RE: Re. Information from specialists and consultants.

[Guest guest]

Thanks for your useful comments!

Re. Information from specialists and consultants.

and ,

I have never posted to this group before, but as this subject is one that I know about, I felt that I must add my twopennyworth.[ Metcalf] Etc

[Guest guest]

Dear and

I tend to agree with Chris. It is wrong to generalise about surgeons in general and urologists in particular but a significant proportion are lacking in communication skills and quite a number tend to be arrogant. I would take issue with on just one point. It is true that consultants are not paid per patient while working for the NHS but some also do private work as well where they do get paid per treatment and can command high fees for an operation

The best way of improving the information and support given to patients and their families is to develop the role of Urology nurse specialists. I know that this has been done in Tunbridge Wells, Maidstone and Bradford. Nurses tend to have considerably better communication skills than surgeons and tend to appreciate the value of patient led support groups and recommend that their patients attend such groups. The feedback we get from patients about Nurse Specialists in Kent has been very positive whereas the feedback on urologists is mixed. It would also be a good idea for GPs to refer patients to a nurse for initial assessment. A trained nurse doing DREs regularly may well be able to detect a nodule that would evade a GP who does DREs infrequently

The Maidstone and Tunbridge Wells NHS Trust has also implemented the draft NICE guidelines on the treatment of urological cancers by the development of Multi Disciplinary Teams where the treatment of each patient is considered by team which includes a consultant urologist a consultant urologist and the specialist nurse. The communication seems to work well here in Kent where two of our members who had failed radical prostatectomies were referred to the oncologist immediately the PSA became detectable and were given salvage radiation treatment promptly thereby increasing prospects that this treatment may be successful.

Happy and Healthy New Year to you all

.

PS As I was typing this email I got the email from in Aberdeen. From different ends of the U.K. there is strong support for increasing the role of nurse/ counsellors

Re. Information from specialists and consultants.

and ,

I have never posted to this group before, but as this subject is one that I know about, I felt that I must add my twopennyworth.

I have spent all of my working life selling drugs to doctors, both G.P.s and consultants... and am still doing it, so I think I know what makes them tick. In my opinion it is almost always the system that they work in that is the problem, not really the doctors themselves.

A Consultant does not get any more pay for working hard than for taking it easy, so human nature being what it is, many of them opt for not working harder than they have to. They have more patients ( by a long way) than their European and US colleagues, and they are paid less than either European or US doctors. If our doctors were paid per patient that they deal with, then you would see a huge rise in the numbers of patients seen. If you give a dog a biscuit, he will do a trick, the more biscuits, the more tricks. Also if patients were free to go to the doctor that they like best and that they feel that they can trust, you would see a much better level of treatment. Of course this is not politically acceptable by any of the major parties so that it will not be in the foreseeable future.

G.P.s are paid rather differently, they are paid for the number of patients that are on their list, not the number of patients that they see. They do not get anything for actually seeing a patient. So the optimum situation for a G.P is to have 3500 patients on his list, who do not have anything wrong with them. They do get paid for attending "updating" courses but this is quite a small amount in relation to the pay they get for having a large list.

With regard to 's comments about the uro who has taken him off the telephone list. I would guess that this is because the uro thinks that he is right about the amount of information that is given to patients and that is wrong. I have found surgeons of any speciality tend to be arrogant. I don't mean this disparagingly, but they are trained to be firmly in charge of their operating theatres... what they say goes, it has to be that way. Unfortunately they often carry this attitude into their consultations, and so come into conflict with the patients themselves and people like us.

I think that it is our job to be a friend and advisor, to patients who are totally bewildered by the diagnosis they have just been given, in order that they can make sense of their decisions. I fully appreciate that this will be impossible if the consultant will not refer patients to us, but there are other ways of killing a cat.

Kindest regards to all

Ward.