Does Peppa Pig encourage inappropriate use of primary care resources?(bmj.com)
bmj.com
Does Peppa Pig encourage inappropriate use of primary care resources?
http://www.bmj.com/content/359/bmj.j5397
130 comments
My experience suggests that 400eur would get you this exact level of treatment in European private practice, although I suspect medical reports by WhatsApp would make most doctors fall foul of relevant data safety laws.
My (extensive) experience of South East Asia is that they’ll run many tests which a European Dr wouldn’t order with a straight face but that you don’t care because it’s generally pretty cheap.
My (extensive) experience of South East Asia is that they’ll run many tests which a European Dr wouldn’t order with a straight face but that you don’t care because it’s generally pretty cheap.
> medical reports by WhatsApp
At least it has end-to-end encryption.
Apart from in-person (which is inconvenient) what's the alternative? Email? SMS? Post?
Provided it's a "good news" follow-up, of course.
At least it has end-to-end encryption.
Apart from in-person (which is inconvenient) what's the alternative? Email? SMS? Post?
Provided it's a "good news" follow-up, of course.
One alternative is to require patients to attend a followup visit to have the report read to them, inconveniencing the patient and wasting insurance/taxpayer dollars.
I’ve had a private hospital give me an online portal to receive results, with online registration requiring the jumping through of many hoops
Cleveland Clinic does this, and it's amazing. The first time I went in they gave me a little sheet of paper that had a code to sign up to their site with (myChart) and now I can get all of my test results, make appointments, and message my doctor all online.
I’ve got a few doctor’s offices/clinics that are in MyChart. It’s wildly convenient. The app and site are generally poorly designed, but work well enough that I’d rather have it than not.
The Universal Health Network of hospitals in Ontario have recently started using an online portal as well - the interface is a little intuitive but it's so much better than the alternative
> My experience suggests that 400eur would get you this exact level of treatment in European private practice
One of the problems is actually that you cannot tell what a certain level of treatment will cost.
One of the problems is actually that you cannot tell what a certain level of treatment will cost.
They need to run more tests because you don't mess around with many tropical diseases that just are not a problem in Europe
I wish. I don't know how to get this service in Israel, for any amount of money.
It's not red tape. It's the millions of (occasionally even aggressive) hypocondriacs, careless people who book appointments and then don't show up, über-entitled tossers who compensate their low status in life by trying to boss around their legally-mandated healthcare providers, and the highly-functioning mentally ill.
These people will hog any system. In some countries they are discouraged by high fees (your 40 euros in Bali are cheap for you but very expensive for locals), but those fees will then become a barrier for a lot of people who really need the service.
I honestly don't know the answer, but there must be ways to create barriers that are porous enough to let the genuinely ill people in and the hoggers out.
These people will hog any system. In some countries they are discouraged by high fees (your 40 euros in Bali are cheap for you but very expensive for locals), but those fees will then become a barrier for a lot of people who really need the service.
I honestly don't know the answer, but there must be ways to create barriers that are porous enough to let the genuinely ill people in and the hoggers out.
It's not red tape. It's the millions of (occasionally even aggressive) hypocondriacs, careless people who book appointments and then don't show up
Allegedy 1-in-5 NHS GP appointments are no-shows, costing north of a billion squids/year. The total NHS budget is £125Bn so that's nearly 1%. Which doesn't seem like a great deal but when you add on all the other waste such as people filling prescriptions they don't need it's going to be pretty significant.
We need a system where you pay a deposit say £10 for an appointment, refunded in full if you show up on time, say £5 if you are late. Because it has a knock on effect on other patients.
Allegedy 1-in-5 NHS GP appointments are no-shows, costing north of a billion squids/year. The total NHS budget is £125Bn so that's nearly 1%. Which doesn't seem like a great deal but when you add on all the other waste such as people filling prescriptions they don't need it's going to be pretty significant.
We need a system where you pay a deposit say £10 for an appointment, refunded in full if you show up on time, say £5 if you are late. Because it has a knock on effect on other patients.
In the US, doctors run perpetually late throughout the day, so I doubt a no-show would affect their operations one way or the other. The patient pays for being on time by waiting.
> We need a system where you pay a deposit say £10 for an appointment, refunded in full if you show up on time, say £5 if you are late.
For many people having to pay a £10 deposit to place a doctor's appointment would be the difference between seeing the doctor or not. Especially near the end of the month there are people for whom £10 is the difference between eating or not eating.
For many people having to pay a £10 deposit to place a doctor's appointment would be the difference between seeing the doctor or not. Especially near the end of the month there are people for whom £10 is the difference between eating or not eating.
There's a very real possibility that a small cash deposit could increase the rate of no-shows.
Right now, a lot of British people feel quite protective of the NHS. They see it as a scarce and precious resource that should be used sparingly. Many people feel a real sense of guilt if they inadvertently miss an appointment, because they feel that they're taking something away from someone who might need it more.
Converting this reciprocal relationship to a transactional relationship is very risky. Many people who would otherwise make an effort to keep their appointments could take the attitude that they're just paying for a service; the lost deposit takes away any guilt about missing the appointment. £10 is a fraction of the actual cost of a missed GP appointment, so the NHS could make a substantial net loss.
I think a far more productive approach would be to use behavioural nudges. It wouldn't be difficult or expensive to give an SMS or automated voice reminder of an appointment. People who persistently miss NHS appointments could be offered support in keeping to their appointments, while being gently reminded of the costs to the NHS and the effects on other patients. I suspect that a bit of psychological carrot-and-stick would be far more effective and far less risky.
Right now, a lot of British people feel quite protective of the NHS. They see it as a scarce and precious resource that should be used sparingly. Many people feel a real sense of guilt if they inadvertently miss an appointment, because they feel that they're taking something away from someone who might need it more.
Converting this reciprocal relationship to a transactional relationship is very risky. Many people who would otherwise make an effort to keep their appointments could take the attitude that they're just paying for a service; the lost deposit takes away any guilt about missing the appointment. £10 is a fraction of the actual cost of a missed GP appointment, so the NHS could make a substantial net loss.
I think a far more productive approach would be to use behavioural nudges. It wouldn't be difficult or expensive to give an SMS or automated voice reminder of an appointment. People who persistently miss NHS appointments could be offered support in keeping to their appointments, while being gently reminded of the costs to the NHS and the effects on other patients. I suspect that a bit of psychological carrot-and-stick would be far more effective and far less risky.
They see it as a scarce and precious resource that should be used sparingly
This is not even slightly true. £11Bn a year is spent on Type 2 diabetes, 80% of which is caused by obesity (source: Diabetes UK). A&E every Friday and Saturday night is full of drunks. People take the NHS for granted.
take the attitude that they're just paying for a service
Well SOMEONE is paying for it. Generally, the people who can't get GP appointments...
This is not even slightly true. £11Bn a year is spent on Type 2 diabetes, 80% of which is caused by obesity (source: Diabetes UK). A&E every Friday and Saturday night is full of drunks. People take the NHS for granted.
take the attitude that they're just paying for a service
Well SOMEONE is paying for it. Generally, the people who can't get GP appointments...
An interesting real-life example of failed economical incitements is a case here a kindergarten started to charge an extra cost for "late pickups", ie later than the what the contract stipulated.
The end result was that "late pickups" increased as the shame of being late was replaced with a transaction fee, signalling that late pickups where allowed by the rules.
The end result was that "late pickups" increased as the shame of being late was replaced with a transaction fee, signalling that late pickups where allowed by the rules.
