Wednesday, 31 October 2007

Street Doctor - negligent medicine at prime time

Luckily I have not had to endure many episodes of the BBC's woeful 'Street Doctor', unfortunately last week I was unlucky. Not only is the program negligent in the way that it portrays medicine as something that can be done on a street corner without a proper thorough history and examination, but it is also negligent in the way that the doctors get medical things very wrong indeed. In last weeks episode there were these glaring errors:

Plantar Fasciitis - a man with mild plantar fasciitis was treated immediately with a steroid injection. This was poor medicine as he should have been treated with simpler measures before a steroid injection was even considered, however the Street Doctor went straight for a treatment that is at best slightly controversial and at worst can result in serious complications. This was undoubtedly poor medicine.

Dupuytren's disease - the Street Doctor got this very wrong stating that it was a thickening of tendons and could be treated with a steroid injection. This is complete rubbish, Dupuytren's is a disease of the palmar fascia and not the tendons, and cannot be treated with steroid injections.

Sebaceous cyst - a poor old chap got terribly scared by the Street Doctor telling him that squeezing his infected cyst would result in the infection spreading to the bloodstream, what utter hogwash. In fact squeezing an infected cyst may well prevent the infection becoming more systemic, the complete opposite of the doctor's advice.

This program is an embarrassment and a danger. It encourages sloppy half arsed medical practice and spreads medical misinformation to the general public. It's therefore no surprise that the BBC should see it as a key part of its new cutting edge programming. A cynic would even go so far as to say that this pathetic attempt at taking care into the community is being used to add weight to Darzi's corrupt NHS reform program.


Dr Ray said...

Garth, You are right-it is deeply embarrassing and I haven't been able to watch more than a few minutes of it.
Ironic isn't it that qualified doctors walk the streets to entertain the masses while unqualified noctors are almost running our acute medical services now.

Gruff said...

"...without a proper thorough history and examination"

When did you last go to your GP? For all but non-trivial cases this is exactly what happens. I once had a locum GP examine a scalp infection I had from the opposite corner of his surgery (I don't exaggerate here) and I had a full head of hair at the time!

Garth Marenghi said...

It ain't good enough if it does happen, GPs frequently have too little time to properly take a history and examine patients,

you can have all the money and scanners in the world, but it's still the good old history and examination that are the most important!

Anonymous said...

Just found this post through a search engine. As a fellow medic, I think you're all being way too harsh. Agreed that the BBC should ensure accuracy before transmission but none of the errors were of any significance. If you feel that strongly you should take them up with the BBC.

The programme is for the public, not for bitter doctors who have no clue about primary care and spend their time venting their own frustrations and defaming other medics through blogs which offer little useful material to anyone. A real shame.

Cha'mon said...

Grumpy nitpickers unite - we can all sleep safely now and your BP will perhaps have gone up a few mmHg during this process. Shame about your other points in this complaint which were clearly dismissed as they were not justified. (BTW, no superfluous vitriol, sanctimony or self-righteousness in that comment, unlike many of yours).

I wonder what their response to you was? (Go on, publish it...) Could it be that you were actually wrong about something? Surely not. Even if you were, would you ever admit it? It takes a man with real balls to do that...

ECU ruling: Street Doctor, BBC One, 22 October 2007 Publication date: 8 May 2008

A viewer complained the programme had been inaccurate in a number
of respects, notably in describing Dupuytren's Contracture as a disease of the tendons, whereas it is a condition of the fascia.

BBC Editorial Complaints Unit's ruling

The doctor concerned had referred to "tendons" because he considered the anatomically accurate terms likely to be meaningless to viewers. However, he acknowledged that a generic term such as "tissues" would have been more appropriate. The Unit took the view that the inaccuracy was such as to mislead viewers, and upheld the complaint in that respect. However, it did not support the complainant's other charges of inaccuracy. The complaint was partly upheld.

Further action

The production team, presenters and medical adviser were reminded of the need to safeguard accuracy when simplifying technical or specialist concepts.

Jonathan said...

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medical negligence said...

concept of street doctor doesn't work
for longer period of time