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Why don't doctors explain much!

Personally, I enjoy talking to my patients & finding out more about their lives. However, the reality is there simply isn't enough time.

Last week, in clinic there was a patient that had 3 previous heart attacks. His cholesterol was sky-high & he was refusing medication (statins) to bring this down. He explained,"I read on a website that statins are bad for you doc". I spent a good 45 minutes with him explaining the benefits of statins versus their disdvantages. I explained that on average, patients live longer & are less likely to have another heart attack.

In the end, he decided to agree to take statins & walked out a happy man. "Thanks for explaining everything doc. I wished my GP had gone through this with me."

When he walked out the door, I saw how many patients had accumulated in the waiting room I ended up going home an hour late that day. Every other patient who came in after me was either complaining or grumpy.

Serves me right for trying to do the right thing. What should I have done? What would you do in my place?

Do Not Resuscitate!

First, the withdrawl of the JDC from the review body followed by the resignation of Professor Crockard. Now, the latest news that Remedy UK is mounting a legal challenge.

Isn't it time we gave the DNR order on MMC & MTAS? It would be the kindest thing to do!

What a load of Crock!!

"This coming year is the best year to be an SHO"
Professor Alan Crockard, now resigned from the board of Modernising Medical Careers

Can't believe he actually said that? Well watch the video, "Where do SHO's fit in?"

March against MTAS!

March 17- The UK's doctors will march against MTAS, the bungled job application system!

Doctors are marching for a fair job application system. So far, MTAS has been riddled with delays, mistakes, & a lack of transparency.

See you at the protest march today!

Remedy UK

Christmas without the "Christ"

I know its post-Christmas, but here's something that's too good to wait for another year.

Its was the hospital's annual Christmas Tree competition. A circular from hospital management (high up in their glass tower) detailed the criteria by which the best Christmas Tree would be selected:

1.) Religiously non-offensive Christmas Tree!

2.) Compliance with Infection Control policy

3.) Cost-effectiveness

Religiously non-offensive- Christmas is a religious festival celebrating the birth of Jesus, the "messiah" to Christians. How can you make it non-religious??!! It would be like asking Jeremy Clarkson to present "Top Gear" but without any cars in it!

Infection Control- Well, the best tree from an infection control point of view would be no tree. Since we are dispensing with a tree, why not get rid of flowers or cards by patient's bedsides, telephones, curtains or television sets?!

Cost-effectiveness?- Shows how single-track our hospital management are!

To the managers who made these ridiculous rules, thanks for the laughter! We on the wards have had our share & wish you a non-religious Christmas & a target-driven New Year!

Christmas Weekend- The Killing Season

The staff on the wards are edgy knowing that something is afoot & approaching. Its Friday, the last working day before the long Christmas weekend.

During these 4 days, everything routine will grind to a halt. No blood tests, no X-rays, no specialist consultations, no operations, no procedures, NOTHING!. The hospital enters a state of "emergency" where only urgent problems will be dealt with.

In fact, most patients in hospital, will not be seen by a doctor for 4 days unless an problem or emergency develops. They’ll lie languishing in a hospital bed, waiting to catch pneumonia, a bed sore or MRSA.

“People will die! Its like this every year” quipped a senior doctor during our special Christmas lunch in the doctor’s “mess” (staff room).

Instead, the hospital will be manned by a skeleton crew of nurses & doctors. This will is a testing time for any young doctor as they’ll be overstreched on the wards managing crisis after crisis.

I have spent the last 3 Christmases working in hospital & it has always been a harrowing & depressing time. Many relatives visiting Mum or Nan on the ward will be horrified to see their loved one in pain or ignored for days & will understandably demand to see a doctor.

“What’s going on with my Nan? She’s been crying out in agony for hours but no one has seen her!” No doubt this outburst has been partially fuelled by the guilt of a weekend of merriment & a sumptuous Christmas brunch.

The doctor will struggle to explain what’s going with Nan after all, he doesn’t know the patient & doesn’t normally care for them. He’s only covering emergencies & his pager keeps going off! The best he can do is prescribe pain killers & make a hasty retreat!

But these are the lucky patients. There will be many patients who lie in bed with no visitors or loved ones all weekend as they have always done for the past few weeks or month. These are the patients who will die if they run into problems as there will be no one to act as their minder or advocate. What about the nurses you ask? Surely they see their patients’ everyday? Let me just say that nursing care on the wards can be highly variable & I’ve seen nurses who will not call the doctor until the patient has one foot in death’s door!

So why not get extra doctors to work for a few days during this period? After all, we know that this is bound to happen at least once a year! The bottom line is money! There isn’t enough of it to hire extra doctors. Our hospital like many hospitals around the country is broke & the Department of Health (bless their cotton socks!) is treating hospitals like a private business. If there isn't enough money, tough!

So, on my last day at work yesterday, I was asked to represent the doctors & join the carollers singing Christmas songs in the hospital lobby. With my consultant playing the piano & the patients singing along to the tune of “Silent Night”, the scene was surreal. It was a scene akin to one in “Titanic” where the band continued to play & the passengers danced along as the ship was slowly sinking!

I’m off work this year! Merry Christmas!