The reason A&E is being overused is because it became nigh on impossible to get to see a real doctor at a gp practice, and whoever you do see, doctor or otherwise, is mostly concerned with making you go away. People who suspect that two paracetamol might not be sufficient to deal with their particular problem will go to A&E in the vain hope that someone will take them seriously there. And so it becomes the A&E’s job to prove to them otherwise.
I have a Minor Injuries unit near me. This is A&E for non-serious cases - a self contradiction, perhaps. I had a non-healing minor injury and my GP advised me to go there. When I went, I queried the waiting times and was told it was long because all the local GPs had stopped seeing children with cold symptoms, so they all went to Minor Injuries instead.
I'm so happy that the algorithm decided that I needed to watch this stuff. The way his mind works is amazing! I can't understand how I've never heard of him before!
Casualty usually refers to accident insurance. In the US, it would include pretty much all non-life insurance, although they often throw property in there, so Property & Casualty.
we need to re open walk in centres. can’t get an appointment? somethings happened out of gp hours? not an emergency enough for the hospital? go to a walk in centre.
@@walshamite He may not be, how do we know that he didn't have all that time to himself and was asking for extra minutes so that the audience thought they were getting some extra value? Mindgames ;-)
Choosing from available time slots at your GP used to be a thing. They scrapped it. Now it's a phone scrummage each morning until you manage to get through.
If you could get a doctors appointment people wouldn’t overuse A&E We used to have a totally seperate walk in centre by me where you could wait if you wanted a GP but now they’ve even closed that down & merged it with the A&E department at the hospital down the road Has nothing to do with the name
To be fair, this is a marketing guy. The story might not be 100% correct but the meaning behind it is. Names and positioning significantly change user interactions.
well if you read the comment properly you’ll see that I said they merged the walk in centre with the A&E department in my local hospital & it’s called urgent care centre So if I couldn’t get an appointment & i felt the need to be seen then yeah I would because that’s what it’s for! Especially when my son has been ill & can’t be seen by a doctor!!
I've written to my MP, I personally can't understand why you have to be assigned a Gp practice. Instead you could call up on the day and they would assign you any Gp that is free in the area.
When I was 20 years old I could go to the local doctor with no appointment, sit in the waiting room and see my doctor in 15 to 45 minutes. Now I'm 72 and I just don't bother any more because I can't get an appointment. I paid for it but I can't use it, I've learned to heal myself.
I enjoy Rory's diatribes, but when I was presenting a paper at The King's Fund, the guy ahead of me overran his time likewise, so I ... having travelled 200 miles to present my work ... was left 5 minutes. I didn't present it, I just went the 200 miles home. Overrunning is a chronic thing, the same people always do it, and it's a kind of selfishness. Their egos tell them their insights cap everyone else's.
It's so instilled into me that, despite this being an event from 2015 that has already happened and I have no control over, every time time was mentioned I got stressed out watching it. I think though it's on the event organisers to ensure time is kept.
Very true. I also love Rory but there's absolutely no need for overrunning. Ironic that he jokes about GP appointments oblivious to his own poor time management.
I've written to my MP, I personally can't understand why you have to be assigned a Gp practice. Instead you could call up on the day and they would assign you any Gp that is free in the area.
Hospital share of NHS increases as it transfers work to GPs, whose resources and staff are cut. In 2 decades NHS activity has increased 250% and NHS cost inflation is higher than RPI. Everyone is working at or beyond capcity, funds do not follow work, excess work is pushed to other services with just as little capacity but not adapted to do it. Patients and staff suffer.
Rory is my favourite presenter by far. Thrilled to bits to discover I have read all the books in the list - except one. Going to order it right away. [And what a list it is! Favourites: 'Why Everyone (Else) is a Hypocrite' / 'The Righteous Mind' / 'Irrationality' / 'The Rational Animal'. Excellent.
A&E is overburdened because it is the one place in a hospital which always works - if you are prepared to wait. So it picks up the slack of every broken health system, it becomes the default solution for everything.
We as a country need a third treatnent option - true A & E is oversused but the second option is to wait weeks and take time off work for a doctor's appointment. Where is the in between level of need catered for - low level injury or need of help?
Not sure how common it is (I’m in the southeast) but i’ve had this exact issue and I’ve found Minor Injuries Units are great for this. My experience is that they tend to be located quite centrally too so not bad for public transport.
Too often we are told that rather than our GP, or A&E, ask your pharmacist. Which really highlights the inadequacy of low level help being available when needed. Some pharmacies close on Saturday afternoon and Sunday, and public holidays. And often have a full lunch hour. And they do not have access to records which can be important.
