Health system should focus on serious symptoms, not 'worried well' - medical expert

A medical expert says the public needs to realise that not every small lump or instance of pain will lead to greater health complications.

The Project spoke to Invercargill woman and registered nurse Rachel Terrill, who was told by Kiwi doctors that she had chronic back pain, but was later diagnosed with a spinal tumour.

"I was diagnosed with a strained back and proceeded to see some physios, chiropractors, and attended by GP," she said.

"As things escalated, I presented to ED four teams and they just kept saying I had chronic lower back pain, which we disagreed with. I went to Australia, collapsed, and was diagnosed with the [spinal tumour].

"Overall, I don't believe our health system is functioning well together. There are more barriers than there is ease of access."

Dr John Bonning, an emergency medicine physician, says Terrill's case is a tragedy and the health system needs to spend more time focussed on people with significant symptoms rather than the "worried well".

"It is a terrible tragedy, fortunately, picked up in the end, where someone has a complex complication of a very routine thing, back pain, and there are delays in picking it up," he told The Project.

"It is tough because lots and lots of people have back pain, very few have these serious complications.

"We need to be scanning some of these people as they develop significant symptoms, like red flag symptoms of serious pathology, and we need to spend less time scanning the worried well to focus on people with real chance of benefit from that scan."

He said health professionals and the public should be aware of warning signs, but also realise that not every lump or instance of pain is going to signal something more complicated.

"Health professionals and the public need to be aware of the serious warning signs of something serious, when your headache might be a brain tumour or a brain hemorrhage, your back pain may be an abscess around your spinal cord or a tumour, Dr Bonning said.

"Others [need] to realise that most people have headaches and back pain and don't have these complications and shouldn't be using the resource of these scans to save them for those with the real problems."

Dr Bonning said needlessly doing scans, like MRIs, on those who don't need them may clog up the system.

"If we are going to do MRIs on every back pain, we won't be here doing any MRIs on any other patients and we won't be doing the ones with brain tumours… it is the finite resource we need to rationally use and choose wisely with."


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