Comments on Dr Rant: A reply to Bernard Ribeiro

Well said Dr Rant,As a recipient of Sir Bernie's s...

2008-04-28T13:26:00.000+01:00

Well said Dr Rant,

As a recipient of Sir Bernie's spams I am increasingly at lost as to what this man is all about. During the MTAS fiasco he stropped, threw tantrum but the the sum of all his efforts but is a effective as staccato farts at the HMG's MMC trumpet (dis)concertos.

As for the tick-box arse wipes forms that form the basis of training these days - not the number of operations performed or the length and breath of experience in own and related specialties - they do not reflect the qualities of doctors the average Labour voter would like.

Already I have to put up with ST1 and ST2 in Accident and Emergency who cannot reduce ankles or shoulders and get spooked by paronychia. Or FY2s in orthopaedic surgery who panicked at the completely normal post total hip replacement X-rays because they were never formally taught how to look at them -ie no ticked-box arse-wipes to say that they are capable.

However, these doctors will get very fast up the so-called training ladder. Dumbing down of medical training? Yes, presided over by Bernie and Co.

As for the anon who sang praises for the EWTD - you are as in the dark as Bernie's rectal content. The next time you wanted your shoulder/hip/elbow relocated or your wound sutured you have to wait for someone like me - an orthopod culled out of 'training' by MMC but who can actually do the job, with logbooks, exams, courses and CV to prove it. But you will be paffed about by ST1s and ST2s who have very little idea what to do. Perhaps the A&E charge nurse can come to your rescue.

Is 'intelligence' not a variable when (certain) di...

2008-04-27T20:02:00.000+01:00

Is 'intelligence' not a variable when (certain) diagnostic errors are made ?

But I take your point hawkeye, perhaps carelessness and inexperience are more important contributory factors (in statistical terms).

Of course, poor communication is a recurring theme linked to medical (and nursing) cock ups, and to my mind emotional and intellectual skills can play an important role in reducing risk.

"I can accept that (some) doctors are insufferable...

2008-04-27T19:11:00.000+01:00

"I can accept that (some) doctors are insufferable bores when they drone on about how clever they are (especially since there is little evidence to suggest that error rates are going down)"

Don't mean to be an insufferable bore but what does the error rate have to do with how clever we are?

If you have to deal with hundreds of new drugs coming out over the next few years and error rates go up does that make you less clever? Or if more patients are seen by non-medical practitioners? or if you learn new techniques to try on patients, cause more errors but make the majority of them better - does that have any bearing on cleverness?

Just to make the point again, error rates have nothing to do with how clever you are.

Anonymous - In the interest of balance perhaps I m...

2008-04-27T09:39:00.000+01:00

Anonymous - In the interest of balance perhaps I might make one or two observations about your portrayal of docs as avaricious whingers ?

Now I suspect that you don't actually believe any of the tosh you're spouting - spend a few days on a paediatric ITU, busy GP surgery, or, dare I say A&E resuscitation room and you will get my drift.

You seem very pleased that NuLab have 'tamed the medical beast' - but do you really think the likes of Patricia Hewitt is more interested in your welfare than your average doctor ?

Don't forget since Hewitt moved on from her post as health secretary she has been hired by Boots & Cinven, (to the tune of £500,000), despite both companies providing direct competition to the NHS - before she left Hewitt busied herself paving the way for private firms to take over GP practices.

I find this incredible - surely Hewitt puts even the most unscrupulous, golf loving doctor in the shade ?

Get a grip anonymous I can accept that (some) doctors are insufferable bores when they drone on about how clever they are (especially since there is little evidence to suggest that error rates are going down) but to be fair they do handle complex life and death decisions and for this they should be adequately renummerated, as a bare minimum.

Doctors are being shat on at the moment, anonymous, what are they supposed to do, just shut up and take it ?

1. You need lots more training due to the farseein...

2008-04-27T01:05:00.000+01:00

1. You need lots more training due to the farseeing and impressive EWTD.

2. This gives you more training.

3. There will be/is an excess of Doctors.

4. The NHS as a result does not need to employ "consultants" in numbers they have done before to provide the same level of service.

So why should the taxpayer fund consultant posts when there is a cheaper option available?

They should not.

5. If you don't like it, tough, there are plenty who will do the jobs, so do us all a favour and fuck off somewhere else and whine about it there.

Let’s face it your allegiance to "training" only extends as far as your access to "snout in the trough" private practice which is what this is about.

The government have done very well in taming the medical beast, your malign influence is coming to an end and long may it continue.

And further to my comment directly above, I think ...

2008-04-25T10:30:00.000+01:00

And further to my comment directly above, I think the Nazis were 'misunderstood' and they obviously had difficult childhoods.

I think Sub-Consultants are a very good thing & it...

2008-04-24T22:25:00.000+01:00

I think Sub-Consultants are a very good thing & its correct with shorter hours to extend training.

Well done Bernie!

Quite possible the worst part of this (from my poi...

2008-04-24T06:45:00.000+01:00

Quite possible the worst part of this (from my point of view as a medical reg) is that Bernie's been far more rigorous than any leaders from my college.
What a depressing thought.
Having said that I do think there's going to be a role for fellowships to achieve specific training roles.
I do think they should be done preCCT as OOPE. Otherwise there's no structure for assessing their quality.
Already, to become a hepatologist you need to do an extra year separate from your 5year gastro training.

Interestingly that's pretty much what the BMA/Juni...

2008-04-23T18:21:00.000+01:00

Interestingly that's pretty much what the BMA/Junior Doctors Committee has to say on the matter.

Although they've been more diplomatic... but it's all a matter of what style you prefer, I suppose. :-)

http://www.bma.org.uk/ap.nsf/Content/postcctfellowships

Keep up the good work, Dr R.

Another angry gasman

Brilliant, absolutely brilliant - and spot on

2008-04-23T17:24:00.000+01:00

Brilliant, absolutely brilliant - and spot on