At what point do we hold people accountable? If a $10 fully refunded deposit is an insurmountable challenge (which, at least in the US does not at all apply to "many" people.) what would work?
We can't just allow people who give no thought to others, who make bad choice after bad choice, the option to continue to ruin it for the rest of us. I'm sympathetic to low income folks, but surely a 10 dollar deposit you get back if you simply do what you say you're doing to do, is not too much to ask?
We can't just allow people who give no thought to others, who make bad choice after bad choice, the option to continue to ruin it for the rest of us. I'm sympathetic to low income folks, but surely a 10 dollar deposit you get back if you simply do what you say you're doing to do, is not too much to ask?
As a UK resident earning a comfortable wage, I personally wouldn't mind paying a bit more, and hope the NHS continues to be easily accessible. Money can solve many problems, but these kind of "solutions" only adversely affect those don't have enough of it. It isn't like managing such a system has zero overhead.
Glad to hear I'm not the last bleeding heart liberal round here! The solution is to increase taxes and properly fund the NHS.
The solution is to increase taxes and properly fund the NHS.
What would you say that involves? The current budget is £125Bn, so are we looking at £150Bn, £200Bn, £500Bn? Put a number out there and we'll have a national debate on what we are willing to do to finance that.
Noone seems to know what "properly fund" actually looks like, and noone has any appetite for tackling waste, such as missed appointments, or IT outsourcing contracts. £10Bn flushed down the toilet on NPfIT, when you say "save our NHS" you are really saying "save CSC's shareholders", do you realize that?
https://www.theguardian.com/society/2013/sep/18/nhs-records-...
Windfall tax on Accenture et al I say.
What would you say that involves? The current budget is £125Bn, so are we looking at £150Bn, £200Bn, £500Bn? Put a number out there and we'll have a national debate on what we are willing to do to finance that.
Noone seems to know what "properly fund" actually looks like, and noone has any appetite for tackling waste, such as missed appointments, or IT outsourcing contracts. £10Bn flushed down the toilet on NPfIT, when you say "save our NHS" you are really saying "save CSC's shareholders", do you realize that?
https://www.theguardian.com/society/2013/sep/18/nhs-records-...
Windfall tax on Accenture et al I say.
Aren't you tired of rehashing the NPfIT failure, literally decades since it started and even 4 years since the press last covered it? It's just become a talking-point, a right-wing meme. The new systems are not faring much better; it's just a set of hard problems from an organizational perspective.
Conflating IT mistakes (10bn over 20 years, 500m per year - peanuts, from a government perspective) with the entire NHS expenditure, is just misleading propaganda. This is why we can't have a civil debate on what the NHS should and should not provide: the fixation on cost-cutting and its opposite knee-jerk reactions stifle any attempt at reasoning about actual problems.
Conflating IT mistakes (10bn over 20 years, 500m per year - peanuts, from a government perspective) with the entire NHS expenditure, is just misleading propaganda. This is why we can't have a civil debate on what the NHS should and should not provide: the fixation on cost-cutting and its opposite knee-jerk reactions stifle any attempt at reasoning about actual problems.
It's just become a talking-point, a right-wing meme. The new systems are not faring much better
That's a really weird thing to say: are you asserting that the "right wing" is complaining about billions in public money being funnelled into the pockets of capitalist shareholders? Or is "right wing" just your word for "anyone who disagrees with me"?
I'll grow tired of it when the government stops doing business with these companies, insources all the IT work, and hits them with a windfall tax to claw it all back. Is that what you call "right wing"?
That's a really weird thing to say: are you asserting that the "right wing" is complaining about billions in public money being funnelled into the pockets of capitalist shareholders? Or is "right wing" just your word for "anyone who disagrees with me"?
I'll grow tired of it when the government stops doing business with these companies, insources all the IT work, and hits them with a windfall tax to claw it all back. Is that what you call "right wing"?
OK, so only apply this system to someone once they miss an appointment then. At some point people have to take a little bit of responsibility. If you don't need an appointment anymore just call and cancel. Oh but what about those who can't top up their phones? What about what about what about...
This is 20% of appointments. I in no way believe that 12 million people in the UK can't afford a fully refundable £10 deposit.
This is 20% of appointments. I in no way believe that 12 million people in the UK can't afford a fully refundable £10 deposit.
I haven't seen a GP for years although, because of age, I probably ought to just to get a few things checked out. The last time I tried to make an appointment I gave up after encountering a phone that just wasn't being answered - except for the time I got a message saying they were busy and to call back later.
Anecdotally, in the UK this now normal. Apparently you have to beat the system by calling at a certain time and saying your problem is urgent. Obviously, all the people you are referring to know all about this; it's just suckers like me who have to suffer.
The NHS is free at the point of use in the UK - except for dentistry which is only free if you have a low income, etc.
Most folks (in my experience) go full on private and pay a monthly fee plus insurance. It isn't expensive (unless you need some major work doing) and the standard of dental care has improved many fold as a consequence.
Anecdotally, in the UK this now normal. Apparently you have to beat the system by calling at a certain time and saying your problem is urgent. Obviously, all the people you are referring to know all about this; it's just suckers like me who have to suffer.
The NHS is free at the point of use in the UK - except for dentistry which is only free if you have a low income, etc.
Most folks (in my experience) go full on private and pay a monthly fee plus insurance. It isn't expensive (unless you need some major work doing) and the standard of dental care has improved many fold as a consequence.
You highlight an interesting problem with the NHS that quality is extremely variable based on your location.
For example I can book an appointment online at my GPs, so never have to phone anymore. I can normally get an appointment within a week.
Also a number of years ago I needed an MRI and CT scan. I had these 2 weeks after seeing my GP, whereas I know family members that live in a different area and have had to wait months for similar scans.
Edit: For some more data on UK NHS GPs see
* https://www.england.nhs.uk/statistics/statistical-work-areas...
* https://www.gp-patient.co.uk/
For example I can book an appointment online at my GPs, so never have to phone anymore. I can normally get an appointment within a week.
Also a number of years ago I needed an MRI and CT scan. I had these 2 weeks after seeing my GP, whereas I know family members that live in a different area and have had to wait months for similar scans.
Edit: For some more data on UK NHS GPs see
* https://www.england.nhs.uk/statistics/statistical-work-areas...
* https://www.gp-patient.co.uk/
> Obviously, all the people you are referring to know all about this; it's just suckers like me who have to suffer.
Absolutely, but that's exactly why these barriers exist: because dealing with the hoggers sucks up all available resources. It's not like GPs sit around, their time is still allocated for the most part. In a context where central government keeps squeezing GPs (forcing them to work longer hours for less pay than before), they have no incentive to do anything but to deal with the high-maintenance types. Some sort of external shock is required.
I had a similar experience with my local GP surgery, in a working-class area in the North of England. Doctors kept rotating (they would hire kids and other practitioners with no experience, who would then leave very quickly after they realized what the workload was), it was impossible to get an appointment, and more often than not one would just be dismissed with paracetamol. Then people discovered the feedback tool at https://www.nhs.uk/service-search , and inundated the surgery with bad reviews. This seems to have kicked the right asses in gear, and now it's much better. Mind, I still have to log on Patient Access right after midnight to get a same-day appointment, but at least I don't get dismissed once there...
Absolutely, but that's exactly why these barriers exist: because dealing with the hoggers sucks up all available resources. It's not like GPs sit around, their time is still allocated for the most part. In a context where central government keeps squeezing GPs (forcing them to work longer hours for less pay than before), they have no incentive to do anything but to deal with the high-maintenance types. Some sort of external shock is required.
