Can a GP act on gut feeling?
I TOOK my child to the doctor. She just asked me a few questions, examined him and said he was fine. She didn't even do any tests, says the mother.
So do GPs need to carry out a battery of tests before deciding whether a child is ill or can they act on gut feeling?
On average, children under the age of three visit their GP three to four times a year, usually for harmless infections which get better without any treatment.
And, with better childcare, hygiene and immunisations serious illness is becoming far less common.
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But with serious illness so rare, there is always a danger it will be missed.
There is a list of symptoms and signs which doctors are told to watch for but, as GPs often see children in the very early stages, these signs may not be present.
Half of all cases of the serious meningococcal meningitis are missed in general practice, usually because there are no obvious signs; no doctor would have picked it up.
There's been a recent study which I found very reassuring.
Researchers from Oxford and Belgium looked at the records of almost 4,000 children who had seen a GP.
Twenty one of these children were admitted to hospital with a serious illness.
Twelve of these kids were admitted immediately and another nine the second time they were seen.
Of the nine children not admitted immediately, the doctor had a 'gut feeling' in four cases but, after careful examination, could not find anything wrong.
So gut feelings matter.
And, equally important, if the doctor's gut feeling is that the child is well, the child is almost certainly well.
I have seen some desperately anxious parents who have read the books or looked online.
"His temperature was 39.5 and we are really worried."
The child, meanwhile, is running around the room or playing peep-bo with me behind his mother.
I even have an In The Night Garden app on my phone. I can leave my phone on the desk, let Iggle Piggle or Upsy Daisy dance or clean the faces of the Tombliboos and a well toddler will smile and dance.
I will, of course, examine the child but the challenge is not making a diagnosis but helping the parents to understand that their child is well.
So what is meant by 'gut feeling' and can we teach it to new doctors?
One study described it as 'an intuitive feeling that something is wrong, even if the clinical assessment may be reassuring.'
That's still a bit vague to me. It is not the same as a clinical impression which is based on sound scientific observations.
For the last 100 years the medical profession has tried to become more scientific.
It is no longer possible for a doctor to say a treatment is effective because he is a senior doctor who 'knows about these things'.
Today, even Sir Lancelot Spratt in the Doctor in the House books would be questioned.
And if I refer a patient to my hospital colleagues suggesting that all the tests are normal but 'I've got a gut feeling the patient is not well', the letter will be met with derision.
"Typical GP; no idea about modern scientific medicine."
But now it seems that I can use my intuition.
To claim to have a 'gut feeling' about a patient has a scientific basis even though I've no idea why I have a gut feeling.
Of course, will still need science.
We still need to take a good history and examine the patient.
We may still need to carry out tests.
But if everything is normal we can listen to our gut feeling. Is it always right?
I don't know but I've got a gut feeling that Torquay United will improve and at least make the play offs.
Sadly, that 'gut feeling' is not based on science but blind optimism.