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Found 490 results
  1. Content Article
    Doctors are dying by suicide at higher rates than the general population—somewhere between 300 to 400 physicians a year in the US take their own lives. This article in The Guardian looks at why so many surgeons are dying to suicide and what can be done to stop the trend. It examines how the culture of working long hours and the expectation to be 'superhuman' leads surgeons to suppress their symptoms and avoid seeking help for mental health issues. The article also tells the story of US surgeon and President of the Association of Academic Surgery Carrie Cunningham, who has lived with depression, anxiety and a substance abuse disorder for many years.
  2. News Article
    People who seek help for mental health issues should be asked about problem gambling in the same way they are asked about drugs, smoking and alcohol, new guidance has suggested. According to the National Institute for Health and Care Excellence (NICE), those who visit an NHS health professional in England for depression, anxiety or thoughts about self-harm or suicide because of a possible addiction, such as alcohol or drugs, could be at a greater risk of harm from gambling. NICE said questions should be asked about patients’ gambling habits to ensure they could cope with their thoughts and urges. In new draft guidance, it suggested patients should be encouraged to assess the severity of their gambling by using a questionnaire available on the NHS website. Those who scored eight or higher should seek support and treatment from gambling services. Read full story Source: The Guardian, 5 October 2023
  3. News Article
    The use of non-medics in clinical roles is leading to deaths and missed diagnoses, senior doctors have warned. Hundreds of doctors have signed an open letter to the leadership of the Royal College of Physicians (RCP), urging them to take a stand over the rollout of physician associates (PAs). PAs are a newer type of medical role that involves significantly less training than doctors receive. The NHS has used PAs since 2003 but concerns have emerged in recent months about them taking on more advanced work than is appropriate. NHS England set out plans earlier this year to expand their numbers significantly amid ongoing staff shortages. Now an open letter to the RCP’s council, to date signed by 46 fellows of the college and 194 other doctors, sets out concerns ranging from patient safety and liability to the fact that newly qualified PAs can earn more than newly qualified doctors. They say: “There have been several high-profile incidents in which serious illness was missed by a PA when undertaking a role that would normally be filled by a doctor. In some cases, avoidable deaths have resulted. “Given that some of these conditions required more advanced training than the PA had received, the implication is that rare avoidable deaths are a price society must pay for the replacement of medical staff with non-medical staff. We believe this trade-off must be debated widely not just by doctors but also by the lay public.” Read full story (paywalled) Source: The Times, 5 October 2023
  4. News Article
    More than 1 in 10 sexual harassment complaints against doctors are not investigated by the General Medical Council because of an “arbitary” rule, the Observer has revealed. According to data obtained under the Freedom of Information Act, 13% of sexual misconduct complaints made between the years 2017-18 and 2021-22 were closed without investigation because the GMC is prevented from considering alleged incidents more than five years after the event. As part of the council’s remit to protect patient safety and improve medical education and practice across the UK it investigates any kind of complaint against doctors. The figures show the GMC refused to investigate 170 complaints relating to sexual assault, attempted rape, and rape in the period analysed. In 22 of those cases the five-year rule was cited. It received 566 sexual harassment complaints in the same period. Anthony Omo, the GMC’s general counsel and director of fitness to practise, told the Observer: “We can and do waive the five-year rule where there are grave allegations involving sexual assault or rape. In many cases involving sexual allegations, the GMC’s position will be that such serious misconduct is incompatible with continued registration.” A government consultation in February heard that the five-year-rule was “arbitrary” and “a barrier to public protection” as it allowed doctors who may be guilty of inappropriate behaviour to continue practising. However, despite commitments from the Department of Health and Social Care to scrap the limitation as a “top priority”, no date has been set. Read full story Source: The Guardian, 30 September 2023
  5. News Article
    Thousands of women may be missing out on a diagnosis of type 2 diabetes because the thresholds are geared towards men, research suggests. Scientists assessed test results from more than one million patients across the country and concluded that the bar for diagnosis might be set too high for women. They calculated that, if thresholds were lowered slightly, an extra 35,000 women under the age of 50 in England would be diagnosed with type 2 diabetes — increasing the number in this age group with the condition by 17%. Under the present guidelines, those 35,000 women would be given the all-clear and would miss out on the chance of earlier treatment and lifestyle advice, increasing their risk of complications in later life. The team, led by doctors at the University of Manchester and including researchers from hospitals nationwide, stressed that their findings were preliminary, and needed further assessment before their hypothesis was confirmed. But, if proved correct, they believe that about 65 young women may be dying of diabetes each year without a diagnosis. Read full story (paywalled) Source: The Times, 1 October 2023
  6. Content Article
    The adoption of virtual consultations, catalysed by the COVID-19 pandemic, has transformed the delivery of primary care services. Owing to their rapid global proliferation, there is a need to comprehensively evaluate the impact of virtual consultations on all aspects of care quality. This study aims to evaluate the impact of virtual consultations on the quality of primary care. It found that virtual consultations may be as effective as face-to-face care and have a potentially positive impact on the efficiency and timeliness of care; however, there is a considerable lack of evidence on the impacts on patient safety, equity, and patient-centeredness, highlighting areas where future research efforts should be devoted. Capitalising on real-world data, as well as clinical trials, is crucial to ensure that the use of virtual consultations is tailored according to patient needs and is inclusive of the intended end users. Data collection methods that are bespoke to the primary care context and account for patient characteristics are necessary to generate a stronger evidence base to inform future virtual care policies.