I had a similar experience with my local GP surgery, in a working-class area in the North of England. Doctors kept rotating (they would hire kids and other practitioners with no experience, who would then leave very quickly after they realized what the workload was), it was impossible to get an appointment, and more often than not one would just be dismissed with paracetamol. Then people discovered the feedback tool at https://www.nhs.uk/service-search , and inundated the surgery with bad reviews. This seems to have kicked the right asses in gear, and now it's much better. Mind, I still have to log on Patient Access right after midnight to get a same-day appointment, but at least I don't get dismissed once there...
Dentistry's an odd one. In some parts of the country it certainly used to be essentially impossible to get an NHS dentist, and in others it's easy. There are multiple dental surgeries accepting new NHS patients in Oxford, for example, which is by no means a cheap place to operate.
Although NHS dental treatment isn't generally free for adults, it is pretty cheap. I've been lucky enough to find an NHS surgery everywhere I've lived and the standard of care has been generally excellent.
Although NHS dental treatment isn't generally free for adults, it is pretty cheap. I've been lucky enough to find an NHS surgery everywhere I've lived and the standard of care has been generally excellent.
I have heard similar elsewhere, NHS dentistry used to be pretty awful when I was a kid - many people developed phobias that they never got over with obvious consequences.
Maybe the growth of private clinics has had a positive effect on standards overall, though I know a lot of NHS dentists do a bit of both.
Maybe the growth of private clinics has had a positive effect on standards overall, though I know a lot of NHS dentists do a bit of both.
I'm told by my dad that his (private) dentist as a kid also used to be awful; whereas my (NHS) dentist was great. Though I'm told that surgery went downhill when our dentist retired. Very hard to separate out what's going on.
And I think essentially all NHS dentists do private work as well these days. The one bit of private work I've had done was a rear filling: standard amalgam was covered on the NHS tariff, but a cosmetic 'upgrade' to a white composite one was private and at cost.
And I think essentially all NHS dentists do private work as well these days. The one bit of private work I've had done was a rear filling: standard amalgam was covered on the NHS tariff, but a cosmetic 'upgrade' to a white composite one was private and at cost.
As a general principle, be wary of any practitioner who doesn't also do NHS work. The CPD and peer-review keep them on the straight and narrow.
I'm not sure about this since my dentist is a dental surgeon way above the grade of an average practitioner.
May be good advice in general but I don't think that not being part of the NHS should be seen as something negative.
May be good advice in general but I don't think that not being part of the NHS should be seen as something negative.
Anecdotally, in the UK this now normal. Apparently you have to beat the system by calling at a certain time and saying your problem is urgent. Obviously, all the people you are referring to know all about this
This mirrors my experience and stories from friends. The GP system just isn't designed for people who work. The only GP I can actually see is a private one near work, which I pay for directly (not covered by insurance - fortunately I rarely need to go).
This mirrors my experience and stories from friends. The GP system just isn't designed for people who work. The only GP I can actually see is a private one near work, which I pay for directly (not covered by insurance - fortunately I rarely need to go).
> Most folks (in my experience) go full on private and pay a monthly fee plus insurance.
I have private medical insurance paid for by my employer, but as far as I'm aware no one else I know has private insurance because despite its shortcomings the NHS gets the job done.
I have private medical insurance paid for by my employer, but as far as I'm aware no one else I know has private insurance because despite its shortcomings the NHS gets the job done.
Yeah this is almost the same experience in India too. Specialists like orthopedics, ob-gyn, etc. are often walk-in or same day appointments, and finish everything for under $50-$100. The only drawback with the overall health system in India is that there is mind boggling inequality. Easy access to specialists is true in big cities in good neighborhoods, but hospitals and healthcare can truly be medieval in remote or poor villages.
There's also a massive variation in standards. You'd think price and quality are correlated but one does have to perform due diligence as private hospitals routinely overcharge and prescribe unnecessary tests/procedures.
A bigger problem is that the justice system in India is (almost?) dysfunctional so good luck suing a private hospital if things go wrong. Your only hope is that the media picks it up, which can force the government to take action, e.g. [1].
[1] http://www.thehindu.com/todays-paper/tp-national/haryana-pro...
A bigger problem is that the justice system in India is (almost?) dysfunctional so good luck suing a private hospital if things go wrong. Your only hope is that the media picks it up, which can force the government to take action, e.g. [1].
[1] http://www.thehindu.com/todays-paper/tp-national/haryana-pro...
We know that over-testing, over-diagnosis, and over-treatment causes harm, so while what you describe may have been useful for your partner it's harmful when applied to a population.
I'm too scared now to lookup difference in price for an ambulance (after calling 911/112)..
You don't need to look it up, just subtract $0 to know the difference: ambulances are free in most countries.
Oh having been in a few, i know the bill is 1000'ish euros in NL, sure insurance 'pays'. And i still have to pay my insurance, which goes up every year.
It's about 1000$ in Switzerland.
But if it was emergency or an accident your health insurance will pay.
What you just described honestly sounds a lot like direct pay here in the states. If you google “direct pay doctors” in your city you will find some.
Doctors offering direct pay are cash only. They charge a small monthly fee. Here in Missouri it’s about $100/month. For that $100/month you get seen the same day!!! I haven’t been able to get seen by a doctor the same day since I was like 5 and that was 1980. Usually it’s a week or so before an appointment can be made. You also get an hour with the doctor. No rushing you in and out to increase turnover. Most things up to minor urgent care are included as well including stitches and lacerations. You only pay for materials used. Which is usually very cheap. A couple bucks for gauze. A couple for stitches. Medication and labs massively reduced from insurance rates. Flu shots are free. Etc
Direct pay providers are becoming more common as more and more doctors say “screw insurance and federal government red tape and regulations”. They are just absolutely done with the mess and pain of insurance and government regulations. Most even provide house calls! House calls! I haven’t seen a doctor do house calls since little house on the prairie!
Seriously if you are in the states look into it! The wife and I are more than likely moving to direct pay with a high dedeuctible catastrophic insurance plan this year and we will be saving over $500/month on our employee provided Cadillac insurance plan.
Doctors offering direct pay are cash only. They charge a small monthly fee. Here in Missouri it’s about $100/month. For that $100/month you get seen the same day!!! I haven’t been able to get seen by a doctor the same day since I was like 5 and that was 1980. Usually it’s a week or so before an appointment can be made. You also get an hour with the doctor. No rushing you in and out to increase turnover. Most things up to minor urgent care are included as well including stitches and lacerations. You only pay for materials used. Which is usually very cheap. A couple bucks for gauze. A couple for stitches. Medication and labs massively reduced from insurance rates. Flu shots are free. Etc
Direct pay providers are becoming more common as more and more doctors say “screw insurance and federal government red tape and regulations”. They are just absolutely done with the mess and pain of insurance and government regulations. Most even provide house calls! House calls! I haven’t seen a doctor do house calls since little house on the prairie!
Seriously if you are in the states look into it! The wife and I are more than likely moving to direct pay with a high dedeuctible catastrophic insurance plan this year and we will be saving over $500/month on our employee provided Cadillac insurance plan.
Does House M.D. encourage inappropriate dismissal of over-anxious patients?
As a user of GP medical practices, I often wonder why doctors are such douchebags when faced with people who have perfectly fine concerns over what seems to them like trivial symptoms that self-resorbs.
