the thing that strikes me most as a counsellor who actually works in a gp surgery is how little the doctors either know or ar interested in the psychological work that i do. it may be that it is very time limited, or the whole psycho/spiritual mind body focus has moved in to the private sector in the uk. every high street in london has homeopaths,osteopaths and ever health food sotres who address these issues. it does not seem to be some thing on the gps adgendas, here admittedly, in central london. the days when one gp knew his patients and thier families and their circumstances and indeed the family dramas are well over.. you have to ay a private doctor for that kind of care these days. sadly. and i believe thtat the famous gpseminars supervison group held in the tavistock for gps is no longer running.

On Tue, Mar 31, 2009 at 9:23 PM, Norman Holland <[log in to unmask]> wrote:

---------- Forwarded message ----------
From: Norm Rosenblood <[log in to unmask]>
Date: Tue, Mar 31, 2009 at 11:38 AM
Subject: Re: public health and private diagnosis
To: Discussion Group for Psychology and the Arts <[log in to unmask]>

This message was originally submitted by [log in to unmask] (88 lines) ------------------

 Re GP's

My GP friends tell me that sixty per cent of their case load is

Can you hazard a guess as to how much the NHS and other countries would
save--and the drug companies lose-- if they  encouraged and educated
practitioners to diagnose and treat those patients?

There must be a collusion somewhere.

Norm Rosenblood

Norman Rosenblood, Ph.D., Training and Supervising Psychoanalyst
Co-director, Hamilton Centre for Psychoanalysis
8 Mayfair Place
Hamilton, Ontario
L8S 4G1

On Mon, 30 Mar 2009, Meg Harris Williams wrote:

> > Hallo Norm and everyone,
> A few late thoughts on the connections between public health, private
> diagnosis, psychological awareness, that came up in recent mails
> about the PSA business:
> My husband is a GP and diagnoses 2-3 cases of prostate cancer per
> year with the aid of the PSA test. His work-partners (all female
> GP's) stopped using the test after government advice (dictates) to
> the effect that men couldn't stand the worry of being put to further
> (unpleasant) tests only to be quite likely informed that they didn't
> have cancer after all. They might be so traumatised by the
> unnecessary anxiety that they would sue somebody. My husband
> continued to offer the PSA, since after 30 years' experience he had
> worked out how to use it constructively: ie considering it in the
> context of the patient's history, previous tests, and other factors
> basically to do with knowing the patient and learning when to be
> suspicious. The hospital path lab kept complaining that he shouldn't
> be bothering with the test, but theoretically GPs are independent
> contractors so they can decide.
> A few weeks ago all GPs in the UK got a letter from the government
> expressing their disappointment that GPs were not offering the PSA
> test to all males over a certain age. (Latest information leads to
> switch in fashion.) Now it's the GPs who don't offer the test who are
> going to be blacklisted, rather than those who do...
> One of the GP's main functions has always been diagnosis, so that no-
> one should have to self-diagnose and end up with the wrong specialist
> who of course knows nothing of other parts of the body, still less of
> the patient as an individual. And although the primary health care
> system is different here from Europe or the US, everything is tending
> towards getting more homogenous: economics and the blame culture rule.
> In principle, wouldn't it be better in all countries to focus on the
> psychological education of medical doctors so that they can actually
> make use of the experience they acquire? Given that organic diseases
> exist in human bodies it's not enough to 'know about' a disease
> academically, either for lay people or for specialists. Some people
> over here lament the demise of the bedside manner of the
> 'oldfashioned GP'. Instead we should be lamenting the lack of
> communication between mind-awareness and body-awareness, and develop
> resources aimed at educating a  professional group - whether called
> GP's or not - to mediate that transition between the individual and
> the specialist. Somebody who can see the-disease-in-the-patient not
> just the disease is ultimately going to contribute to efficiency and
> economy as well as to scientific accuracy.
> Meg
> (in the UK)

claire odeon hershman