  7. Content Article
    In this consultation, the Department of Health and Social Care (DHSC) is seeking views on the possible introduction of regulations mandating the disclosure of industry payments to the healthcare sector. The consultation concerns the possible introduction of new secondary legislation that would place a duty on manufacturers and commercial suppliers of medicines, devices and borderline substances to report details of the payments and other benefits they provide to healthcare professionals and organisations. This consultation aims to address the second part of recommendation 8 in the Independent Medicines and Medical Devices Safety (IMMDS) Review, regarding real and perceived conflicts of interest in the health system. The proposals will enable respondents to share views on: the information they would need to provide recipients in scope payments that would potentially need to be reported the timing and content of reporting alternatives to regulation. The consultation closes at 11:59pm on 16 October 2023.
  8. News Article
    A 33-year-old New Zealand woman who was accused of faking debilitating symptoms has died of Ehlers-Danlos Syndrome (EDS). Stephanie Aston became an advocate for patients' rights after doctors refused to take her EDS symptoms seriously and blamed them on mental illness. She was just 25 when those symptoms began in October 2015. At the time, she did not know she had inherited the health condition. EDS refers to a group of inherited disorders caused by gene mutations that weaken the connective tissues. There are at least 13 different types of EDS, and the conditions range from mild to life-threatening. EDS is extremely rare. Aston sought medical help after her symptoms—which included severe migraines, abdominal pain, joint dislocations, easy bruising, iron deficiency, fainting, tachycardia, and multiple injuries—began in 2015, per the New Zealand Herald. She was referred to Auckland Hospital, where a doctor accused her of causing her own illness. Because of his accusations, Aston was placed on psychiatric watch. She had to undergo rectal examinations and was accused of practising self-harming behaviours. She was suspected of faking fainting spells, fevers, and coughing fits, and there were also suggestions that her mother was physically harming her. There was no basis for the doctor’s accusations that her illness was caused by psychiatric issues, Aston told the New Zealand Herald. “There was no evaluation prior to this, no psych consultation, nothing,” she said. She eventually complained to the Auckland District Health Board and the Health and Disability Commissioner of New Zealand. “I feel like I have had my dignity stripped and my rights seriously breached,” she said. Read full story Source: The Independent, 6 September 2023
  9. News Article
    Junior doctors and consultants in England are to coincide strikes during the autumn in an escalation of the pay dispute with the government. It will be the first time in this dispute they have walked together and comes after junior doctors voted in favour of continuing with strikes. In the British Medical Association ballot 98% voted in favour, giving the union a fresh six-month mandate. Junior doctors have already staged five walkouts this year. They will strike on 20 to 22 September - the first day of which coincides with a walkout by consultants. They will then walkout on 2 to 4 October, which is when consultants will also be striking. When the two groups strike together cover will be provided to staff emergency services as well as a small amount of cover on the wards. Read full story Source: BBC News, 31 August 2023
  10. News Article
    Delays in patient care and a lack of consultant support have left junior medics fearing for their mental health, an NHS England investigation has discovered. Junior doctors described haematology services delivered from University Hospitals Birmingham’s Heartlands Hospital as “chaotic”. Their concerns are raised in a report by NHS England Workforce, Training and Education (formerly Health Education England). UHB’s haematology service has been under scrutiny since 2021, when HSJ revealed whistleblower concerns over patient safety, including a series of blood transfusion’ never’ events. The WTE team visited UHB in April. As a result, the haematology service is now subject to the General Medical Council’s enhanced monitoring regime. This means intensive support is given to trainees and the trust to improve medical training. UHB’s obstetrics and gynaecology department is also under enhanced monitoring. The WTE report warns that consultants working across multiple sites left trainee medics at Heartlands without sufficient support and supervision. Most conversations with consultants were via telephone, leaving juniors feeling “unsupported and insecure”. The report stated: “Trainees described the workload … as chaotic and some reported the stress … was affecting their mental health… Some reported they do not feel valued, and the panel heard examples of people crying every day. Most described their roles as 100 per cent service provision… [they] reported very limited learning opportunities overall.” Read full story (paywalled) Source: HSJ, 24 August 2023
