On a relaxing chilly Autumn day, after the dogs are walked and work is complete, a spot of TV watching can be great.
My remote finger scrolls its way through the channels and lands on a light TV drama detective show. There are some classic old programs, some have a bit of historical content and humour thrown in. They are relaxing.
The old ones show how crimes were solved before there was DNA testing and fancy tech. There is a huge footprint in the mud just below the window, or a dropped compact case. Detectives find a pair of boots that fit perfectly, discover that someone only wears that shade of face powder. The perpetrator is found, the crime is solved, program ends.
But in real life, in real law and real courts people get convicted for crimes they didn’t commit. May be the weight of evidence on balance seems to support that they ‘did it’. Many times, this brings into question the skill of the lawyer to construct a strong ‘case’, a strong argument. These cases often go to appeal, a new team is appointed, better arguments, better evidence, more critical clean thinking. Back to court, the story line may be a not guilty verdict.
Producing well thought through evidence to support a strong argument is a necessity. But sometimes the process is a bit like this ‘witch’ sketch from Monty Python.
We use the word ‘evidence’ all the time in healthcare. As professionals, we are tasked to use an evidence supported approach, evidence for the care we provide. But some people in medical teams are a bit sloppy in this regard.
Their approach to choosing evidence may be as basic as the old detective simply finding a boot to fit a footprint in the mud. Just because a boot fits the footprint isn’t enough. There are quantum numbers of factors that need to be taken account when we provide evidence to support an argument
Put simply, it’s not fair on people wanting an opinion if a clinician offers boot or shoe evidence that roughly fits.
As the man servant Jud in Winston Graham’s Poldark says:
“T’int right, t’int fair, t’int proper.
If you are a patient with pain, who wants help and support to get better, there are some steps you can take to discover what sort of evidence there is for the likely NHS care you are offered. There are care pathways laid out in the NICE guidelines. These are available for everyone to read. You can dig more deeply to explore the reasoning, argument for their suggested guidelines of what is supported or not supported. It will be in the documents.
Highlighting that we are in such a state of interesting times in regard to discussions over evidence for treatments may be enough to have many people thinking. A lot of patients may not give this any thought at all, but just imagine evidence for treatment is done by some huge centralized agency, but it isn’t.
In writing this, I’m mindful, that if you are in pain then exploring even small chunks of easy to digest information is taxing. If you are depressed and in pain, then even to consider exploring may be too much. To be anxious, in pain and fearful of doing the wrong thing, then to have the suggestion, “go and do some exploring” could be overload. Having a body belching out toxic pain feelings, seemingly out of control and battling Cancer, MS, Parkinson’s, ongoing nasty, nasty pain isn’t a time to explore. Just coming to terms with the concept that persisting ongoing pain could be a part of life in the future might be something you are not ready to accept.
However, raising these points can be helpful for those having less than great success with their current providers. Perhaps those who found the shoe they were offered didn’t fit their footprint of pain. Maybe they have had a percentage of care offered on the NHS guidelines, then have been judged to have completed their prescribed course of care and sentenced to life as is.
Sometimes people are thrown a ‘lifeline’ by a complementary or alternative provider who offers good results based on ‘evidence’. Perhaps some people with pain consider turning their back on the whole arena of ‘standard issue’ healthcare, following some little light of hope. It’s natural to wonder where to turn next, best thing to try next, wanting to find out.
My tips for people who find themselves wanting to know more:
- Read around the topic, have some deep conversations with your primary care health team. If you want to go try something new, still stay under the care of a medical Consultant, the best specialists are usually happy for people to get additional help.
- Ask for the science to support words that practitioners use. If practitioners can only show you an article in a magazine or publication, ask about the study that the publication used. If they can’t explain, or they can’t show you, or they get defensive, simply ask them how they know it works. Is it just because they tried it out and it worked on a couple of other people, or did someone tell them or did they read it in a book like a story?
- You are not expected to BE the expert, but you do need to know how to know how to become an expert in asking for science & evidence
- Always have hope But balance that by knowing that some practitioners may offer you old boots they inherited as evidence rather than using a tech approach to solve the ‘crime’
If this raises any questions then send them in on the contact form, if I cant help I’ll look to find someone who can.