Empowered by doctors and readily available resources, most minor illnesses can be managed by patients, parents and carers themselves. Dr Matthew Mayer, GP and member of the BMA General Practitioners Committee, explains how self-care in many instances results in, not inferior care, but the best care.
As doctors, aside from treating people, one of the most influential things we can do is to equip patients to treat themselves. At work I see a lot of minor illnesses and particularly advise a lot of parents on how to manage their children when they have anything from a cold, a sore throat, a fever or earache. I would argue that, when it comes to minor illnesses, self-care is not inferior care, second-class care, or care on the cheap. I would say that in these cases self-care is the best care.
Minor illnesses not only take up an enormous amount of GP time, but take even more of the patient or parent’s time in having to take time off work and out of school, in childcare and travel. If we can safely and effectively manage these illnesses ourselves, then we can save not just the NHS but also ourselves a lot of time and resources.
Most minor illnesses are self-limiting, meaning they go away by themselves and do not require a ‘cure’. They self-limit by making the patient feel awful and limiting what they can do. It’s easy to think that the reason doctors don’t do much for these illnesses is because we don’t need to, because the illness will go away by itself. This isn’t true. It’s also easy to think that there might be a quick fix to these illnesses, such as antibiotics or other medication. This also isn’t true. It’s because the patient or their parent/carer is perfectly capable to managing the illness themselves, and as doctors it is our job to empower them to do that.
I’m a father of four as well as a GP. My children rarely have to attend the doctor. One may assume that this is obviously because they have a doctor at home and I can treat them myself. But this is not the case. My fitness to practice would be called into question if I fished some antibiotics out of my bag and gave them to one of my kids. We’re simply not allowed to do that. If they are ill enough to need the attention of a doctor, then they need to see a doctor other than me. That’s best practice. So, the reason they don’t go to the doctor much isn’t because they have me. It is because, as a doctor, I know that most of the time they can be well looked after with medicines and remedies which are available over the counter or even in a supermarket. I also know that, although they’ll be pretty grumpy for a bit, they will get better.
The best thing about this knowledge is that you don’t need a medical degree to learn it or to use it. We have a saying in medicine – “treat the patient, not the disease.” If one of my kids has a temperature of 39 degrees but is running around playing, then they probably don’t need any paracetamol. I also know that although paracetamol may work to reduce pain in about 20 minutes, it can take two hours to affect temperature. Symptoms such as fever, cough, vomiting, diarrhoea are all bodily reactions to different kinds of infection. These are not necessarily symptoms to be concerned about, nor are they symptoms a doctor will be able to relieve you of. In actual fact, these symptoms are often beneficial to your body in fighting the disease. The mainstay of treatment in most cases is supportive remedies to make you feel better while your body fights the infection.
But part of self-care is also about knowing what red flags look like. Red flags are what we, as doctors, tell patients and parents to watch out for as warning signs. If you spot a red flag, it’s important to seek medical advice. Most of the time, it might be nothing, but these flags serve as a safety net to catch those patients who are getting more unwell. Red flags include things such as a child not wetting nappies, or a temperature that never comes down. They also include fast or laboured breathing, or a child not being able to keep any fluids down, or a rapidly worsening rash.
The NHS has started producing leaflets to teach self-care for different types of minor illness. I think these are a good idea. Such a leaflet may say, for example, that most cases of earache do not require antibiotics, that ibuprofen is an effective painkiller in these cases, and that unless there is discharge or pain in both ears in children under two, then you don’t need to see a GP. Armed with this knowledge, you are well equipped to manage this condition without any equipment, expertise or prescription. Furthermore, you don’t even need to remember this information, you can file the leaflet away for the next time someone has an earache. Next time you have a minor illness, check out resources such as the Self Care Forum website, NHS website, Patient UK or your local pharmacist. If you think there are some red flags, or something doesn’t feel right, call 111 for advice. Remember that with these sorts of minor illnesses, the vast majority of the time you are more than capable of treating it yourself.
Dr Matthew Mayer is a GP and member of the BMA General Practitioners Committee and policy lead for GP workload. Follow the committee on Twitter @BMA_GP