I called my GP surgery 20 September. I said I had pain in my foot and bony protrusion on the outside I was told I could go on a waiting list, they were making appointments four weeks in the future. I would be informed when an appointment became available. So far 3 weeks on - no message about an appointment. Mmmmmm foot stil painful. Update. Foot got better without intervention. No idea what was wrong or if it is serious or will reoccur. Appoint eventually set as a telephone call on 26th October. I just shouldn’t have bothered. Apparently doctors are now so skilled they can examine a foot over the telephone.
The reason you don't get a pay rise as leisure is that your time is worth far more than you are paid. As a result, a 10% pay rise is cheaper than 3% time off.
In New Zealand A&E is free, a GP appointment can cost up to $180, has a long waiting time and most GPs will just give you a prescription and tell you to go away...
As someone who tried the solution of using one converter with a multiple outlet port, this didn't go over well. The circuit breaker shorted and fliped off electricity to the whole house. Granted, this was an American adater and an old Dutch house.
Top tip on signs on motorways.. if you notice they will give you a choice, in his case the choice was London both sides. He knows that London is a long way but his turning will be within a pretty short distance. Keep to the left as London isn’t the turn off but his junction is pretty much assured. You get this on almost all junctions where the motorway diverges.
I was trying to work out what was wrong with the sign. Absolutely nothing, clearly indicating M25 use left lane. Blaming bad road craft on bad signage.
Or pay attention earlier. Half a mile before the sign he moans about there is a clear sign showing that the road is splitting in two and the white line markings change to make that obvious. He clearly shouldn't have a licence if he genuinely thinks the signage is confusing.
The problem with the extension lead is that you need all your electronics to have the same plug. Anyone who travels a lot will have electronics with different plugs
Now, you don't even get a piece of paper for a prescription. It's automatically sent to the chemist and it waiting for you when you arrive - or probably not, because the chemist is overwhelmed by the number of prescriptions waiting to be processed. So, even the option of a delayed prescription is no longer available.
Luxury - we would've dreamed of 4 days. We have to wait 2 weeks. And our appointment is scheduled for 2 o'clock in the morning, half an hour before we go to bed after working 25 hours t'ut mill...
I've never had any problems getting an appointment. A phone appointment..... usually with a nurse practitioner. At the end of the day I get my prescription and I feel better. All good
@JimmyZmenos-df6op top tip - all GPs are independent practices contracted to the NHS (GP federation are just bigger capatilist groups contracted to the NHS). That is why surgeries have partners, much like law firms.
They changed the name to "Emergency Department" where I live. I've been sent there twice over the last 4 years by doctors. And spent many times there as a kid. What I've noticed is, waiting times are the worst they've ever been. Now, the only thing I've noticed is that the population in my area has increased... An unmanageable amount. But it can't be that. Because the Guardian tell me it's not. Must be climate change or sumfink.
10:15 in Savannah, I presuppose that we were unable to much change the environment- the lion/snake/food/… was a given, not something to be changed anytime soon by a meekly human with/without fire
Emergency department could be better because it shows what it does but in the US Hospital emergency departments are known as the emergency room does not appear to lower the amount of overuse
In the US it makes sense...bcoz ppl don't have health insurance, they ACTUALLY don't have any choice. In the UK it just gets abused for non emergencies. We're an entitled bunch.
Yes, the road sign one is really obvious (assuming you've actually passed a driving test!). The sign for the M25 is only over the left lane, so it's clear that you need to be in the left lane for it.
It used to be called "casualty" like the TV drama. Who wants to be a casualty? I believe, as others have said, that not having to rely on A&E should be a first step in reducing demand on it.
Excellent lecture! I don't know if Rory has ever met an economist, because they would be more aligned with his mindset than he expects! Assuming a rational mindset is just the starting point to create a baseline model, then economists spend lots of time trying to identify and measure instances of rationality which deviate from that model.
In the US, we have something called Urgent Care. It's for things that are not important enough to be an actual emergency, but urgent enough you need it dealt with. Like say, you sliced your hand open on a piece of sheet metal. Does the UK not have this middle ground?
Some hospitals do have "Urgent Care Centres" In London we have Barts and Finchley Memorial, maybe more, London is a bit on the big side. Yes, they do exist and work very well. We also have 111, a phone service that I have used to good avail.
I have been in A&E twice in the past 3 year, and both times I felt like a stranger in my own country. Perhaps if this were addressed, it might take some pressure off the NHS
Placebo choice is great for parenting: if you say "tidy your room" it won't get done; say "I need you to tidy your room or.." with a worse option, they will tidy the room.
