Do you follow your GP on Twitter?

I did. For a day. I pretty quickly realised that I didn't want to know what he really thinks about his patients and his practice. Not that he named anyone, it was more an attitude I detected. I do know him well, so perhaps that was also a factor. His tweets made me feel uncomfortable.

Then, last week I 'twistened' in to the RCGP twitter feed from their panel discussion on GPs and their use of social media. Frankly, it made me feel ill. Some patients may be taken in by their GP's use of social media, but when the chips are down, what really counts is the face-to-face time with a caring medical professional.

I do follow other healthcare professionals on Twitter, in my capacity as social media networker for two small charities. One is a local cardiovascular support group, the other is a local older people's community centre. I follow the CCG, local GPs, specialists, hospitals, and associated support and community groups. The GPs will almost never interact, retweet or favourite, but they are always on hand to dispense politically correct health care messages.

I really do think that if GPs are on Twitter that it should be for the engaging and interacting, not for spouting those same old messages that the Government is paying for. It is boring. We know we must not smoke, drink or eat takeaways. We know we must eat five portions of fruit and veg a day, exercise regularly, check our breasts, have a smear test. 

What we want to know is that when we really need to see a doctor, the receptionist will be helpful and sympathetic, the waiting room will be clean and inviting, and the doctor will be available, and will see you on time.

Now, if you could tweet that, I'd be happy to follow you. Until then, I'll communicate at our next appointment, whenever that might be.

I'd love to know your thoughts. Do you follow your GP on Twitter? Does your GP follow you bacK?

The 'white coat effect'

More than 10 years ago, a student doctor in my GP surgery botched a simple blood pressure reading on me. He cranked the cuff up too high, which made me angry and hurt my arm. By the time he managed a reading, my BP was way up. So he called in the b*tch female GP I never go to. Unsympathetic, she sent me home, but not before decreeing that I should report for another BP measurement the following week. And so began 6 months of BP measurement hell, which ended with my husband, a cardiologist, phoning the senior GP to get a sense of perspective. 

I do not have high blood pressure. I never have. They labeled me with 'white coat effect'*. Rubbish. What I have is a built-in annoyance with idiocy. Particularly in GPs. It starts when I book an appointment. Thank goodness I can now book online and avoid the ferocious gatekeepers. I then check-in at the handy terminal (avoiding said miseries/nosey parkers) at the desk. I sit and wait and wait and wait (sometimes up to an hour). The waiting room is hot, uncomfortable, smells of the great unwashed, and is full of sick people. I try yoga breathing. I stretch. I take a walk. I browse the Cosmo. I feel my blood pressure rising, but I am not sick. I just need a prescription review. I wish I could run away. Unfortunately, I can't avoid the actual doctor. He does have his uses. 

Eventually, I am called. He repeats my contraception prescription annually, provided I can provide a BP reading. He accepted that Dr B was suitably qualified to monitor my blood pressure. I hope he never finds out that Dr B doesn't have time to take my home BP readings; I do it myself. I bought a BP monitor with the right sized cuff for my arm. I take the measurement on my left arm, about 1 week before I am due to see the doctor. Tickety-boo. All is well. Life goes on.

Does anyone else feel like this when they go to the doctor? 

*For more information about 'white coat effect' click here.

Care.data : I'm opting out

Updated. NHS England, having listened carefully to patients and doctors, have decided to go ahead with the plan to automatically upload your medical records to a central database. If you don't want this for your information, you need to opt-out. 

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Two weeks ago, an innocent looking leaflet dropped through the letterbox. A quick read of it, and I decided I needed to know more about the Health and Social Care Information Centre (HSCISC). OK, I've been to the website, consulted my GP practice, spoken to a few hospital doctors, and listened to the public debate. I'm definitely opting-out.

Why? 

Firstly, the data which your GP will give the HSCIC will not be as anonymised as the information leaflet would have you believe. Your date of birth, gender and NHS number will be linked with your medical data. So, if there were to be a hack attack, or  someone with malicious intent, all our personal information could be exposed.

Secondly, having worked as a researcher, I know that it is devilishly difficult to keep track of all the data and what it can be used for. In theory, specific permission has to be sought to carry out analysis of the data, but these applications are usually very broad-based, to enable researchers to carry out what we in science happily call 'fishing expeditions'. That is, we don't actually have a null hypothesis but we think we can make something from all the information. It is bad science but it pays the bills and almost everyone does it.