  11. Content Article
    The Prescribing Safety Assessment (PSA) is a 60-question exam required as part of UK medical training to progress from FY1 to FY2. This independent review into the PSA was commissioned by the Medical Schools Council (MSC) together with the British Pharmacological Society (BPS) in the summer of 2022. It suggests a strategic future direction for the PSA and addresses how the PSA has impacted prescribing assessment and practice for medical students and Foundation Year 1 (FY1) doctors. It is intended to support national decision making about the future of UK prescribing assessment in the context of the imminent introduction of the Medical Licensing Assessment (MLA).
  12. News Article
    Conduct guidelines for UK doctors are being updated to spell out what constitutes workplace sexual harassment, amid concerns abuse is going unchallenged. The General Medical Council, which regulates doctors to ensure they are safe and fit to care for patients, says it is adopting a zero-tolerance policy. The new advice explains it is not just physical acts that can be a breach. Verbal and written comments or sharing images with a colleague count too. The new guidance will not come into effect until the end of January, after a five-month familiarisation period for staff. And some say there is still a long way to go. Dr Chelcie Jewitt, an emergency-medicine doctor who is part of the Surviving in Scrubs campaign group, which aims to raise awareness of sexism, harassment and sexual assault in the healthcare workforce, said: "We have spoken with the GMC about the guidelines and we do think that they are a step in the right direction - but there is still a long way to go on this journey to eradicating the culture of sexual misconduct within healthcare. "The GMC has the potential to make a real difference and we need to see them supporting victims when they report perpetrators. "We need their reporting processes to be transparent and clearly explained to victims. "We need cases to be thoroughly investigated rather than dismissed. "And we need appropriate, proportionate sanctioning of perpetrators." Read full story Source: BBC News, 22 August 2023 Read a blog Dr Chelcie Jewitt wrote for the hub: Calling out the sexist and misogynist culture within healthcare
  13. News Article
    The exodus of healthcare workers from Nigeria, Ghana and Zimbabwe continues, despite the WHO red list and a range of laws to keep them at home. It took nearly three hours of queueing in Ikorodu general hospital in Lagos state, Nigeria, before Hadijat Hassan, a retired civil servant, could see a nurse. The 66-year-old has attended the clinic for health checks since being diagnosed with diabetes nearly 10 years ago. But since May, she says, the delays, often while suffering from excruciating pain in her legs, are worse than ever. “You can get there [the hospital] and meet about 50 people waiting to be attended to,” Hassan says. “They said all of their nurses and doctors have been leaving for abroad. Just a few are left.” In Nigeria, there is one doctor for every 5,000 patients, whereas the average in developed countries is one doctor for about every 254 people. A hospital official said the Ikorodu management get resignation notices from nurses and doctors almost every month. “Many leave for the US, Canada, UK and, most recently, Australia,” says the official, who asked to remain anonymous. The National Association of Nigeria Nurses and Midwives has reported there is now a ratio of one nurse to 1,160 patients. Its president, Michael Nnachi, said that more than 75,000 nurses had left Nigeria since 2017. “If you look at the conditions of service of health workers generally, you’ll see the difficult challenges complicated by the current economic realities,” he said, adding that rising inflation has compounded the problems. The World Health Organization predicts a worldwide shortage of 10 million health and care workers by 2030 – mostly in low-income countries, where people are leaving for opportunities abroad. This is despite the WHO’s introduction of a safeguard list to stop rich countries poaching from poorer countries with staff shortages. The “red list”, launched in 2020 with plans to update it every three years, includes Nigeria, Ghana, Zimbabwe and 34 other African countries. Yet the UK’s nursing regulator, the Nursing and Midwifery Council, says more than 7,000 Nigerian nurses relocated to the UK between 2021 and 2022. Data from the Ghana Registered Nurses and Midwives Association shows that nearly 4,000 nurses left the country in 2022. In Zimbabwe, more than 4,000 health workers, including 2,600 nurses, left in 2021 and 2022, the government said. The WHO has no powers to prohibit recruitment of doctors from countries on the list, but recommends “government-to-government health worker migration agreements be informed by health labour market analysis and the adoption of measures to ensure adequate supply of health workers in the source countries”. Read the full article here
