327 pages, The Friday Project/HarperCollins
Review by J.S. Colley
I received an ebook for review purposes.
Further Confessions of a GP is, as you might guess, the second in a series. I haven’t read the first book, Confessions of a GP, but it didn’t surprise me that there could be further tales. Several members of my family are in the medical professions, and I worked as a medical receptionist in my youth. Need I say more? But, since this was written by a UK physician, could I relate to the stories? It turns out dealing with the public in the UK isn’t vastly different from dealing with them in the USA.
This is the kind of book that can be read in snippets. Coincidentally, it’s the perfect reading material to take along to a doctor’s appointment so you’ll have something other than magazines with last year’s winner of the sexiest man alive on the cover. It’s also great to keep by your bedside to read a chapter or two before bedtime. Hopefully, you’ll drift off to sleep after reading one of the more poignant stories rather than one of the more disturbing.
What struck me most about the doctor was his compassion. Even while relaying less-than-flattering stories about his patients’ antics, his respect and concern were apparent. Also, he admits physicians aren’t all-powerful. He acknowledges that, most often, doctors are merely a sounding board for patients while time and nature cures them. I found the stories entertaining, enlightening, poignant and, at times, downright gross. Everything I’d expect in a GP’s tell-all.
One can’t talk about health care in the UK without talking about the NHS and Daniels doesn’t shy away. Since the US is going through the sometimes-painful implementation of a new health system, I was both interested in learning more about the UK system and, frankly, sick to death of hearing about the politics of it all. There were only a few instances where politics bled through, so it was tolerable.
However, I have to correct the doctor on two statements, one where he claims the US’s “private health-care system” has scared the public into thinking they need a yearly colonoscopy screening, and the other where he claims US doctors gave a woman suffering from false pregnancy a C-section.
Regarding the first claim: the American Cancer Society recommendations are for a colonoscopy every 3-5 years, if indicated, and every 10 years if the first colonoscopy is normal. They do advise a “yearly fecal occult blood test.” (Poo is talked about in the book, so I won’t avoid it here.) I also looked up the guidelines for a “private sector” health insurance company and found the same recommendations. I do have first-hand experience with this. After my initial colonoscopy, my “private sector” doctor told me that I didn’t need another for ten years. And believe me, if I’m told I don’t have to go through that nasty test for a decade I’m not going to argue. Daniels may be confusing American celebrities, who have scared people into believing they need this test once a year, with the recommendations of the (paraphrasing) “money-hungry private health care system,” but the official American Cancer Society and insurance guidelines are clear.
The second claim regarding the woman with false pregnancy appears to be true, but it was in Brazil, not the USA. Perhaps there was some confusion because Brazil is in South America. I give Daniels the benefit of the doubt, as perhaps he knows something I don’t. But, when I google it, all the news stories claim this happened in Sao Paulo.
The doctor takes a few jabs at America’s health care system to bolster the opinion of his own. Some of his criticism may be deserving, but he fails to mention that we (even before the Affordable Care Act) have Medicaid—a government sponsored health insurance for the poor.
Also: “Every region has hospitals operated by state and local government (public hospitals) as well as some nonprofit hospitals that provide a safety net for anyone who needs care, regardless of ability to pay.” And this: “…hospitals […] required to provide treatment under the Hill-Burton Hospital Program. Hospitals that receive construction funds from the federal government must provide some services to cancer patients who can't afford to pay for their care. Approximately 300 hospitals take part in this program.”
Daniels does, in a self-deprecating fashion, give a disclaimer after one of his accounts, where he admits he has no idea if the story is accurate or not, but he says he “read it on the internet, so it must be true?!” It is all meant to be fun and, in the end, I have no problem with the Daniels upholding a system he believes in but, if he is going to be specific, he should ascribe the correct horror story to the correct country, even if it is meant to be anecdotal. This type of thing is what helps perpetuate false impressions.
I give credit to anyone who enters the medical field, it is often a stressful and underappreciated profession, where nothing less than perfection is expected. If the reader takes away anything from these “confession” books, I hope they understand that physicians and nurses are only human, who want to do the best for their patients even when the patients are being unreasonable. And, despite the few brief forays into the political side of things, I thoroughly enjoyed the candid tales.