GPs one symptom approach will fail allergic patients

According to new guidelines from the Royal College of GPs (RCGPS) patients are now only being allowed to discuss one symptom per 10 minute appointment despite often having to wait for up to a month to get an appointment Dr Stokes – Lampard head of the Royal College stated

“I am saddened that we have signs up in surgery saying ‘Your appointment is to consider one problem only “. Those signs sadden me because they are a sign of our flawed system and not the sign of an efficient healthcare system.”

This might be acceptable if the visit was for say a verruca or acne but for the allergenic patient it is totally unacceptable. If you have one allergy symptom there are comorbidities with other symptoms. Even twenty years ago in 1997 the Journal of Allergy and Immuniology reported asthma , rhinitis, conjunctivitis and eczema have comorbidity/ interrelated symptoms. http://www.sciencedirect.com/science/article/pii/S009167499770126X.  Since then allergy IgE and hypersensitivity non IgE have increased according to Professor Graham Devourex “Since about 1960, the prevalence of asthma and allergic disease has increased sufficiently to become a major public-health concern. Concurrently, there have been marked changes in our diet, and it has been proposed that these changes have contributed to the increase in the prevalence of asthma and allergy”http://www.nature.com/nri/journal/v6/n11/full/nri1958.html .It is worth noting that this applies to both adults and sick children.

All this leaves the allergic patient who does not realise that their rhinitis and eczema may have a root cause severely compromised urgently needing to find a resolution to their distressing conditions. Allergy is an autoimmune and an inflammatory disease as are arthritis, hypothyroidism , Type 1diabetes and certain types of anaemia. In 2017 most of these conditions are increasing relentlessly.

Visiting the GP with only one symptom will probably result in different lotions for eczema and on the next visit nasal spray for a runny nose or maybe a different antihistamine . This approach has the effect of treating symptoms with a” sticking plaster”

Unfortunately for GPs and the NHS patients have access to the internet and can read the latest evidence based science covering such issues as the gut microbiome and desensitisation to peanut allergy . They can apply the research to their symptoms and rightly expect a multi symptom approach called “functional medical” to their health instead of a one symptom approach which one could think is almost reverting to the dark ages for patients . I wonder how long they will accept it ?

Marlene Hochstrasser

 

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