
Does Peppa Pig encourage inappropriate use of primary care resources? - petepete
http://www.bmj.com/content/359/bmj.j5397
======
throwaway13337
Recently, I experienced this kind of excellent healthcare service while on
holiday with my partner in Bali.

She got sick so we phoned a clinic. Immediately, we were asked to come down.
The doctor talked with us about theories for what was wrong for at least 20
minutes explaining why it was x and not y casually.

He ran a blood test and within half an hour came up with a likely cause. He
sent us home while he had another test that would take longer but would
confirm his suspicions from the first test. After getting back those results,
he texted us on Whatsapp with a picture of the results sheet he received. He
then had a medication delivered by motor bike to our hotel.

After 1 week, he followed up again on Whatapp asking if my partner was feeling
okay now.

The whole thing cost 40 euros including tests and medication.

I would love to pay 400 euros for that service anywhere in the West.

Maybe Peppa Pig is the right idea and health care just needs to up their game
by removing red tape.

~~~
psergeant
My experience suggests that 400eur would get you this exact level of treatment
in European private practice, although I suspect medical reports by WhatsApp
would make most doctors fall foul of relevant data safety laws.

My (extensive) experience of South East Asia is that they’ll run many tests
which a European Dr wouldn’t order with a straight face but that you don’t
care because it’s generally pretty cheap.

~~~
jenscow
> medical reports by WhatsApp

At least it has end-to-end encryption.

Apart from in-person (which is inconvenient) what's the alternative? Email?
SMS? Post?

Provided it's a "good news" follow-up, of course.

~~~
psergeant
I’ve had a private hospital give me an online portal to receive results, with
online registration requiring the jumping through of many hoops

~~~
lightbyte
Cleveland Clinic does this, and it's amazing. The first time I went in they
gave me a little sheet of paper that had a code to sign up to their site with
(myChart) and now I can get all of my test results, make appointments, and
message my doctor all online.

~~~
manyxcxi
I’ve got a few doctor’s offices/clinics that are in MyChart. It’s wildly
convenient. The app and site are generally poorly designed, but work well
enough that I’d rather have it than not.

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d--b
_Does House M.D. encourage inappropriate dismissal of over-anxious patients?_

As a user of GP medical practices, I often wonder why doctors are such
douchebags when faced with people who have perfectly fine concerns over what
seems to them like trivial symptoms that self-resorbs.

In the show House M.D., Dr. House is a very prominent medical doctor who
specializes in very rare diseases and is often dismissive about patient's
problems. On 78 occasions during the show, Dr. House talks about the patient
as "a lier who's perfectly fine", and refuses to take their case.

Conclusion: Although the show demonstrate accurate and interesting cures to
very rare diseases, the way it talks about the average patient is pretty bad,
and may help explain why doctors behave like jerks on a variety of occasions

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benjaminwootton
>> As a general practitioner, I have often wondered why some patients
immediately attempt to consult their GP about minor ailments of short
duration.

Typical dismissive attitude of most GPs in the UK to make you feel guilty for
consulting them.

Having sick children can be worrying and minor ailments can actually be more
serious in a child, so it's hard to know when to ride it out and when to seek
a second opinion.

~~~
psergeant
> make you feel guilty for consulting them

While they shouldn’t be making you feel guilty per-se, they’re gatekeepers for
the public, finite resource of NHS care, and help stop healthcare spending
spiralling out of control.

~~~
J-dawg
This to me seems like one of the fundamental problems with the NHS.
(Compulsory caveat: we're very lucky to have it and it's way better than the
American system, etc etc)

But the primary care side of things basically _has_ to be a bit shit for the
whole thing to work. Because demand for healthcare is so elastic. Almost every
single one of us has those little niggles, aches and pains and things that we
_ought_ to get checked out.

If we could get a GP appointment at 24 hours notice, and be guaranteed an un-
rushed meeting with a sympathetic and friendly doctor, demand would skyrocket.
The system _has_ to limit demand _by never getting too good_.

There isn't really a private alternative because, in the UK, NHS GPs are the
gatekeepers of _everything_. You need a referral letter from an NHS GP to see
a specialist on your own private medical insurance. There are some companies
with private GPs but they're extremely expensive, presumably because there
isn't much competitive pressure.

So the system finds an equilibrium, where it's frustrating but tolerable. Not
quite good enough, but not quite bad enough that it's worth paying for a
private GP.

~~~
jon-wood
> There isn't really a private alternative because, in the UK, NHS GPs are the
> gatekeepers of everything.

I think this is slowly shifting. I have private medical cover via my employer
and one of the things included in that is access to video chats with GPs via a
mobile app - obviously they can't diagnose everything without being physically
present, but they can do referrals for things where its obviously needed.
There are a few services popping which offer this sort of thing for a one off
fee for each appointment as well.

~~~
J-dawg
Thanks for the reminder! I think my employer's medical insurer also recently
started offering this. I'll have to give it a try next time I need a doctor.

It's interesting that the insurance companies have noticed the weakness in the
NHS system. Presumably they sell this service to their clients in terms of
reducing the time lost from attending GP appointments.

I also don't think that services like this are going to be a satisfactory
replacement for an in-person visit. I bet they err very much on the side of
caution, and are likely to end up sending people back to the NHS if there's
any doubt. But for those situations where you just need a referral rubber-
stamped they could be fantastic.

