recent GP survey on stress not being an illness

"Dr knows best" / society needs people to take responsibility for their own health are 2 ends of the same "spectrum" perhaps.

I understand that in other countries people go straight to the specialist involved.

That "gatekeeper" role of the GP combined with a triage role might mean that consultants aren't needlessly under too much load.

You're right

 maybe as part of the shake-up for those able to do so (with a back-up for those who aren't) using an IT solution to go straight to the specialist involved makes a lot of sense to me...

I don't know I think there have always been people who are more or less engaged with their health, there are still younger people who have the same attitude of my parents and grand parents that the doctor knows best and you don't question them and certainly never disagree with them. Then there are loads of others who do want to be treated as individual and expect it, I'm not saying its an easy position for anyone to be in, but over all I think the whole system could do with a shake-up. Access to consultants is always through a GP unless you go privately, worst of all, you will likely see the same consultant whether you go private or NHS. There are some specialities that are so few of them I wonder if there are enough consultants to teach anyone coming up the ranks? I did ask about seeing an allergy specialist and my GP didn't know if there was one, certainly not round here as far as he knew, how can that be right when there are more and more people with multiple allergies around?

Because they are not treating people as individuals.  Furthermore the public has become immune to being treated as individuals because many people appear to not have the capacity to engaged with on this basis - whether this is a new thing or an old - has relevance to social changes that have taken place more recently I do not know.

I think many GP's are aware of the conditions their patients are living in and thier financial circumstances, it used to be that if a GP wrote to the council someone would get rehoused or get some other sort of help, social service etc, but now with services cut to the bone and a tiny number of council houses compared to the need, everyones stuck. 

I think more and more GP's are aware of the need for a holistic approach, but the whole system is set up to make it very difficult. If they send you to one consultant, you have to wait for them to see you, say theres nothing they can do and tell you to go back to your GP and the whole sorry merry-go-round starts again.

Many services that are supposed to be an alternative, like pain clinics are so out of date, they're promoting stuff that I read in womens magazines 30 years ago, how can this be state of the art? How can it be that they're telling you to do stuff that would be in a self help book? 

++Its likely pragmatic GPs view stress as a symptom of something else. Until perhaps it affects them and becomes chronic. They have some of the most regimented roles of social servants. But also going from the intensive training of becoming a doctor to the relatively placid and monotonous daily routine. A lot of surgeries where I am vary the the times doctors can work - this is probably also one of the reasons you may have to wait a long time see a doctor.

Scientifically it would be hard to prove stress as physical illness, more consistent with being a mental illness caused by the body's response to physical situations. When people work remotely they can deal a lot better with stress. So removing yourself from the physical enviroment certainly has an improving factor on quality of life as we saw during the pandemic (with many people opting for hybrid roles). 

Consistent routines also cause fatigue which lead to stress. Eventually the body will break if it is subjective to repetetive motions (and thoughts).

Yes I agree completely.

The "biopsychosocial" model proposed by Engel in 1977 covers this ( and yes no doubt "reinventing the wheel" of how health has been seen by for a longer period than we have had medical doctors...)

One consideration is possibly that if one goes to a hairdresser they and you expect the visit to be for a haircut...

I think it fair to consider that medicalisation of social and psychological issues is very difficult to change with predictable response from all concerned...

it may be profoundly difficult for practitioners and patients to juggle the components of the biopsychosocial model given the complexity of social understanding today.

e.g. the doctor realises that actually the major presenting cause is the social conditions the person is living in - but the person says "I've come about my diabetes Dr...." Or the person and maybe the Dr. realises that in the way society is currently set up "I can't work because of my mental health problems" is an absolutely rational thing for that person to say...

Iain said:

It is worthwhile noting the the article says we do not yet have prevalence rates for autistic doctors and the responses they got would be hard to make statistically meaningful conclusions from due to confirmational bias. 

Exactly!

