Posted by: Witch Doctor | November 25, 2010

Choice? Is “patient choice” a con also?



Somewhere out there is a marketing guru with a tongue in cheek approach:

It has been pointed out to me that ” Evian ” backwards is ” Naive.”


Most members of The Humankind are fascinating, My Black Cat.

Just fascinating……

“In a sense we’re buying choice, we’re buying freedom.”

This is the ultimate example of how easily The Humankind can creep.

In many ways, My Black Cat, this is symbolic of the reason why we are continuing to bang our heads against a brick wall to blog!

“Creep” is not synonymous with “choice”

“Creep” captures The Humankind. It does not free them.

“I think bottled water is the most revealing substance for showing us how the global capitalist market works today”

Some of us have had a conversation about this before….

“I think bottled water actually represents a kind of caricature of… the global economy.”

This illustrates how The Change Agents of Industry operate A Pure Market, and generate vast riches for themselves, My Black Cat.

And they call these riches the product of “Choice.”

We are very wary of the term “Patient Choice.”

Aren’t we, My Black Cat?

We are wary about “Patient Experience” too.

We think they might be potent, wayward, threatening spells that have escaped from their bottles and are in the wrong hands.


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  1. Only yesterday on my round I was commenting on the bottled water con only to find two bottles of water right by the computer where I was working. Earlier in the day a junior doctor, admittedly on a very hot ward, had said to me that “there’s no water up here”. On another ward I was interrupted while looking up some results when a water delivery man came to pick up enormous empty plastic water bottles which had been stored under the desk.

    As they say in the film, bottled water has been “transformed from novelty to necessity”. If intelligent people can fall for this on such a grand scale what hope is there for other markets and choices which are being foisted upon us?

    We are like puppets on strings and Big Business is controlling us. What is the point of a private sector using our scarce resources to produce things we don’t need and only want because they have duped us into wanting them?

    It is, of course, now completely unstoppable. If you mention to managers that the hospital could save thousands by stopping the bottled water supplies they look at you as if you are bonkers. If you say patients just want good care and not choice they certainly think there is something the matter with you.

    Our thinking is not our own. It has been engineered by people who just want to have our money.

  2. Patient Choice is just an illusion; it is a clever market place ploy – there is no real choice – just an illusion of choice. It is the maniputation of patients and doctors alike. Choose and Book leaves the real choice in the hands of Referral Management Centres, manned by pen pushers who have no medical experience, and who select on tick box symptoms, based on what ever (often isolated) symptom they deem as important. So the real choice is in the hands of the non-medical pen pushers.

    I not know who the most competent, say cardiologist, in my area is – I need my GP to guide me here; I trust his judgement; I believe he knows the best route for me; I want him to choose for me.

    Patient Experience: bah! Humbug! Does management really care? No, for if so, the fiasco of Choose and Book would come to an end. If you are unlucky enough to have a bad patient experience – does management care? Perhaps Yes, but only in the sense that they quietly want to brush it under the carpet; they grind you down by countless delays in the hope that you will just give up, and when the meeting finally happens – they stare at you with blank expressions and may reluctantly admit that something did go wrong, and then scapegoat by blaming the GP.

    I choose not to buy bottled water – I just turn on the tap. I do not want to choose where I go or who I see, if presented with a medical problem; I want my GP to choose for me, for I trust his judgement.

    It is all a massive con Witchdoctor – we are led to believe that we have been offered more – when it is probable we are offered less.


  3. Dr Grumble,

    It was interesting in the film how “One,” the bottled water that is not encumbered with shareholders, seems to donate all profits to Africa. If this really is as altruistic as it seems, perhaps as doctors we should offer all patients who require no treatment at all, a choice of no treatment, homeopathic medicines, Reiki, aromatherapy, loads of goodies from The Spell Pantry, etc etc, and charge them a lot of money for it. In order to keep it above board, we could explain to them that there is no scientific evidence any of these treatments will do them any good, but it may encourage them, through the placebo effect, to heal themselves. The patients or rather clients would, of course, be advised that all profits will go to providing healthcare in third world countries. Surely this knowledge would give them a warm, healing glow.

    They would be donating to charity.

