Health: We can't tell how often they do it or whether they're any good at it

Dr Phil Hammond
Monday 15 September 1997 18:02 EDT
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"Hello, the Infirmary."

"Hello, who am I speaking to?"

"Switchboard."

"Could you be a bit more specific?"

"Maureen on switchboard."

"Hello Maureen. My name's Sally."

"And?"

"Well, I've been referred to Mr Brylon for my periods ..."

"Just putting you through."

"Stop. I don't want to be put through. I want your opinion."

"On your periods?"

"On Mr Brylon. I've got my Patient's Charter in front of me and it says that I have a right to be referred to `a consultant acceptable to me'."

"So?"

"I know nothing at all about Mr Brylon. So how can I tell if he's acceptable?"

"Have you asked the GP?"

"He says he's a good chap and he's got the shortest waiting list. But does that mean he's efficient and works very hard? Or is he so bad, no one wants to see him?"

"I did overhear him in the staff canteen saying his golf handicap had gone up from five to 15 in the last two years."

"Yes, but that could mean he's playing less golf because he's putting more hours in as a doctor - or that he's playing the same amount and losing his hand-eye co-ordination."

"Well, he took five goes to master the Mexican salad ..."

"Can't you give me anything more concrete?"

"Not officially. We're allowed to tell the public who the consultants are and roughly what they do - but not how often they do it and whether they're any good at it."

"And unofficially?"

"I couldn't say."

"That's what the BMA said: `All our consultants are highly trained - we cannot recommend individuals.'"

"So why are you asking me?"

"I just thought that if anyone knows what really goes on in a hospital, it's those incredibly helpful switchboard operators. I mean, you must hear everything."

"Well, Doris in theatre doesn't reckon much to Mr Brylon's knots, but I've never heard a patient complain. In fact, Cybil in out-patients says he gets more bottles of whisky at Christmas than the other gynaecologists put together."

"So he's a nice man?"

"Oh yes. And very old-fashioned, too."

"Meaning?"

"Well he doesn't piddle about with keyhole surgery and lasers. He's very much straight down the middle and out with the lot."

"Lovely. Any other surgeons you could recommend?"

"Mr Masani's the talk of the hospital since he appeared in the Good Doctor Guide."

"Great."

"But Sheila from Medical Records reckons he forged his own recommendations."

"Still, he might be worth a shot."

"Not for you, dear, he's a knee man. Can I just ask how much schooling you've had?"

"Why?"

"Leslie from the library, she's got women's problems so she had a nose through the journals. And guess what?"

"What?"

According to some professor in Cambridge, you're 15 times more likely to have a hysterectomy if you've got no secondary education."

"Why?"

"A letter in last week's British Medical Journal says that removing the wombs of low-income women is often more efficient than taking the time to educate them and treat them medically."

"But I'm already being treated medically."

"What with?"

"Norethisterone."

"Ah, well that's your problem. Leslie says that although it's the commonest prescribed drug for heavy periods in the UK, there's no evidence it's any more effective than a placebo."

"So what should I take?"

"Leslie recommends tranexamic acid if you want to hold on to your womb. Either that or go back to school."

"Or I suppose I could marry someone rich?"

"Just so long as he isn't a doctor. Poor women have much higher rates of hysterectomy than rich women except for ..."

"The wives of doctors?"

"Yes. And the highest rate amongst them is for ..."

"The wives of gynaecologists?"

"Precisely. Rumour has it Mr Brylon gave his wife one for her 40th birthday."

"Thank you Maureen, you've been most helpful."

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