In the show House M.D., Dr. House is a very prominent medical doctor who specializes in very rare diseases and is often dismissive about patient's problems. On 78 occasions during the show, Dr. House talks about the patient as "a lier who's perfectly fine", and refuses to take their case.
Conclusion: Although the show demonstrate accurate and interesting cures to very rare diseases, the way it talks about the average patient is pretty bad, and may help explain why doctors behave like jerks on a variety of occasions
As a user of GP medical practices, I often wonder why doctors are such douchebags when faced with people who have perfectly fine concerns over what seems to them like trivial symptoms that self-resorbs.
In the show House M.D., Dr. House is a very prominent medical doctor who specializes in very rare diseases and is often dismissive about patient's problems. On 78 occasions during the show, Dr. House talks about the patient as "a lier who's perfectly fine", and refuses to take their case.
Conclusion: Although the show demonstrate accurate and interesting cures to very rare diseases, the way it talks about the average patient is pretty bad, and may help explain why doctors behave like jerks on a variety of occasions
>> As a general practitioner, I have often wondered why some patients immediately attempt to consult their GP about minor ailments of short duration.
Typical dismissive attitude of most GPs in the UK to make you feel guilty for consulting them.
Having sick children can be worrying and minor ailments can actually be more serious in a child, so it's hard to know when to ride it out and when to seek a second opinion.
Typical dismissive attitude of most GPs in the UK to make you feel guilty for consulting them.
Having sick children can be worrying and minor ailments can actually be more serious in a child, so it's hard to know when to ride it out and when to seek a second opinion.
I've noticed this dismissive attitude as well, and I'm a generally healthy adult who goes to the GP very rarely.
People go to the doctor because they don't know what's going on with their body and they are worried. They don't know that it's a minor ailment until an expert tells them. I hate this trend for shaming people just for being worried (which of course can be a sign of a mental health condition in itself).
I think the difficulty here is that doctors do have to deal with hugely ignorant people on a daily basis. The fact that many people apparently haven't grasped that antibiotics don't do anything for viral infections is testament to this. (Seriously - there was recently a national NHS ad campaign about this).
People go to the doctor because they don't know what's going on with their body and they are worried. They don't know that it's a minor ailment until an expert tells them. I hate this trend for shaming people just for being worried (which of course can be a sign of a mental health condition in itself).
I think the difficulty here is that doctors do have to deal with hugely ignorant people on a daily basis. The fact that many people apparently haven't grasped that antibiotics don't do anything for viral infections is testament to this. (Seriously - there was recently a national NHS ad campaign about this).
The GP in the UK thinks that having weeks of waiting period for a GP appointment is normal. So, of course, they triage and prioritise and Peppa Pig level of care is seen as terrible use of constrained resources.
On another forum, I got a UK GP upset that my country suggest people over 40 to see a GP once a year for a checkup. What a waste of resource it seemed to him, he could not believe it.
Well the truth is that in most of the European countries, seeing a GP is simply a non-issue. Even in my in law family village, 70 km away from the nearest city, population reaching 100 inhabitant there is a GP 3 full days a week, free. 8 km from there, there is a 24/7 walk-in centre. I never experienced "you have to wait for weeks to get an appointment" or the "go through the list of common ailment and their cure for 2 weeks before requesting a GP appointment". You are sick, you go to the GP open consultation, he will see you within the hour. Or you call and he will come in the afternoon. That's what GP visit mean in other EU countries.
Before coming to the UK I never had to go to the A&E. Now, I'm really sad to say because it is a terrible waste, but that's my primary care centre (after self medication). My GP has a month waiting list, 2+ weeks if I'm happy to go to a GP that has never heard of me.
I don't think the NHS realise just how far they have been bled out over the years. They rely on statistic and forgot anything about the side concern. Sure maybe seeing a GP once a year when you are asymptomatic 40 year old does not have an immediate ROI. What they lost sight of is the indirect ROI, like GP knowing his patient ? Or even patient knowing his GP ? That has been proven recently that simply trusting your GP increase the efficiency of medication.
Note that A&E has been tremendous. They really helped us understand what to be worried about with small babies and children. But there is nothing (thankfully) they did that a GP in my home country would not have done.
On another forum, I got a UK GP upset that my country suggest people over 40 to see a GP once a year for a checkup. What a waste of resource it seemed to him, he could not believe it.
Well the truth is that in most of the European countries, seeing a GP is simply a non-issue. Even in my in law family village, 70 km away from the nearest city, population reaching 100 inhabitant there is a GP 3 full days a week, free. 8 km from there, there is a 24/7 walk-in centre. I never experienced "you have to wait for weeks to get an appointment" or the "go through the list of common ailment and their cure for 2 weeks before requesting a GP appointment". You are sick, you go to the GP open consultation, he will see you within the hour. Or you call and he will come in the afternoon. That's what GP visit mean in other EU countries.
Before coming to the UK I never had to go to the A&E. Now, I'm really sad to say because it is a terrible waste, but that's my primary care centre (after self medication). My GP has a month waiting list, 2+ weeks if I'm happy to go to a GP that has never heard of me.
I don't think the NHS realise just how far they have been bled out over the years. They rely on statistic and forgot anything about the side concern. Sure maybe seeing a GP once a year when you are asymptomatic 40 year old does not have an immediate ROI. What they lost sight of is the indirect ROI, like GP knowing his patient ? Or even patient knowing his GP ? That has been proven recently that simply trusting your GP increase the efficiency of medication.
Note that A&E has been tremendous. They really helped us understand what to be worried about with small babies and children. But there is nothing (thankfully) they did that a GP in my home country would not have done.
In the context of an (albeit semi-satirical) article in a medical journal, it's a legitimate question to ask and not at all 'dismissive'. The economics of a healthcare system requires such things to be asked.
From the perspective of a GP, they might find it troubling that, despite continual patient education efforts, patients persist in seeking GP consultations for symptoms of minor ailments rather than opting for a nurse (or even a chemist). Patients can usually be seen by nurses sooner and for longer consultations, with the ability to prescribe and triage for further diagnosis/consultation.
My own idea for why this happens (in a UK context, at least) is that nursing's reputation for basic healthcare skills persists amongst the public, as well as a notion that nurses may be acting 'above their station' in diagnosing and treating patients. The popular idea of nursing as providing basic care and observation is something that tends to be done by healthcare assistants these days. The role of specialist nurses - including nurse practitioners - in recent times should allay such legitimate concerns, but it might be the case that they are encumbered with a low-visibility public presence or status. Another idea that occurs is that it seems to have been part of patient culture for patients to arrange appointments with a family GP when seeking assessment and treatment - a norm passed down through family generations? Changing it or introducing new norms within families' relationships with primary care providers may be a particularly tricky challenge to overcome.
From the perspective of a GP, they might find it troubling that, despite continual patient education efforts, patients persist in seeking GP consultations for symptoms of minor ailments rather than opting for a nurse (or even a chemist). Patients can usually be seen by nurses sooner and for longer consultations, with the ability to prescribe and triage for further diagnosis/consultation.
My own idea for why this happens (in a UK context, at least) is that nursing's reputation for basic healthcare skills persists amongst the public, as well as a notion that nurses may be acting 'above their station' in diagnosing and treating patients. The popular idea of nursing as providing basic care and observation is something that tends to be done by healthcare assistants these days. The role of specialist nurses - including nurse practitioners - in recent times should allay such legitimate concerns, but it might be the case that they are encumbered with a low-visibility public presence or status. Another idea that occurs is that it seems to have been part of patient culture for patients to arrange appointments with a family GP when seeking assessment and treatment - a norm passed down through family generations? Changing it or introducing new norms within families' relationships with primary care providers may be a particularly tricky challenge to overcome.