~~~
jon-wood
The few times I've used them they've been fantastic. My wife has fairly
frequent ear infections, on the last occasion we paid for an online GP
consultation as it was 8pm on a Friday night, meaning it would either be at
least Monday to see our GP or a £20 taxi ride across town to see an out of
hours doctor. Instead she was seen within half an hour, and a prescription
sent to our local pharmacy and ready to pick up within an hour of starting the
process. Thankfully it seems the NHS are catching on and have started offering
something similar in London.

------
GFischer
That is exactly the standard of care I enjoy and expect in my country
(Uruguay). It's light-years ahead of what my otherwise far wealthier sister
and brother in law experience in San Francisco.

You can call an ambulance if you feel sick enough to not want to go to the
doctor (like a 100 degree fever or higher) and it'll cost zero - you do have
to pay a subscription that's currently about 20 dollars (on top of free
healthcare).

------
guidedlight
Interesting article.

It pretty much works exactly like that in Australia (National Home Doctor
service).

You call a number, talk to a call centre person about the symptoms. Then a
doctor comes to your house after hours, diagnoses the problem, and supplies a
prescription for medicine.

It is 100% free, and government paid. My daughter watches Peppa Pig and has an
equivalent experience herself.

------
koliber
Peppa Pig presents many other unrealistic scenarios, as it is a childrens'
cartoon for the youngest. If parent's are using it as guidance, the problem
lies elsewhere. It is not an instructional series nor an educational film.

~~~
mar77i
I like your attitude and had a sensible chuckle.

------
wlkr
Fantastic article! Absolutely hilarious! I highly recommend reading the
Christmas papers by the BMJ from other years.

~~~
tshanmu
Christmas crackers: highlights from past years of The BMJ’s seasonal issue:
[http://www.bmj.com/content/355/bmj.i6679](http://www.bmj.com/content/355/bmj.i6679)

------
rovek
Spoiler alert: This is satire. Calm down.

------
narrator
Does Elmer Fudd encourage innapropiate use of hunting rifles?

~~~
jmmcd
I liked the world when people knew a joke when they read it.

------
vortico
Although it seems the intention of the author is partially to make a humorous
article for other GPs, I think that popular culture case studies are useful in
medicine and science for finding strong causal links to certain behaviors.

For example, I believe that many cases of Trichotillomania (hair pulling
disorder) can be attributed to the game Animal Crossing from 2001 to present,
due to the weed-picking game mechanic, paired with existing OCD behavior.

~~~
zimpenfish
Has there been a rise in trichotillomania cases since 2001? I've done several
searches but can't find any useful statistics (only pre-2001 numbers).

~~~
vortico
I do not know, but I do know that online support communities have emerged in
the last decade due to the internet. Perhaps I could find one and bring it up
there. My belief is nothing but a personal observation (although I think the
causality is glaringly obvious.)

EDIT: To the downvoter, could you explain the reason?

~~~
noxToken
I didn't downvote you, but I'm guessing it's because of your claim. Blaming
trichotillomania on a video game is pretty bold, and you haven't provided
anything to back it up. It's a dubious claim to start.

------
alphadevx
That show is full of so many inappropriate examples for children, it is
unreal. I have banned my kids from watching it.

~~~
zython
Would you like to provide some of those examples ?

edit:proved => provide

~~~
jon-wood
The one that particularly grates on me is the relentless hounding of Daddy
Pig, particularly about his weight. Mummy Pig is often the instigator of this,
despite it clearly upsetting her husband and teaching her children that it's
ok to shame people about their body. (Also, relative to the other pigs on the
program, Daddy Pig isn't even that large).

Miss Rabbit is a prime example of the perils of zero hours contracts, she's
constantly having to find new jobs, and often trying to hold down multiple
jobs at the same time.

~~~
isfield
The constant use of "silly daddy". The show seems to attack the father figure
whilst making the mother figure seem always right (in my personal opinion).
Mummy pig is overweight too, nothing gets said about that though. It feels
like a reverse gender bias in that show.

------
PeachPlum
You mean "Calls the vet" not GP

------
jacquesm
For an intelligent person the good doctor seems to have missed the fact that
this is a show aimed at very young children and does not necessarily reflect
how adults in the families of Peppa Pig watchers would react.

More research into the course of inappropriate use of primary care resources
beyond Peppa Pig is indicated, perhaps combined with a dose of common sense,
which unlike over-use of antibiotics does not have any known side-effects.

~~~
joelthelion
For an intelligent person, you might have missed that this was written
slightly tongue-in-cheek :)

~~~
jacquesm
Sorry, but no. It references a published paper and is in no way written in a
way that would alert me to the fact that it was satire. As witnessed by the
rest of the comments in this thread if it was intended that way it mostly
missed the mark.

~~~
pmyteh
It /is/ a published paper - in the BMJ (a medics' trade paper-cum-journal),
which has a tradition of off-the-wall articles in its Christmas edition. Its
regular readers know this, so it's only those of us in the Internet peanut
gallery who are likely to be misled.

