Depression and anxiety are common issues and many people will suffer mental health issues at some point during their lives. Cognitive behavioural therapy (CBT) is the frontrunner (excuse the pun) in the prevention and treatment of these conditions with drug therapy remaining a much used and valuable alternative. Those readers who have suffered from depression and/or anxiety may also have been advised to take some exercise. This is valuable advice as it turns out….
Another reason to give lifestyle advice?
“Lifestyle” advice like eating healthier, losing weight, exercising more are seemingly a panacea to cure all illness so it is easy to shrug your shoulders and say “well doctors always say that don’t they?” However it makes sense to give such advice as suffers of depressive or anxiety disorders are at increased risk of significant physical ailments such as cardiovascular disease and diabetes (and are at higher risk of being obese). But there’s more…..an increasing body of evidence suggests exercise is comparable to antidepressant medication for treating anxiety and depression. Yes really, if you can find the motivation to exercise you have an equal chance of feeling better as if you had pills.
The big difference between Pills and exercise
All medication has the potential to cause side effects
Bad luck all you sceptics because a new study has been published to add to the body of evidence:
Does this mean I won’t get medication to treat me if I’m depressed? Absolutely not, what it means is if you sit down with one of our doctors they will take the time to go through all the options and devise a plan that is most likely to help your particular circumstances.
“Private GP’s? Aren’t they just used by the rich and famous?”
That’s something we hear a lot when people discover what we do. The reality is that a survey published in May 2022 showed around 7% of UK adults people use private GP practices, that’s a lot more than just the rich and famous. So, if you are new to the idea of a private GP you might be asking yourself what are all these people using private GPs for? Why do they choose a private GP? What does it cost??? Let’s see…..
The more obvious…
Most people are familiar with some things they cannot get via the NHS such as DVLA medicals, assessments to certify somebody is fit to fly/compete/race/parachute jump etc. Traditionally much of this work would have been done by your local NHS GP practice. However, with the ever increasing pressure on them NHS practices are unable to find time to do anything other than deliver NHS services. Hence now it is much more common to seek out a local Private GP practice for these services. However that’s still not the commonest reason people visit our practice
“I want more…”
Many people visit us because they need more of something that they can’t get enough of………
….Time
Many patients first visit us because they really value having more time with our GPs. Our standard face to face consultations in Banbury are 30 minutes allowing more time to understand listen, understand and discuss a patient’s concerns. Being rushed through a 10 or 12 minute consultation when you know it could be a long time before you get to see a doctor again can be stressful and frustrating. All the GPs I have ever met will tell you that they really dislike rushing patients and feel the same emotions – Certainly they didn’t choose a medical career to rush around trying their best buried within an impossibly frenetic list of appointments. More time is also directly linked to the next “more” on the wishlist….
…..Understanding
Many patients report leaving a consultation with a GP or other healthcare professional with questions unanswered or confused about what has been explained to them. We explored this in another post. The three basic ingredients to help understanding are:
1 – Being face to face with your GP
2 – Longer consultations of up to 30 minutes
3 – Being sent a copy of the consultation notes, including main points in plain English after the consultation
….Continuity
Research shows patients are much more likely to feel satisfied with outcomes of a consultation or series of consultations if they see the same doctor. The traditional idea of the local GP who knows you and your family has been all but destroyed by the well meant but misguided efforts by successive governments to create more access to health care professionals.
At OxMed Private General Practice we work hard to make sure you see the doctor you wish to see so you can get to know them and they can get to know you and your personal health situation.
What does all this cost?
The vast majority of our patients book our “up to 30 minute, face to face consultation”. The consultation fee includes the issuing of any prescriptions needed during a consultation and/or any administration required if you need to be referred to a specialist. At the time of writing the standard consultation fee is £160. You can find the current costs of our most common fees here.
Being transparent about costs
From the outset we wanted to avoid having a headline grabbing super cheap price for a consultation to attract clients in who then find that actually they need to pay for several extras which they hadn’t been informed about (anybody thinking of any airlines at this point?). If you need to know more about the likely costs then we will always take the time to go through this with you. Likewise if you use our choose and book online service then you will always see the cost of the consultation as you are selecting your appointment.
Is a Private GP for me?
We see people from a wide range of ages, backgrounds and personal circumstances. Some people use the practice for all of their GP needs, others come to us for a specific thing (Certificate to say you can jump out an airplane for charity anyone?) and others just dip in when they wish to.
So if you are considering using a private GP please get in touch and we would be happy to speak to you
An attractive headline for sure! 8-10,000 steps was previously the “magic number” Brilliant, stop walking so far as 5,000 steps is good for us. Credit due to the BBC et al in finding a good news story.
However…
One of my favourite BBC radio series is BBC Radio 4 – More or Less. The series examines the statistics behind the headlines. When the government announces we have x number of new nurses etc they will ask questions like “Compared to when?”.
