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Source: (consider it)
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Thread: Conflicting Advice & The Overuse of the NHS
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
I am moved to think about this via a combination of reading the news and having a cold.
I have a cold, I know it is probably a self-limiting viral infection - that may last slightly longer than average owing to the fact I also have asthma. It is winter, this condition is not surprising.
So - the conflicting advice:
Part 1: stuff that is meant to be true
A) I know a cold will typically last one to two weeks (7-14 days)
B) In theory I know my employer doesn't want me at work sick
Part 2: policy
A) Over the counter cold medication recommends seeking medical advice if you take it for longer than 3 days
B) I can report for sick for only up to 5 working days without a doctors note
C) NHS advice is not see yur GP with cold symptoms unless they are still present after three weeks - 21 days
Part 3: outcomes
A) No employer accepts you being off sick with a cold for two weeks - so basically they want you to work if you're not *too* sick, result you struggle in then potentially end up with more shorter absences and take longer to recover (and infect others who end up in the same position.). If you are going to work whilst not *too* sick, you are going to manage that by using over the counter meds - the ones that tell you to go to the doctor after 3 days.
b) If you do take sick leave for a whole cold you will need a doctor's note and the doctor will a) not be able to fit you in a timely appointment to get one and b) feel their time is being wasted if you manage to see them, as you have a viral infection that should be treated with self-care
C) If you follow the advice written on the medication, the GP will also be pissed off at you turning up at the surgery after 3 days
Do we think some pressure on the NHS could be eased if some effort was made to co-ordinate on these issues ? Millions of people get colds every winter nevermind the rest of the year, how much time and resource could be saved iff all three sectors, NHS, Meds manufacturers and employers worked to the same timescales ?
[code fix -Gwai]
[ 14. January 2015, 18:12: Message edited by: Gwai ]
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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Beeswax Altar
Shipmate
# 11644
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Posted
21 days?
Here people run to their doctor after a couple of days if not at the first sign of a cold. Sometimes they go to urgent care or even the emergency room. Doctor writes a prescription for an antibiotic usually a z pack. Maybe, the z pack helps maybe it doesn't. Z pack probably won't make things worse unless it does. I've started to wonder if doctors pass out z packs as Halloween candy.
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Losing sleep is something you want to avoid, if possible.
-Og: King of Bashan
Posts: 8411 | From: By a large lake | Registered: Jul 2006
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Dafyd
Shipmate
# 5549
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Posted
I'd say that if your employer doesn't want you to come in sick, with lower productivity it's their HR department's responsibility to sort out their policy. You're not there to do your HR department's job (unless you're in the HR).
You probably ought to try not to infect your co-workers for their own sake. But I shouldn't go second-guessing the HR policy for the company's sake.
(I suspect that the advice on the over the counter medicine is there to cover the pharmaceutical company if they get sued, and has little to no intrinsic merit.)
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we remain, thanks to original sin, much in love with talking about, rather than with, one another. Rowan Williams
Posts: 10567 | From: Edinburgh | Registered: Feb 2004
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lilBuddha
Shipmate
# 14333
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Posted
Simply go in to work every day that you are sick and sneeze on your boss.
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I put on my rockin' shoes in the morning
Hallellou, hallellou
Posts: 17627 | From: the round earth's imagined corners | Registered: Dec 2008
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
quote:
Originally posted by Beeswax Altar:
21 days?
Here people run to their doctor after a couple of days if not at the first sign of a cold. Sometimes they go to urgent care or even the emergency room. Doctor writes a prescription for an antibiotic usually a z pack. Maybe, the z pack helps maybe it doesn't. Z pack probably won't make things worse unless it does. I've started to wonder if doctors pass out z packs as Halloween candy.
Why are they giving out antibiotics for a viral infection ![[Confused]](confused.gif)
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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Garasu
Shipmate
# 17152
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Posted
Anything for a quiet life . Some of them will give out homeopathic remedies instead...
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"Could I believe in the doctrine without believing in the deity?". - Modesitt, L. E., Jr., 1943- Imager.
Posts: 889 | From: Surrey Heath (England) | Registered: Jun 2012
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no prophet's flag is set so...
Proceed to see sea
# 15560
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Posted
I am an employer of 12 people. I agree that sending people to doctors for sick noted for work is an abuse of a publicly funded health system. Both employees and employers should have reasonable expectations of each other. Sick notes and coughing on customers or co-workers is not okay, and nor is goofing off by taking a sick day when you're not ill. These things need to be dealt with elsewise than going to a doctor's office and/or getting a note from the doc.
The medical association here discourages employees being required to obtain doctor notes. The issues are:
- waste of physician time; we all know it is a cold
- exposure of everyone in the waiting room to virus-shedding coughing & sneezing sick person
- no you cannot have antibiotics, and stop trying to pressure docs to get them (as noted by Doublethink.)
