Following the comments of a previous post, a reader affirmed that doctors would be happy if patients were healthy. I think we are losing perspective in the interesting debate that had been held … Physicians do not want healthy patients and can never be our aspiration. Do not confuse the universal desire to have a simple job of wanting a job without meaning. The meaning of our profession is to provide health to people. The problems do not come by the severity or complication to diagnose or treat a disease but in the perversions inherent in the current health system. We do not complain about a hypertensive patient who has to add drugs to keep figures within limits or the person to be prescribed an immunomodulator to avoid rejection of his kidney transplant, for many visits required by the first or very expensive that is the second medication. Complaints come when the system is abused. When, for example, explaining that a cream analgesic has no more effect than the massage itself and that any moisturizer or oil that favors the massage will come well, the patient answers “Yes, but the Calmatel © is free for me. insurance” I am not talking about a difference of opinion (“I notice more relief with Nolotil © than with paracetamol, tell me about it”), but about the abuse of the system. To bring the cartons in pairs to make a visit every week instead of one every month and take advantage to get a new reason for consultation. Of the dependence of certain drugs of discarded efficacy (or health risks with prolonged use) without taking into account more criteria than “Once Don So-and-So sent me (ten years ago) and I did well, so I use it since then » Of the «As it is raining I put a warning so that the doctor comes to my house» (is that the title made me immune to the showers?). Or “I feel very tired and I have not been analytical for two months”, a frequency that is not even included in the health program +65 in force in Andalusia, designed by politics and not by clinical evidence. It’s not that we want healthy patients, it’s that we want sick patients. To those of us who have something to be able to solve. That is why many colleagues defend (defend) some kind of measure that regulates access, without limiting or restricting it. That health care remains universal, but that a few do not harm the quality of care received by those who truly need it.
Contraceptive methods, fortunately, there are numerous, increasingly more and with fewer side effects and greater ease of use. But they are not equivalent among them. It is not the same to use one or the other. Generally, mothers of adolescent girls fear pregnancy above all and when they come to consultation or go to Family Planning they ask about hormonal contraceptives. And they are greatly surprised when, for that situation, I strongly recommend condoms more than anovulators. Such an uncomfortable method that depends on a man (“we all know how unconscious they are when they feel like it”)? Better than the patch? I do not think so… They are forgetting that the risk that runs with a sexual relationship is not just an unwanted pregnancy, but also diseases. AIDS is the most serious (incurable today) but much more numerous are gonorrhea, lymphogranuloma, syphilis and infection by papillomavirus, which not only causes condylomata acuminata but also is a risk factor for the development of cervical cancer. Against them, hormonal methods do not protect. And generally, if a fifteen-year-old girl already has a sexual partner, it will not be the same for the rest of her life, which increases the risk of infection. Let’s blame it on how difficult it is to find your better half and that, the more contacts with different people, the more likely you are to match someone with a disease. See more here hormonal contraceptives In the specific case of cervical cancer, the risk of suffering from it increases if both men and women have had sexual intercourse before the age of 16 or if they have had numerous sexual partners. Although the disease manifests thirty or forty years later and only women suffer. The choice of contraceptive method has to be based not only on the comfort of putting on a patch a week or stopping the previous game to put on a condom but on various factors of the couple, not only of the woman: stability of the relationship, smoking habit , age, allergies, frequency of contacts … But yes, use the method that is used, that is used well. You can not take a condom for two years waiting for the opportunity to use it and trust that it has the same effectiveness, nor (true) take two pills together of a daily anovulatory as if it were the postcoital pill to avoid having to use a condom .
This Tuesday Antena3 premiered a new “series of doctors”, produced by Ficción TV (Grupo Zeta) that has familiar faces such as Miguel Ángel Muñoz, Toni Acosta (making it clear to the main audience: those who became orphans after A step forward) or Nancho Novo (who became very fashionable to early in the decade and since The Comedy Club has been seen rather little). The plot is very simple: Rich boy (Ulysses) who studied in the US is forced to work before the galloping bankruptcy of his family. And, of course, he can not work anywhere else than in one of the poorest neighborhoods in Madrid, the (fictional) Pingarrón Stream. All said. In front of the almighty House and the American series with egregious figures that you admire or hate (Grissom, Shark, Ally McBeal …), we propose a series that diverts attention to the extras. And there are many for any viewer to find someone to identify with. It is what has always worked in Spain: Chronicles of a people, Menudo is my father, I am Bea, Hands to work, Tell me, Dear teacher, Los Serrano … I will not be particularly punctilious with the specific errors of representation of the profession since I assume it is a series of entertainment and not a documentary about public health, so I will overlook details such as inspections for prolonged sick leave are made to the patient, not the doctor. But for the approach of the plot itself, yes I have some words … Let’s see, who thought it was credible to put a doctor with no experience or approved specialty to run a public health center without opposition, property or anything like that? Without entering, of course, into the political game that involves the entire underworld of intermediate positions. Surely it was the same who thought that the play on words between the name of the protagonist (I would call it McGuffin) and the true syndrome of Ulysses was intelligent humor. And the same for his faculty colleagues. That pija operated girl, what is supposed to do in that medical consortium? Pass consultation I do not think … Ok, I rely on my brief experience in a private clinic in which I, just finished, did not paint practically anything, but I do not think it is very different in the rest of clinics in the country. The choice of actors seems right to me. That M.A.M. I think an insufferable actor does not mean that he is a suitable person to approach that audience goal that he mentioned at the beginning. He looks young, transmits insecurity to his character and looks good. There were also elements that I liked, such as the brief moments in consultation. That mother defying the pediatrician, the “I’m not coming to the doctor a lot” said by whoever is there once a week, the so-called “this is a virus, paracetamol and a lot of water” that by dint of repeating it has become in a cantinela without a message (but today it served me to break the ice with a patient and her son, thanks to the laughter), or the “I change doctor” as a mechanism to prolong the fuller where possible. But a brief, unable to trace the tone. To make credible the weak premises that sustain the argument, such as the situation of the protagonist, their social relationships or their inability to leave work in the neighborhood in question (do not like the center? Go somewhere else, if possible outside of the big cities, you must be the only one who has not heard that there are no family doctors in Spain …) Overall, I thought it was a simple series without bad intentions, in which the profession and the neighborhood are portrayed in favor of the plot although without falling into “everything is an almost incurable disease” or in “what good doctors live” of other titles. A series that does not hurt if you stay in it a few minutes to zap, but lacks the hook to leave the command on the table.