That is/was the case for me kiwipip 

I believe that Alexithymia, has something to do with this

Also called emotional blindness, as a neuropsycholgial phenomenon characterized by not being able to process or describe one's emotions . Instead, some people with alexithymia express emotions nonverbally.

Alexithymia - Wikipedia

Your points are well made mrs.snooks 

1 - 1 Agreed, "there are lies, damned lies and statistcis" I once attended a meeting where the professional body's advisor on use of statistics began their talk with us with "first decide what it is you want to show..."  Needless to say my response was forthright and appeared profoundly confusing to many of the people in the meeting.  (and these people had all received a graduate/post graduate science qualifications...)

1- 2 I admit to being very frightened in and by society and I think it comes in no small measure from being autistic.  Thanks for the "heads up" about who we might trust.  Please continue to be as brave as you are able to and (notwithstanding the be careful who one trusts bit!) I and others believe you and support you.

2- 1 yep, money, perhaps not even readers these days as enough money can keep parts of the media running even with few readers and able to be quoted by other wider parts of the media  - Private Eye magazine has had a running joke about the sale of The Telegraph - that someone has actually bought a copy...  

2 -2 yep - and what/who are they in it for..

2-3 yep - what drives these people isn't some heart-felt social agenda anymore - makes me deeply suspicious too

If you take a strict definition of what a medical problem is and isn't, then things like a broken leg might not be a medical condition, likewse appendix removal, thats a surgical one. Stress could be considered a mental health problem, which as we all know is an awkward thing provoking extreme reactions, from pull your socks up, to filling you with every pill they can find in the hope that one works.

I think the problem is more a lack of holistic thinking about health, than anything else. Mind and body are linked, is your IBS playing up because your stressed, or are you stressed because your IBS is playing up?

"twice exceptional" springs to mind 

thanks for the link to the evidence ArchaeC 

ArchaeC said:

I wouldn’t think that all autistic GPs would agree with you.

If they are able to sustain working in this field then they must be exceptional people indeed to not be overwhelmed by all the stressers present.

It is worthwhile noting the the article says we do not yet have prevalence rates for autistic doctors and the responses they got would be hard to make statistically meaningful conclusions from due to confirmational bias. 

one of the best known ways of alleviating stress is having "locus of control" in a situation.  GPs potentially have this and are very well trained in exercising it.

In context. a health service that is unable to meet the needs of patients erodes this locus of control and increases stress experience.  

I too am beginning to question BBC autonomy and capacity to filter for bias in factual reporting ArchaeC 

personal supervision helps -

having a service provision that even by 1% excedes the needs would resolve most of the problems i suspect

I think they should have personal supervision like counsellors and therapists do, someone more experienced they can talk to about their patients, without breaking confidentiality, either about a specific problem that they can't get to the bottom of, or just the grind of seeing people they can't help because the real problems are poverty.

According to my son, GP's in England charge £50 for a sick note, so it's not an easy or cheap option, but one that will eat more than half of your weeking benefit payment. 

Iain said:

I honestly doubt any autist could stay the course to be a GP, and if they did then they are a crash waiting to happen

I wouldn’t think that all autistic GPs would agree with you.

According to this journal, “Difficulties faced by autistic doctors, in our experience, rarely relate to patient care”. 
https://bjgp.org/content/71/708/294

I think it might be a statistically relevant proportion of "high functioning" autistic people who find themselves in such jobs Iain .

I suspect that their capacity to "stay the course" might be one of the contributory factors to high burnout in the profession.

Would be interesting and informative to have the accurate statistics to make my thoughts on the matter more objective.

Phased said:

So what I'm saying is that with GPs mostly living with extreme stress as part of their daily life (until they succumb to it themselves... )  it's hardly unlikely they think being stressed is not an illness.

I would agree with you Phased 

BBC standards at their editing department have declined. Sometimes I can’t make head or tail of what they are saying in the News App because they use a cut and paste style of unrelated facts and figures to put together an article. I think this is another example of a headline plucked from thin air.