They made it 'non-insured service' and thus require payment of $35.00 by the patient to get such a note. The workplace is specifically prohibited from having any diagnostic information, so $35.00 gets a note that reads "I have examined <name of person> on <date> and advised them to be off work for <amount of time>."
I think that if the HR dept or boss has trouble with an employee's absenteeism from work, this is the issue that needs to be specifically addressed with the frequently-absent employees, and the average worker needs to be trusted. If the workplace has issues such that basic trust is broken, it is not a workplace I'd want any part of. To suggest that all workers require treatment like children is a symptom of a distrust between employers and employees and is the problem that requires addressing.
Further, we have a publicly-funded 24 hour nurse-staffed "Health Hot Line" which anyone may call for advice whether covered under Medicare or not (the parallel to NHS). An adult child of mine who was visiting over Xmas called after she became ill and got the advice about what cardinal signs to watch for and if any emerged, then go to what we call "minor emergency clinic". (This also avoids people going to a hospital emergency dept for non-hosp types of things.) As an employer. I can ask a worker to call the Health Hot Line and in follow-up ask if they have a plan for their recovery. But I'd never ever ask what the details of the illness are, only job-relevant facts. We have employee disability insurance which would come into play if the illness is long, and their nurses can review medical info at arms length from the employer.
I'm not naive enough not to know that some employers and workers more or less hate each other. Such situations are not solved via health issues.
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Out of this nettle, danger, we pluck this flower, safety.
\_(ツ)_/
Posts: 11498 | From: Treaty 6 territory in the nonexistant Province of Buffalo, Canada ↄ⃝' | Registered: Mar 2010
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Leorning Cniht
Shipmate
# 17564
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Posted
quote:
Originally posted by Doublethink.:
Millions of people get colds every winter nevermind the rest of the year, how much time and resource could be saved iff all three sectors, NHS, Meds manufacturers and employers worked to the same timescales ?
It rather depends what your job is, doesn't it? If you are a nurse on a cancer ward, I don't imagine anyone wants your viruses, thank you.
If you work in a small sealed shed with a few other people, you're still reasonably likely to share your cold around.
If you work in an office by yourself, or outdoors, then you being at work probably doesn't increase anyone else's chances of getting ill much.
I don't think there can be a one size fits all solution.
Posts: 5026 | From: USA | Registered: Feb 2013
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Doublethink.:
B) I can report for sick for only up to 5 working days without a doctors note
Which seems entirely reasonable and indeed is longer than for a lot of employers (around here I think it's common to say you need if it's more than 3 days).
Frankly, if your colds are making you unfit for work for over a week at a time, then you are an outlier (or what you've got isn't actually a 'cold'). You yourself have indicated that there's a plausible reason for this, that it interacts with your asthma.
If you've got another condition that risks interacting with a cold and making it affect your health more, it seems reasonable to me to say that you're exactly the kind of person who needs medical care to monitor the infection. Just because you've got the same virus as someone else doesn't mean it's going to affect you in exactly the same way. Just because most viral infections are self-limiting doesn't automatically mean it's incapable of affecting certain individuals more seriously, including when they have other health issues at the same time. The same viruses that can cause colds can also trigger viral pneumonia.
[ 15. January 2015, 01:01: Message edited by: orfeo ]
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Barefoot Friar
Ship's Shoeless Brother
# 13100
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Posted
quote:
Originally posted by Doublethink.:
Why are they giving out antibiotics for a viral infection
Standard operating procedure around here. They say "it's to ward off any secondary infections", but the truth of the matter is that a) Americans think that if they go to the doctor and aren't automatically prescribed something then they are not getting properly cared for, and b) Americans are largely clueless about how antibiotics work anyhow. They're told to take this medicine for so many days, and Lo and Behold! they're magically better after that time. They don't realize that they just got over it despite the antibiotic, not because of it.
I don't take antibiotics unless the doctor says that what I have is bacterial, and I don't go to the doctor if I already know what it is. I don't go for colds, or stomach viruses, or flu, or anything else I know I'll get over. Mrs. Friar thinks I'm being obstinate, and maybe I am, but I refuse to go and pay money to be told something I already know.
Excuse me, I have to go yell at the neighborhood kids to get off my lawn.
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Do your little bit of good where you are; its those little bits of good put together that overwhelm the world. -- Desmond Tutu
Posts: 1621 | From: Warrior Mountains | Registered: Oct 2007
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cliffdweller
Shipmate
# 13338
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Posted
quote:
Originally posted by Barefoot Friar:
quote:
Originally posted by Doublethink.:
Why are they giving out antibiotics for a viral infection
Standard operating procedure around here. They say "it's to ward off any secondary infections", but the truth of the matter is that a) Americans think that if they go to the doctor and aren't automatically prescribed something then they are not getting properly cared for, and b) Americans are largely clueless about how antibiotics work anyhow. They're told to take this medicine for so many days, and Lo and Behold! they're magically better after that time. They don't realize that they just got over it despite the antibiotic, not because of it.
