Thursday, 29 May 2008

The world has gone mad

When I was a youngster at medical school I remember being taught the importance of the doctor patient relationship, it was interesting stuff at the time, and even then it was emphasised how the relationship could be varied to get the best outcome out of it for the patient. Many factors affect this complex relationship, the personalities of the doctor and the patient, the issues being dealt with, the time available et cetera. Sometimes the patient wants a more paternalistic approach, and sometimes the patient wants to be involved more in the decisions making process.

Frequently what the patient wants is not best for the patient though. Whether it be the overweight smoker who does not want to listen to a doctor politely explaining the implications of their lifestyle, or the women with breast cancer who wants to be told that herbal medicine can be used to treat her cancer instead of the effective modern approach. These patients would be happy to be badly managed by their doctors, demonstrating the serious problems with assessing doctors by relying solely on patient satisfaction surveys. Ironically Harold Shipman was very popular amongst his patients, likewise I have seen countless examples of patients who have been negligently managed who have also been very happy with their care.

Teachers are being plagued by the same politically correct nonsense, I'm sure many of us can recognise that our best teachers were frequently not our favourite teachers at the time. I wonder how long it will be before all parents are forced to respond to all the unjustified complaints from their offspring, it may well result in TV all day with ice cream for breakfast, lunch and tea. Some of the new breed of Health Care Practitioner such as the nurse specialist love this new method of assessment, as they simply defer tricky problems that might make them unpopular to the doctors, while they have so few patients to see in so much time that they can afford to indulge the patient with plenty of ego massaging attention and a few cups of tea.

The world is going mad. Junior doctors already have things hard, they are easy targets for bullying from other staff due to the short nature of their placements;they are now an easy target for other HCPs thanks to the wonders of the 360 degree assessment which allows the assessors to criticise in a completely unaccountable fashion. What next, all doctors being forced to enlist themselves with websites that allow patients to rate their care in a similarly unaccountable one way fashion?

The doctor patient relationship should be a two way street, not the one way street that our nonsensical politically correct culture is trying to force upon us. While it is important that patients have sufficient power to comment and complain, it is equally important that doctors are not subject to unfair abuse and bullied by manipulative aggressive patients. I wonder what the reason for the deteriorating discipline in patients, pupils and children is these days? It couldn't be anything to do with out politically correct culture empowering them way beyond the limits of common sense?

Doctors do not have an easy job, they frequently have to choose the lesser of two evils and it is not uncommon for some people to be offended in the process, even when the best option is chosen in the most polite way humanly possible. Opening yet another avenue in which patients can unaccountably vent their spleens promises to benefit no one, except the politicians who want to enslave our profession. I wonder, will this new set of chains enable us to feedback on the management prowess of Sir Darzi, Sir Liam and Dame Carol? I very much doubt it.


Witch Doctor said...

Your link to this site which allows patients to rate their care is a vision of the future of Web 2 (or is it Web 3 Health?). It's coming fast and will be here to stay.

However, as patients learn more about their conditions through Web 2-3 they will become more discerning regarding those looking after them and, contrary to the government's vision, doctors will be in constant demand. Knowledge, experience and judgement will be valued again. It will take a few years though.

Patients with a lot of information, but limited ability to risk assess, become very worried. So do clients.

This is one of several reasons My Black Cat and I think (nae know) we need more doctors. We should be planning for this now.

And doctors will need more time with each patient as well as time to produce high quality internet resources relating to their own clinics and specialties. We should be planning for this too.

This witch feels the current degrading of the medical profession is a painful but temporary phenomenon for ill advised political reasons.

Dr Xavier Ray said...

I read somewhere that the iwantgreatcare website is the brainchild (bastard brainchild perhaps)of Neil Bacon who set up Drs Net. It does open up the possibility of anonymous hounding and persecution of doctors by malicious or mad patients with no possibility of redress and is deeply worrying.

Anonymous said...

bizarrely you can't rate Dr bacon on the site.

If he feels its such a good idea how come he is not ready for the feedback?