Know your patient before testing for ADHD!

As BBC’s Panorama investigates the reliability of online ADHD diagnoses, two private doctors in Merseyside say this is an unfortunate example of why diagnostic tests should only be arranged if recommended by an experienced clinician.

In this case, the tests in question were questionnaires or structured interviews, potentially just as misleading as high-tech scans of those with no symptoms of physical illness.

When they set up Formby GP, a private GP service in Formby, these doctors were keenly aware of the temptation for private doctors to sell unnecessary tests and treatments. They describe Formby GP as ethical because they explicitly strive never to recommend unnecessary tests and treatments. They argue that GPs can really help patients by recommending referrals only after excluding other explanations

Formby GP’s Clinical Director, Dr John Cosgrove, worries that it can be difficult for those that are not doctors to recognise good clinical practice. “Panorama compared ‘mystery shopper’ style consultations with online clinics to a consultant who had explicitly invited television cameras in. Panorama rightly referred to NICE guidelines. Guidelines, however, are not protocols, and are often simply the opinion of one particular panel of experts. It would not be appropriate for clinics always to follow guidelines blindly. This is really difficult for regulators such as the Care Quality Commission, whose approval of services could be mistaken for endorsement of the quality of clinical care, rather than just governance processes.”

Dr Heather Ryan, Managing Director, explained that they started Formby GP so as to be able to offer unhurried face to face consultations to anyone that wanted it. She enjoys getting to know her patients in person, which also provides so much more information than an online chat.

Dr Cosgrove said, “Around 5% of children are believed to have ADHD. Left untreated, it can significantly impact upon a child or adult’s life, so it’s great news that there is more awareness of this condition now, and various effective treatments are available. On the NHS, it can be hard enough to get an ADHD assessment for a child; in adults it is almost impossible. Clinics that can carry out proper assessments are invaluable, and we could use more of them, whether private or NHS!”


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