In my neck of the American woods, health care providers will not prescribe antibiotics for viral infections. Doesn't stop people from nattering after them, but no, it's not gonna happen. Heck, in this neck of the woods you're luck to be able to SEE a health care provider, much less get their hands on any sort of prescription.
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"Here is the world. Beautiful and terrible things will happen. Don't be afraid." -Frederick Buechner
Posts: 11242 | From: a small canyon overlooking the city | Registered: Jan 2008
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
Overprescription of antiobiotics is a problem in lots of places. It contributes to antiobiotic resistance.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Golden Key
Shipmate
# 1468
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Posted
Lots of people don't have any benefits, even paid sick days. So they have to figure out whether or not they can financially afford to take time off.
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Blessed Gator, pray for us!
--"Oh bat bladders, do you have to bring common sense into this?" (Dragon, "Jane & the Dragon")
--"Oh, Peace Train, save this country!" (Yusuf/Cat Stevens, "Peace Train")
Posts: 18601 | From: Chilling out in an undisclosed, sincere pumpkin patch. | Registered: Oct 2001
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Karl: Liberal Backslider
Shipmate
# 76
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Posted
quote:
Originally posted by orfeo:
Overprescription of antiobiotics is a problem in lots of places. It contributes to antiobiotic resistance.
Understatement of the year. It's probably the primary cause. Overprescription of antibiotics and the resulting resistance is probably already killing thousands and will only get worse.
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Might as well ask the bloody cat.
Posts: 17938 | From: Chesterfield | Registered: May 2001
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Golden Key
Shipmate
# 1468
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Posted
Also, AIUI, anti-biotics given to food animals.
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Blessed Gator, pray for us!
--"Oh bat bladders, do you have to bring common sense into this?" (Dragon, "Jane & the Dragon")
--"Oh, Peace Train, save this country!" (Yusuf/Cat Stevens, "Peace Train")
Posts: 18601 | From: Chilling out in an undisclosed, sincere pumpkin patch. | Registered: Oct 2001
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
quote:
Originally posted by orfeo:
quote:
Originally posted by Doublethink.:
B) I can report for sick for only up to 5 working days without a doctors note
Which seems entirely reasonable and indeed is longer than for a lot of employers (around here I think it's common to say you need if it's more than 3 days).
Frankly, if your colds are making you unfit for work for over a week at a time, then you are an outlier (or what you've got isn't actually a 'cold'). You yourself have indicated that there's a plausible reason for this, that it interacts with your asthma.
If you've got another condition that risks interacting with a cold and making it affect your health more, it seems reasonable to me to say that you're exactly the kind of person who needs medical care to monitor the infection. Just because you've got the same virus as someone else doesn't mean it's going to affect you in exactly the same way. Just because most viral infections are self-limiting doesn't automatically mean it's incapable of affecting certain individuals more seriously, including when they have other health issues at the same time. The same viruses that can cause colds can also trigger viral pneumonia.
There is a difference between being ill, and being unfit to work. And then there is the issue of being infectious. I work in a hospital. I go into work with a cold if well enough, but don't go onto the ward and cancel appointmennts with my immunocompromised patient because
I don't want him to get pneumonia.
I may go in and do mainly paperwork.
But my basic point was - if the NHS does not want patients with mild viral infections wasting GP time, it would be of benefit to talk to the pharmaceutical industry and change the advice written on the medication, and talking to business leaders about changing the way self-certification of illness iis managed.
I would have been back at work this week if I had not taken an over the counter remedy - that turned out to interact really badly with my asthma (not noted on its side effects).
Coughing so much you vomit is really not a good look in a hospital - the one thing they really don't want you to bring in is norovirus, it shuts services it spreads so fast, so we have really concrete advice about is not turning up to work for at least 48 hours after vomiting and diorrhea.
Thing is, that advice is a lot more use than don't come to work if you're ill. Similarly, it by more use to say, don't cone to work if yu run a temp of more than x for more than y amount of time. Likewise with seeking GP advice.
All the guidance is ridiculously vague - and then they wonder why people attend (or don't) services inappropriately.
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
The advice on cold medication to see someone if your symptoms persist is because your initial belief that you have a 'cold' might be wrong.
Symptoms are not at all infection-specific. A runny nose and a sore throat are not what the virus is doing, it's what your immune system is doing in an effort to remove the virus.
[ 15. January 2015, 09:56: Message edited by: orfeo ]
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
I know, but, the advice on when to see your gp from the NHS is based on exactly the same process of you self-assessing your symptoms.