Digging deeper…
This latest study is from the Medical University of Lodz in Poland and Johns Hopkins University School of Medicine in the US. The researchers looked at 226,000 individuals – an impressive amount of data to collate and analyse. They concluded that walking an increasing amount did, up to the level studied reduce of an early death. The effects could be seen from 4,000 steps upwards – et Volia a headline is born! Wait up though…….it went on to say for every additional 1,000 steps/day (up to a maximum of 20,000) the incidence of an early death reduced by 15%.
Misleading use of a great study?
What I find slightly concerning about the way the study was reported in the mainstream media was that what the study added to our knowledge was that you can, with a big enough dataset, show that as little as 4,000 steps/day can increase your life expectancy. However the bigger the dataset the easier it is to show small improvements, so our big take home message from OxMed Private General Practice is please do get out there doing some exercise and remember, if you are capable of doing so, you really ought to still try to exceed 4,000 steps a day. If you need any more encouragement then the average person burns 30-40 calories walking 1,000 steps, so if you go for 10,000 rather than 5,000 that’s also 150-200 calories walked off. (If you want a more interesting way of thinking what 200 calories of food looks like then try this creative article from the Guardian)
If you do have mobility issues or a health condition that is putting you off taking some exercise please do get in touch with us and we will happy to help you get a bit more active.
“Can you help? I’ve been suffering with symptoms of XYZ, seen a doctor or two and had some tests. I’m really confused about what to do next. I just don’t know what’s going on and who to see?“
All the amazing healthcare professionals I’ve met share a desire to care well for their patients however all too frequently “the system” ends up confusing patients or constraining doctors in their efforts to achieve the best solution for everyone.
If you have been lost in your own healthcare story then you are not alone. We regularly speak with patients who have been seen by one or more doctors, maybe had some tests but just not feeling they understand what the underlying cause is, what ought to happen next or where to go next for help.
So how does this happen? It turns out that there are several factors at play:
Factor 1: The stressed patient
Visiting a doctor can be very stressful, you might have been rushing to make the appointment or already stressing about how you can fit everything you want to say into the short consultation. You may already have been wound up by work/kids/other life hassle or are annoyed with yourself for being ill at all. We can also throw “White coat syndrome” into the stress creating cocktail (where people show a stress reaction when in the presence of doctors ). Finally there is my personal favourite: Catastrophising. This where we have convinced ourselves, often “helped” by asking “Dr Google” or friends what is wrong, that we MUST have something dreadful when rational statistics suggest this is highly unlikely!
Factor 2: The information absorbed in a typical consultation
“40-80% of medical information provided by healthcare practitioners is forgotten immediately.”
Oh dear! When you look at the scientific research on how we all behave as patients then it all get’s rather scary. The above is a direct quote from one of the most comprehensive studies on our ability to take in information when in a consultation. The study also showed that the greater the amount of information presented, the lower the proportion correctly recalled. Worried yet? Well brace yourself as it get’s a bit worse…
“….almost half of the information that is remembered is incorrect.”
The mathematicians amongst you will now have calculated that in the worse case you could forget 80% of what you are told, correctly retained about 10% and have about the same amount of incorrect information carefully “retained” as well!
Factor 3: Complexity
Each of us has somewhere around 37 trillion living cells of approximately 200 different types that all have to work harmoniously in various complicated intertwined, interdependent systems to keep us healthy. When things go wrong it can all get very complex. As most of us don’t have a medical or nursing degree it’s hardly surprising we struggle to understand what’s happening to us when we are ill.
Factor 4: Ambiguity
Frequently, especially in the earlier stages of a given disease or illness, the symptoms can be just the tip of the iceberg, and frequently early symptoms can be vague (tired all the time anyone?) or unusual for the given problem (Any fans of “House” will know where I’m coming from!)
Help us understand
All doctors have ongoing reviews and training on how to communicate with patients as it’s well proven that the more a patient understands correctly what’s happening the more likely they are to take their medication correctly or comply with advice about the myriad of other things that can be done to improve their health.
Here’s some of the things we do at our practice to try to help our patients understand their conditions better:
Face to face consultations
Wherever possible we encourage patients to see the GP in person, we find people are more relaxed when they feel they know their GP and can read body language etc much more.
Longer consultations
For most situations we recommend a 30 minute consultation and we can arrange longer if circumstances require it. Removing the sense of urgency, allowing time for checking understanding, answering questions and recapping key points all helps
See the same GP
Not only is it nicer to see a GP who knows you and your health history a recent Norwegian study demonstrated it’s actually means we are live longer, get admitted to hospital less and are less likely to need a doctor out of hours. However there’s a problem…
Those are the words of the head of the Royal College of General Practitioners in October 2021.
At OxMed Private General Practice are very focussed on ensuring you can see the doctor you want to and we know our patients value the continuity of care we provide.