    Is that moral, do you suppose, if it cuts the legs off the health-care predators ready to pounce in the UK?

    Would that be patient choice?

    It seems the market for this is already there.

    Somehow, it doesn’t feel right though.

  4. Hypercryptical,

    I think the idea of Referral Management Centres is one of the most appalling developments within the NHS. There should never be an obstruction, either by a committee or any other kind of “Triage,” between an individual GP communicating with an individual consultant about a patient or vice versa.

    What worries me even more than the existence of these centres, is the fact that some GPs and consultants must have been complicit members of the committees that made decisions regarding referrals. No doubt these centres were regarded as some kind of clever “waiting list initiative” and many Brownie points would have been scored somewhere along the line.

    My feeling is that these referral obstructions are dangerous and it should be immediately reversed. Patients should be advised of the dangers.

  5. One water doesn’t really make bottled water acceptable. It just makes it seem acceptable. People are still buying something they do not need and only want because their minds have been engineered to want it. All the people employed by One are essentially wasting their time and oil is being wasted on the bottles and moving the water about. It would be better to drink from the tap and send all the money we would have spent on water to charity. Or, if people think the NHS needs more money (and it soon will), they could pay more tax. Because bottled water is mostly essentially private it is seen by the government as a success and not what it really is: a massive waste of resources.

    As for the useless things people want in fringe medicine, it’s difficult to sell a placebo while explaining it is useless. Nevertheless I can see that since our hospitals, the ones in England anyway, are soon going to be thrown to the wolves I do see that there might be a case for offering harmless placebos for a fee and using the income to subsidise treatments that work for those that need them.

    Our hospital already makes money from the sale of, yes, bottled water. They sell it in the shopping centre that is gradually taking over more and more of the ground floor. This prime site is, of course, where you should put the most used patient services and the limb fitting centre. But for those you have to use the stairs or wait for a lift. It’s all, of course, about money.

  6. Our local supermarket is huge. Where have they situated the pharmacy at a time when the population is ageing? In the corner furthest away from the entrance.

    “One water” doesn’t really make bottled water acceptable. It just makes it seem acceptable. People are still buying something they do not need and only want because their minds have been engineered to want it.”

    You are right of course, Dr G. I suppose the same could be said for many other marketing ploys too. This series is going to cover breakfast cereals and yoghurt next.

    Regarding placebos generating funds, My Black Cat thinks the new “College of Medicine” is worth watching. She also noted the “.eu” in their domain name. This sort of thing gets her really excited!

  7. I have felt beguiled by the food and drug industries for many years and no longer trust much that they profess. I felt many others probably felt as confused by the huge choices of so called ‘healthy’ foods.

    To this end I began researching natural foods and finding out what ‘real’ nutrients and benefits could be found in them with no side affects like the addition of sugar or salt or any other unhealthy additive. Then I collated this information and set up a non profit advertisement free website listing an A-Z list of all natural food and it’s benefits and an A-Z list of ailments with recommended foods that may benefit plus other useful information and add to it as time allows or scientific proven information become available. See:

    The choice on this website is up to the individual as no ‘false claims’ are being made. I believe people are more intelligent than the food and drug industry gives them credit for and all they require is the simple facts without being bombarded with confusing messages. Tapping into peoples fears and suffering to sell products that have little benefit after the process food has undergone to my mind is both underhanded and detrimental to their health.

    I am pleased there is now a ‘food watchdog’ and hope we can trust their findings but, at the end of the day, a wide varied diet of the truly organic and natural foods in moderation and the odd treat should be the way people eat. All they need is to be educated on what exactly those foods are and which ones can help them if they do have a tendency towards a particular ailment.

    Money should not be the driving force behind products we consume because it will always be taken advantage of by the unscrupulous and aggressive marketing executives.

    If we wanted to assist the UK economy at this time, we could do no worse than buy from our own organic farms and producers and smaller shops, but this is made impossible by the bulk buying, processing, fast foods and cheap prices which are all available to the world’s giants.

    The food and drugs industries are such huge controlling corporations now we cannot escape from their massive advertising campaigns but my little website, I hope, helps the common person on the street to perhaps understand a bit more about what they are and should be putting into their bodies!

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