finger on the pulse

Warning: health scares can damage your health

I Took my kids to a famous hamburger emporium today. It's their idea of a treat. We had passed several cafes along the way, and I had tried to drag them in. I wanted a cappuccino and a brie baguette. They wanted a soggy bun and a piece of fried cardboard. They won, as usual. As we entered, my first thought was I wished I owned the place. It was packed. We joined a queue and then fought for a table. The only place we could sit was in the street - at least it felt like the street, because there was a gale blowing through. I wasn't happy. I'd paid VAT to sit in here.

My 15-year-old then made a very deep remark. This made a change from the usual grunts that he emits. So I sat up and listened to him. He said, "It doesn't look like anyone's worried about BSE in here." He was right. They were all tucking into their whammyburgers with great gusto. There was hardly a beanburger in sight. Had these people really changed their eating habits? Certainly not.

People had been scared enough in the first few days of media hype. Beef sales dropped, and everyone switched back to Salmonella-ridden chicken. One week later Sainsbury's cut the cost of beef, and it was all sold out in five minutes. One of my friends bought loads, and stuck it in her freezer. I asked her what she was going to do with it. She replied, "I'll just wait till the scare is over, and then we'll eat it". What can you say?

The scare with the greatest impact for me recently was the one surrounding the Pill. It started on a Friday, never a good day to launch anything, especially something to do with contraception when everyone needs their Pill over the weekend. The phone buzzed all day, and patients came in genuinely scared that they were going to get a DVT ( Deep Vein Thrombosis) any moment. I was on the phone, and saw "extras" that day, to try and allay the fears as quickly as possible.

Some women decided to change their Pill, others stuck with it. Over the next few weeks a few women came in to see me. Then it went quiet. No one came in to talk about it, and I only discussed it with a few women as they came up for review. Panic over. The real consequences were far greater. Three months later the abortion rate increased across the UK. The fear of DVT had been so great for some women that they had stopped their Pill and used nothing at all.

I am faced with a new health scare nearly early every week, and patients come in expecting me to give out advice - whether to eat or not to eat, to take their tablets now or to stop. It often takes months before there is any consensus amongst doctors on what advice should be given. If you put 100 doctors in a room and asked them for their opinions you would get 100 different replies. Are doctors eating beef? Some are and some are not - and that says it all.

Everything we do has some risk. Eating - you can choke on a fish bone; working - always a dangerous thing to do; leisure - I've always wanted to know what this was; and travel - give me a ticket and I'll go anywhere. If we talk about risks, they must be compared to other known risks to put them into perspective. But as GPs we don't always have the comparable data at our fingertips and this makes our jobs even harder.

All I can tell you is that you are far more likely to die from being hit by a train than from contracting Creutzfeldt-Jakob disease. If you smoke, why are you worrying? You will probably drop down dead from heart disease or lung cancer way before then anyway.