This article is about my experience with Doctors about Blood Pressure measurement and my aversion to take medication unless patently necessary.
At my last birthday I was required to renew my medical certificate to allow me to continue to drive my car. Here in Australia when you reach 75 you have to prove that you are entitled to drive. When visiting my GP for this purpose he gives me an eye test, BP measurement and we have a brief discussion—he handed over the certificate and the visit was over within ten minutes.
As he was on holiday, I saw my wife Margaret's GP instead; not so with this visit. Half an hour later we came to the BP test which showed a somewhat higher number this visit. We had a brief discussion: no I did not prefer medication unless essential, I was in very good health, the figure was about what it had been for many years, but I understood that when getting older the rate usually would gradually increase.
She was having none of that, insisting to put me on a low dose of medication to start and would review me in a week’s time to assess the level of medication required she then completed the certificate which basically reveals that I am fit to drive my car and see a doctor on a regular basis.
A week later, no change in the BP level. She insisted she put me on a full dose.
Another week later the BP was not much different.
I was having difficulty understanding what she was saying with her Asian accent. In time, Margaret explained that the doctor said I had “the white coat syndrome”. I was pleased that she suggested we buy a BP machine. A week later, back with the doctor, my recorded information showed variable but very reasonable results and I suggested going without the medication but reluctantly accepted a reduction only.
As I join Margaret in her appointments with her doctor on other than routine visits, she knew me well enough, but her method of doctoring did not sit well with me. In time I gathered the courage to go back to my old GP, her partner in the next room, and discussed my wish to keep medication to a minimum or (preferably do without).
His approach was “fair enough”. Stay on the half medication, keep regular records, if it goes up too much double the medication, see me in a month’s time, earlier if I wanted to.
At the visit a month later reviewing the recorded data, he found the results excellent, suggesting I stay on the low half dose medication and if the downward trend continued I could go of the medication altogether. After a brief further discussion I was out of his office within 10 minutes.
I had investigated hypertension on the Internet and gained the impression that the current trend was if testing anyone above 120/80 put the patient on medication and better still reduce this rate, the lower the better.
More research by me on the Internet revealed comments by several Specialists:
• Don't automatically medicate and avoid to prescribe if possible.
• Treat each case on it's own.
• They view nothing wrong with 130/90 (I'm below that).
I am a very independent person preferring to be in personal control of myself and that includes my health and see my Dr (GP in particular) as a consultant. I need to decide. Back to my Doctor experience, I assured Margaret it was not a male versus female problem but that Doctors need to listen carefully to what their patients want.
My GP is a Belgian, long time resident with fluent English.
Margaret's GP is of Asian descent and you can only understand what she says by working hard at it.
I feel Doctors of any nationality are fine but effective communication when consulting is paramount, and this is where our Health System is letting us down. It can't be too hard to ensure appropriate training in speaking English. (Who is talking? A Dutchman who had to learn communicate in the English language.)