NHS says, if you are coughing, sneezing and feeling crap - take over the counter meds and don't come see us unless the symptoms aren't gone after three weeks.
Meds say, if you are coughing, sneezing and feeling crap - take over the counter meds and go see the GP if the symptoms aren't gone after three days.
[ 15. January 2015, 10:15: Message edited by: Doublethink. ]
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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Barnabas62
Shipmate
# 9110
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Posted
quote:
Originally posted by Barefoot Friar:
Excuse me, I have to go yell at the neighborhood kids to get off my lawn.
![[Killing me]](graemlins/killingme.gif)
On a serious point. I have asthma as well, and winter viruses (I have one now) have plagued me for 20 years as a result. A short term "48 hour virus jobby" can take a couple of weeks or more to clear up in me. I've learned there's not much to be done other than "grin and bear it". But I'm retired, so the work complications don't apply.
When at work, I talked specifically to HR about this issue and got my records noted. But you have my sympathies, DT. I got to hate the winter months.
I don't see any easy way of more generally joining up the dots, however.
[ 15. January 2015, 10:16: Message edited by: Barnabas62 ]
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Who is it that you seek? How then shall we live? How shall we sing the Lord's song in a strange land?
Posts: 21397 | From: Norfolk UK | Registered: Feb 2005
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Jane R
Shipmate
# 331
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Posted
Barefoot Friar: quote:
Standard operating procedure around here. They say "it's to ward off any secondary infections", but the truth of the matter is that a) Americans think that if they go to the doctor and aren't automatically prescribed something then they are not getting properly cared for, and b) Americans are largely clueless about how antibiotics work anyhow. They're told to take this medicine for so many days, and Lo and Behold! they're magically better after that time. They don't realize that they just got over it despite the antibiotic, not because of it.
![[Eek!]](eek.gif) Good grief, no wonder your healthcare system costs so much!
Judging by the number of hospitals that have been declaring major incidents recently, the NHS is creaking somewhat - but this is partly because GPs are no longer responsible for out-of-hours care. So anyone with a minor ailment in the evening or at weekends has to phone 111 for a non-emergency consultation, and they will often tell you to go to A&E just to be on the safe side. I had to take my mother-in-law to A&E last year because she'd had a tooth out and the wound wouldn't stop bleeding; we should have gone back to the dentist, but she'd had the tooth out last thing on Friday and if we hadn't gone to A&E (on the advice of the 111 service) it might have gone on bleeding for the whole weekend. And she's 86; if she'd spent the entire weekend unable to eat because her mouth was bleeding she could have been really unwell by Monday.
Some hospitals have minor injury clinics alongside A&E, which is a much more efficient use of resources IMNSHO.
Posts: 3958 | From: Jorvik | Registered: May 2001
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
I note in the recent coverage of the 400,000. extra visits to A&E doctors stated that patients were being advised to go - and that's why they were going.
Is the problem being too risk averse ?
[crossposted]
[ 15. January 2015, 10:24: Message edited by: Doublethink. ]
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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Felafool
Shipmate
# 270
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Posted
ISTM that this is more of an issue with employment terms and conditions, which generally in the UK specify something like 5 days 'uncertified sick leave'....(strangely these days included non-working days e.g.weekends).
I suspect this in turn is reflecting the Statutory Sick Pay (SSP) UK policy, which means that after a specified number of days' certified sick leave, the Government pays a proportion of the wages during the period of certified absence.
That's the root that needs addressing, because that drives the cold/flu sufferer to their GP after 5 days, even though we know that there is nothing to be done (except sign a sick certificate!)
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I don't care if the glass is half full or half empty - I ordered a cheeseburger.
Posts: 265 | Registered: May 2001
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Barnabas62
Shipmate
# 9110
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Posted
I think the NHS problem is strapped resources and an increasingly desperate game of passing the parcel. A & E are left holding the baby.
[And that mixed metaphor is not virus-produced; all my own fault.]
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Who is it that you seek? How then shall we live? How shall we sing the Lord's song in a strange land?
Posts: 21397 | From: Norfolk UK | Registered: Feb 2005
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Jane R
Shipmate
# 331
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Posted
I think it's a combination of several things.
First, the 111 service can only do so much over the phone. If they are not sure what's wrong with you (and they have to rely on your own description of your symptoms; if you are ringing up because your child has fallen over and is now bleeding all over the carpet and screaming blue murder you may not be in a fit state to describe what's happening calmly) they will probably tell you to go to a doctor or A&E to be assessed in person.
Second, there is no middle course between waiting to see your GP (which could take several days) and going to A&E. Some things just can't be left that long - if you have a head injury resulting in bleeding into the brain on Friday, for example, you could be dead by Monday. My mother-in-law probably wouldn't have been, but she was very uncomfortable and distressed.
