[avtur3]

The discussion about the rights and wrongs of where to park an Ambulance pre-supposes that you can get one to attend in the first place, my recent experience is that is dialing 999 to request an ambulance for someone in genuine need of hospital treatment will not necessarily get you the response you expect.

My mother in law had a very bad fall a couple of weeks ago in a shopping centre car park, she's very frail and a bollard she put her hand on for support gave way, the bollard fell to the ground as did she, she wasn’t able to make any attempt to break her fall. She landed on her head, left shoulder and left elbow, ambulance called within seconds by a passer-by. (There's a whole other issues regarding the failed bollard)

Long story short, 45 minute later no ambulance, a person who stopped to help was an off-duty ambulance paramedic. I was taken to one side and told that it was likely we’d be waiting at least another 2 hours if not longer. The ambulance control room insisted MiL stay on the floor laying on her left hand side her body weight on her badly damaged elbow in the full blazing near 30 degree sun of the day. The paramedic offered to assess her and see if was safe to move, eventually we got her into a wheel chair and moved her out of the sun. The paramedic said if we wanted here treated the only way it was going to happen was to take her to hospital ourselves. Which we did.

Hospital one eventually confirmed that MiL has smashed her elbow, she needed an operation and discharged her telling us to take her to a different hospital (again take her yourselves because there is zip chance of an ambulance) despite having an xray showing the extent of the damage to her elbow, they didn’t even put her arm in a sling. They appeared just to want us off their premises.

So we drove to hospital 2 where we had to start the whole process again, eventually her arm was put in a plaster cast, this was now 12 hours since the fall, we eventually got to see an orthopaedic registrar just after midnight, that being over 13 and half hours after the fall. He was gobsmacked at how we’d been treated, apparently the cast should have been applied at the first hospital and there was no need at all to be sent to the second hospital.

The fall happened at 10.30am on a Monday, we finally got home at 2am Tuesday. The operation eventually happened 9 days later. What I saw in the A&E waiting area at hospital 2 was truly shocking, a lot of people there were suffering in different ways but much probably attributable to mental health problems. As for the waiting on trolleys, probably 12-15 actually inside the A&E admission area, all with ambulance crews waiting to be passed on over to hospital staff, the penny dropped as to why we didn’t get an ambulance.
Luckily MiL is surround by an able and caring family who were minded to do what we had to do to get treatment. I’m genuinely fearful of ever needing an emergency response in the area we’ve moved to. I would give anything to have the former health minister Mr Hunt shadow us through that day and see how he would have apportioned blame towards those involved because he certainly wouldn’t take any responsibility himself.

So back to the matter of commenting about how an ambulance is parked, if you’re lucky enough to get an ambulance then the last thing to worry about is how the damn thing is parked.

[johnm]

My analysis of SiL experience not his @Jim Jones he is remarkably positive about his clients (not customers he’s a professional not a tradesman)

However the system he works within he is rather less positive about and with good reason IMHO.

[Flyin'Dutch']

@avtur3 - shocking

[Flyin'Dutch']

My analysis of SiL experience not his @Jim Jones he is remarkably positive about his clients (not customers he’s a professional not a tradesman)

IMNSHO people seeking/needing the services of health care professionals are patients - the stam of the word going back to the Greek for 'suffering' - pathos.

Customers/Clients are those able to purchase goods and services at will, choosing which services they want from whom.

The vast majority of patients have no options, mental health patients even less so.

By accepting one's duty to look after patients we as healthcare professionals also make it clear that our duty goes beyond what sales folk need to provide to customers/clients. The latter can there and then decide never to avail themselves of their latest supplier - a luxury not afforded to most patients

[kanga]

<pedantic classicism> 'patient' is from Latin, 'pathos' from Greek </>

.. but both from ultimately cognate words meaning 'suffer'

While working in a path lab, I included 'passim' in a urinalysis report. A youngish doctor asked me to clarify. I told him I was deeply shocked that a medic was not fully competent in Latin. A doctor whom I knew in the '60s told me that his doctor father had always followed the 2nd Lesson in church in his Greek New Testament. O Tempora, O Mores

(But my Latin and Greek are much better than my Dutch)

</drift>

[Flyin'Dutch']

<pedantic classicism> 'patient' is from Latin, 'pathos' from Greek </>

If only I had gone to a better university I might have been taught that better.....

[Jim Jones]

A patient’s role is to tell the truth and follow doctor’s orders.

The modern view is that of “service user” and “service provider”. The power relationship is different, to the dismay of traditionalists.

The OPs judgement of the nature of service users may be distorted by the selection of anecdotes his SiL provided.

My current practice environment (drug and alcohol problems) has many challenges, the key for me is always to identify the positives, (albeit in an ocean of negatives).

[johnm]

The modern view is at odds with 2000 years of practical experience and has more to do with political correctness than practicality IMHO.

[Jim Jones]

The modern view is at odds with 2000 years of practical experience and has more to do with political correctness than practicality IMHO.

Would you prefer this approach to health care relationships?

[jerry_atrick]

A patient’s role is to tell the truth and follow doctor’s orders.

<snip>

The trick is, for a patient, is to be able to get to see a doctor (outside of London, anyway). I won't go into great detail, but my son suffers an affliction to which the local NHS were actively placing distractions in front of us to stop him from being seen [edit] by a doctor[/edit]. Fortunately, I have a relative who works in the area of specialism of which there is a dearth in the South West and was able to get advice from a top practitioner in a foreign country on the other side of the world, which when presented to the local NHS (recounting all the symptoms that the local NHS admitted they already knew), they agreed to make available a doctor...

In short, they fed me and my family BS; and we trusted them. Up until we learned that they did that, we had noting but accolades for the NHS - of course, on the rare occasion we needed them, we were in London.

[johnm]

@Jim Jones i’d Certainly prefer that caricature to those perpetrated daily in the modern healthcare system.

[Jim Jones]

@Jim Jones i’d Certainly prefer that caricature to those perpetrated daily in the modern healthcare system.

It’s true some find that approach reassuring...

[Genghis the Engineer]

Isn't the infallibility of physicians, and the view that they should not be questioned rather like the historic view of airliner captains - that we know caused a great many accidents. Reading papers by people like Atul Gawande, I understood that for much the same reasons medicine was trying to get away from that culture.

Respect for the skill and knowledge of a physician is not the same as following their decisions blindly. Clearly telling the truth is indeed paramount as if they're not working with the truth, no physician is going to consistently make the best decisions they can.

G

[Chris Martyr]

Certainly prefer that caricature to those perpetrated daily in the modern healthcare system.

Hear Hear.
But the really weird thing about JJ's you-tube clip was that they were all speaking in perfectly coherent English .

[Flyin'Dutch']

A patient’s role is to tell the truth and follow doctor’s orders.

The modern view is that of “service user” and “service provider”. The power relationship is different, to the dismay of traditionalists.

The OPs judgement of the nature of service users may be distorted by the selection of anecdotes his SiL provided.

My current practice environment (drug and alcohol problems) has many challenges, the key for me is always to identify the positives, (albeit in an ocean of negatives).

Jim

I am a bit disappointed with what you have written - being so close to my posting I cannot draw any other conclusion than that you think that I have some old-fashioned idea about the doctor-patient relationship and how that should be modelled.

Can assure you that nothing could be further from the reality in how I see that relationship and how I do my level best to treat patients without any interpersonal gradient, au contraire, try to empower them to ensure that their views, wants, needs etc are all part of the process.

In addition both in the forensic service and GP out of hours service I have instrumental in introducing nurses and other health care professionals to make sure that patients' needs were met better than in the traditional models employed in the past.