Friday 31 January 2014

Be More American

The City of Coolidge, Arizona, founded by my great uncle Dick - I don't know why

Sound advice for patients from Professor David Haslam, the boss of NICE (the UK Government's gatekeeper approving drugs and other treatments for NHS use - not the safety check but the benefit-versus-cost check if that makes sense) - see the story here and coverage on Hafal's Facebook platform here.

The Prof says we all need to behave more like Americans when we talk to our doctors. This means that instead of sitting quietly and being grateful for whatever the doctor decides to do for us, we should engage in a proper discussion and negotiate the best treatment available having regard to our own preferences.

The Professor says: "The fundamental point is it’s your body - and the more you understand about the drugs you are taking, or what you might be able to have, the better you are able to work with your doctor."

The Professor previously worked as a doctor near an American air force base and contrasts how his American patients engaged with him compared with the British:

"Americans tended to want to know more about their treatment than the British who tend to be much more ‘thank you doctor, I will take that’."

This is really important stuff. We hear a lot of debate about drugs and other treatments which NICE may or may not approve but this testimony proves that if you don't ask for the ones they have already approved you likely won't get them. I can understand the Professor's frustration.

We all know that this problem is much worse in mental health where several obstacles prevent patients getting the best treatment:

(1) Many patients struggle to articulate their needs because of their mental illness

(2) Doctors, like the rest of society, often have a problem with the idea of listening to mental health patients

(3) The complexity of so much of the medication, especially the antipsychotics - that difficult mix of variable effectiveness, unpleasant side effects, and difficulties in managing dosage etc

(4) Cost - even where NICE has approved we know that NHS Boards are keen to avoid using the more expensive drugs

(5) Access to psychological therapies - where do you start? Often not even considered by doctors and frequently unavailable if they are considered

This year Hafal is committed to working with our partners the Mental Health Foundation and Bipolar UK to help patients get the best possible treatments (this is in addition to our joint summer campaign on physical health).

Watch this space and other Hafal media - especially our next Mental Health Wales magazine which will have a special focus on treatments. You heard it here first.


Welsh people make good Americans as George Washington remarked - eighteen out of the fifty-six signatories of the Declaration of Independence were of Welsh descent.

Another fascinating view of Coolidge - there are more of these but I don't want to spoil you...