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Peppa Pig blamed for raising expectations of health service

A children's TV character has been blamed for raising expectations of the health service, a leading medic has said.

Peppa Pig's Dr Brown Bear contributes to an "unexpected expectation" of care, Dr Catherine Bell wrote in the British Medical Journal.

“Exposure to Peppa Pig and its portrayal of general practice raises patient expectation and encourages inappropriate use of primary care services,” she writes in an article described as tongue-in-cheek.

"As a general practitioner, I have often wondered why some patients immediately attempt to consult their GP about minor ailments of short duration," Dr Bell states.

"As the mother of a toddler and frequent witness to the children’s television series Peppa Pig, I might have discovered the answer."

She adds: "Dr Brown Bear, a single handed GP with whom the Pig family is registered, appears to provide his patients with an excellent service—prompt and direct telephone access, continuity of care, extended hours, and a low threshold for home visits. But could this depiction of general practice be contributing to unrealistic expectations of primary care?"

She cites the good doctor's out of hours house calls, his prescribing of medication despite admitting it's not needed as well as his disregard for client patient confidentiality.

The article references three examples.

In the first Dr Bear offers a piglet rash cream when conceding the problem would clear itself naturally. Dr Bell argues it encourages people to “access their GP inappropriately” by seeing him make a home visit and by issuing prescription medication, Dr Brown Bear has either prescribed “antibiotics in an era of rising antibiotic resistance” or paracetamol which is available over the counter, rendering the doctor’s visit pointless.

"Case 1 questions whether Dr Brown Bear is an unscrupulous private practitioner, rather than an NHS GP," writes Dr Bell.

In the second case the doctor answers the phone for a minor illness - George suffering a cold - before heading straight over to his home, again outside normal hours. Dr Bell described the doctor's actions as a "clinically inappropriate urgent home visit,” although concedes on this occasion the doctor gave a clinically appropriate reaction.

And in the third case Dr Brown Bear makes an emergency visit to see Pedro the pony with a cough before he himself catches the cough. Eventually, the townsfolk all go to the surgery to administer him with a some medicine and sing a song.

"His disregard for confidentiality, parental consent, record keeping, and his self-prescribing indicate that the burden of demand from his patient population is affecting his health,” writes Bell.

Dr Bell, in a disclaimer, states she has no conflicts of interest: "It may look like my child is sponsored by Peppa Pig, but any claims to this effect are false."

Concluding she adds: Peppa Pig conveys many positive public health messages, encouraging healthy eating, exercise, and road safety. However, from (repeated, mostly involuntary) review of the subject material, I hypothesise that exposure to Peppa Pig and its portrayal of general practice raises patient expectation and encourages inappropriate use of primary care services. Further study is needed to confirm this.

"Dr Brown Bear was approached for his perspective on the cases discussed; however, he is unable to comment pending the outcome of a fitness to practise investigation."

Despite the less than seriousness of the article, the Royal College of GPs has said people need to understand when it is appropriate - or even if it is appropriate - to contact their doctors.

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