Thirdly, minor problems if left untreated can develop into more serious problems which are more expensive to treat. This is particularly important for children and elderly people, who can develop problems quite quickly. If my mother-in-law had been left bleeding for the whole weekend she might have collapsed from the cumulative blood loss and/or lack of food and had to be hospitalised, thus taking up resources that ought to be reserved for acute cases.
We need better out-of-hours GP cover. If we had that, it would take some (most?) of the heat off A&E.
Posts: 3958 | From: Jorvik | Registered: May 2001
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
What about if pharmacists could certify for minor illness for a short period ?
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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Liopleurodon
Mighty sea creature
# 4836
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Posted
quote:
Originally posted by Barnabas62:
I think the NHS problem is strapped resources and an increasingly desperate game of passing the parcel. A & E are left holding the baby.
[And that mixed metaphor is not virus-produced; all my own fault.]
Yeah... my mental health problems reached crisis levels a couple of times in the last few months. The first time Mr Liopleurodon called the NHS advice line (whatever it's called these days) and was told to take me to A&E. So he did. They sent me home with a letter to show my GP telling her to refer me to the emergency mental health services urgently. She did. I got an appointment with a shrink a few weeks away. Before this appointment, things got really bad again, and my dad phoned the mental health centre to see what they could do. They told him to take me to A&E. He did. A&E said they'd like to send me to my GP with a recommendation to refer me to the mental health team. I pointed out that we were going in circles and my dad got irate and eventually there were phone calls to get the home treatment team round to my house and an appointment was set up with an emergency psychiatrist. In the meantime the mental health centre cancelled my original appointment without telling me and when I got there the shrink was on annual leave.
I'm going to add here that the emergency shrink changed my meds, I stabilised and I'm doing much better, but if I hadn't had the support of my dad and my husband I might well not be alive now, because I was in no state to fight for what I needed. There should have been an on-call psychiatrist in A&E. I know they're expensive, but almost everything that happened here was a waste of time and money. As the NHS gets stripped back further, it's only going to get worse.
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Our God is an awesome God. Much better than that ridiculous God that Desert Bluffs has. - Welcome to Night Vale
Posts: 1921 | From: Lurking under the ship | Registered: Aug 2003
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Doublethink.:
What about if pharmacists could certify for minor illness for a short period ?
They can here, now. That change was implemented a couple of years ago.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by Doublethink.:
I know, but, the advice on when to see your gp from the NHS is based on exactly the same process of you self-assessing your symptoms.
NHS says, if you are coughing, sneezing and feeling crap - take over the counter meds and don't come see us unless the symptoms aren't gone after three weeks.
Meds say, if you are coughing, sneezing and feeling crap - take over the counter meds and go see the GP if the symptoms aren't gone after three days.
Blame the lawyers.
And I say that in all seriousness. It's highly likely the private pharmaceutical companies don't want people suing them saying "I took your medication and it didn't cure me of (insert disastrous disease here)".
Of course, no-one ever made a serious claim that cold medication could cure you of anything, but I honestly wouldn't be surprised that they're guarding against the possibility that someone blames them for inducing a state of complacency.
So, yes to your later comment about being risk-averse.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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Barefoot Friar
Ship's Shoeless Brother
# 13100
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Posted
Do said medications contain acetaminophen? Because if so, that's likely your culprit. ODing on it is really easy, and it can really hurt (and sometimes kill) you.
Well, I say "culprit", but it's not the culprit. orfeo is right about the lawyers covering their tushies from potential lawsuit.
[ 15. January 2015, 11:31: Message edited by: Barefoot Friar ]
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Do your little bit of good where you are; its those little bits of good put together that overwhelm the world. -- Desmond Tutu
Posts: 1621 | From: Warrior Mountains | Registered: Oct 2007
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Jane R
Shipmate
# 331
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Posted
Doublethink.: quote:
What about if pharmacists could certify for minor illness for a short period ?
Might help. Then again, you would probably have to pay for the privilege of being signed off work (our doctor charges £15 for sickness notes, as I discovered when my daughter's school demanded written confirmation of her migraines for bureaucratic purposes). So anyone who can't pay the charge, or doesn't want to, will still have to drag themselves into work and cough germs over everybody.
Posts: 3958 | From: Jorvik | Registered: May 2001
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
I think it was the expectorant / decongestant - made me cough a lot which irritated my lungs which triggered my asthma which made me cough etc (Phenylephrine hydrochloride.)
There is another decongestant I know I shouldn't take - so I'd carefully checked it wasn't in these pills. After it all went to crap, looked at the side-effects leaflet and saw they can cause bronchospasm - fantastic ![[Roll Eyes]](rolleyes.gif)
[ 15. January 2015, 11:55: Message edited by: Doublethink. ]
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
quote:
Originally posted by Jane R:
Doublethink.: quote:
What about if pharmacists could certify for minor illness for a short period ?