Once you are inside the building it is too late, nobody is going to take the walk of shame back to the car without at least some painkillers. Some people know what A&E means. Young people and foreigners don't know what it means because all the signs abbreviate it to A&E. They just think A&E means the serious part of the hospital.
The a&e example is based on a false premise. It's not hard to get less oeople to come to a&e. Its hard to stop people who dont need to come and not stop those who do. Also getting antibiotics after a doctor prescribes you antibiotics isnt an "implicit bias in the choice architecture" that nobody realised. You've just been explicitly told to take antibiotics.
Entertaining but also... I don't want my doctor to give me meds to take in 4 days so as to save a few quid. If I'm bad enough that I've had to see the doctor, I want healing immediately. In an ideal world, I want the problem fixing before I complain, not the week after.
I think the example with antibiotics alludes to the issue of antibiotic resistance rather than a money-saving exercise. The other may be that certain medications are so in-demand that the demand cannot be met, therefore defer prescription in the hope that some opt to try alternative methods (e.g. dulaglutide used for type 2 D but prescribed for weight-loss). Your point still absolutely stands for almost all other circumstances, though.
@@FerventRebutter Doctors should treat the patient in front of them, not delay prescription to avoid a problem that might never occur. As for shortages in medicine, there's no excuse in 2024 to have any shortages in medicine. The trouble with treatment via statistics, is that ignores the individual.
@@TheDandonian Medicine has interest in public health in addition to the patient in the consulting room. The problem that you suggest may never occur is actively occuring; hospital microbiologists make decisions on a case-by-case basis as to whether a broad sprectrum antibiotic with known resistance responses is appropriate to prescribe. It's all well and good saying there is no excuse, but it's true. Demand is not being met and this isn't being aided by primary care practitioners prescribing, I would argue, erroneously. The issue with treating the individual without factoring in public health is that the individual, and the remainder of public health, will suffer. To not account for this is demonstrably myopic.
@@FerventRebutter Demand is not being met because we had a government determined to destroy public services in an effort to reduce the tax bill of the wealthy. I'm yet to be convinced that Starmer will improve things but let's be clear, it is a deliberate choice to let people suffer and doctors didn't get into medicine to let people suffer. As for this ludicrous notion that the public health is at odds with the individuals health... A sick individual is a significant drain on the "public health". You are presenting this as some false choice, which is ironic considering the video.
@TheDandonian No, demand is not being met because manufacturers, that are abroad more often than not, are not able to increase production to meet our needs. That is not to say you haven't raised a valid point on our government's track record, beyond party, to destroy public services. If you take the time to read the thread back, it is you casting public health and individual care at odds with each other and that a practitioners sole responsibility is the patient, not the population. This is patently false, in theory and in practice. The very examples alluded to here are not a sick person draining public health resources, but someone with, for example, upper respiratory tract infections demanding antibiotics that may be needlessly prescribed.
i think you just discovered the origin of ADHD! The Bee's that don’t care about the waggle dance are the 1st basic example of the diagnosis. Just answered a lot of questions for myself. Thank you very very much for this revelation.
I think ADHD is better explained by your intuition sensing you are on wrong paths. And society in the West is making many people go on wrong life paths
There's no intermediate between having a benign rash you don't mind waiting two weeks to have seen and you've broken your leg. There's no system to cover the things in the middle
There is! There's a regular GP appointment, an emergency GP appointment and A&E. Ironically, the problem really is a marketing one, because the first two are rarely separated. But ask any receptionist if you can have an emergency appointment and you'll usually be seen that day.
@@addison_reilly5904 Receptionists (Under instructions from the practise) will advise you that appointment slots are available only by phoning on a certain day, or advising you that all slots are full and phone back another day or if you ask for an emergency appointment they ask you questions about your condition and advise you they have no slots if it's not deemed critical enough or they will do a telephone call back, so it's not straight forward, it's too much of a lottery maybe not in all practises but in to many and the main reason is to many users from abroad flooding the infrastructure for 14 years (600,000 surplus last year alone!)!?!
Also explains why ADHD and ASD occurs in a population of humans. Autism helps me spot the missing options. ADHD makes me the bee that ignores the wiggle.
Ah yes ... indeed if I see people smoking I always ask why they aren't vaping. (One reason is the abundance of cheap smuggled ciggies by the way). And I say one choice is DEFINITELY bad for you and the other might be but might not be. Go for that! Also I point out the value of a KNOWN dose of nicotine vs randomly spiked ciggies (soooo immoral). But people need a pocket stress reliever ... think of something???
