Monday, 13 July 2015

The online private GP

I wasn't very well last week. This was really rather annoying as we were just back from a lovely holiday in Wales and I had plenty of work to catch up on. So when I woke up on Sunday morning to find I had cellulitis on my leg, I was not best pleased. (note: not cellulite, this is a bit more serious, a staph aureus skin infection requiring antibiotics). The small scratch from the dog two weeks previously had left me with a red, hot, painful, infected swelling. In situations like this, being married to a cardiologist is no help at all. I wailed in frustration. How would I get an appointment at the GP during the week? How long would I have to sit in the waiting room? Should I call 111, or go to the walk-in centre in Woking? Then I remembered seeing a advert on TV for PushDoctor.co.uk - an online private GP.

Registration was easy and setting up the video contact was simple, almost 'hands-free'. I got an appointment for 10am last Sunday morning. The fee for 10 minutes is £25, then £15 for each 10 minutes thereafter. If a prescription is required, you pay £4.50.

Reminders are sent by text and email. At 10am, the doctor appeared by video call. She introduced herself and in a couple of minutes we had agreed my diagnosis was correct and I needed a course of antibiotics. She asked several questions regarding general health, medications and allergies before writing the prescription. This did take longer than I expected, I think some people don't talk and type very well, and my consultation ended at 10 minutes 13 seconds.

The prescription was emailed to me straight away and after a short delay for the security code to be sent by text, I was able to open the PDF document and print it out.

So far, so good. Except that when the statement arrived in my inbox, I had been charged £15 for another 10 minutes, for being 13 seconds over due to slow typing. There was no alert during the consultation to let me know that this would happen, although the small print does outline charges. Of course, I complained and the charge was reversed immediately, so my advice is to keep an eye on the time.

One other comment. I took a photo of my leg and wanted to upload this before the appointment. This isn't possible, so you are left trying to do it during the consultation, which didn't work for me. 

During the registration process I was asked if I wanted my records shared with my GP. I chose not to. Why? I'm not sure. Perhaps because my relationship with my GP is simply on an ad hoc basis, as *touch wood* I don't have a chronic illness to manage. Perhaps because it might offend my GP that I chose this option. Perhaps because it is simply nothing to do with him, and I can't see why all aspects of my life should be recorded. 

Anyway, the up-side of this process was that within a couple of hours of waking on a Sunday morning, I had a prescription and was on my way to the pharmacy. The pharmacist had never heard of PushDoctor.co.uk (better marketing to health professionals would help). The private prescription cost £4.50 plus £6 for the actual tablets. A small price to pay for starting to feel better straight away.

And how does the GP/out-of-hours service/walk-in centre/111/A&E/999/NHS fit in with this? Rather well, I think. There is a lot of choice for treatment and advice. It may not always be free or immediate, but everyone should be able to access an appropriate level of healthcare at any time of day or night.

Disclaimer: I did not receive any inducement or incentive from PushDoctor.co.uk to write this post. I am blogging about my experience because the face of healthcare provision is changing and the emphasis need not always be on GPs or the NHS. 



Monday, 6 July 2015

What the Boxers did on holiday

We climbed the dunes
We walked at Penrice woods (Millwood)

We made a Brin-cave for his cool, quiet time

Zozi slept with Mr B

Pawfect for everyone.

Sunday, 5 July 2015

Rested, restored and ready

I think we all underestimated the toll the building work would take on our health and wellbeing. Whilst we had excellent builders, the project did have its ups and downs and the bathroom still isn't quite finished to our expectations. Nothing to do with our fabulous builders, but a totally avoidable cock-up between the plumber and his supplier. The less said about that, the better (for the time-being anyway). On top of which, our practice has been extremely busy (good), and Dad hasn't been well (bad).

When Dr B suggested we book our week away in Wales as usual I must admit, I wasn't sure. So soon after the builders? At the beginning of summer? With all that work to do in the garden? He was adamant, and so our wedding anniversary week was spent on the beach at Llangennith (possibly the best beach in the UK).

We booked our usual cottage. The Boxers felt right at home. The neighbours all came to say hello. But we were tired. It took 2 days to feel normal. We simply hadn't realised how tired we were. 




But a few hours in the sea washed the tiredness away. It restored us, we hardly even spoke to each other, just getting on with getting better. We knew it was all OK when we got in the car for the drive home on Saturday. We looked at each other and smiled.



When did life get so gritty? Why don't we take more time out?

