… A Taste of His Own Medicine

Tuesday, 07:10

BBC Radio 5 Live breakfast interview with Nicky Campbell.

CAMPBELL:         While sources suggest the NHS is considering making vaccination mandatory for front line staff, BBC figures have shown up to 20% of healthcare staff in London remain unvaccinated against Covid-19.  We ask GP Dr Rick Brown why this is.  Dr Brown:  why the hesitancy among doctors?

BROWN:              I’m glad you’ve asked me that, Nicky.  Initially the delay was embarrassment.  To begin with doctors were embarrassed about jumping the queue.  The majority of UK doctors are achingly middle class and couldn’t bear to be seen putting themselves above the over 85s and chronically ill.  Having their own vaccinations first felt like the crew pushing to the front to be the first into the lifeboats on the Titanic.  But as time has passed and most of us have been working flat out in vaccinations clinics, let alone trying to run our own surgeries, the moment seems to have passed and the rest of us have basically… forgotten.

CAMPBELL:         But wouldn’t you say it was important that we all follow the science on this?

BROWN:              Oh yes, vitally important.

CAMPBELL:         In the same way as you would expect patients to follow other important medical advice such as for heart disease or blood pressure?

BROWN:              Ah…

CAMPBELL:         Is that not the case?

BROWN:              I’m glad you asked…  Actually I’m a little bit less glad you asked me that one.  You see, the thing with heart disease is that in any given year most people will be…  fine.  Most people who are going to have a heart attack will have it anyway, whether they’re on tablets or not. 

A small proportion of lucky people may be prevented from having a heart attack by taking medication, but lucky people tend to be OK in the first place. 

And unlucky people tend to get so many side effects, and the tablets make them so miserable every day, preventing something that may never happen, that it’s hard to justify keeping on using them.

CAMPBELL:         That’s quite alarming to hear.  Surely there’s value in getting help with other medical problems – injuries or backache for instance?

BROWN:              Ah.

CAMPBELL:         No?

BROWN:              Well, most musculoskeletal injuries get better on their own anyway, and those that don’t get better certainly won’t go away by taking painkillers.  Physio’s pretty good but patients are surprised when they’re asked to do exercises.  They generally hope physio works by some kind of…magic?

CAMPBELL:         What about antibiotics?  One of the great triumphs of medical science over the last hundred years?

BROWN:              Oh, lord no!  What do you think people with colds did for the first two million years of human evolution?  Just die?  No, no.  We reserve antibiotics so we can end a consultation quickly when we want people to go away.  Otherwise we have to explain why they don’t work for viruses again and again which gets tedious.  Of course, there are the secret antibiotics which we use ourselves in the week before Christmas or to be well for our children’s birthday parties but we keep pretty quiet about those.  No, no.  It’s just a virus:  rest and plenty of fluids.  That’s the way.

CAMPBELL:         So you feel that for quality treatments we should be accessing specialists directly rather than through general practitioners, perhaps?

BROWN:              Oh, lord, no!  They’re even worse!  Just the same as us except five times as expensive to the NHS, with worse parking.  And if their treatments worked do you not think your GP would have tried those first? But because they dress better and have nicer cars it doesn’t look quite so much like they’re winging it.

CAMPBELL:         (GETTING ANNOYED) So is there in fact any point in seeing doctors at all?  Are there any treatments that actually help and justify the ten years of training?

BROWN:              Well the pill’s useful, and asthma inhalers or insulin can be handy.  Talking things over with a friend often helps.  Fresh air’s pretty good and most doctors are coming down in favour of exercise and a healthy diet.

CAMPBELL:         Anything else?

BROWN:              Errr.  Brush your teeth?

CAMPBELL:         Dr Brown.  Go away.

BROWN:              You’re welcome.