Haha did anyone tell the surgery doctors after Covid who only wanted to see private patients using NHS patients slots when you were told to go to A&E for non emergency urgent issues but would argue over the phone that you just go because they wanted to get paid for jobs they were not doing and see the private patients at the same time. No I don’t think all docs are like this but my practice they all did that. So I left to join my mums and they were amazing well I say amazing but professional is the word they were behaving like a doctor that knows all patients need to be seen not just the cash cows
I went to doctors with pain in lower leg, started in back. Doctor gave me prescription for pain killers. Said i give you 2 weeks worth, if pain doesn't go, come back. I took 1 tablet, pain went away. But, he said i give you 2 weeks worth, so do i continue taking? I took another 5 tablets, 1 each day, then had mild heart attack....might not have happened if doctor didn't say 2 weeks worth.
Can anyone explain what this guy is talking about? I understood the words, and the jokes, but have no idea what point he is making. A&E is like a bad motorway junction which is like a wine list which is not like Red Bull???😮
I worked out the extention lead with a forign plug when I was like 7, needed to power my gameboy + minidisc player at the same time while on family holidays
What a blessing to have Rory around us.
Gives good lines to justify sociopathic selfishness
The reason A&E is being overused is because it became nigh on impossible to get to see a real doctor at a gp practice, and whoever you do see, doctor or otherwise, is mostly concerned with making you go away. People who suspect that two paracetamol might not be sufficient to deal with their particular problem will go to A&E in the vain hope that someone will take them seriously there. And so it becomes the A&E’s job to prove to them otherwise.
9 years ago it was a lot easier to get a GP appointment.
This is the correct answer. People would rather wait 12hrs in A&E than over a month for their GP to see them.
I have a Minor Injuries unit near me. This is A&E for non-serious cases - a self contradiction, perhaps. I had a non-healing minor injury and my GP advised me to go there. When I went, I queried the waiting times and was told it was long because all the local GPs had stopped seeing children with cold symptoms, so they all went to Minor Injuries instead.
@@HeathyHeatherson Labour have really done a number on the NHS these past 10 years.
@@gregh378I’m confused why is it Labour’s fault for the last 10 years of the NHS
He reminds me of Stephen fry, with a dash of hitchens and that one favourite school teacher that had a influence on your life
He's much cleverer than Stephen Fry
@@jimbo4375 No need for that sort of comment.
You are right Rory vocabulary reminds me of the late Hitchens , Rory is also funny and Articulate .
And his disregard for a time limit is a bit Zizek
he has similar mannerisms to John Bercow as well to me
I'm so happy that the algorithm decided that I needed to watch this stuff. The way his mind works is amazing! I can't understand how I've never heard of him before!
Ditto
Yep, same. So glad to discover Rory recently. Also Alex O'Connor
@@drapearscosmic skeptic? I haven't watched a lot of him recently, but he's pretty good as well. He's been around for ages haha
@@crazymonkeyVII that's the one, for some reason I've only been shown both of these 2 in the last month. Great content from both of them.
@@drapears I agree!
I'm old enough to remember when A&E was known as Casualty. This, with its overtones of fallen in battle, could be a better way to go.
Casualty usually refers to accident insurance. In the US, it would include pretty much all non-life insurance, although they often throw property in there, so Property & Casualty.
we need to re open walk in centres. can’t get an appointment? somethings happened out of gp hours? not an emergency enough for the hospital? go to a walk in centre.
Would be jam packed with old duffers and the unemployed, you'd have to queue for days.😂
I love him. "just another minute..." X10
😆 that was genius. He was the human equivalent of the Microsoft progress bar.
He is a bullshitter
Fine till you're waiting for your own slot. He steals the time off others with a smile.
@@walshamite He may not be, how do we know that he didn't have all that time to himself and was asking for extra minutes so that the audience thought they were getting some extra value? Mindgames ;-)
@@walshamite He was the last speaker before lunch. I doubt the delegates would complain.
Choosing from available time slots at your GP used to be a thing. They scrapped it. Now it's a phone scrummage each morning until you manage to get through.
If you could get a doctors appointment people wouldn’t overuse A&E
We used to have a totally seperate walk in centre by me where you could wait if you wanted a GP but now they’ve even closed that down & merged it with the A&E department at the hospital down the road
Has nothing to do with the name
To be fair, this is a marketing guy. The story might not be 100% correct but the meaning behind it is. Names and positioning significantly change user interactions.
so you used to go to A&E despite not having had an accident nor it being an emergency?
well if you read the comment properly you’ll see that I said they merged the walk in centre with the A&E department in my local hospital & it’s called urgent care centre
So if I couldn’t get an appointment & i felt the need to be seen then yeah I would because that’s what it’s for!
