“Hmmmm 160/90” I muse with my best concerned look
“Oh my blood pressure is always up when I see a doctor – it’s white coat blood pressure” Accompanied by a dismissive hand flap.
“Okay, now here’s your sick certificate….that was three days last week?”
Hold on there !!
There is something wrong with this scenario.
Sure if I had a 12 patient an hour habit that would be an easy level B.
White coat blood pressure!
I haven’t worn a white coat since my days as a pharmacy student and after a busy day compounding that surely wasn’t white. If I recall the white coat went into a vat of purple dye just prior to graduation but that is another story.
Today, I read a paper by O’Callaghan in the AFP (Aust Fam Phys 2013; 42 (6) 376-9) which suggests that this patient runs a 40% chance of developing hypertension over the next 10 years even if his diagnosis is correct. The next step would a suggestion that ambulatory blood pressure monitoring may prove him absolute correct – lets give it a go.
And so a new conversation trail begins…….
If you want to know how the story ends have a look at this Heart Foundation link.