  14. News Article
    As junior doctors begin a four-day strike today with a two-day strike by consultants a fortnight later, Sir Julian Hartley, chief executive of NHS Providers, said: "Trust leaders are very worried about six more days of severe disruption across the NHS this month. "We could be close to a tipping point. Trusts and staff are pulling out all the stops to reduce waiting times for patients but with no end to strikes in sight the sheer volume of planned treatment being put back due to industrial action will make it almost impossible for trusts to cut waiting lists as much as the government wants. "Waiting lists are now at a record high of 7.57 million, the pressure on urgent and emergency care services is relentless and an already stretched NHS is gearing up for another high-demand winter as pressure on tight budgets mounts. "A string of strikes – which have led to more than 835,000 routine treatments and appointments being put back since December – is estimated to have cost the NHS around £1bn already including lost income and hiring expensive staff cover. "The number of rescheduled appointments could be close to 1 million after this month's strikes and consultants have called another two-day strike in September. There will be a long-lasting effect on patients who have had treatment delayed and on already low staff morale. "Concerns are mounting too over how patient safety will be maintained during August's strikes as many NHS services will be even more stretched as many staff are on much-needed summer holidays and cover is harder to secure. "It's vital that the government and unions find a breakthrough urgently. Trust leaders understand the strength of feeling among striking staff and why they're taking action. Everyone in the NHS wants to concentrate on treating more patients more quickly rather than spend days making plans to cope with strikes. "People can still rely on the NHS during strikes, calling 999 in an emergency. For less urgent cases people should use 111 online for help and advice."
  15. News Article
    New responsibilities for doctors regarding their use of social media and tackling toxic workplace behaviours and sexual harassment are among key proposals in the General Medical Council’s (GMC) planned update to its core ethical guidance. The regulator has launched a 12-week consultation on the draft new content of 'Good medical practice', which outlines the professional values, knowledge and behaviours expected of doctors working in the UK. This represents the first major update of the guidance since it first came into effect in April 2013, with the review process launched last year. The GMC said the draft new update follows months of working with doctor, employer, and patient representatives, as well as other stakeholders, and reflects the issues faced in modern-day healthcare workplaces. Included for the first time in the draft new guidance is a duty for doctors to act, or support others to act, if they become aware of workplace bullying, harassment, or discrimination, as well as zero tolerance of sexual harassment. For the first time, the GMC's ethical guidance proposes 12 commitments, including: Make the care of patients my first concern. Demonstrate leadership within my role, and work with others to make healthcare environments more supportive, inclusive, and fair. Provide a good standard of practice and care, and be honest and open when things go wrong. Ensure my conduct justifies my patients’ trust in me and the public's trust in my profession. Read full story Source: Medscape, 27 April 2022
  16. News Article
    In an unprecedented murder case in the United States about end-of-life care, a physician accused of killing 14 critically ill patients with opioid overdoses in a Columbus, Ohio hospital ICU over a period of 4 years was found not guilty by a jury Wednesday. The jury, after a 7-week trial featuring more than 50 witnesses in the Franklin County Court of Common Pleas, declared William Huse not guilty on 14 counts of murder and attempted murder. In a news conference after the verdict was announced, lead defense attorney Jose Baez said Husel, whom he called a "great doctor," hopes to practice medicine again in the future. The verdict, he argued, offers an encouraging sign that physicians and other providers won't face prosecution for providing "comfort care" to patients suffering pain. "They don't need to be looking over their shoulders worrying about whether they'll get charged with crimes," he said. The trial raised the specific issue of what constitutes a medically justifiable dose of opioid painkillers during the end-of-life procedure known as palliative extubation, in which critically ill patients are withdrawn from the ventilator when they are expected to die. Under medicine's so-called double-effect principle, physicians must weigh the benefits and risks of ordering potentially lethal doses of painkillers and sedatives to provide comfort care for critically ill patients. To many observers, however, the case really centered on the largely hidden debate over whether it's acceptable to hasten the deaths of dying patients who haven't chosen that path. That's called euthanasia, which is illegal in the United States. In contrast, 10 states plus the District of Columbia allow physicians to prescribe lethal drugs to terminally ill, mentally competent adults who can self-administer them. That's called medical aid in dying, or physician-assisted dying or suicide. Read full story Source: Medscape, 27 April 2022
