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Should GPs go to their patients\' funerals?

Thursday, March 18, 2010

The Jobbing Doctor, in a characteristically thoughtful post, touches on this difficult issue:

I am starting my morning surgery very early next week in order to attend a funeral. I have looked after the person in question for 3 years, and have got to know her and her family well. I was surprised, shocked and saddened by her death.

The Jobbing Doctor

I grappled with this difficult problem for years and never felt entirely comfortable with it. The conclusion I came to, rightly or wrongly, was that I was not going to go to a patient\'s funeral unless I would have gone to the funeral had I not been their doctor. Maybe that decision was wrong. I do not know. I do know, though, that it would not have been possible, or appropriate, to go to all the funerals. Some patients who died I hardly knew. Their illness might well have been dealt with entirely by the hospital. That was often the case with sudden medical problems such as heart attacks. Sometimes, if the hospital communication was not good (often), I might not even hear that the patient had died. There were many patients, of course, who died at home, and who I had been looking after and with whom, often, I had had a close and long standing professional relationship. I found that, by and large, few of even these families let me know when the funerals were. But some did. How do you decide which one to attend? I understand, as only a doctor can, what the JD means by saying the he was \"surprised, shocked and saddened by her death\" but these are not criteria (and I don\'t suggest the JD thinks they are) for attending a funeral.

How does one get it right? Did I offend some families by not going to funerals? I hope not, but it is possible I did.

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Biased BBC is at it again

Thursday, March 18, 2010

NHS BLOG DOCTOR gets a lot of email. This morning, there are three from Consultant Gastroenterologists, all giving their names, and all infuriated by the activities of Dr Penny Neild. I have never heard of her, but she is also a consultant gastroenterologist. You may have noticed (regular NHS BLOG DOCTOR readers will have noticed) that the biased BBC has the habit of giving a news platform to individuals who wish to promote their own opinions. These promotions, for that is what they are, might be acceptable if they were billed as opinion pieces, but they are not. They appear as \"news\" but in reality are advertorials for an individual\'s eclectic and often eccentric views. Remember in Widow Twankey and the Whipping Boys the appalling \"Dr\" Jennifer Wild was allowed, unchallenged, to plug her self-promotional views on CBT. Although styled as a \"Dr\" and a \"Consultant\" she is in fact a clinical psychologist who specialises in, guess what, CBT. Her contribution was so biased that they received a deluge of phone calls and emails and, unusually for the BBC, they felt obliged at the last minute to interview a doctor to give some balance.

Today, the BBC have given a similar platform to Dr Penny Neild. At least she is a real doctor.

Gastroenterologist Dr Penny Neild, who works at London\'s St George\'s Hospital, said training on how to spot and tackle malnutrition was \"patchy\". She said medical schools and junior doctor programmes were focusing too much on the science of being a doctor rather than basic care.

BBC

It\'s the usual sort of guff. Penny Neild has a niche interest and thinks everyone else should have it too. So, who exactly is Penny Neild? If you Google her, you get a lot of results, mainly from the private sector. Top of the list (I wonder if this is one of the examples of someone paying to be top of the Google search?) comes \"The London Gastroenterology Partnership.\" You can see Penny and her colleagues there. There is a undoubtedly lot of expertise in this clinic, but you will not be accessing it on the NHS.

Every patient has different needs and will require either a consultation with no investigation or a number of varying tests and scans to help with the diagnosis of their condition. Our consultants also practice from different Hospitals across South West London and each Hospital has a different price list. It would, therefore, be impossible to list all the variations here.

To receive an indication of likely costs please telephone our Enquiries Line on 0208 337 4080.

Paying to see Penny

I\'m sure you can see Penny on the NHS as well if your GP will refer you, and if you are in the right catchment area. But that is not the point, is it? The point is, the BBC presents something masquerading as news, suggesting that, unlike Penny, most doctors do not have the skills to recognise malnutrition. (It\'s a variant on our dear friend the \"Nigel Molesworth self-adjusting thank you letter\" approach to news used by uneducated medical journalists). It\'s codswallop but, because the BBC says it in a news article, people will believe it. So, next you Google Penny, and soon you are checking your private health insurance to see if you can afford to consult her.

The BBC article says :

\"The issue of malnutrition has been a long-running concern in the NHS. Up to one in four patients may be at risk, research shows\"

Yes, we know that. And we know why. No one is unimportant enough on the wards to feed the patients anymore. Elderly people lie helpless in bed whilst food is put in front of them and then, a few hours later, when it is cold, congealed and uneaten, it is removed. Maybe if we sent all these patients to the London Gastroenterology Partnership, someone there would feed them. One of the consultant gastroenterologists who emailed said:

This has made me furious this morning - and I was already in a dire mood. What utter, utter rubbish. Patients starve in hospitals because the food is utterly inedible, and because the nurseys don\'t do their jobs anymore.

...and the bit about there being too much basic science in
medical school - I am close to apoplexy.

Consultant Gastroenterologist.

The Biased BBC needs to think before it prints, and it needs to present a balance.

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