Bruce Arroll is a Professor of General Practice at the University of Auckland and a GP at the Greenstone Family Clinic in Manurewa Auckland
My first clinical impression of primary care was of lots of symptom clusters that did not appear in Harrisons Textbook of Medicine. These symptoms would fluctuate and I would investigate some and often find no satisfactory answers from my investigations and referrals. I gradually learned to use time as my diagnostic test and some of these symptoms would disappear while others would stay. Many of them did not follow any anatomical or physiological pattern. I now prefer the term illness without disease1 as Medically Unexplained Symptoms (MUS) sounds like if you did just one more (or the right) scan/xray/referal/consultation you'd find the answer. There was a qualitative study on what patients liked when they had MUS. Their preference was for some sort of explanation ...continue reading →
What sort of research would we be doing if medical research were crowdfunded? Sarah Knowles from Manchster believes that too much research money is wasted on studies that don’t deliver. Some don’t even manage to recruit the desired number of participants. Many funded research studies aren’t studying a question that is of importance to patient stakeholders. Sarah, a researcher in primary care mental health (“We compete with disability research for who gets the least funding!”) strongly advocates for crowdfunding of research. Think Kickstarter. She says it’s the way to ensure public engagement and patient voice in medical research; she points out that whenever she mentions it to other researchers they usually balk. She thinks this probably has to do with fear that we don’t possess adequate ability to communicate why our research is important and to make a compelling case for funding.
Sarah was the last of a panel of speakers at a session on day 2 of #sapcasm entitled “Dangerous Ideas”. The session was modeled on the reality show Dragons’ Den. Speakers pitched their ideas at the audience for five minutes and then the audience had five minutes to throw questions and comments at the speakers (to which they could respond).