  17. News Article
    Doctors at an acute trust believe their clinical leaders have failed to tackle the ‘big personalities’ accused of being aggressive bullies, a review has found. The probe at University Hospitals of North Midlands Trust was prompted by a survey carried out last year by the British Associations of Physicians of Indian Origin, after concerns were raised by its members. The review was undertaken by Birmingham-based equalities charity Brap, and Roger Kline, a research fellow at Middlesex University Business School. It found the trust was not an outlier in statistical measures of bullying and harassment, but suggested the situation was still worse than leaders would wish. They said: “The most common reason people cited for bullying/harassment they experienced was the personality, attitude, and disposition of their managers and colleagues… it is felt senior clinical leaders have, in the past, failed to tackle these ‘big personalities’. “It is worth noting feedback from interviews suggesting many doctors feel they have endured poor behaviour – talking over people during meetings, criticising work in public, aggressive questioning – for years, and have simply become inured to it. The reviewers found that as a consequence, certain people within the organisation were perceived to be “bullet proof”, and added: “We would suggest the trust needs a big, long-term plan to ‘rehumanise’ the organisation. “The trust’s existing culture has permitted, and continues to permit infringements in behaviour… While this is not condoned by senior leaders in the trust, the lack of a plan to proactively tackle a legacy of overlooking poor behaviours has allowed them to persist.” Read full story (paywalled) Source: HSJ, 6 April 2022
  18. News Article
    Doctors too often "ignore" women's pain, Sajid Javid said as he called for change in the wake of the Shrewsbury maternity scandal. Writing for The Telegraph, the Health Secretary said the wider NHS needed to do much more to listen to women, adding that too many are left in pain and ignored by clinicians. On Wednesday, the Ockenden report revealed that the deaths of 201 babies and nine mothers at Shrewsbury and Telford NHS Trust could have been avoided, citing a failure to listen to women. Mr Javid wrote: "This week we have seen the tragic reality of what can happen when women's voices are not listened to when it comes to their care. "Donna Ockenden's report into maternity failings at Shrewsbury and Telford Hospitals raises specific concerns for maternity services, but more widely we must address issues across the whole of the health and care system when it comes to listening to women's concerns and recognising their pain." In the joint piece with Maria Caulfield, the minister for women’s health, Mr Javid welcomed a "shift in the way we talk about women's health", with more open discussions about areas once seen as taboo. But the pair said more needed to be done – specifically to improve the treatment of endometriosis, an extremely painful gynaecological condition. "We must ensure all women feel confident in going to their GP when they experience symptoms of endometriosis and, when they do, that they are listened to," they said. Too many were "spending too long in pain waiting for a diagnosis, often feeling ignored by clinicians", they warned. Later this year the Government will publish a women's health strategy, which will examine issues including fertility, menopause, and prevention and treatment of diseases. Read full story (paywalled) Source: The Telegraph, 31 March 2022
  19. News Article
    A doctor's bid to be voluntarily removed from the medical register on health grounds has been rejected. It means Dr Heather Steen, who is accused of failings following the death of Claire Roberts in 1996, will still face a fitness to practice tribunal. The tribunal would have been halted if she had been removed from the register, as she would no longer have been a doctor. Claire Roberts died at the Royal Belfast Hospital for Sick Children, where Dr Steen worked, in October 1996. The nine-year-old's death was examined as part of the hyponatraemia inquiry. Her father Alan said his family welcomed the decision to refuse the paediatrician's application. He said the tribunal hearing was "in the public interest" and should proceed "to maintain public confidence in the medical profession, the regulatory process and to ensure that professional standards are upheld". Read full story Source: BBC News, 28 March 2022
