Sore Throat

Sore Throat

I have become complacent in thinking that only elected politicians and their lickspittles undermine GP services.  This week I was reminded that doctors are sometimes their own worst enemies. A big ‘thank you’ to Flemish researchers and their study of the treatment of sore throats, published in the British Medical Journal. I fear it will be in the health pages of the Daily Wail before you read this. The authors – in their own words – offered the ‘weak recommendation’ of prescribing a single dose of steroid to patients with a sore throat. This made the pain go away a whole 11 hours sooner, but didn’t reduce time off school or work. They wrongly concluded this is ‘likely to be offered in the context of a consultation that would have taken place anyway’. The researchers totally ignore what is called ‘opportunity cost’ – the important jobs we can’t do when we are tied up doing trivial tasks. UK primary care is already in crisis. Look at the waiting time for a routine appointment. We have a finite number of doctors and nurses. We (only) have ten and a half hours in the working day. There is only so much we can safely do. If we are talking to patients with a sore throat, we can’t spend an extra few minutes with someone suffering a mental health crisis, or visit a terminally ill patient. So if you are a normally fit patient with a short-lived sore throat (they typically last 5-7 days) please don’t expect a prescription for steroids. Take painkillers from the pharmacy or supermarket. Seek advice from the nhs.uk website or a pharmacist if unsure. Speak to us if your sore throat may have a bearing on another illness, or if the course of the sore throat doesn’t pan out as expected. Excessive doses of steroids cause side effects including shrinkage of your gonads. If you think you need a doctor or nurse’s prescription for a simple sore throat, this is precisely the opposite effect to what you need.