One of the most common things that we hear when a patient arrives for an initial consultation is that they have been to their GP for assistance initially.
We ask the patient if they would present to their GP if they had a toothache. The response is obvious. So if a patient would not go to a GP for a toothache why would they present for a clinician who, in their 5 years of undergraduate training has spent less than one week a year on musculoskeletal conditions. Particularly, when there are chiropractors available to present to, who have spent all of their 5 years undergraduate training on musculoskeletal conditions and the appropriate treatment of them.
I would like to recount a story that occurred at my practice a few years back.
One morning the telephone rang and a local senior GP was on the end. He is a GP who has “specialized” in musculoskeletal medicine. I say “specialized” because when one has only had 5 weeks undergraduate training in a medical topic, doing a few supplementary weekends does not give a GP anywhere the knowledge and experience of a chiropractor.
This GP listed symptoms that his wife, an Accident and Emergency doctor herself was suffering. At the end of the list he asked me if I thought the problem could be musculoskeletal. As he had just outlined the symptoms of one of the most common and simple conditions that I treat I found myself somewhat aghast that a GP “specialized” in musculoskeletal medicine did not know the answer himself.
It was arranged that his wife attend the clinic early in the afternoon. On arrival the patient was dressed in a surgical gown. It transpired that she had spent a night in Airedale Hospital. She had been prescribed opiates, seen by 5 different hospital doctors, X-rayed and had an MRI taken. But none of the 5 hospital doctors or the two investigations undertaken had produced a diagnosis. The opiates had done nothing to ameliorate the pain either.
The patient presented having difficulty to breathe, found it very painful to move and stated that the pain level was 9 out of 10. She was also 28 weeks pregnant.
Having taken a short history and having examined her, the working diagnosis I had constructed from the telephone conversation was confirmed. Within 10 minutes the patient felt 70% better. Her breathing was normal and not painful to breathe. Her movement improved immensely and her demeanour vastly improved.
When her husband, the GP returned he was amazed at the alteration.
Now the scary thing about this story is that, it happened to an A&E doctor, who would see plenty of patients with similar conditions in her daily routine but had no idea as to the diagnosis. She was married to a GP, who had a specialism in musculoskeletal medicine and who, in his daily clinic, has as the second most common conditions that present to him patients with musculoskeletal complaints. Additionally, she was seen by 5 hospital doctors, none of whom had any clue as to the nature of her problem.
80% of the population will experience low back pain at least once, at some stage in their lives. That is just low back pain. It does not cover neck pain, shoulder, knee, or thoracic pain. Yet there were 7 doctors with a minimum of 60 years experience between them and none of them with a single clue.
How much did it cost the NHS to accommodate this patient in a hospital overnight, undertake X-ray and MRI, prescribe and administer opiates, utilize 5 doctors, all to no avail?
Yet, the cost to correct the problem was less than £150.
Is it any wonder that the NHS is so costly, and that patients, who need to present to a chiropractor and get the benefit of their knowledge and treatment are wasting time going to a GP, and losing income by being off work needlessly.
So, the question once again arises:-
If you wouldn’t sit in a GP’s waiting room with a toothache, what on earth are you doing there with a musculoskeletal problem?
2nd May 2019