  20. News Article
    A Derby doctor who has been the subject of eight tribunals in less than nine years has been sanctioned for a further four months. Dr Anatta Nergui was originally found guilty of misconduct in 2014 and has been found to have not fully reflected on the severity of his offending in six different hearings since. The psychiatrist was suspended by the Medical Practitioner Tribunal Service (MPTS) in 2014 for running a website and blog which offered incorrect medical advice to those who got in contact with him. In 20 of 22 cases, he was found to have failed to recommend that the patient saw a doctor or psychiatrist, and failed to recommend a counselling or psychotherapy course in 30 cases, among other complaints, which put patients at "significant risk of harm". The latest tribunal aimed at assessing his fitness to practice, held in March 2022, has imposed a further four months of conditions on him, after the MPTS found that "despite there being a low risk of repetition, the remediation had not yet been completed", according to the chair of the tribunal, Jetinder Shergill. In the MPTS determination, released on Thursday (March 17), Mr Shergill said: "While the tribunal was satisfied that there is sufficient evidence Dr Nergui is a competent and safe doctor, there remains a lingering concern that he did not appreciate the findings made against him from the patient’s perspective and/or did not express this in a clear, cogent manner. The tribunal considered that Dr Nergui might have benefitted from seeking feedback from a trusted colleague or mentor, reflecting on what went wrong and setting out his thought processes on avoiding similar risk. "In short, the self-reflection has led Dr Nergui down a restricted path of understanding, leading him to focus on the legal aspects of the process and semantics rather than the primary issue which was one of patient safety. If he had sought the input of a third party, it may have led to him developing an alternative view rather than the binary approach that he has adopted. This left the tribunal with the view that whilst there has been some insight, remediation is not yet complete." Read full story Source: Derbyshire Live, 18 March 2022
  21. News Article
    A paediatrician who was at the centre of one of Northern Ireland's longest running public inquiries will appear before a professional misconduct panel. Dr Heather Steen is accused of several failings following the death of Claire Roberts at the Royal Belfast Hospital for Sick Children in October 1996. The nine-year-old's death was examined by the hyponatraemia inquiry, which lasted 14 years. It examined the role of several doctors. Among his findings, the inquiry's chairman Mr Justice O'Hara said there had been a "cover-up" to "avoid scrutiny." Monday's tribunal will inquire into allegations that, between 23 October 1996 and 4 May 2006, Dr Steen "knowingly and dishonestly carried out several actions to conceal the true circumstances" of the child's death. Also that the doctor provided inappropriate, incomplete and inaccurate information to the child's parents and GP regarding the treatment, diagnosis, clinical management and cause of her death. The tribunal website adds: "It is also alleged that Dr Steen inappropriately recommended a brain-only post-mortem for Patient A (Claire Roberts) when a full post-mortem was necessary. "In addition, it is alleged that Dr Steen failed to refer Patient A's death to the coroner, inappropriately completed the medical certificate of cause of death and inaccurately completed the autopsy request form for Patient A. "Furthermore, it is alleged that during a review of Patient A's notes, Dr Steen failed to consult with the necessary colleagues and medical teams and provided a statement and gave evidence to the coroner's inquest into Patient A's death which omitted key information." Read full story Source: BBC News, 21 March 2022
  22. News Article
    A doctor who has suffered violent shakes and hallucinations during her ongoing 15-month battle with long COVID has criticised the government's plan to "live with the virus". Dr Kelly Fearnley told Sky News she contemplated ending her own life due to the debilitating long-term effects of coronavirus, which she caught while working on a COVID ward in November 2020. The 35-year-old from Leeds, who was previously fit and healthy, initially had flu-like symptoms before she suffered shortness of breath and painful rashes over her body, as well as swelling around her eye. More than a year later, she is still unable to return to work due to the effects of long COVID, which have included violent shakes lasting up to 14 hours at a time, hallucinations, night terrors, severe pins and needles in her arms and legs, and a resting heart rate of 140 beats per minute. With Prime Minister Boris Johnson set to unveil his "living with COVID" plan on Monday, Dr Fearnley branded it a "strategy of denial, driven by the need to cut costs" and she felt "angry and let down". Read full story Source: Sky News, 20 February 2022
