Statins

I don't think there is any incentive for Doctors to prescribe statins. I broached the subject with my Doctor and he said it was no skin off his nose if I didn't take them. He said I required them but the onus was on me to actually take the tablets.

I'm sure the Big Pharma can easily afford the 'publicity' for its drugs via GPs, and probably does. Why does anyone 'advertise'? Because it's profitable.

My first memory of a GP is of our family one from when I was nine years old. His surgery was a room in the house he lived in with his family, so he could easily be relaxing at home if there were no patients for early morning or evening surgery. At least, one supposes so, in theory, and the practice of it would be easier too, given the proximity of his family sitting-room.

Yes it is very complicated - and yet ... why would he Government want to increase costs by putting people with conditions that could really be helped by, say statins- unless it made financial sense as well as medical sense. GPs are encouraged to discuss the benefits of statins if you have diabetes or heart disease and a raised cholesterol - but they can't force you to accept. Most GPs I know would have much preferred not being given quotas in exchange for financial gain, as they knew it would alter the trust between patient and doctor.
Look at immunisations for children and flu jabs for the elderly or with conditions that would make flu dangerous - it makes sense to encourage GPs to spend more time explaining the benefits. It can take a huge amount of time and patience to explain the benefits of immunisations to parents after the dreadful Wakefield accusations re: Crones and autism. And yet, for all the children to be safe form the return and disastrous effects of diseases like measles, you MUST have a high intake overall, approx 90+% - so time and effort to educate, explain, etc, is well worth while. And costly too - would the Government via NHS spend so much time and money to explain all this, just to benefit big pharmas- or because it saves lives?

GPs were also forced to open surgeries earlier and later to benefit working patients- so they could see a doctor before or after working hours. Makes no sense to offer those aps for retired patients at all - and as you say, no sense for a GP NOT to be eating his meal with her/his family if nobody wants the late/early aps!

I thought I had read somewhere that doctors (or their 'businesses') get paid for prescribing statins too, but I couldn't remember where I'd seen it, so I'm not surprised by what you say, jane. Of course, just because it is recommended doesn't mean we have to take the things.

It's not quite true that GPs pay isn't related to their prescribing patterns Granjura
They have Quality Outcome Frameworks (QOFs), ie targets, to adhere to, not all of them clinical though.
Recently there was a bit of an upset when practices which were failing to get their early morning slots and late evening slots filled, had money deducted from their contract values by the PCTs.
You can imagine the scene - the GPs sitting there twiddling their thumbs while the patients were at home enjoying their evening meals with their families, and getting their pay deducted too
That's why when i ring my practice to get an appointment I am offered the 7.15am slot, and the receptionist sounds less than pleased when I say I'd prefer to attend at a more civilised hour.
I don't know for certain if there's a QOF related to statins, but I think there is, for people considered at risk. This may change though, if the recommendation for all over 50's to have statins is implemented.

I do worry about 'informed decision' via the internet though. There is an awful lot of rubbish on the net. In the UK we are very lucky that GPs and specialists are NOT directly connected to financial gain via prescribing. Why on earth would my GP spend a lot of time talking to me about why statins could prevent heart problems and strokes- when it makes no difference to the way they are paid? I have an excellent GP I can truly trust - and he is on statins too, because he has spend much time studying the issues, and has come to the conclusion it can really help him avoid severe conditions related to his health. Why would he take them if he didn't believe it is beneficial?

Agreed that it makes no sense to me, or to my GP, to put everyone over 50 on statins - but it does make sense for many patients with a history of such in their family, and due to other conditions. My mother never had statins has it was 'before' her time- as her legs failed her, and her sight, memory, etc - it would have been 'easy' to conclude that statins had caused all this - had she been prescribed them?

A friend of our was stick thin, and had a very healthy vegetarian diet. His doctor found that he had high cholesterol and wanted to put him on statins- but he refused, having read so much negative things on the internet. He died of a massive heart attach in his early 60s - and his wife considered suing the GP because he did not insist that he took statins! She didn't in the end- as she realised it was a non-starter.

Anagram that would definitely be too much information

Our ex next door neighbour who was a doctor , used to get through a bottle of whiskey a day . He eventually died of liver failure, quite sad really as he was nice person

Not OK if your doctor's tee-total, though...

I like that Mamie
I recently had to see an ENT consultant and during the usual interrogation confessed that I did sometimes go over the recommended alcohol intake.
He said that the recommendations were based on old flawed evidence, and as long as you weren't drinking more than your doctor, you were doing ok

I suspect that one of the reasons that France has a good reputation for health care is because of all the screening. I don't understand putting people on statins at eighty though.
My doctor (retiring shortly boo-hoo) always says that giving up cheese / cream / wine might let you live a bit longer, but it would feel like a very long time.

Thanks Nanad.
I wonder how many of us have been offered these checks at our GP practices.
A friend who used to work in hospital administration once told me (some years ago now, so perhaps things are changing) that the NHS isn't really interested in screening, because of all the illness it would uncover and the costs of treating it!!
The only reason we have breast cancer screening and cervical cancer screening is because of powerful lobbying from women's groups.
Screening for man-diseases like prostate cancer and heart disease has lagged a long way behind.