I experience the same thing in the UK. I rarely go to the doctor. Perhaps once a year if that. If I go it is because something hasn't gotten better after a number of weeks, I am unsure about something or genuinely uncomfortable. The doctor is usually dismissive unless something is hanging off.
My partner was hospitalized for pneumonia. That was despite seeing a doctor 4 times. Each time the doctor was dismissive about the problems she was having. It was only when she struggled to get out of bed that a doctor said it was time to go to hospital.
This has happened for similar issues attending different doctors for issues such as fatigue (turned out to be low iron levels after an operation) and wrist pain (turned out to be RSI which required multiple cortisone injections and prolonged time off work.)
This attitude makes you not want to attend the doctor unless you become critically ill.
My partner was hospitalized for pneumonia. That was despite seeing a doctor 4 times. Each time the doctor was dismissive about the problems she was having. It was only when she struggled to get out of bed that a doctor said it was time to go to hospital.
This has happened for similar issues attending different doctors for issues such as fatigue (turned out to be low iron levels after an operation) and wrist pain (turned out to be RSI which required multiple cortisone injections and prolonged time off work.)
This attitude makes you not want to attend the doctor unless you become critically ill.
Our gp encourages children visits. When you look at return on healthcare investment for children in terms of years of life left, it makes sense. Plus kids don’t self report very well, you need a doctor to diagnose.
> make you feel guilty for consulting them
While they shouldn’t be making you feel guilty per-se, they’re gatekeepers for the public, finite resource of NHS care, and help stop healthcare spending spiralling out of control.
While they shouldn’t be making you feel guilty per-se, they’re gatekeepers for the public, finite resource of NHS care, and help stop healthcare spending spiralling out of control.
This to me seems like one of the fundamental problems with the NHS. (Compulsory caveat: we're very lucky to have it and it's way better than the American system, etc etc)
But the primary care side of things basically has to be a bit shit for the whole thing to work. Because demand for healthcare is so elastic. Almost every single one of us has those little niggles, aches and pains and things that we ought to get checked out.
If we could get a GP appointment at 24 hours notice, and be guaranteed an un-rushed meeting with a sympathetic and friendly doctor, demand would skyrocket. The system has to limit demand by never getting too good.
There isn't really a private alternative because, in the UK, NHS GPs are the gatekeepers of everything. You need a referral letter from an NHS GP to see a specialist on your own private medical insurance. There are some companies with private GPs but they're extremely expensive, presumably because there isn't much competitive pressure.
So the system finds an equilibrium, where it's frustrating but tolerable. Not quite good enough, but not quite bad enough that it's worth paying for a private GP.
But the primary care side of things basically has to be a bit shit for the whole thing to work. Because demand for healthcare is so elastic. Almost every single one of us has those little niggles, aches and pains and things that we ought to get checked out.
If we could get a GP appointment at 24 hours notice, and be guaranteed an un-rushed meeting with a sympathetic and friendly doctor, demand would skyrocket. The system has to limit demand by never getting too good.
There isn't really a private alternative because, in the UK, NHS GPs are the gatekeepers of everything. You need a referral letter from an NHS GP to see a specialist on your own private medical insurance. There are some companies with private GPs but they're extremely expensive, presumably because there isn't much competitive pressure.
So the system finds an equilibrium, where it's frustrating but tolerable. Not quite good enough, but not quite bad enough that it's worth paying for a private GP.
> There isn't really a private alternative because, in the UK, NHS GPs are the gatekeepers of everything.
I think this is slowly shifting. I have private medical cover via my employer and one of the things included in that is access to video chats with GPs via a mobile app - obviously they can't diagnose everything without being physically present, but they can do referrals for things where its obviously needed. There are a few services popping which offer this sort of thing for a one off fee for each appointment as well.
I think this is slowly shifting. I have private medical cover via my employer and one of the things included in that is access to video chats with GPs via a mobile app - obviously they can't diagnose everything without being physically present, but they can do referrals for things where its obviously needed. There are a few services popping which offer this sort of thing for a one off fee for each appointment as well.
Thanks for the reminder! I think my employer's medical insurer also recently started offering this. I'll have to give it a try next time I need a doctor.
It's interesting that the insurance companies have noticed the weakness in the NHS system. Presumably they sell this service to their clients in terms of reducing the time lost from attending GP appointments.
I also don't think that services like this are going to be a satisfactory replacement for an in-person visit. I bet they err very much on the side of caution, and are likely to end up sending people back to the NHS if there's any doubt. But for those situations where you just need a referral rubber-stamped they could be fantastic.
It's interesting that the insurance companies have noticed the weakness in the NHS system. Presumably they sell this service to their clients in terms of reducing the time lost from attending GP appointments.
I also don't think that services like this are going to be a satisfactory replacement for an in-person visit. I bet they err very much on the side of caution, and are likely to end up sending people back to the NHS if there's any doubt. But for those situations where you just need a referral rubber-stamped they could be fantastic.
The few times I've used them they've been fantastic. My wife has fairly frequent ear infections, on the last occasion we paid for an online GP consultation as it was 8pm on a Friday night, meaning it would either be at least Monday to see our GP or a £20 taxi ride across town to see an out of hours doctor. Instead she was seen within half an hour, and a prescription sent to our local pharmacy and ready to pick up within an hour of starting the process. Thankfully it seems the NHS are catching on and have started offering something similar in London.
And then they chastize you because "Why did you not come sooner? Now your easily cured at a early stage disease has become life-threatening."
I'm sure more expenses on early symptoms and making people ask for a diagnosis when in doubt would end-up as a lot less money used to try curing things at a late stage.
I'm sure more expenses on early symptoms and making people ask for a diagnosis when in doubt would end-up as a lot less money used to try curing things at a late stage.
So write to NICE, who develop the guidelines GPs follow, and tell them your ideas?
I think it's fair to say that, in the U.S. at least, this has failed.
How much is too much to spend on healthcare?
The same doctors then fight extremely hard against the expansion of the roles of registered nurses to tend to these minor ailments that they’re too good to treat.
Amusingly, in the UK it's nurses who have been resisting the professionalisation and expansion of ancillary roles. Despite broadening their scope of specialism and responsibility over the past couple of decades, a specialist nurse friend tells me that they're quite stubborn as a profession, with other roles (e.g. technicians and assistant practitioners) overtaking parts of the job that nurses could have taken.
> Amusingly, in the UK it's nurses who have been resisting the professionalisation and expansion of ancillary roles.
What's the reason behind this - government wants them to do more work without more pay? An innate sense that they're doing exactly the right job and why change it?
What's the reason behind this - government wants them to do more work without more pay? An innate sense that they're doing exactly the right job and why change it?
Oops, missed your question until just now. The impression I got from my friend/colleague is that nursing in the NHS is an innately conservative and rigid culture (as it is in other areas of healthcare), which goes to the heart of nursing's governing body in setting policy. Whilst nursing has expanded the scope of roles available in recent years (taking on prescribing responsibilities and increased specialisation), it perhaps might not have been at quite the pace or breadth as circumstances require. Consequently, some of the supporting roles that are more flexible, like technicians and healthcare assistants, have started to take on more routine tasks like simple obs and assessment; this makes sense because in most cases, taking blood, measuring lung function and hearing etc. are easy to do - the actual assessment and signing off of work is still done by a (more expensive and better utilised elsewhere) clinician.