Tuesday, 26 May 2015

Local politics in action

Now that the dust has settled on the general election, I feel the need to gather my thoughts. I didn't vote along party political lines, because I don't believe that a national government can ever truly understand what is needed in each community. That responsibility is down to the local organisations and individuals,  many voluntary, who work tirelessly to support vulnerable people, community projects and the environment.

Not even the county council or the town councillors, let alone the police and countryside rangers, get out much these days. They hide behind social media and council meeting agendas to discuss improvements to our lives. Recently, I asked the parish council for assistance with a persistent fly-tipping matter in the woods. I got no support there either. So Mr B and I cleaned it up, again. I collect litter almost every day. 

I think that if I keep my verge neat and tidy, then others might recognise that this is a good way to live, and do the same.

I notice that there are others around the village who feel the same. The nice old lady who walks past every day and smiles. The chairwoman who walks her dogs a different route each day to get a feel for what is going on in each street. The village organisation that runs events in support of local enterprises. The school governor who keeps an eye on things generally. And the 'sergeants' who make sure that the maintenance is always done.

It is these local people, through their commitment to our village, that deserve recognition for their work, not politicians in Westminster. It is these people who make sure that we live in a pleasant environment, look out for our neighbours, and make sure we have a safe, happy village.

I vote for local politics.


Friday, 22 May 2015

Do doctors talk about dying?

Many people think that having a conversation about dying is reserved for those with cancer. We tend to forget that there are other, often chronic, illness such as heart failure, which also need careful management of the expectations of end-of-life care. Although there have been so many advances in heart disease, people do still die from it.

Since I started work as practice manager for a cardiologist, I have had the privilege to learn about some of the patients' stories. These patients often face lengthy illnesses, frequent hospital visits and invasive procedures. Sometimes, the heart is too damaged and nothing more can be done.

The specialist I work for feels strongly that patients and their families should have as much time as possible to come to terms with the fact that they are entering the last months of life. It isn't always possible to give an exact time scale, which is why the conversation must be  sensitively timed. He also tells patients that he speaks from personal experience, because until you have experienced the loss of someone very close to you, you cannot possibly understand the turmoil of emotions that goes with planning for the end of someone's life.

Enlightened families ask questions about how to access extra care, register a do not resuscitate order, and make plans for the smooth handling of their affairs. If your doctor (specialist or GP) isn't having that conversation with you and your family, please make sure you initiate it, because doctors like the rest of us, feel nervous talking about death. After all, they studied medicine to preserve life.

A conversation about dying shouldn't be about the end, it is about planning for the end. In many cases, there is still plenty of living to do, and families should strive to do this, laying down memories for the future.


Wednesday, 20 May 2015

Who do you turn to when your Mum is dying?

I have very mixed feelings about the support we were offered towards the end of Mom's life. Everyone was lovely and kind to Mom, but nobody would talk about her dying. Even the Macmillan nurse wouldn't broach the subject because she said that Mom wasn't ready to talk about it. I remember that day very clearly. Even I could see that Mom had weeks to live, the tumours were growing out her back, they had all but blinded her and just about paralysed her. The community nurses came and went, leaving Dad to do most things. The GP cried a lot. 

I had to do something so I gave up my job and went in search of a conversation - about dying. I found it on the internet, with strangers, who having gone through the painful loss of a loved one, wanted to, perhaps needed to, share their experiences.

Day by day that late summer, as I sat with Mom, we talked about her choices.  I asked Mom to think about where she wanted to die. She wanted to be at home so we invited the GP to complete a Do Not Resuscitate form for her file. This would stop the paramedics from taking Mom to hospital, should Dad panic in the middle of the night.

Mom didn't want to go in to hospice, so the District Nurse at the GP surgery helped us to obtain a hospital bed, commode, portable oxygen and carers to assist with bathing and dressing. We made Mom comfortable at home and settled into a routine.

I noticed little things in the last week of Mom's life. Tinges of blue in her fingers and toes, dry skin, a darkness behind her eyes. I urged the Community Nurse who called on us that morning to talk to Dad, who was still in denial. As she went through the Liverpool Care Pathway with him, the horror began to sink in. I think he must have had a quiet word with Mom later that day, a word between lovers, saying good-bye. Mom's death came peacefully not long after that.

In the days that followed, I held Dad's hand as we talked about Mom's funeral wishes. She had been very clear with me about the service, the hymns and readings, and had even written a poem.

It isn't easy facing death, but it does help to talk about it. I hope that by sharing our experience, we might be able to help someone else.