No I mean You!
This post is for anyone who lives (with MS) in or works (neuros & nurses) in England.
Also for any Americans, as I know you like your constitution stories:-)
If you live in England you must read this Constitution, because it may be the Legal system that changes prescribing habits. Getting rid of smoking in public met resistance, however once Employment Law was muted to sue employers after their workers got Lung cancer, etc. from second hand smoke, it was gone from public places.
There are many people who are risk averse and will do nothing rather than take effective treatment. There are others that will take the chance that treatment will be better for them in the future.
I must admit I don’t buy the former attitude..
Likewise there are neuros, who belong to the “wait and see” brigade, who are happy to do nothing.
Frankly this “There, there…we’ll get you a nice wheelchair” attitude is something that should have been drummed out of medicine long ago. There is now a large range of treatment options for people with relapsing MS and these options need to be explored, yet some of the armory is discarded.
I know that these do nothing/very little neuros exist in the UK and elsewhere as I have heard their opinions with my own ears, but this is not a name and shame exercise
However, I must say that I think that our neuros (ProfG, NDG, DrK), sometimes have to pick up the pieces of some of these “laggards”, as people get refereed to BartsMS for treatment not offered/given to them by others, when it is rather/too late to obtain optimal benefit.
Remember. It is not the neuro that suffers the consequence of their action..it is you!
Therefore, you must be informed.
I write this post because last Night I went to a meeting, a hypothetical medico-legal case was discussed (MS in the Dock/Courtroom) with a Barrister (Specializing in Medical Negligence).
They went through a scenario (a lawyer becoming unemployed associated with cognitive decline). The Barrister demonstrated how the actions of the doctor could easily loose the country millions by simply not following the rules.
Remember ignorance of the rules(Law) is not a defense.
Simply put. You don’t know….you loose the case.
It was clear that if you live/work in England that you must read the NHS Constitution. It may help you avoid the issue of the post Code lottery.
Likewise if you are a neuro, you should read it too, to avoid potential negligance claims.
Remember in this constitution “You have the right to drugs and treatments that have been recommended by NICE for use in the NHS” If your neuro fails to discuss these options they may be being negligent in the eyes of the court.
Some treatments are currently only given at specialist centres, but if you live in the sticks/boonies and medical backwaters that lack the facilities of big city/teaching hospitals, this is not a legal reason why the treatment should not be offered/available.
Remember it is your right to get access to treatment if the NICE approves the use for criteria that you meet. Remenber for some this just means disease is active, eg. an MRI lesion.
This view could make the country become more equitable and may help places develop their MS services.
Guide to decision making
Maybe the Association of British Neurologists should repeat last nights exercise at their meeting and so they know if they are a laggard or not, as the Long arm of the Law may be coming their way in the future.
CoI None considered relevant , but have received honoraria from Sanofi-Genzyme, Merck.