That sounds like a US thing, does that happen in the UK as well?
My experience is in AU. Every state is a bit different though.
I haven't heard of this before, can you expand on this?
It's kinda late, but to bring it back in a bit my experience is with AU - the government in my state wants to use nurses to do low-level healthcare stuff and General Practitioners (doctors who do family medicine, not a specialization) are pushing back because they say the funding doesn't stack up, and people need to be driven in to GP offices to ensure lifecycle heathcare.
Some people think they're rentseeking, some people think they have a point. I obviously have my opinion but I won't push it on you.
Some people think they're rentseeking, some people think they have a point. I obviously have my opinion but I won't push it on you.
Not at all my experience: both my GP and our kid's GP (the infant specialist) are welcoming, and the medical centre staff are pretty efficient at triaging patients so those that clearly don't need to be seen by a GP can be helped by a nurse or redirected to the pharmacy.
> so it's hard to know when to ride it out and when to seek a second opinion.
Your GP isn't the first port of call though. People can ask a pharmacist, speak to NHS 111 or read NHS Choices.
Your GP isn't the first port of call though. People can ask a pharmacist, speak to NHS 111 or read NHS Choices.
Pharmacists can be great, but my experience of NHS 111 has always been awful. Anytime I've spoken to them the script has basically covered checking whether I have Ebola, whether I'm conscious, whether I'm bleeding to death, and then they've told me to go and see a doctor.
That is exactly the standard of care I enjoy and expect in my country (Uruguay). It's light-years ahead of what my otherwise far wealthier sister and brother in law experience in San Francisco.
You can call an ambulance if you feel sick enough to not want to go to the doctor (like a 100 degree fever or higher) and it'll cost zero - you do have to pay a subscription that's currently about 20 dollars (on top of free healthcare).
You can call an ambulance if you feel sick enough to not want to go to the doctor (like a 100 degree fever or higher) and it'll cost zero - you do have to pay a subscription that's currently about 20 dollars (on top of free healthcare).
Interesting article.
It pretty much works exactly like that in Australia (National Home Doctor service).
You call a number, talk to a call centre person about the symptoms. Then a doctor comes to your house after hours, diagnoses the problem, and supplies a prescription for medicine.
It is 100% free, and government paid. My daughter watches Peppa Pig and has an equivalent experience herself.
It pretty much works exactly like that in Australia (National Home Doctor service).
You call a number, talk to a call centre person about the symptoms. Then a doctor comes to your house after hours, diagnoses the problem, and supplies a prescription for medicine.
It is 100% free, and government paid. My daughter watches Peppa Pig and has an equivalent experience herself.
Fantastic article! Absolutely hilarious! I highly recommend reading the Christmas papers by the BMJ from other years.
Christmas crackers: highlights from past years of The BMJ’s seasonal issue: http://www.bmj.com/content/355/bmj.i6679
Spoiler alert: This is satire. Calm down.
Although it seems the intention of the author is partially to make a humorous article for other GPs, I think that popular culture case studies are useful in medicine and science for finding strong causal links to certain behaviors.
For example, I believe that many cases of Trichotillomania (hair pulling disorder) can be attributed to the game Animal Crossing from 2001 to present, due to the weed-picking game mechanic, paired with existing OCD behavior.
For example, I believe that many cases of Trichotillomania (hair pulling disorder) can be attributed to the game Animal Crossing from 2001 to present, due to the weed-picking game mechanic, paired with existing OCD behavior.
Has there been a rise in trichotillomania cases since 2001? I've done several searches but can't find any useful statistics (only pre-2001 numbers).
I do not know, but I do know that online support communities have emerged in the last decade due to the internet. Perhaps I could find one and bring it up there. My belief is nothing but a personal observation (although I think the causality is glaringly obvious.)
EDIT: To the downvoter, could you explain the reason?
EDIT: To the downvoter, could you explain the reason?
I didn't downvote you, but I'm guessing it's because of your claim. Blaming trichotillomania on a video game is pretty bold, and you haven't provided anything to back it up. It's a dubious claim to start.
That show is full of so many inappropriate examples for children, it is unreal. I have banned my kids from watching it.
Would you like to provide some of those examples ?
edit:proved => provide
edit:proved => provide
The one that particularly grates on me is the relentless hounding of Daddy Pig, particularly about his weight. Mummy Pig is often the instigator of this, despite it clearly upsetting her husband and teaching her children that it's ok to shame people about their body. (Also, relative to the other pigs on the program, Daddy Pig isn't even that large).
Miss Rabbit is a prime example of the perils of zero hours contracts, she's constantly having to find new jobs, and often trying to hold down multiple jobs at the same time.
Miss Rabbit is a prime example of the perils of zero hours contracts, she's constantly having to find new jobs, and often trying to hold down multiple jobs at the same time.
The constant use of "silly daddy". The show seems to attack the father figure whilst making the mother figure seem always right (in my personal opinion). Mummy pig is overweight too, nothing gets said about that though. It feels like a reverse gender bias in that show.
It's an awful show. The worst part is the anti-intellectualism where the young boy who knows things is immediately dismissed as a "clever clogs" every time he opens his mouth.
I hear the “Spiders are our friends!” episode travels poorly to other countries, and is banned in Australia.
I can confirm this is true. The episode was banned by abc but was still shown on Australian Netflix.
It is generally not a good idea to befriend a spider in Australia unless you know the exact species, even then it is generally best just to give them their space.
It is generally not a good idea to befriend a spider in Australia unless you know the exact species, even then it is generally best just to give them their space.
Children not wearing seat belts in cars and not wearing bike helmets are two. (These have now been corrected).
I.e., can you give some examples which illustrate your point?
Ok some examples:
1. Daddy pig is portrayed as an idiot. In fact, there are no positive male figures in the whole show. Check sexism.
2. All of the animals are married to animals of the same type: there are no "inter-racial" marriages. It is also full of racial stereotypes. Check racism
3. The only person in the show who seems to work, Mrs Rabbit, has several jobs that she does badly (perhaps due to exhaustion) and speaks with a working class English accent (while all of the other characters have upper/middle class accents). Check classism.
4. It heavily promotes the British royal family, especially in the recent movie. Check elitism.
Unless you want to fill your kids full of prejudice from an early age, avoid.
1. Daddy pig is portrayed as an idiot. In fact, there are no positive male figures in the whole show. Check sexism.
2. All of the animals are married to animals of the same type: there are no "inter-racial" marriages. It is also full of racial stereotypes. Check racism
3. The only person in the show who seems to work, Mrs Rabbit, has several jobs that she does badly (perhaps due to exhaustion) and speaks with a working class English accent (while all of the other characters have upper/middle class accents). Check classism.
4. It heavily promotes the British royal family, especially in the recent movie. Check elitism.
Unless you want to fill your kids full of prejudice from an early age, avoid.
I feel silly nitpicking critiques of Peppa Pig, but it's Miss Rabbit who has to work constantly to sustain herself. Mrs Rabbit (her twin sister) lives in a comfortable heteronomative relationship with Mr Rabbit, who works to support both her and their many children.
> Daddy pig is portrayed as an idiot.
I strongly disagree! It looks that way superficially, but he is highly resourceful and skilled. He's an engineer, a champion diver, and superb musician. In contrast, Mummy Pig is mostly a non-entity.
> All of the animals are married to animals of the same type: there are no "inter-racial" marriages.
