Monday, July 30, 2007

Nationalised Industries - where we should be grateful for what we get

I have a rather amusing post about sailing this weekend - but this chap's humour has been sapped by having to deal with a Nationalised Industry - where us, the customer, is a nuisance who gets in the way of putting put new posters about their targets and getting paid extra to do it.

Another one of my chappist predictions here - I would pay to see a doctor for a routine requirement in a time that suits me, not that suits them. I am a customer, they would therefore compete for my business and serve me according to my needs.
There is a gaping hole in the market (Are you listening Tesco...?) for medical care at a reasonable price in a time bracket that suits me.
£18 for a consultation between 05.30 and 07.30 and £15 for one between 17.30 and 21.30

Pay in advance, by card. People would turn up, on time as they have an incentive to do so.

In other words - a bit of market pressure might liberate things.

Not being a NEET / useless / student / unemployable / pensioner / interminably lazy - I am required to work for a living.
I therefore have to take half a day off - how else do they expect me to be available in their 'office hours' (09.30 - 16.30)

But why the urgency to see a Quack?

I need an Epi-pen.

I have a specific allergy to a specific nut, and my dearly beloved has become insistent that I carry said item, lest I be laid low while we are harrying the sea-lanes.

I tried to facilitate the acquisition by speaking to a Doctor (His call to me - charge £15 - you see where this is going, don't you....)

I spoke to him, but I received no satisfaction. He will need to see me.

But, I cried, 'am I not registered on your database as suffering from an anaphylaxia.?'

Indeed I am. And the doctor can see it. And when I was last hospitalised with said needle into the heart.

'So - why can't you issue the prescription and I can collect it at my leisure - without losing half a day's most precious leave?'

He insists on seeing me before he will prescribe this potentially lethal injection.

'Why?, I asked, 'Short of giving me a patch test - which the Nurse would do to ascertain the accuracy of my claim, and that I am who I say I am - is there anything you could discern about my condition by observing me in the flesh that would preclude the provision of said gadget'.

'No, Mr. D.' He said coolly - 'It is so I can be instructed in it's use.'

I thought about this.

'Listen Sawbones, old chap' - quothe I, 'If I need it - I am already about to throw a seven, and it would be my compatriot who would have to administer it, Pulp Fiction stylee through my sternum. Not I. '
'Yes, I appreciate that - but if you administered it to yourself incorrectly and died, your estate might sue us.'

'Will I have to sign a disclaimer showing that I have received these instructions?'

'Of course not.'

'Ah, but would the person administering it have to sign one on receipt of it?
'No, but it should only be used by someone with correct medical training.'

'A device designed to be used by an amateur in a first aid situation should only actually be used in a hospital with a doctor present?'

'Well, not strictly...'

'Don't tell me, if it is used by anyone other than a trained medic, all liability is excluded?

'Even so Mr. D - you will need an appointment.'

'Very well - You can see me at 06.45 on Friday morning'
'That's not our office hours'......
'Your office hours, correct. It is when I am available. When can you see me?'
'I'm not permitted to make appointments, you will have call reception separately.'

Fucking marvellous. £15 to be told to come back and see them all to get something they know I need, but so they are seen to tell me that if I use it it is at my own risk.

This is a bit like writing on a life jacket : 'This is not a life saving device and should not be used in water by someone who cannot swim. Using this device excludes the manufacturer from any liability. ' (I have actually seen that on an American lifejacket)

My cool has departed me. Not a happy chap, now.

The image suggests that a little bit of practice with biro would sufficient, anyway. Bloody thing is intramuscular, not even intracardial.


sigismund said...

Epipens kill more people than they save.


Even a paramedic would hesitate. Give em too early - it will wear off too early - and trust me you dont want two. Too late, and well you will be late.

They have a short shelf life and you have to go thru the same rigmarole each time.

Dont bother - watch what you eat. Try getting one on a plane :-)

Nicodemus said...

I have managed so far by watching what I eat. I shan't bother taking it on the plane.
I have had one pulp fiction moment from brazils already - which is why i don't eat muesli, or unmarked chocolates, as the next one will kill me, lest I have the pen. However - as you say it has a short shelf life. Interestingly the dispensing method is exactly like that of atropine.

Still I have been instructed to carry one, by someone who clearly cares for me.

Anonymous said...

"Epi-pens kill more people than they save." - source?

"Even a paramedic would hesitate." - the point of epi-pens is that they're for use in extremis; you use them or you die. No paramedic would hesitate in those circumstances.

Short shelf life? The shelf life is 12 months. You don't have to go through the same process each time, the trick is to get a doctor who isn't an imbecile. Or go private, of course (thought you had private healthcare anyway, N? Or aren't you covered for pre-existing conditions?)

If it wasn't for epi-pens, one of the most important people in my life would be dead, so you can imagine what a pile of shit I think your post is, Sigismund, and you should be able to see why I think that the risk of using an Epi-pen is far outweighed by the risk of not using it.

It's up to N whether he has one or not, of course, but I asked him to get one as I know just how easy it is to die from anaphylactic shock, even if you DO "watch what you eat".

Nicodemus said...

NB: It gets worse each time - so she is speaking a good deal of sense.
If it happens again, I'm brown bread.

Nicodemus said...

Have got private, but The company Bupa doesn't work like that - it only kicks in when an NHS doctor refers me to a consultant. And there is an annual excess of £50.
I still have to wade through officious numbskulls who work part time at my local quack to get this.

They said they will not hesitate to prescribe, but I still have to be told to read the instrcutions.

I will also have to get a letter from them (£35) to put it in my carry-on - the unpressurised hold will make it pop, probably.

FYI - Parameds carry both Adrenaline and Atropine - and wouldn't need an epi-pen. Just as they carry a 'how-to' card for a defib, they carry a quick kit for an anaphylaxia case. It's nasty - and it has a knitting needle.