Wednesday 17 January 2018

Maurice Gueret: A fine bullock with 'red water' at night

Online appointments and premium charges are on their way says Maurice Gueret, but never mind the bullocks

GPs are questioning their career due to stress.
GPs are questioning their career due to stress.

Maurice Gueret

The advertising of healthcare on the radio is a science in itself. Insurance companies heavily target Lady Gaga stations offering all sorts of inducements, such as reduced prices for children and deals for new families.

This is their lucrative end of the market with lots of premiums and precious few claims. Up the radio dial, private hospitals chase the Claude Debussy end of the spectrum, promoting the sobriety of their emergency rooms, the relative ease of admission and reassurance about the expertise of their specialists.

There's precious little to choose between private hospitals these days. St Vincent's Private might just edge it for me in Dublin, with their golf-course views and open-plan coffee shop. But it surprises me that in the midst of such cut-throat competition, nobody has chosen to waive or reduce parking fees. Most patients and visitors are happy to pay a reasonable charge for parking their car, but it is the amount charged that sticks in the craw.

Paying about five euro for one hour and one minute is nothing less than extortionate. Some UK hospitals would let you stay all day for that. The fees that arise when patients are critically ill and have family members present around the clock would bring extra tears to the eye.

The 'first 20 minutes is free' rule in some clinics means that a driver can be designated to keep the engine going and pop in and out of the car park every 18 minutes. Car parks cost money to build and maintain. But they tend to be built and maintained by profit-led companies who advise on revenue potential. It would be nice to see one or two hospitals ignore the norms of this industry, in the interest of patients. The first one to charge by the minute and not by the hour, will be highlighted here.

 

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Online hospital appointments are very much in the embryonic stage in Ireland. It's not easy to bring in any sort of nationwide system when you have a jigsaw of a health service with half the pieces missing. This month, one Dublin hospital started to ask its Warfarin patients to book their regular coagulation blood tests online.

Those who cannot do so have been offered a short telephone service for two hours each morning in which they can book. But if they call this number outside of these restricted hours, they have to pay a few euro in premium phone charges to make the booking.

We need to keep a close eye on this sort of development. It's bad enough for governments to rake in all sorts of hidden charges without hospitals getting in on the same act too. Next thing they'll be chasing booking fees and charging extra for butter on your popcorn.

 

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I'm all in favour of a digital society, but a caring digital society would make sure that everyone is helped, whether they have a ticket to ride or not. Developers of information technology in the public service need to accept that there is a substantial cohort of the population who prefer their mice to have four legs and wouldn't know an email from a website.

And before younger readers snigger at the idea, it might surprise you to know that there are quite a number of doctors practising in Ireland who do not have computers. I know this precisely because they have told me so.

In another generation or two this may not be the case, but it's true now, and as far as I know there is nothing in our State's constitution which says those without computers must be cherished that bit less.

 

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I told you some months ago about the retiring vet in the south east whose practice team baked him a cake topped with a cow, a bulging veterinary bag and a marzipan tub of his favourite animal skin remedy, Sudocrem.

Well thanks to social media, I discovered the other day that a Meath-based lady cardiologist who retired recently was presented with a wonderful cake that looked just like a defibrillator. It looked far too good to eat, but I'm sure she got a very nice and well-deserved shock at the thoughtfulness of her work colleagues and how highly her work was regarded.

 

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Doctors think they have a lot to complain about these days, but spare a thought for a GP colleague who is struggling with the auto-correct spelling function on her computer. She was referring a patient for surgical treatment of swollen blood vessels on his legs but her keyboard did not like the correct diagnosis and converted it to a case of vario coloured veins!

 

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The same doctor was reading my piece about Professor Louis Gleeson, the veterinary surgeon in Stradbally who also worked as a general practitioner. She remembers another lovely GP, long since deceased, who gave her locum work in the years when her family was young.

He was a part-time farmer and also had some horses. One winter's night she went to answer the front door and was greeted by a welly-wearing gent who was not at all happy to see her. "Where's Sullivan?" he asked (not the Doctor's real name), craning his neck to look past her into the house. "He's on a night off and I'm the doctor on duty," she replied. "Can I help you?" "You're no good at all to me Ma'am," was the response.

"One of Sullivan's bastes is down, he needs to come out quick." The 'baste' in question was a fine bullock with 'red water' or haematuria as doctors and vets would call it. The doctor, his wife and the local vet spent the night giving multiple blood transfusions and ministering to the sick bullock and his bloody urine, whilst the locum remembers a blissful, uninterrupted good night's sleep. Sometimes it's good not to know too much.

Dr Maurice Gueret is editor of the Irish Medical Directory

drmauricegueret.com

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