Regular contact with a doctor in primary care leads to less meaningless hospital

[Argirios Argiriou]

Γράφει ο Σουηδός Γενικός Ιατρός Eric Bertholds σε μια Σουηδική ομάδα Γενικής Ιατρικής στο facebook. Το μεταφράζω στα Αγγλικά:

That regular contact with a doctor in primary care leads to less meaningless hospital care, I have experienced as a district doctor in Norway and above all as a home care doctor in a small municipality in Sweden. If I judged that an emergency transport to the hospital would not benefit a patient with eg stroke, blood poisoning, covid infection, cold sores, tumor growth, kidney failure engraving, vertebral fracture, heart attack, etc., the ambulance was not called but good symptom relief was given at home / nursing home, including sedation if required to achieve good symptom relief.
It is not only acute meaningless (not "unnecessary") ambulance transports that can be avoided if we get "more health centers and doctors who say no". Thanks to good knowledge and contact with the patient / relatives, we were able to inhibit (say no to) countless from the hospital prescribed eg malignancy investigations and also treatments, the latter often decided at so-called multidisciplinary conferences (MDK) consisting of several medical specialists most of whom did not met the patient.

This is how PC Jersild described it in the biggest Swedish newspaper Dagens Nyheter last Sunday More about P.C. Jersild here: Δεν είναι ορατοί οι σύνδεσμοι (links). Εγγραφή ή Είσοδος

"As you get older, it is as if time pushes us out on a large field. But it is not just any field, the ground is filled with buried mines. The further out on the field you go, the denser the mines are. Right as it is difficult to avoid stepping on a mine marked “infarction.” A little further on, mines threaten marked “stroke” and “aortic rupture.” If you manage to get past that trap, you expect a “brain tumor” and beyond that “bowel cancer”. Leukemia, melanoma and Alzheimer's are also lurking in the ground. If you include the more unusual diseases, a thousand mines are waiting for me - the description is not a black painting but simple statistics that anyone can take part in.
So what will happen when a mine is triggered? A few die and fall and will not burden the care, but the vast majority end up in the care and nursing system. If you are lucky, you will not end up in a queue but will be taken care of in a reasonable time. What the upcoming trip looks like depends not least on the diagnosis. Of course, I do not know exactly how I will die. We have already touched on the heart, if I suffer from a stroke, I hope that it is either mild and can be rehabilitated - or that it is large so that I die immediately.
Swedish advanced healthcare is considered to be at the top. Cancer can usually be operated on with good results. But not all forms. If I suffer from a tumor in the pancreas, I hope that the surgeon agrees with me that we will not. But this is not certain, doctors are indoctrinated to always put continued life first. You can try to persuade me. It is as if the most technologically advanced care sometimes lacks a stop button. "

And this is how Hanne Kjöller (a swedish writer) wrote in the same newspaper 3/7 2018:

"Because so much can now be treated - and should be treated when young people fall ill - the question arises when to stop treatment. What makes the question difficult is that, in terms of the death certificate, there is no natural death. Aging is no diagnosis, no The death of 110-year-olds is also explained in terms of heart attack, stroke, kidney failure or cancer - a condition that in a 50-year-old can often be treated successfully.
But just as it is with old cars, there is a limit when it is no longer meaningful to repair them because you can assume that something else will stop working the week after, it is with old people. Unlike the car, their lives can even be risked by opening the bonnet. And even if they were to survive a few more days or weeks - how lucky would it be if they could never roll out of the workshop? "