Especially when my son has been ill & can’t be seen by a doctor!!
I've written to my MP, I personally can't understand why you have to be assigned a Gp practice. Instead you could call up on the day and they would assign you any Gp that is free in the area.
When I was 20 years old I could go to the local doctor with no appointment, sit in the waiting room and see my doctor in 15 to 45 minutes. Now I'm 72 and I just don't bother any more because I can't get an appointment. I paid for it but I can't use it, I've learned to heal myself.
"One of the things I didn't have to talk about" 😂. Rory is the secret ingredient in red bull. He could go forever & I could listen 😂
I enjoy Rory's diatribes, but when I was presenting a paper at The King's Fund, the guy ahead of me overran his time likewise, so I ... having travelled 200 miles to present my work ... was left 5 minutes. I didn't present it, I just went the 200 miles home. Overrunning is a chronic thing, the same people always do it, and it's a kind of selfishness. Their egos tell them their insights cap everyone else's.
My boss has a saying: "Punctuality demonstrates respect for others because we respect their time".
It's so instilled into me that, despite this being an event from 2015 that has already happened and I have no control over, every time time was mentioned I got stressed out watching it. I think though it's on the event organisers to ensure time is kept.
Very true. I also love Rory but there's absolutely no need for overrunning. Ironic that he jokes about GP appointments oblivious to his own poor time management.
The event organiser should be aware that certain speakers tend to overrun and organise the schedule accordingly.
@@dmac2573 Is it not possible that as a marketing genius the over-running thing may have been a ploy to gain attention for the final points?
If you want less people to go to A&E start tell GP receptionists to stop doing telephone diagnosis and just book the appointments.
I could not agree more
I've written to my MP, I personally can't understand why you have to be assigned a Gp practice. Instead you could call up on the day and they would assign you any Gp that is free in the area.
Love the way Rory’s flowery language gradually loosens up the audience, he really is a joy to listen to and so right!
Right about some things but not by any means everything.
Hospital share of NHS increases as it transfers work to GPs, whose resources and staff are cut. In 2 decades NHS activity has increased 250% and NHS cost inflation is higher than RPI. Everyone is working at or beyond capcity, funds do not follow work, excess work is pushed to other services with just as little capacity but not adapted to do it. Patients and staff suffer.
wow this is from 9 years ago, Rory is in my youtube feed all the time at the moment this talk seemed so fresh
Rory is my favourite presenter by far. Thrilled to bits to discover I have read all the books in the list - except one. Going to order it right away. [And what a list it is! Favourites: 'Why Everyone (Else) is a Hypocrite' / 'The Righteous Mind' / 'Irrationality' / 'The Rational Animal'. Excellent.
Amazing speaker, but horrendous time management
A&E is overburdened because it is the one place in a hospital which always works - if you are prepared to wait. So it picks up the slack of every broken health system, it becomes the default solution for everything.
We as a country need a third treatnent option - true A & E is oversused but the second option is to wait weeks and take time off work for a doctor's appointment. Where is the in between level of need catered for - low level injury or need of help?
Urgent care
NHS barely has any secondary care, especially when it comes to mental health. You get primary care (GP) and A&E. Nothing in between
Not sure how common it is (I’m in the southeast) but i’ve had this exact issue and I’ve found Minor Injuries Units are great for this. My experience is that they tend to be located quite centrally too so not bad for public transport.
@@tbone4033 I must say I hadn't heard of them but that sounds positive. Thanks your reply.
Too often we are told that rather than our GP, or A&E, ask your pharmacist.
Which really highlights the inadequacy of low level help being available when needed. Some pharmacies close on Saturday afternoon and Sunday, and public holidays. And often have a full lunch hour. And they do not have access to records which can be important.
Been carrying the four gang extension lead with just one adaptor abroad for nearly 20 years now!
@27:00 randomness is the holy grail of computer science , for slightly different reasons , but sooomuch value in it
This man is changing my life one video at a time. I thought I was deluded believing what I believed. Perhaps I am and that's beneficial?
You must have a weak mind
I called my GP surgery 20 September. I said I had pain in my foot and bony protrusion on the outside I was told I could go on a waiting list, they were making appointments four weeks in the future. I would be informed when an appointment became available. So far 3 weeks on - no message about an appointment. Mmmmmm foot stil painful. Update. Foot got better without intervention. No idea what was wrong or if it is serious or will reoccur. Appoint eventually set as a telephone call on 26th October. I just shouldn’t have bothered.
Apparently doctors are now so skilled they can examine a foot over the telephone.