It's not right. 

I have previously said that I wouldn't give blood for experiments in the research lab. Cells and genetic material from these experiments can be stored for years without anyone accounting for it. Any number of researchers can have access to this material, and with very few questions asked. I declined then, and I'm declining now.

In principle, I'm not against the use of data, or for that matter, donated blood or tissue, but until there are better controls across all universities, I do not believe that is possible to know exactly how your data is stored and used. And don't think that your information will stay in the UK either. It is widespread practice to share research data across research communities, in Europe and further afield. These collaborations maximise the research dollar, but will expose the vulnerability in data protection.

If you are concerned, make sure you register your opt-out with your GP today.

Women in STEM careers

Written evidence submitted by Lesley Beeton PhD, in my personal capacity (August 2013).

Summary

• Science teaching for girls at school would benefit from ‘women scientists in the  classroom’
• Science degrees should not be seen as the second choice to Medicine or Veterinary science
• A foundation ‘term’ at university before embarking on BSc study would cement the science basics, increase confidence in the subject and produce stronger postgraduate candidates

1.    Introduction

I am a biologist. I was not encouraged to take chemistry and physics at school, but with school leaving distinctions in biology and maths, I was accepted for BSc study. I spent the summer at foundation school, catching up on chemistry and physics. These are skills which I have used ever since, in my medical science research career.

I have a PhD in the genetics of cardiovascular disease, but I followed a more traditional university career of BSc, Bsc Hons and MSc, before embarking on PhD study as a mature student. This path allowed me the hone my research skills, develop transferable skills and grow with confidence.

I supervised final year BSc student research projects at the University of Surrey from 2004 to 2011.

I am a science blogger, commentator on medical practice, advocate for dying matters, and practice manager for a specialist cardiology practice. I support Thandulwazi Maths and Science Foundation in Johannesburg, South Africa.

2.    Women scientists in the classroom

I was taught by the same very enthusiastic biology teacher for 5 years at high school, and I enjoyed it very much. There was no encouragement to study chemistry and physics, although I was very capable and did take maths. I understand that school education should be broad-based in subject matter, but giving girls the easy option of biology and a language or art, instead of physics and maths, is not good practice.

The successful women scientists I know all demonstrate an understanding of these basic science skills, crucial to calculations and experimental design in the laboratory.

A programme of getting women scientists into the classroom would help to overcome this reticence, build confidence and open new horizons for pupils and teachers.

I mentored a GCSE pupil for a short period in the laboratory. This student wanted to apply to veterinary school after A-levels. As competition for vet school places is fierce, pupils must demonstrate their passion for the subject. The pupil had no knowledge of the basics of cell biology, as there had not yet been any teaching on mitosis and meiosis. I found this staggering.

3.    Encourage Science degrees as first choice

Half of the undergraduate students I supervised had chosen BSc study as a second choice to Medicine or Veterinary Science. These were mostly women students, who were hoping to successfully re-apply after graduation. These capable students saw a career in science teaching, research or strategy as a significantly lower career choice.

Outside of the key centres of excellence in science, research funding is limited. Women scientists, like myself, wanting to work close to home or have flexibility around family life, have little choice. Move or commute, or don’t have a career in science. This is a great loss to science. More flexibility and improved career development funding would see more women staying in science, and showing their daughters that a career in science is worthwhile. What better example to set.

4.    A foundation ‘term’ for better scientists

Undergraduate final year science students could not perform basic calculations, such as ratio and proportion, molarity, molality, or titrate acids and bases. They were unable to prepare solutions for the laboratory, often misunderstanding simple instructions such as make up the volume using a volumetric flask.

Such was their lack of confidence that complex laboratory and experimental instructions had to be written down in detail, like a ‘recipe’ book. Final year students should be able to work independently, with supervision. These students graduate as BSc Hons but lack the necessary skills for postgraduate research or research careers. Many leave science altogether at this point.

Conclusion

Science careers begin at school. It cannot be left to universities to produce scientists. Girls must be shown the value of science careers, as they are many and varied, but all require a strong, confident knowledge of the principles which underpin our subject.

Read the Science and Technology Select Committee report published today.

*STEM Science Technology Engineering Maths