Relaxing our patients
We do everything we can to help you relax when you visit us. From the calm waiting area where you can relax and have a coffee whilst you wait (Ed: unless the doctor has forbidden it!) to being reassured we will have time to take great care of you, everything is done to allow you to “take it all in”. We also schedule our GPs to minimise their time pressures which further helps the effectiveness of your visit.
Patient care coordinators
Every elite athlete will tell you that the majority of their success is down to what they do before and after their competition. Well not all of our patients are super fit athletes (and we hope our consults don’t feel like a marathon!) but the principles still apply. So bring on our Patient Care Coordinators – AKA the “can do” team. We have one mega mission:
“To make everything from first contact with the practice to the last “loose end” of any onward care as smooth and efficiently as possible.“
We love it when a doctor reports back that a patient mentioned us in a consultation and felt well looked after – that’s a “Made my day” moment for me for sure!
Your clinical notes
After every consultation you will get sent a copy of the consultation notes where all the important stuff is written down. We always incorporate a summary at the end of each set of notes which is written in plain English (rather than “medical speak”) so you can read and re-read the important points whenever you wish.
Is there anything else I can help you with today?
I hope this has given you a flavour of why communication between health care professionals and patient is a lot trickier than you might have first envisaged. If you have any further ideas how we can make your visit to us better please do let us know. Meantime next time you hear “The doctor will see you now”, take a deep breath and relax.
….providers range from ‘well-meaning to cynically preying on people’s health anxieties for financial gain’. Unauthorised programmes may cause ‘significant harm’
London GP and RCGP overdiagnosis group chair Dr David Spitzer
I was inspired to write this post after reading an article in “Pulse”, a widely read publication for doctors. The article was entitled “Screening by the back door”. Written by medical journalist Emma Wilkinson (@Emmajourno). The availability and accessibility of a wide range of screening tests to diagnose disease or predict future disease risks has the potential to massively increase our health. Government backed screening programmes are run only after significant time and expertise has been invested to ensure they are fit for purpose and have a significant impact on the health of the UK population. Strong value for money and “risk benefit” calculations are a big part of the government’s assessment.
Private screening tests
There remain plenty of other screening scenarios where there are still significant benefits to the appropriate patients but where for various reasons (often financial) the screening tests cannot be done on the NHS. So therein lies the case for private screening. With a rapidly increasing breadth of tests becoming available claiming they can detect/predict a wide range of conditions why shouldn’t people part with their hard earned cash in return for peace of mind? As with many things in life the answer is “it depends”, and on what it depends begins with being well informed about the appropriateness of the test/s for you….
Appropriate screening
Appropriate screening, defined as the appropriate test/s performed only on patients that fit the criteria for which the screening test was designed can be highly beneficial. Combine good screening tests with interpretation from a doctor who has a good knowledge of the individual patient and you have the basis for tests that can prove valuable and in more extreme cases life saving. Particularly for patients with good reasons to fear a certain disease (eg family history) to be tested and know more about their likelihood to be affected by a given disease can be invaluable in making decisions about their health.
The dangers of screening tests
A poor screening test can throw up lots of false positives (in statistical parlance this means they lack sensitivity), which results in a lot of “worried well” people who not only may suffer emotional harm from worries generate but may also go on to have further tests. Alternatively they may lack sensitivity and so fail to flag up disease risks and leave a patient incorrectly reassured they are OK. (For a fun explanation about sensitivity and specificity try this video.) You might be sitting there thinking well surely if the tests are good enough surely they will be 100% sensitive and 100% specific but the reality is this is a never possible!
Both the above scenarios are an “everybody loses” situation where less scrupulous testing organisations bounce the now terrified patient back to the over stretched NHS or, possibly worse, recommend further private tests and investigations. In the second case patients don’t take precautions or make lifestyle adjustments that could improve their health and or life expectancy because “the test said I was OK”!
To be tested or not to be tested, that is the question…..
I recommend the following four step guide to be able to make an informed decision about whether you wish to be screened for a given medical conditions/s
1 – Do your homework. Find out about the test, there’s lots of peer reviewed material out there published by governments and independent institutions.
2 – Is the same test available to you on the NHS? There is a very informative page on the NHS website here.
3 – Ask questions of any service provider about WHY is this test/s appropriate for YOU? WHAT does the test actually test for? How sensitive are the tests? How specific are the tests?
4 – Consider carefully before buying any test kits, scans etc that are offered with no or limited consultation with a doctor.
Here at OxMed Private General Practice we set our fee structure so that we make no income from commissioning tests. All tests can only be requested by one of our experienced GPs after they have listened carefully to your concerns and are confident you are able to make well informed decisions about what tests you would like.
If you want to discuss screening tests, we offer a wide range of individual tests and wellness packages. We are always happy to respond to any enquiries with no obligation to proceed.
OxMed Private General Practice 