Kind of a tough thread, being about the Brit healthcare and all.
Still, the topic itself is broad enough (I think) to talk about American healthcare.
I think the doctor would be entirely correct in America as well. With American medicine going to “evidence based medicine”, doctors, NPs and PAs are going more and more to computer answers. Put in the symptoms (that the examiner who sees 30 patients per day knows about) and it spits out the “evidence based” diagnosis and treatment. Now, courageous is the physician, NP or PA who ignores that and relies on his/her own judgment, because “evidence based medicine” is a “safe harbor” in avoiding malpractice claims. But give a “wrong” answer and you’ll be treated inappropriately, more likely than not.
I remember an NP being sharply criticized for treating a patient for strep throat. Why? Because the patient had a cough, and a cough is not in the “proper” symptom complex for strep throat. Worse, the NP ordered a culture for strep, which was positive. Why order a culture when the symptom complex didn’t fit the formula? Never mind that the patient actually HAD strep throat. Both the strep and the cough cleared up by the next visit, but the NP was still criticized for it.
And that 30 patients/day thing is getting more and more common. In some medical complexes, it’s the physician’s “quota”.
And since reimbursement for “well care” has increased at the expense of “chronic care”, nobody wants the “chronic care” patients and a lot of medical complexes have shifted to “well care” notwithstanding that at least some studies suggest that “preventive medicine” doesn’t improve outcomes.
And a person needs to be concerned about those questionnaires the doctors or their nurses are supposed to ask every patient annually. There are routine “counseling” things the doctor or nurse has to give and record that he/she did. Don’t drink, don’t smoke, lose weight, get more exercise, change your diet, take this medication proactively, do this test, lots of things. If you don’t comply, your non-compliance is eventually noted and you stand a chance in the future of being relegated to the “chronic” category as medical resources become more scarce and expensive.
The oncoming mess in American health care is likely to be of a different sort than that in Britain, one suspects, but I believe it will be (already is in many ways) a mess all the same.