that sounds a bad time when you were diagnosed. exhausting coming up against this stuff when you're trying to get your head around everything that's happening. And all when you might've most needed some faith in how doctors work. How long did it all take to sort out?
yes i think it's a big problem when the GP won't record what they're told and the specialist sometimes ignores what you say unless the GP has told them it too. I've seen records where the referral letter and the report back from the specialist were exactly the same information. it's a big waste of resources.
once a doctor has written something down, it's so hard to sort it. Objective evidence that the record is wrong or fictional, doesn't mean they'll make amendments to ask doctors not to use the untrue info. A record can be proven untrue, and a breach of GMC regs, the Data protection act, the GP contract and the Equality Act, and is inevitably going to cause further harm, but still nobody will act to amend it. It would take a court case.
From seeing other people's records after serious medical errors - when doctors have nearly killed a patient and caused serious permanent disability - it looks like there's an informal mutual butt covering system. The priority seems to be defending all medics against complaints and litigation, even where they know dishonesty will cause further physical harm.
I'd like to see a no blame system, like in Finland. they don't try so hard to blame or protect individuals, and there's a bit more open communication about what's happened and what needs to change in the system to prevent future harm. It's not perfect but it'd help.
I was trained in case history taking for another healthcare job. We were using the same model and text books that doctors are trained with. not meaning I had the exact same training, but it was interesting.
It made me get how hard a doctor's job is, how much you need to know, even to know what questions to ask. I saw how easy it is to take a wrong turn in your questions, or lose focus or empathy for a moment, and cause harm. I think the job is intellectually and emotionally too big a job for anyone, and mistakes are inevitable. But if mistakes are inevitable, there has to be a way to communicate about them and resolve them.
I felt the training in case history taking was not good enough. It pressured us to ask the fewest possible questions and make the shortest notes, as if this showed you knew what you were doing. It encouraged corner cutting and too much faith in what we felt/thought we already know, because we're the experts. It's easy for experts to believe what they feel is the truth, and scary jobs can make people more vulnerable to overconfidence. But to be safe in that job you have to be able to cope with knowing you're always out of your depth to some extent.
We had all the same discriminatory thinking that everyone else has. When you add in the scared overconfident expert/mini god thing, it meant diagnosis could be based on discriminatory assumptions. It did my head in.
I'd write five pages of notes where my colleagues would write one and a half. It works fine if you include a summary. If anything goes wrong, or if things don't go as hoped, you have this information and you've a better chance of working it out. I get it that doctor's don't have time to work that way, but that means there's a bigger need for a system that resolves mistakes openly.
It all gets a bit circular. That expert status and power gap between patient and doctor causes of a lot of medical mistakes. The need to do the job quick adds to both mistakes and the expert status/power gap. The expert status/power gap means there's no way resolve mistakes.
One day if there's time and energy to spare, (ha!) it'd be good to do something on bringing together patients' experiences of all this stuff.
I'm doin lot of ranting and rambling here these days. I've spent too much of my life thinking about this stuff! I'm off out to the woods.
I hope it's a good day with you.