Might help. Then again, you would probably have to pay for the privilege of being signed off work (our doctor charges £15 for sickness notes, as I discovered when my daughter's school demanded written confirmation of her migraines for bureaucratic purposes). So anyone who can't pay the charge, or doesn't want to, will still have to drag themselves into work and cough germs over everybody.
As a public health measure this stupid.
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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Jane R
Shipmate
# 331
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Posted
Oh, I agree. But schools are expected to treat children with chronic illnesses as if they were truants now; so you have to get documentary evidence that you are not making up your child's illness if his/her absences are more frequent than the government says they should be.
I can understand why the doctor charged £15 for the letter. I can even understand why the head teacher insisted on having it (it's not like she had much choice in the matter under the new rules). What I can't understand is why everyone has to be treated like a criminal because of a few people who allow their children to skip school on a regular basis.
Posts: 3958 | From: Jorvik | Registered: May 2001
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itsarumdo
Shipmate
# 18174
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Posted
Just to throw a small grenade in the works.. The non-industry research on flu vaccines shows that people who receive them suffer less minor colds but more SARS-type infections. So why is there a flu vaccination campaign? Because ordinary flu comes and goes within a few days and there is maybe a day off work here and there, but very few hospitalisations or extended periods off work or subsequent long lasting health issues. One of the problems both for NHS admissions and funding is that the pharma industry manages to sell products that are worse than useless (i.e. on long term analysis the complication/mortality rate on taking the medication is way more than the problem that was supposed to be solved by use of the medicine). I shudder at Labours NHS policies because from where I sit it looks like another meal ticket for the pharma industry. 1% of the NHS budget is already for Statins, projected to rise to 3%, BUT the best quality independent research points out that Statins cause more health problems than they solve. So not only is there steadily increasing expenditure of £billions, but some of it is not only useless, but is also adding to the treatment load for other NHS departments.
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"Iti sapis potanda tinone" Lycophron
Posts: 994 | From: Planet Zog | Registered: Jul 2014
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mdijon
Shipmate
# 8520
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Posted
quote:
Originally posted by itsarumdo:
The non-industry research on flu vaccines shows that people who receive them suffer less minor colds but more SARS-type infections.
Not true.
quote:
Originally posted by itsarumdo:
BUT the best quality independent research points out that Statins cause more health problems than they solve.
Not true.
Next?
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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itsarumdo
Shipmate
# 18174
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Posted
quote:
Originally posted by mdijon:
quote:
Originally posted by itsarumdo:
The non-industry research on flu vaccines shows that people who receive them suffer less minor colds but more SARS-type infections.
Not true.
quote:
Originally posted by itsarumdo:
BUT the best quality independent research points out that Statins cause more health problems than they solve.
Not true.
Next?
Sorry, but your statements are not true. Hong Kong study 2013(?) on flu vaccines - one of the few studies to use a saline (instead of a ground substance) control. Peter Gotsche/Cochrane collaboration on Statins (though he was quoting a study not done by himself, but rather the largest publicly funded study carried out up to 2014).
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"Iti sapis potanda tinone" Lycophron
Posts: 994 | From: Planet Zog | Registered: Jul 2014
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Beeswax Altar
Shipmate
# 11644
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Posted
quote:
Originally posted by Barefoot Friar:
quote:
Originally posted by Doublethink.:
Why are they giving out antibiotics for a viral infection
Standard operating procedure around here. They say "it's to ward off any secondary infections", but the truth of the matter is that a) Americans think that if they go to the doctor and aren't automatically prescribed something then they are not getting properly cared for, and b) Americans are largely clueless about how antibiotics work anyhow. They're told to take this medicine for so many days, and Lo and Behold! they're magically better after that time. They don't realize that they just got over it despite the antibiotic, not because of it.
I don't take antibiotics unless the doctor says that what I have is bacterial, and I don't go to the doctor if I already know what it is. I don't go for colds, or stomach viruses, or flu, or anything else I know I'll get over. Mrs. Friar thinks I'm being obstinate, and maybe I am, but I refuse to go and pay money to be told something I already know.
Excuse me, I have to go yell at the neighborhood kids to get off my lawn.
The reason I've heard is that the infection might be bacterial or viral so they give the antibiotics just in case it's bacterial. So, you go to the doctor with symptoms of the cold and the doctor will give you antibiotics in case it's a sinus infection. Add a sore throat to the symptoms and more bacterial infections become a possibility.
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Losing sleep is something you want to avoid, if possible.
