Sometime ago, I was sharing some financial nuggets with teenagers about key questions to answer before a purchase:
- Do I need it?
- Can I afford it?
- Is it cheaper elsewhere?
Are there questions we can ask ourselves before sending off an eConsult, AskMyGP or other online message to our GPs, making a call or deciding to visit the GP surgery to book an appointment? Despite what some ‘experts’ may say, these are exceptionally challenging times to be unwell. Last week we focused on healthy living. The demand for GP appointments is far ahead of supply and will only get worse in the (winter) months and years ahead except serious changes are made at all levels, beginning with individual, families and communities living healthier lives, with the understanding that those who are well do not generally need to see a doctor.
Despite our best efforts, many of us will fall ill. The Self Care Forum defines Self-care as the actions that individuals take for themselves, on behalf of and with others in order to develop, protect, maintain and improve their health, wellbeing or wellness.
What was your response the last time you experienced a symptom, anywhere in your body – headache, earache, red eye, mouth ulcer, sore throat, chesty cough, abdominal pain, low back pain, problem down below, knee pain, etc. What did you do?
It is true that many health problems are managed by individuals and families without recourse to formal healthcare. As always our genes, lifestyle, environmental factors and the quality of health services influence our health-seeking behaviour. Many symptoms are associated with pain which is one of the cardinal features of inflammation, our body’s primary response to insults to prevent and limit damage. Much research in the last decade has shown that some of the chemicals released as part of the inflammatory response by the body also act in the brain and affect our behaviour.
While one person may perceive pain and feel their world is coming to an end and immediately call the doctor, another person may shake off the same pain and go to work. Some people are described as “frequent flyers” in formal health care because they are forever contacting us for appointments. Others ignore symptoms and present for care when it is almost too late. In the ideal world, we will only see those who have tried self-care for an appropriate duration without improvement prior to presentation.
These are ways people respond to symptoms before contacting their GP.
- Do nothing
- Rest
- Keep hydrated
- Homemade Remedies
- Take medicines from the Medicine Cabinet
- Seek the advice of others – family, friends, social media, “Dr Google”
- Pray
- Visit the Community Pharmacy
- Other health and informal health practitioners
- Watchful waiting …
Illness behaviour and Care-Seeking Behaviour have also been well researched and offer clues into what pathways people follow before their first GP call. We are at different stages along the health pyramid. There is a fine line between Self-care and Minor Ailments. While some people continue to practice self-care when they have minor ailments, others may choose to seek formal care in dedicated clinics such as Minor Ailment Schemes in Community Pharmacies, Minor Injury Units or clinics run by Allied Health Professionals in primary care and Unscheduled Care Clinics.
Self-care is also carried out by people doing their wound dressing, self-administered injections, catheter drainage, etc. People with many Long Term Conditions (LTCs) also learn to look after themselves.
We commonly hear patients say something along these lines, “I don’t want to waste your time. I think it’s a viral infection but I just wanted to check that it is nothing more serious.” Well, you’re right you’ve wasted an appointment and yes, you’re right again, it’s just a cold and will run its course in another week or so! You do not need to validate what your gut feeling is. We have a magical 2-3 week waiting period in primary care when many symptoms are expected to subside. First, read about the conditions and be knowledgeable. These fact sheets will help for some common conditions. Develop the skills for self-care: healthy living, have some over-the-counter (OTC) medication at home – Paracetamol, antacids, antihistamines, laxatives, anti-diarrhoeal medication. Be confident that the common things are the most common. Instinct is fact filed away in your subconscious.
Do self-care, learn about the common symptoms and how long they last. If symptoms can be treated with OTC medication, please go to the pharmacy and not make your GP the first port of call. Before that Online Consultation or phone call, ask these questions:
- Can I self-care?
- If I can treat the symptoms, are the medicines available OTC?
- Have I given self-care enough time?
There are several key lessons which you could read here (Self Care) but I will leave this with you:
Despite people’s willingness to initially self-treat, there are still 57 million GP consultations a year for minor ailments at a total cost to the NHS of £2 billion, which takes up, on average, an hour a day for every GP.
Enough said!
Abiye Hector-Goma is a General Practitioner based in Leeds, UK who cares about his 10k patients and the local communities where his practices are based. He is keen to pursue work-life balance with the help of better-informed patients and their families.
@KayHector
ExpertPatients@outlook.com
www.kayhector-proactivehealth.com