The reason you don't get a pay rise as leisure is that your time is worth far more than you are paid.
As a result, a 10% pay rise is cheaper than 3% time off.
In New Zealand A&E is free, a GP appointment can cost up to $180, has a long waiting time and most GPs will just give you a prescription and tell you to go away...
Why did you pay so much for a GP. Are you an overseas citizen?
More later hours/24 hr open walk ins would reduce alot of hospital influxes especially of A weekend
As someone who tried the solution of using one converter with a multiple outlet port, this didn't go over well. The circuit breaker shorted and fliped off electricity to the whole house. Granted, this was an American adater and an old Dutch house.
Top tip on signs on motorways..
if you notice they will give you a choice, in his case the choice was London both sides. He knows that London is a long way but his turning will be within a pretty short distance.
Keep to the left as London isn’t the turn off but his junction is pretty much assured.
You get this on almost all junctions where the motorway diverges.
Hasn't he heard of a satnav?
I was trying to work out what was wrong with the sign. Absolutely nothing, clearly indicating M25 use left lane. Blaming bad road craft on bad signage.
Or pay attention earlier. Half a mile before the sign he moans about there is a clear sign showing that the road is splitting in two and the white line markings change to make that obvious. He clearly shouldn't have a licence if he genuinely thinks the signage is confusing.
@@jamesbailey9512 The A20 is fairly unusual though (the M25/A20 junction too) in that the turnoff is on the right instead of the left.
The problem with the extension lead is that you need all your electronics to have the same plug. Anyone who travels a lot will have electronics with different plugs
I used to have the option to pay for an extra week of annual leave each year. I did that as I’d always prefer slightly less money and more time off.
Now, you don't even get a piece of paper for a prescription. It's automatically sent to the chemist and it waiting for you when you arrive - or probably not, because the chemist is overwhelmed by the number of prescriptions waiting to be processed. So, even the option of a delayed prescription is no longer available.
The whole NHS is on a delayed prescription, it takes 4 days to get a GP appointment!
Luxury - we would've dreamed of 4 days. We have to wait 2 weeks. And our appointment is scheduled for 2 o'clock in the morning, half an hour before we go to bed after working 25 hours t'ut mill...
In Herts I usually get same day… not nhs it’s local practices which are independent businesses contracted to nhs..
I've never had any problems getting an appointment. A phone appointment..... usually with a nurse practitioner. At the end of the day I get my prescription and I feel better. All good
That’s pretty good! In the U.S. it takes weeks
@JimmyZmenos-df6op top tip - all GPs are independent practices contracted to the NHS (GP federation are just bigger capatilist groups contracted to the NHS). That is why surgeries have partners, much like law firms.
They changed the name to "Emergency Department" where I live. I've been sent there twice over the last 4 years by doctors. And spent many times there as a kid.
What I've noticed is, waiting times are the worst they've ever been. Now, the only thing I've noticed is that the population in my area has increased... An unmanageable amount. But it can't be that. Because the Guardian tell me it's not. Must be climate change or sumfink.
10:15 in Savannah, I presuppose that we were unable to much change the environment- the lion/snake/food/… was a given, not something to be changed anytime soon by a meekly human with/without fire
Emergency department could be better because it shows what it does but in the US Hospital emergency departments are known as the emergency room does not appear to lower the amount of overuse
In the US it makes sense...bcoz ppl don't have health insurance, they ACTUALLY don't have any choice.
In the UK it just gets abused for non emergencies. We're an entitled bunch.
I did the plug extension thing long ago although rather than taking an adapter just rewired the plug.
Thats it! Never ordering anything except for Gin ever again.
An excellent speaker, I need to find more of his meanderings.
I love this guy
Interesting talk, but I don’t understand the road sign problem. The left one has M25 in the largest letters.
Yes, the road sign one is really obvious (assuming you've actually passed a driving test!). The sign for the M25 is only over the left lane, so it's clear that you need to be in the left lane for it.
Typical adman. Finding problems where there aren't any.
I’m so pleased I have found out about this guy. Great lecture and passionate about his knowledge.
I really want this guy to do a guide for parenting.
It used to be called "casualty" like the TV drama. Who wants to be a casualty? I believe, as others have said, that not having to rely on A&E should be a first step in reducing demand on it.
sutherland talks about thinking creatively and not dismissing alternative ideas but i cant seem to comment on this video
Excellent lecture! I don't know if Rory has ever met an economist, because they would be more aligned with his mindset than he expects! Assuming a rational mindset is just the starting point to create a baseline model, then economists spend lots of time trying to identify and measure instances of rationality which deviate from that model.
