Welcome to Wyndham House Surgery

Wyndham House Surgery is committed to high quality, accessible, community based healthcare.  We are a friendly, healthy, hardworking, innovative team who share core values of empathy, trust and honesty, in a harmonious, supportive environment.

Rated “Outstanding” by the CQC (Dec 2015)

 

Pros & cons of scans

“I would like a scan please?” is the opening gambit in many consultations.  It is a simple and direct request but often leads to some complex and difficult conversations.  This is because ordering any test does not come risk free.  The consequences of too many X-rays, ultrasounds, CT and MRI scans are enormous for both individual patients and the NHS as a whole. The problems are more than concerns about excess radiation but more to do with the complications of uncovering things that we were not looking for. These incidental findings almost always turn out to be nothing worrying but only after much time and money is spent on exploring them. MRI scans provide the most detailed imaging available and as a result have the highest ‘incidentaloma’ rate. The chance of a headache being a symptom of a brain tumour is very small (approximately 1 in 1000) however the chance of finding something abnormal on a brain scan can be as great as 1 in 10. This leads to further investigations that have costs for both patients and the NHS. Although medical science has a fantastic understanding of the anatomy, physiology and pathology of the human body we are still a long way from fully explaining everything abnormal we find. Watch, wait and see what happens is a highly valued diagnostic tool; it is the cheapest and most effective treatment strategy we have for almost all minor illnesses and GPs are very skilled at using it.  Most patients prefer this approach rather than taking medicines with their potential to cause side effects.  However, watching and waiting when there is something physical to see or an abnormal test result to consider is much more anxiety provoking. Symptoms are easy for patients to monitor, however abnormal scans and blood results are more difficult to manage. So if a doctor seems reticent about ordering a test that you request it is often much more complicated than it might at first seem.  This is not direct rationing, it is evidence based decision making that is considering the pros and cons of the test. We can now treat many carcinomas very successfully however ‘incidentalomas’ are starting to prove more difficult, more complicated and much more expensive for all.

Anthony O’Brien

Parish Magazine article 2019