Interesting article jane and so true.

www.bbc.co.uk/news/health-16137013
Check out this link. Over 40's should be offered health checks. Your mother is being treated disgracefully merlot.

That's awful Merlot.
I had an old aunt who lived out in the country a few miles from Penzance and her GP practice did an annual assessment of her needs (GP coming to the house) in addition, of course, to anything else she needed.
I think there is a rule that repeat prescriptions have to be reviewed every 12 months - it certainly says that on mine. I take thyroxine and have to have a blood test every year to make sure the dose is still right.
Perhaps you could suggest to the GP that 'review' does actually mean a physical examination of his patient in order to carry out a proper assessment.
this article describes the potential dangers of polypharmacy in older people - adverse drug reactions and interactions, poor compliance and confusion.

My poor old mum would probably still be able to walk if she hadn't been prescribed simvastatin. She had a stroke five years ago aged 89 and was put on a cocktail of drugs (her prescription is three pages long). She needed a zimmer frame to get about because the stroke left her weak on one side but she could get out and about with members of the family. Once she developed pains her legs that was it. She now has to be hoisted out of bed and into her chair. Mum has not had a review of her medication in all this time so I rang her GP a couple of months ago to question this. All he said was, 'Everything's fine, there's no need to change anything.' I can't remember the last time he visited her.

the type of statin matters a great deal, gps prescribe the cheapest which is Simvastatin, and that has greatest side affects ie muscle pain.

I wason that for couple months and my legs ached so much I insisted it was changed, got the usual cost to n hs as Atorvastatin am on now is more expensive a lot more, but I replied my husband has worked hard all his life putting money into nhs I do no want to be economised on.

It got changed, then about 2 years ago got letter saying been altered again, once again I wrote back and got it altered, you have to really look out for yourself as sadly most gps think budget which they are forced to do in fairness.

I am not on them because of cholesterol but trigylycerides which is another fat level in blood, and my father died at 60 massive coronory which makes them cautious for you thankfully!!

My dogs too are really happy with the extra walkies! Sounds like you're doing everything possible Merlot . It's hard isn't it?

Thank you for taking the time and trouble Nanadogs even if it did disappear. It's happened to me as well.

Blow it....just written a long post to you merlot and it's vanished! Totally wiped out tonight so will try again tomorrow.

That doctor who refused the cholesterol test should be struck off! Tell him it is you who pays his massive salary and it is his duty to keep you as healthy as possible [regardless of age] none of that 'well what do you expect at your age' stuff. My husband [87] got that and tore him off a strip - doc is much more pliable now!! Good luck, and stick to your human rights.

Nanadogs My GP said he trusted me to make the necessary lifestyle changes to lower my cholesterol. I don't have a sweet tooth so hardly ever eat chocolate, biscuits or cake. We eat loads of fruit and veg as we mostly grow our own, have at least two non meat days per week and eat plenty of oily fish. We don't smoke and drink in moderation. There is also no family history of high cholesterol and although I am overweight I am definitely not obese. Cutting down on carbs, which were my downfall during the cold winter months is just about the only lifestyle change I can make. I don't really fancy eating huge amounts of Benecol because of the calories.
The dogs are having an extra half an hour walkies everyday so at least they're happy

I don't mind my GP 'telling me off'. She is very straightforward, open and never patronises. For example some GPs say 'your blood pressure is fine' she will say 'your blood pressure is 119 over 75' instead. When my cholesterol shot up during my annual test she wanted to know what was causing it and did not just reach fir the prescription pad. I told her what I wanted - 12 weeks to bring it down though life-style change and another test at the end of the 12 weeks. She agreed.

nkf I would not tolerate a doctor like yours. He is obliged to offer you this test and is failing in his duty of care by refusing. I would also question his competency; you cannot tell just by looking at someone whether or not they are healthy on the inside.

Re Benecol etc. yes it's better than nothing and in tests it did lower cholesterol, but you have to take it in large amounts to show any benefit. Having said that it is one of the changes I am making, along with cutting down on all saturated and trans-fats, especially chocolate. Chocolate and some crisps contain more saturated fat per 100g than pork pies. I will alo increase my consumption of foods like porridge and oily fish.

I need to lose about 10lbs anyway so this is the kick up the backside I needed.

Sorry about that sook, your husbands mobility I mean.
I know where you are coming from. Since my OH's cancer operation, and subsequent treatment, what ever medication is prescribed seems to have many many side effects. And , although he is now a picture of health again, there are days when he simply cannot move. It is either a swollen ankle, a swollen knee, etc. etc. Oh, well the price we pay for modern medecine.....
Good thing that you mentioned triglycerides!!!!!!

NfkI take Omega 3 fish oil capsules with my GPs approval. They are said to maintain normal cardiac and brain function and vision. My cholesterol count hasn't dropped but the ratio between good and bad has much improved since I started taking them and my triglyceride count was normal.