Why Britain Still Has a Stiff Upper Lip

Week in and week out in my GP surgery in North Wales I meet patients who have waited weeks, months and even years to seek help for a medical problem because they are simply too embarrassed.
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'Stiff upper lip' sounds like a phrase from Britain's golden past - reminiscent of Captain Mainwaring from Dad's Army or the aristocratic Crawley family in Downton Abbey.

In today's 'anything goes' era - with reality TV and social media plunging ever deeper into the intimate details of our daily lives - surely we are less reserved about showing emotion and seeking help for our problems?

Surprisingly, when it comes to speaking up about embarrassing or intimate health problems, nothing much has changed.

Week in and week out in my GP surgery in North Wales I meet patients who have waited weeks, months and even years to seek help for a medical problem because they are simply too embarrassed.

Embarrassing bodies

Take the young woman who came to see me after suffering for four years with a serious case of acne. Too self-conscious to seek medical advice, she had tried to treat it herself with over-the-counter remedies and covered it up with lots of make-up. Unfortunately, because she left it so long to seek help, she had significant scarring. If she'd only come to see me earlier, a simple prescription could have vastly improved her skin in just six to ten months.

Embarrassing body parts are of course another reason for not seeing your doctor. A case that stands out in my mind is the 19-year-old who presented with one testicle swollen to five times its normal size; he'd waited nine months before making an appointment. He was lucky - there was no serious underlying cause - but there could have been.

Less lucky was the 40-year-old woman who presented with bleeding from the back passage. She had endured it for months and only made a doctor's appointment when she literally couldn't sit down. Sadly, she was diagnosed with rectal cancer.

Erectile dysfunction

Erectile dysfunction is by far the biggest area of embarrassment for men. They tend to drop it in awkwardly at the end of a consultation when they're are about to walk out of the door. Yet help is readily available for ED and it's also important to investigate whether the problem is linked to more serious conditions, such as heart disease and diabetes.

Health charities are doing excellent work to persuade people not to be embarrassed about seeing a doctor. The latest campaign from Bowel Cancer UK featuring Holby City actor Ben Richards is a good example. Richards describes himself as a 'typical bloke' in delaying seeking help about symptoms including blood in his stools and changes in his bowel movements.

Why are we so embarrassed?

Despite the rise in these campaigns, and the use of high-profile celebrities to front them, people still remain reluctant to talk about intimate medical problems. Why?

New research shows that it is down to embarrassment and a stiff upper lip: 65 per cent of people surveyed in a recent opinion poll said they would rather suffer in silence than endure an awkward face-to-face conversation about intimate symptoms.

And it's not just their GP that they are reluctant to talk to - 38% said they also felt embarrassed about confiding in their partner.

Instead of talking face-to-face, people are turning to the internet for help. Forty-one percent had self-diagnosed via the internet and 17% admitted to buying drugs online.

While the internet is an excellent resource in many areas of life, it's risky to use it for self-diagnosis of medical problems. We've all experienced the alarming results that 'Dr Google' delivers on a symptom search.

Online GP consultations

However, technological advances mean there are now medically-safe online services - including confidential consultations with working NHS GPs.

In addition to my NHS work, I work for one such service and I am passionate about the role online medicine can play in making healthcare more accessible.

In an era when shopping and banking online are commonplace, people want and expect the same convenience from health services. In our research, 76% of people said they would choose to consult a doctor online rather than face-to-face if they could.

Their reasons for doing so were not just to avoid embarrassment, although this was key. They also wanted an online service to get a quick appointment or for advice on minor problems without troubling their regular GP.

So, while we may not be any closer to relaxing that stiff upper lip, the good news is that we now have more ways than ever to access trusted medical advice that can prevent our worries about embarrassing bodies becoming a serious health issue.

Dr Nitin Shori is the Medical Director of the Pharmacy2U Online Doctor service

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