expensive but much is top quality, but few can afford it, and blind faith in the system here. VERY SAD