Species ~ race is your own, silly, interpretation.
> perhaps due to exhaustion
Or because doing things badly is a core component of slapstick humour.
I strongly disagree! It looks that way superficially, but he is highly resourceful and skilled. He's an engineer, a champion diver, and superb musician. In contrast, Mummy Pig is mostly a non-entity.
> All of the animals are married to animals of the same type: there are no "inter-racial" marriages.
Species ~ race is your own, silly, interpretation.
> perhaps due to exhaustion
Or because doing things badly is a core component of slapstick humour.
> race is your own, silly, interpretation.
Are you dismissing me as "silly Daddy" now? Sorry could not resist ;-)
Are you dismissing me as "silly Daddy" now? Sorry could not resist ;-)
1. There are "sensible" male characters, such as the Dr. (bonus: Doesn't promote male dominance). In fact, most adult characters aren't serious. That's one of the things that kids find funny.
2. Let's teach them realistic biology. They're difference species, how could they possibly have rabbit and elephant parents - what would the child be? But the fact every species is friends with each other suggests it's ok to "mix".
3. Daddy pig goes to work, and what about the Doctor? There's a teacher, policeman, mechanic. (straw-man: you have differentiated class by accent)
4. I'm far from a royalist, but there's no harm in teaching about the royal family and our heritage.
Disclaimer: I enjoyed watching Peppa Pig.
2. Let's teach them realistic biology. They're difference species, how could they possibly have rabbit and elephant parents - what would the child be? But the fact every species is friends with each other suggests it's ok to "mix".
3. Daddy pig goes to work, and what about the Doctor? There's a teacher, policeman, mechanic. (straw-man: you have differentiated class by accent)
4. I'm far from a royalist, but there's no harm in teaching about the royal family and our heritage.
Disclaimer: I enjoyed watching Peppa Pig.
> Let's teach them realistic biology. They're difference species, how could they possibly have rabbit and elephant parents - what would the child be?
Ok if we are going to run with that very tenuous argument, how come there are animals walking around on two legs, wearing clothes, talking to each other? Clearly the lesson for kids is not biology, it's "people" (an analogy thereof in this instance) of the same "type" marry each other exclusively.
> you have differentiated class by accent
No, the show makers have. Either this was a deliberate decision or a mistake.
> but there's no harm in teaching about the royal family and our heritage
I might agree to that if the kids watching were British, but this show is widely exported, so in my case not my heritage (or thankfully my kids).
Ok if we are going to run with that very tenuous argument, how come there are animals walking around on two legs, wearing clothes, talking to each other? Clearly the lesson for kids is not biology, it's "people" (an analogy thereof in this instance) of the same "type" marry each other exclusively.
> you have differentiated class by accent
No, the show makers have. Either this was a deliberate decision or a mistake.
> but there's no harm in teaching about the royal family and our heritage
I might agree to that if the kids watching were British, but this show is widely exported, so in my case not my heritage (or thankfully my kids).
> how could they possibly have rabbit and elephant parents - what would the child be?
Maybe they could adopt (a panda bear, for example). Suggesting that marriage is related to reproduction is highly offensive to many people.
Maybe they could adopt (a panda bear, for example). Suggesting that marriage is related to reproduction is highly offensive to many people.
If you're a fan of that concept you should watch some Hey Duggee (you should watch some anyway, it's a masterpiece of children's TV), in which a crocodile character is adopted judging by his elephant parents. The really beautiful thing is that this is never mentioned explicitly, he just has elephant parents, and that's fine.
This is the funniest thing I've read all day.
Let's dive in:
> Daddy pig is portrayed as an idiot
And yet he is loved by his family. He makes mistakes but also has many successes. It's probably his pride which is made fun of; he thinks of himself as amazing and perfect and yet makes mistakes, which are humorous in that context.
> All of the animals are married to animals of the same type
They sure are. I'm not sure why this is racist (but feel free to educate me at length). The target audience is two-year-olds, after all.
Come to think of it, I don't know that they're even married. Adult relationships aren't touched at all. Perhaps they're cohabiting but divorced due to London property prices.
> The only person in the show who seems to work, Mrs Rabbit,
Except for Daddy Pig, Mummy Pig, various workers at Daddy Pig's office, Mr Bull & friends, teachers, police etc etc.
"Friends" doesn't focus on the working lives of the main characters for the obvious reason that it's boring.
Mrs Rabbit doesn't seem exhausted (except as the explicit topic of one episode); it's more a Homer Simpson thing where it's funny that she does so many different jobs.
Accents are definitely racist though. Let Sarah Ann Kennedy know that she is a bad person.
> It heavily promotes the British royal family
It's a British show; why would you expect anything else?
Here's my gripe: animals never eat animals. It's always corn or carrots. Now, in a multi-racial society filled with animals of different needs, how does one get enough protein? I'm sure Mr. Bull has a little rabbit cage in his basement with a forced breeding program, his dark secret. We could explore it over the course of three episodes, as he is slowly outed and blackmailed by his friends. It culminates in an electric chair scene where he screams "Let's DIG UP THE ROOOOOAD!<zap>". Then everyone has meat for dinner.
Let's dive in:
> Daddy pig is portrayed as an idiot
And yet he is loved by his family. He makes mistakes but also has many successes. It's probably his pride which is made fun of; he thinks of himself as amazing and perfect and yet makes mistakes, which are humorous in that context.
> All of the animals are married to animals of the same type
They sure are. I'm not sure why this is racist (but feel free to educate me at length). The target audience is two-year-olds, after all.
Come to think of it, I don't know that they're even married. Adult relationships aren't touched at all. Perhaps they're cohabiting but divorced due to London property prices.
> The only person in the show who seems to work, Mrs Rabbit,
Except for Daddy Pig, Mummy Pig, various workers at Daddy Pig's office, Mr Bull & friends, teachers, police etc etc.
"Friends" doesn't focus on the working lives of the main characters for the obvious reason that it's boring.
Mrs Rabbit doesn't seem exhausted (except as the explicit topic of one episode); it's more a Homer Simpson thing where it's funny that she does so many different jobs.
Accents are definitely racist though. Let Sarah Ann Kennedy know that she is a bad person.
> It heavily promotes the British royal family
It's a British show; why would you expect anything else?
Here's my gripe: animals never eat animals. It's always corn or carrots. Now, in a multi-racial society filled with animals of different needs, how does one get enough protein? I'm sure Mr. Bull has a little rabbit cage in his basement with a forced breeding program, his dark secret. We could explore it over the course of three episodes, as he is slowly outed and blackmailed by his friends. It culminates in an electric chair scene where he screams "Let's DIG UP THE ROOOOOAD!<zap>". Then everyone has meat for dinner.
> Accents are definitely racist though.
I clearly said classist.
> It's a British show; why would you expect anything else?
I was expecting a childrens show, not a reinforcement of a world view that some people (royals) are better than others, just because they are born that way. So elitism. Not a positive message for kids, sorry if you disagree.
Glad you found my post funny though, you should look at some of the other articles online criticizing this show, and remember this is your child's psychology at a very impressionable age being influenced. As a parent, I don't find that funny I take it very seriously.
I clearly said classist.
> It's a British show; why would you expect anything else?
I was expecting a childrens show, not a reinforcement of a world view that some people (royals) are better than others, just because they are born that way. So elitism. Not a positive message for kids, sorry if you disagree.
Glad you found my post funny though, you should look at some of the other articles online criticizing this show, and remember this is your child's psychology at a very impressionable age being influenced. As a parent, I don't find that funny I take it very seriously.
