In article <[log in to unmask]>, Ian
McNicoll <[log in to unmask]> writes
>There was a paper in the college journal a few years ago which showed that older
>docs paid less attention to raised BPs. The usual suspects were rounded up -
>more education, training, personal development required bla bla. I think these
>results simply reflected the experience of older GPs and their ability to temper
>guidelines with a 'holistic' approach e.g. Wee Jeanie is already a nervous wreck
>and thinks she is dying. If I start treating her BP of 165/95 we are both going
>to have a bloody awful time in the next few years. - Aw stuff it!!
Couldn't agree more. EBM is useful but only as a starting point for
decision making. It needs modifying by patient utilities, amongst other
criteria, to provide the appropriate management. Medical righteousness
is no substitute for personal well-being.
Regards
George
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