-Og: King of Bashan
Posts: 8411 | From: By a large lake | Registered: Jul 2006
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mdijon
Shipmate
# 8520
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Posted
quote:
Originally posted by itsarumdo:
Sorry, but your statements are not true. Hong Kong study 2013(?) on flu vaccines - one of the few studies to use a saline (instead of a ground substance) control. Peter Gotsche/Cochrane collaboration on Statins (though he was quoting a study not done by himself, but rather the largest publicly funded study carried out up to 2014).
There are masses of studies showing the safety of flu vaccines (although no mortality benefit) and showing mortality benefits of statins.
Which studies are you quoting? Can you link?
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mdijon nojidm uoɿıqɯ ɯqıɿou
ɯqıɿou uoɿıqɯ nojidm mdijon
Posts: 12277 | From: UK | Registered: Sep 2004
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ExclamationMark
Shipmate
# 14715
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Posted
Employers can insist on a sick note after one day's absence if they so choose (often used on those who are on final warnings and/or those who attendance record is poor. The "number of days" issue is therefore irrelevant in this debate.
Part of the issue is the ride that some (emphasise some) employees take their employers for over sickness. Companies want evidence for a sickie and see it as the NHS's duty to provide it. A sickie with no note equates to a "conduct" issue.
As for infecting everyone else, I've always been told by medical people that colds etc. are infectious before they actually appear. So being there with a cold (which you know about)isn't much different in the infection stakes from being there developing a cold (which you don't know about).
Posts: 3845 | From: A new Jerusalem | Registered: Apr 2009
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Doublethink.
Ship's Foolwise Unperson
# 1984
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Posted
Employers demanding a sick note for minor illness effects demand on GPs - it is not a good use of medical resources. Not unlike them arbitrarily deciding something else such as, we won't believe you are ill unless you can show us an antibiotic prescription.
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All political thinking for years past has been vitiated in the same way. People can foresee the future only when it coincides with their own wishes, and the most grossly obvious facts can be ignored when they are unwelcome. George Orwell
Posts: 19219 | From: Erehwon | Registered: Aug 2005
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ExclamationMark
Shipmate
# 14715
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Posted
quote:
Originally posted by Doublethink.:
Employers demanding a sick note for minor illness effects demand on GPs - it is not a good use of medical resources. Not unlike them arbitrarily deciding something else such as, we won't believe you are ill unless you can show us an antibiotic prescription.
No it's not but it is a requirement that has been generated by the small number of people who abused the concept of self certification.
it's not really about antibiotics either - they don't make much difference to the normal cold and flu stuff around. left alone the illness goes in 7 days, treated and it will last a week.
If the illness is as minor as you say then it's presumably possible to work anyway so no note required.
[ 15. January 2015, 17:53: Message edited by: ExclamationMark ]
Posts: 3845 | From: A new Jerusalem | Registered: Apr 2009
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ExclamationMark
Shipmate
# 14715
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Posted
quote:
Originally posted by mdijon:
quote:
Originally posted by ExclamationMark:
Employers can insist on a sick note after one day's absence if they so choose
It should be only for more than 7 days.
They need proper grounds for notes for one day absences.
Proper grounds are pretty broad in scope - the usual reduction in requirement is applied where there has been an unexplained history of short absences and/or there are concerns on conduct and/or capability.
I guess that there's been an increase in use of GP's, hospitals etc as people recognise that they pay for this service (via taxes), so they're jolly well going to use it. It's called consumerism.
Mind you remove the admissions to A & E caused by alcohol and you'd have something close to enough space.
Posts: 3845 | From: A new Jerusalem | Registered: Apr 2009
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Amika
Shipmate
# 15785
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Posted
quote:
Originally posted by Doublethink.:
I have a cold, I know it is probably a self-limiting viral infection - that may last slightly longer than average owing to the fact I also have asthma. It is winter, this condition is not surprising.
Do we think some pressure on the NHS could be eased if some effort was made to co-ordinate on these issues? Millions of people get colds every winter never mind the rest of the year, how much time and resource could be saved if all three sectors, NHS, Meds manufacturers and employers worked to the same timescales?
I know this problem all too well. My process was usually: get a cold, keep on going to work; get a bad chest due to asthma/cold, keep on going to work. In fact, go to work even if literally blue in the face with wheeze as no one cared a jot. No doctor was harmed or even seen in the activation of this policy.
Happy days! ![[Biased]](wink.gif)
A few days off to rest and recuperate would have been great. Sadly the alternative always seemed to be expedient. It wouldn't have helped me to have seen a doctor, but rest would probably have aided recovery. Once in a while I would just have to take a couple of days off, but normally I struggled through and felt awful. I even cycled to work when my lips were literally blue on more than one occasion.