As a parent, I think it's more important to conserve your energy and worry about things that actually matter.
I agree that Peppa Pig is not a perfect show. I'll take it over Teletubbies (thanks again, Brits!) or Barney (thanks, USA!) But really, I'm not that concerned, because TV is not my primary means of educating my child.
Perhaps your child is different, but mine is indifferent to the subtleties of race/class/diversity politics. My child likes it when Daddy Pig falls down. He likes it when George goes fast in the racing car.
He doesn't know who the royals are and has no concept that maybe they're good and maybe they're bad and maybe it's theoretically unfair that people are treated differently by birth, but really isn't that a true statement anyway about life being unfair and pointless? Why should pigs get different treatment from dogs? Why can't cats dig up the road?
I agree that Peppa Pig is not a perfect show. I'll take it over Teletubbies (thanks again, Brits!) or Barney (thanks, USA!) But really, I'm not that concerned, because TV is not my primary means of educating my child.
Perhaps your child is different, but mine is indifferent to the subtleties of race/class/diversity politics. My child likes it when Daddy Pig falls down. He likes it when George goes fast in the racing car.
He doesn't know who the royals are and has no concept that maybe they're good and maybe they're bad and maybe it's theoretically unfair that people are treated differently by birth, but really isn't that a true statement anyway about life being unfair and pointless? Why should pigs get different treatment from dogs? Why can't cats dig up the road?
Doctor Brown Bear is a positive male role model, TFA notwithstanding. As is Granddad Dog, IMO. And there are other workers who are less of the exploited proletariat than Miss Rabbit - Daddy Pig works as some kind of architect/structural engineer, Madam Gazelle runs the playgroup and so on. But yes, its class relations in particular is dodgy.
Not as bad as Thomas the Tank Engine, though. Don't get me started on that.
Not as bad as Thomas the Tank Engine, though. Don't get me started on that.
Thomas the Tank Engine is terrifying. Its the protestant work ethic turned into a totalitarian regime led by the The Fat Controller. You're either a Really Useful Engine or you're going to the scrapheap, so you'd better hope you don't get on the Controller's bad side.
Re: point 1 - George is a polymath who immediately masters anything he turns his hand to
Peppa is a spoilt brat
I don't need to prove anything, simple watching a few episodes is sufficient evidence. Or try reading any of these to see I am not alone in this view: https://duckduckgo.com/?q=peppa+pig+sexist&t=hf&ia=web
If you make an assertion contrary to mainstream belief, you need to prove it, plain and simple.
Posting a search engine result page is not sufficient, I can do the same to "prove" 9/11 was a conspiracy to enable GMO chemtrails.
Posting a search engine result page is not sufficient, I can do the same to "prove" 9/11 was a conspiracy to enable GMO chemtrails.
See my examples below then. Immediately being confronted with "prove it/provide links" responses to a stated opinion, based on personal experience of watching the show in question, is not very helpful either.
You have made fact statements, not stated opinions, in addition to not providing any foundation to base those on which would be required by others regardless.
If I say "Show X is bad" then people will expect of me to back up this opinion somehow. This can be as easy as citing examples of why but not by handwaving as "I watched it and thought it was bad".
Example; I think Steven Universe is a bad show. I've watched it through to Season 2 yet I found it lacking in character attachment and depth, meanwhile the animation and storytelling was quite good. Overall I did enjoy it but not enough to keep consuming it.
That is how you should have approached this so people would not jump on you. You can explain it but lacking any explanation people will demand it.
If I say "Show X is bad" then people will expect of me to back up this opinion somehow. This can be as easy as citing examples of why but not by handwaving as "I watched it and thought it was bad".
Example; I think Steven Universe is a bad show. I've watched it through to Season 2 yet I found it lacking in character attachment and depth, meanwhile the animation and storytelling was quite good. Overall I did enjoy it but not enough to keep consuming it.
That is how you should have approached this so people would not jump on you. You can explain it but lacking any explanation people will demand it.
> You have made fact statements, not stated opinions, in addition to not providing any foundation to base those on which would be required by others regardless.
Read my response below to another poster.
Read my response below to another poster.
I've read it previously to writing my last reply but it doesn't change your previous behavior in any way.
You're aware you're getting up in arms about citing sources over a show for two year olds, right?
And? I do not treat this any differently because "It's just a kids show man!" especially considering the contents of the discussion.
Fine, consider myself suitable policed for my bad behavior of "having an opinion about a kids TV show". Good job.
I did this like 2 years ago and I cant remember why. My son started to repeat something from the show I didn’t agree with and it was hard to explain so I banned. Also I think it doesn’t have any positive message like other cartoons.
Peppa and another show that I can’t remember the name but it is about “worms”. This other show is in Netflix Kids but it is very bad for childrens, has some very weird messages.
Peppa and another show that I can’t remember the name but it is about “worms”. This other show is in Netflix Kids but it is very bad for childrens, has some very weird messages.
really? They never have an argument an are always positive and cheerful, even when the kids are crying it stops in about a second; man I wish my family was more like the one in this show...
I am not banning it because it shows a lot of social interactions to the kids.
I am not banning it because it shows a lot of social interactions to the kids.
You mean "Calls the vet" not GP
For an intelligent person the good doctor seems to have missed the fact that this is a show aimed at very young children and does not necessarily reflect how adults in the families of Peppa Pig watchers would react.
More research into the course of inappropriate use of primary care resources beyond Peppa Pig is indicated, perhaps combined with a dose of common sense, which unlike over-use of antibiotics does not have any known side-effects.
More research into the course of inappropriate use of primary care resources beyond Peppa Pig is indicated, perhaps combined with a dose of common sense, which unlike over-use of antibiotics does not have any known side-effects.
For an intelligent person, you might have missed that this was written slightly tongue-in-cheek :)
Sorry, but no. It references a published paper and is in no way written in a way that would alert me to the fact that it was satire. As witnessed by the rest of the comments in this thread if it was intended that way it mostly missed the mark.
It /is/ a published paper - in the BMJ (a medics' trade paper-cum-journal), which has a tradition of off-the-wall articles in its Christmas edition. Its regular readers know this, so it's only those of us in the Internet peanut gallery who are likely to be misled.
"Dr Brown Bear was approached for his perspective on the cases discussed; however, he is unable to comment pending the outcome of a fitness to practise investigation."
I think that does rather suggest that the article is not entirely serious...
I think that does rather suggest that the article is not entirely serious...
The BBC seems to have picked this article up (http://www.bbc.co.uk/news/health-42322216). It looks like they also missed that it was satire.
Maybe it's a language/culture barrier, but it reads VERY satirical to me, especially once you get to the "Discussion" section. Especially the discussion of Case 3 is hilarious.
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She got sick so we phoned a clinic. Immediately, we were asked to come down. The doctor talked with us about theories for what was wrong for at least 20 minutes explaining why it was x and not y casually.
He ran a blood test and within half an hour came up with a likely cause. He sent us home while he had another test that would take longer but would confirm his suspicions from the first test. After getting back those results, he texted us on Whatsapp with a picture of the results sheet he received. He then had a medication delivered by motor bike to our hotel.
After 1 week, he followed up again on Whatapp asking if my partner was feeling okay now.
The whole thing cost 40 euros including tests and medication.
I would love to pay 400 euros for that service anywhere in the West.
Maybe Peppa Pig is the right idea and health care just needs to up their game by removing red tape.