Re: Direct access to cancer diagnostics: the promise and perils of bypassing GPs

Dear Editor,

A huge proportion of symptoms GPs see have no explanation. There is a large and likely increasing prevalence of health anxiety. Fear of “cancer” is often the end point of much of the anxiety of being alive. Fear of “missing cancer” is the end point of many GPs’ anxiety about being a doctor. Cancer is often not inevitably fatal and in older people is more akin to a chronic disease, “you’ll likely die of something else”. All symptoms, signs and diagnoses need context. Secondary care services are very convergent in their dealings with health, “my bit is fine, discharged”. Doing investigations, especially “a scan” relieves the anxieties of patient and GP. Some investigations, especially an MRI are acquiring almost a mystical oracle like aura.

The above creates quite a toxic mix if patients can get easier access to investigations. GPs are much more likely to go down an investigation route if it’s easier to go down that route. Investigations can allow the physician to pass the buck to those investigations. “The computer says no!”