  23. News Article
    Medical records contain a plethora of information, from a patient’s diagnoses and treatments to marital status to drinking and exercise habits. They also note whether a patient has followed medical advice. A health provider may add a line stating that the patient is “noncompliant” or “non-adherent,” signalling that the patient has been uncooperative and may exhibit problematic behaviours. Two large new studies in the US found that such terms, while not commonly used, are much more likely to appear in the medical records of Black patients than in those of other races. The first study, published in Health Affairs, found that Black patients were two and a half times as likely as white patients to have at least one negative descriptive term used in their electronic health record. About 8% of all patients had one or more derogatory terms in their charts, the study found. The most common negative descriptive terms used in the records were “refused,” “not adherent,” “not compliant” and “agitated.” The second study, published in JAMA Network Open, analysed the electronic health records of nearly 30,000 patients at a large urban academic medical centre between January and December 2018. The study looked for what researchers called “stigmatising language,” comparing the negative terms used to describe patients of different racial and ethnic backgrounds as well as those with three chronic diseases: diabetes, substance use disorders and chronic pain. Overall, 2.5% of the notes contained terms like “nonadherence,” “noncompliance,” “failed” or “failure,” “refuses” or “refused,” and, on occasion, “combative” or “argumentative.” But while 2.6% of medical notes on white patients contained such terms, they were present in 3.15% of notes about Black patients. Looking at some 8,700 notes about patients with diabetes, 6,100 notes about patients with substance use disorder and 5,100 notes about those with chronic pain, the researchers found that patients with diabetes — most of whom had type 2 diabetes, which is often associated with excess weight and called a “lifestyle” disease — were the most likely to be described in negative ways. Nearly 7% of patients with diabetes were said to be noncompliant with a treatment regimen, or to have “uncontrolled” disease, or to have “failed.” The labels have consequences, warns Dr. Schillinger, who directs the Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center. “Patients whose physicians tend to judge, blame or vilify them are much less likely to have trust in their doctors, and in the medical system overall,” Dr. Schillinger said. “Having health care providers who are trustworthy — who earn their patients’ trust by not judging them unfairly — is critical to ensuring optimal health and eliminating health disparities.” Read full story (paywalled) Source: The New York Times, 20 February 2022
  24. News Article
    A trust breached its own internal illness policy when managers sacked a doctor who had PTSD and had been drunk at work, an employment tribunal has ruled. Judges criticised the move as a “complete failure” by East and North Hertfordshire Trust when Vladimir Filipovich was dismissed in July 2019. Dr Filipovich was summoned to a hearing following allegations he had been drunk at work, did not disclose a diagnosis of post-traumatic stress disorder to his employer, and failed to take a recommended prescription of Citalopram. In a decision published this month, the tribunal sharply criticised how the trust’s investigator handled the Citalopram claim, concluding he “did nothing to investigate the matter whatsoever”, and found ENHT had “appeared to simply take legal advice” on how to dismiss Dr Filipovich. The tribunal also concluded ENHT “stopped following” its own illness policy, which aimed to get practitioners to return to work, and “abandoned” its requirement to obtain the latest occupational advice. Read full story (paywalled) Source: HSJ, 21 July 2023
  25. News Article
    A trust has been accused of presiding over the deterioration of a key service amid communication problems between senior leaders and a ‘worrying series of resignations’ which has left the department with ‘no doctors’. The British Association of Dermatologists wrote to Worcestershire Acute Hospitals Trust on 13 July to request an urgent meeting with the provider’s management to discuss the matter. The letter, seen by HSJ, outlines fundamental patient safety and staffing concerns about the trust’s dermatology service and accuses the trust of putting “continued communication barriers” between clinicians and management. The letter, signed by BAD president Mabs Chowdhury, says there are now “no doctors in the department” after two consultants and a locum consultant resigned “due to apparent unhappiness with the running of services [and in] a continuation of a worrying series of resignations”. Read full story (paywalled) Source: HSJ, 19 July 2023
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