In Spain, we have Urgencias for life and death emergencies. Traffic accidents are a separate department.
"accidents" doesn't just mean car accidents
In the US, we have something called Urgent Care. It's for things that are not important enough to be an actual emergency, but urgent enough you need it dealt with. Like say, you sliced your hand open on a piece of sheet metal. Does the UK not have this middle ground?
Some hospitals do have "Urgent Care Centres"
In London we have Barts and Finchley Memorial, maybe more, London is a bit on the big side.
Yes, they do exist and work very well.
We also have 111, a phone service that I have used to good avail.
Excellent speaker!
I understand. In death, a member of project mayhem *has* a name. His name is Rory Sutherland. His name is Rory Sutherland…
Just discovered Rory Sutherland. I could listen to this guy all day.
Brilliant. Absolutely brilliant...
Apart from fundamentally misundersatnding and misrepresenting science at the end, interesting talk.
If you know you want the M25 turn off, why would you wait for the next sign?
Stunning, I am speechless. The content, his tone, everything 👏
Thank you sir!
Why is Rory not PM?
The having an extension cord with one adapter has been my travel trick for years... I always need to charge my phone, laptop and camera
Wow you must be saving 10 or 20 grams on wires there pal, you climbing Everest?
@johnfruma5381 absolutely nothing to do with weight.. it's also more wires, one more actually just less plug adapters. Now try again using your brain
I have been in A&E twice in the past 3 year, and both times I felt like a stranger in my own country. Perhaps if this were addressed, it might take some pressure off the NHS
I've been carrying a 4 way cable for years!
Is this the most clipped video into TH-cam shorts ever?
I’ve been doing the extension plug thing for about 20 years. Am I better than you!? 😂
Placebo choice is great for parenting: if you say "tidy your room" it won't get done; say "I need you to tidy your room or.." with a worse option, they will tidy the room.
Excellent.
Has rory ever visited an a and e dept. It looks like a scene from mash. And does he really think people dont understand what a and e stands for?
Once you are inside the building it is too late, nobody is going to take the walk of shame back to the car without at least some painkillers.
Some people know what A&E means. Young people and foreigners don't know what it means because all the signs abbreviate it to A&E. They just think A&E means the serious part of the hospital.
You clearly don't work in A&E...
oh my gosh that 4 gang plug thing is genius
The best thing about this was Rory using psychology tricks to get himself an extra 10 minutes of speaking time
The a&e example is based on a false premise. It's not hard to get less oeople to come to a&e. Its hard to stop people who dont need to come and not stop those who do.
Also getting antibiotics after a doctor prescribes you antibiotics isnt an "implicit bias in the choice architecture" that nobody realised. You've just been explicitly told to take antibiotics.
Master class, bravo 👏🏻
Blimey Andy Serkis has let herself go
Entertaining but also... I don't want my doctor to give me meds to take in 4 days so as to save a few quid. If I'm bad enough that I've had to see the doctor, I want healing immediately. In an ideal world, I want the problem fixing before I complain, not the week after.
I think the example with antibiotics alludes to the issue of antibiotic resistance rather than a money-saving exercise. The other may be that certain medications are so in-demand that the demand cannot be met, therefore defer prescription in the hope that some opt to try alternative methods (e.g. dulaglutide used for type 2 D but prescribed for weight-loss).
Your point still absolutely stands for almost all other circumstances, though.
@@FerventRebutter Doctors should treat the patient in front of them, not delay prescription to avoid a problem that might never occur. As for shortages in medicine, there's no excuse in 2024 to have any shortages in medicine. The trouble with treatment via statistics, is that ignores the individual.
@@TheDandonian Medicine has interest in public health in addition to the patient in the consulting room. The problem that you suggest may never occur is actively occuring; hospital microbiologists make decisions on a case-by-case basis as to whether a broad sprectrum antibiotic with known resistance responses is appropriate to prescribe.
It's all well and good saying there is no excuse, but it's true. Demand is not being met and this isn't being aided by primary care practitioners prescribing, I would argue, erroneously.
The issue with treating the individual without factoring in public health is that the individual, and the remainder of public health, will suffer. To not account for this is demonstrably myopic.
@@FerventRebutter Demand is not being met because we had a government determined to destroy public services in an effort to reduce the tax bill of the wealthy. I'm yet to be convinced that Starmer will improve things but let's be clear, it is a deliberate choice to let people suffer and doctors didn't get into medicine to let people suffer.
As for this ludicrous notion that the public health is at odds with the individuals health... A sick individual is a significant drain on the "public health". You are presenting this as some false choice, which is ironic considering the video.
