10feet
Junior Member
Posts: 68
|
Post by 10feet on Jul 20, 2009 21:27:48 GMT
So to go back to the original topic the ethicality of random screeing.
Jbb asked : Going back to the ethics debate about worrying 99 and finding 1 postive diagnosis- this is the approach used when looking at potential maliganant melanoma - if in doubt, refer on immediately. So what do you think the difference there is?
I had hoped someone else would come in here as Shy and Pete had a go at her last puzzler.
Hey ho, once a prat always a prat...with malignant melanoma, like diabetes, it is a well publicised condition but many patients self refer to GPs taking responsibility for initiating the 1st contact re melanomas. A patient can see what is happening.
Correct me if I am wrong, it is an agressive cancer if left undiagnosed but fast diagnosis and rapid treatment the long term prognosis is good. There is a beginning and an end to this condition
I think the incidence of malignant melanoma in young people is quite high so potentially we have a high impact on earning capacity/social care/family services.
Nope not getting it. Come on guys, help me out...
PTP
|
|
jbb
New Member
It's nothing to do with me anymore!!
Posts: 20
|
Post by jbb on Jul 21, 2009 7:00:56 GMT
Hi PTP,
I think you're fairly much bang on regarding the differences with MM and DM - because MM is so aggressive and can be rapidly-progressing, early detection is essential in both limiting major damage and saving life, and yes, the incidence in younger people is rising rapidly.
So, posing another question, if we have DM and MM at opposite ends of the spectrum in relation to progression speed, etc, what approach should we have in trying to detect these things early ? I don't know if there is an ideal answer to this, but am happy to see if anyone else has suggestions.
Judith
Judith
|
|
hilo
New Member
Posts: 6
|
Post by hilo on Jul 21, 2009 12:25:50 GMT
Hi PTP and judith
good debate here guys.
As I see it we are a good position to spot worrying signs on the feet with regards to MM- quite often the patient cannot see the sole of their foot or do not look at it!Under the nails a black mark is usually taken as bruising by the patient so it is vital to be aware of alternative DD. Even with a small chance of malignancy it is better to send the patient off to the GP to get it checked. I am afraid I very rarely write letters, I get the patient to make an appointment or if really worried I ring the GP myself, with the patients permission . I know that the GP refers immediately and they get an apoointment within 2 weeks.
With diabetic patients, in my PP I am rarely the first port of call so I cannot lay claim to huge numbers of diabetic diagnoses. It is more often the case that I pick up on the fact that the patients are non compliant, in which case I try to encourage them to adhere more to the recommendations. If I see changes from the previous visit, I ask the patient to make an appointment themselves with the GP or diabetic nurse. Although the long term complications are significant, they do not compare to life threatening issues. I expect to see hundreds of diabetics, I have only seen a couple of MMs!
As podiatrists we are not in the profession to be the most important practitioner that they see, but part of a team- none of us can deal with problems other than in the foot so it requires referral and good rapport with other disciplines.
Hilo
|
|
seekerofwisdom
Full Member
Seekerofwisdom (password seeker) is a general login. Please Identify youself by signature
Posts: 180
|
Post by seekerofwisdom on Jul 24, 2009 8:38:40 GMT
Hello ddddyyy, Why do you have -ve karma? Did you upset someone ?
Curious SOW
|
|
|
Post by samrandall on Jul 24, 2009 8:54:55 GMT
It's a robot.. automated programme designed to get us click on the links at the bottom of it's post..
Robert, Can you ban it?
S
|
|
|
Post by Admin on Jul 24, 2009 18:15:16 GMT
Done. Not the first.
|
|