Doctors take 6 months to diagnose Lyme disease

The usual ‘doctors failed to diagnose my child’ story from the Daily Mail. The headline says it all:

Schoolgirl may be paralysed by disease that mother diagnosed on internet after doctors left baffled for six months

The 13 year old girl with a chronic headache, vertigo and photophobia was finally diagnosed with Lyme Disease.

‘She was diagnosed with Epstein-bar virus [her mother says], without the glandular fever. Then meningitis, then the psychiatrist comment was the best one.

‘They even suggested it could be a clot or a tumour at one point, which was worrying.’

All sensible differentials one might think. Lyme disease is very rare (see below) and without a history of a characteristic rash, bites or travel to more prevalent regions, most doctors would not consider it as a differential diagnosis – but that wouldn’t make a very good headline.

Incidence of Lyme disease (a little out of date!)

Skin cancer excision in primary care scare

The Times reports that having skin cancers removed by GPs may not as effective as having it done in hospital by a dermatologist:

Dr Helena Malhomme dela Roche, who carried out the study, said: “The incomplete excision rates for patients with high-risk BCC managed by GPs is unacceptably high at 54 per cent.”

Dr Elisabeth Fraser-Andrews, one of the authors of a study of BCC surgery in Essex, said: “The proportion of BCCs excised in primary care is low, showing that patients receive sub-optimal treatment in primary care compared with secondary care.

The article rightly points out that auditing of GPs practice, especially when it comes to skin cancers, is of vital importance. It does not, however, tell us the size of the study or give GPs the opportunity to respond.

LED helmet cures dementia!

I remember talking to someone about this device – i think her dad was involved with the project. I thought she was making it up, but apparently not, as this article in The Daily Mail proves. How wearing 700 LEDs for 20 minutes a day can reverse dementia is beyond me. I eagerly await the randomised controlled trials.

12 die every year due to prescribing errors

The National Patient Safety Agency (NPSA) report that 60,000 prescribing errors were made in the last 18 months – see this article in The Independent.

Most incidents were caused by health workers giving the wrong medication to the wrong patient, the wrong dose or strength of drug being given out, or not given at all. Poor communication, failure to read notes and miscalculation of doses are all to blame, according to the NPSA.

2 deaths every months is, of course, a shocking figure. Could perhaps, the statistics be given to the public in errors per prescription? 60,000 errors is less than 1 per doctor per 18 months, which sounds rather different.

Rate my doctor site launched

UK doctors now face a form of scrutiny far more terrifying than the GMC: from Sunday we will be rated on-line by our patients on Iwantgreatcare.org.

The site is a shining example of Darzian medicine and will give all of us lazy, unsympathetic doctors a kick up the backside:

Professor Chris Bulstrode, of Oxford University, a consultant orthopaedic surgeon and member of the GMC, said: ‘This website is a great idea and will put the cat among the pigeons with the medical profession, which is just what’s needed. Doctors will feel threatened, and rightly, as one or two will find their trousers round their ankles.’ from The Observer.

The concept of the site will make many doctors’ stomach churn – including my own. Its a nasty gimmick that fails to realise that the perceived quality of a doctor depends on many external factors, such as the firm they are working in, working patterns, hospital management and training. The medcal blogging community are, unsurprisingly, kicking off, with NHS blogging doctor summing things up well.

Pulse reports that Dr Bacon, the site’s founder, has been issued a formal warning from lawyers representing a group of 37 doctors who oppose the site.

MRSA cure in the pipeline – again

The Observer reports that a vaccine to prevent MRSA will be available in 10 years time, according to CMO Sir Liam Donaldson. A vaccine to prevent C. diff vaccine will be ready in just 5 years. The article doesn’t mention how these vaccines will come about, but I’m sure Sir Liam wouldn’t lie.

Sound familiar? If the vaccine doesn’t work, there’s always the cure.

Hello world!

Welcome to Doctor Jo’s blog. Please forgive me for the weak pseudonym.