@TheDandonian No, demand is not being met because manufacturers, that are abroad more often than not, are not able to increase production to meet our needs. That is not to say you haven't raised a valid point on our government's track record, beyond party, to destroy public services.
If you take the time to read the thread back, it is you casting public health and individual care at odds with each other and that a practitioners sole responsibility is the patient, not the population. This is patently false, in theory and in practice.
The very examples alluded to here are not a sick person draining public health resources, but someone with, for example, upper respiratory tract infections demanding antibiotics that may be needlessly prescribed.
I've missed that turning a number of times
You must be a very disciplined driver if you don't go over the white chevrons after having missed junction 1 of the M20.
This is the keys to door of life.
What clicker is he using for the presentation?
Seems bees are like the matrix with neo ignoring the waggle dance!
i think you just discovered the origin of ADHD! The Bee's that don’t care about the waggle dance are the 1st basic example of the diagnosis. Just answered a lot of questions for myself. Thank you very very much for this revelation.
I think ADHD is better explained by your intuition sensing you are on wrong paths. And society in the West is making many people go on wrong life paths
Great stuff
Ah! Rory I have an extension lead permanently in my suitcase!!
language is a community
There's no intermediate between having a benign rash you don't mind waiting two weeks to have seen and you've broken your leg. There's no system to cover the things in the middle
There is! There's a regular GP appointment, an emergency GP appointment and A&E. Ironically, the problem really is a marketing one, because the first two are rarely separated. But ask any receptionist if you can have an emergency appointment and you'll usually be seen that day.
@@addison_reilly5904 Receptionists (Under instructions from the practise) will advise you that appointment slots are available only by phoning on a certain day, or advising you that all slots are full and phone back another day or if you ask for an emergency appointment they ask you questions about your condition and advise you they have no slots if it's not deemed critical enough or they will do a telephone call back, so it's not straight forward, it's too much of a lottery maybe not in all practises but in to many and the main reason is to many users from abroad flooding the infrastructure for 14 years (600,000 surplus last year alone!)!?!
Thanks for letting him finish! some places are way too quick to cut people off on time - good to hear brilliance speak.
Your ecig argument is not factual. NHS England give ecigs on prescription even though their efficacy is doubted.
Also explains why ADHD and ASD occurs in a population of humans. Autism helps me spot the missing options. ADHD makes me the bee that ignores the wiggle.
Is his shirt front sticking out of his fly?
The 'Take the White Pills then the Red Pills' thing is genius!
17:04 tap water please lol
I've been moaning about terrible road signs for years in this Country
Ah yes ... indeed if I see people smoking I always ask why they aren't vaping. (One reason is the abundance of cheap smuggled ciggies by the way). And I say one choice is DEFINITELY bad for you and the other might be but might not be. Go for that! Also I point out the value of a KNOWN dose of nicotine vs randomly spiked ciggies (soooo immoral). But people need a pocket stress reliever ... think of something???
Rory on top form here, love it
An accident severe enough to go to an "A&E" is an emergency. So why even have "Accident" in there at all? Why isn't it just the Emergency Dept?
They increasingly are just “emergency departments” though I would argue some accidents can require A&E without being true emergencies.
Haha did anyone tell the surgery doctors after Covid who only wanted to see private patients using NHS patients slots when you were told to go to A&E for non emergency urgent issues but would argue over the phone that you just go because they wanted to get paid for jobs they were not doing and see the private patients at the same time. No I don’t think all docs are like this but my practice they all did that. So I left to join my mums and they were amazing well I say amazing but professional is the word they were behaving like a doctor that knows all patients need to be seen not just the cash cows
7:45 the centre lines thicken indicting the upcoming change
"Yes, but."
Rory, thank you. Please do climate change next.
I went to doctors with pain in lower leg, started in back. Doctor gave me prescription for pain killers. Said i give you 2 weeks worth, if pain doesn't go, come back. I took 1 tablet, pain went away. But, he said i give you 2 weeks worth, so do i continue taking? I took another 5 tablets, 1 each day, then had mild heart attack....might not have happened if doctor didn't say 2 weeks worth.
Can anyone explain what this guy is talking about? I understood the words, and the jokes, but have no idea what point he is making. A&E is like a bad motorway junction which is like a wine list which is not like Red Bull???😮
Sadly I fear the medical ears are slightly deaf to out the box thought processes.
I worked out the extention lead with a forign plug when I was like 7, needed to power my gameboy + minidisc player at the same time while on family holidays
[02:41]
Amazing
0:00 You mean like change it to "THE CLUMSY IDIOTS DEPARTMENT"?