I think people with colds and flu, including asthmatics, should stay away from doctors if at all possible. I cringe now when I think of my earlier days of antibiotic-seeking (as I'd been advised I needed them if ever I got a cold) and attendance at the surgery. Later experience showed me that I would recover naturally given time. Of course workplaces are even more stringent now and the ideal would be understanding employers rather than an ever-ready NHS. Dream on, I think!
I should add that in the office(s) where I worked just about everyone came in when they had colds. The pressure to *not* be off work was very strong.
Posts: 147 | From: Ingerland | Registered: Aug 2010
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by itsarumdo:
Because ordinary flu comes and goes within a few days and there is maybe a day off work here and there, but very few hospitalisations or extended periods off work or subsequent long lasting health issues.
Flu kills people.
Just because it doesn't kill everyone doesn't mean it's a good idea to just let the disease spread without using the means available to stop it.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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orfeo
Ship's Musical Counterpoint
# 13878
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Posted
quote:
Originally posted by ExclamationMark:
Part of the issue is the ride that some (emphasise some) employees take their employers for over sickness. Companies want evidence for a sickie and see it as the NHS's duty to provide it. A sickie with no note equates to a "conduct" issue.
One of my former employers once had a policy that the number of sick days you could take per year was unlimited.
At some point, powers that be decided that this was a terrible thing, and that clearly this meant employees were taking more days off than they should, and that we needed in the next employment agreement to change this into a finite number.
They did.
The average number of sick days taken went up.
The biggest single reason why absence is a conduct issue is because bosses MAKE it a conduct issue. There are all sorts of studies that show how treating people with distrust makes them distrust you right back, and of course that applies to employees as well. Which kind of employee is going to be more motivated to work well for you - the one you've got a good, trusting relationship with who feels valued, or the one who is made to feel like a naughty child or petty criminal because you let them know you've got your eye on them constantly?
Employers who set up the workplace as a battleground rather than a collaboration are shooting themselves in the foot.
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Technology has brought us all closer together. Turns out a lot of the people you meet as a result are complete idiots.
Posts: 18173 | From: Under | Registered: Jul 2008
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ExclamationMark
Shipmate
# 14715
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Posted
quote:
Originally posted by orfeo:
quote:
Originally posted by ExclamationMark:
Part of the issue is the ride that some (emphasise some) employees take their employers for over sickness. Companies want evidence for a sickie and see it as the NHS's duty to provide it. A sickie with no note equates to a "conduct" issue.
One of my former employers once had a policy that the number of sick days you could take per year was unlimited.
At some point, powers that be decided that this was a terrible thing, and that clearly this meant employees were taking more days off than they should, and that we needed in the next employment agreement to change this into a finite number.
They did.
The average number of sick days taken went up.
The biggest single reason why absence is a conduct issue is because bosses MAKE it a conduct issue. There are all sorts of studies that show how treating people with distrust makes them distrust you right back, and of course that applies to employees as well. Which kind of employee is going to be more motivated to work well for you - the one you've got a good, trusting relationship with who feels valued, or the one who is made to feel like a naughty child or petty criminal because you let them know you've got your eye on them constantly?
Employers who set up the workplace as a battleground rather than a collaboration are shooting themselves in the foot.
It depends where the distrust starts: if it begins with the employee being prepared to take time off for the least reason, then it will bring a responsive action from the employer. Who wants an important project to founder because you can't trust staff not to come in on a warm day?
In the UK it's those companies with more flexible approaches to absence (mainly the Government and public sector), which see more absences - alongside shorter hours (on average) and better provisions for maternity, paternity etc.
I don't see ASDA/Walmart in the UK doing too badly when, arguably, they are one of the more robust employers in the UK when it comes to absence and staff matters. On the other hand local councils are bywords for inefficiency and non delivery and have very liberal policies on absence etc - and you have no right of recourse if they don't deliver, as happened to something I was involved in recently.
Some kind of balance is best: employers trust staff to get on with the job and staff recognise that employers have certain deadlines that mean you have to work through stuff in order to finish the job and get others.
Posts: 3845 | From: A new Jerusalem | Registered: Apr 2009
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ExclamationMark
Shipmate
# 14715
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Posted
quote:
Originally posted by orfeo:
[QUOTE] Which kind of employee is going to be more motivated to work well for you - the one you've got a good, trusting relationship with who feels valued, or the one who is made to feel like a naughty child or petty criminal because you let them know you've got your eye on them constantly?
Sorry missed this before .... I agree with you - clearly the one who feels valued. But, in too many cases that trust is destroyed by other employees who take the employer's kindness and grace for a ride, alongside the good will of their fellow workers.
There's nothing more destructive to any work team, than someone in it taking everyone for a ride. Good people won't trust kind employers who let it happen. I've seen far more criticism and demand for action against people who don't pull their weight from fellow employees, than I have from employers.
Posts: 3845 | From: A new Jerusalem | Registered: Apr 2009
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