Friday 11 July 2014

The raison d'être of academia


Things never quite work out the way you want them to in academia (or when you play Germany). Finger clicking or reputation alone doesn't seem to do the trick. It's hard work, sheer doggedness, never accepting your fate, turning a rejection around to a positive, time management, keeping your staff engaged. And keeping the family happy at home! Why do we do it - it enriches us, makes life so much more interesting, and somewhere somehow you'd like to thing you are making a difference. Always useful to remind ourselves about our raison d'être when the chips are down!

Hector Chinoy PhD FRCP
www.inflammation-repair.manchester.ac.uk/staff/HectorChinoy/
www.twitter.com/drhectorchinoy



Tuesday 8 July 2014

Use of the term "Doctor" - please be open and upfront to your patients

Is it fair on patients that non-medical practitioners can use the title Dr without opening stating they are not a physician?

I had a consultation recently where a patient had seen a chiropractor who used the title Dr. The patient assumed that the chiropractor was a doctor and it is not clear on the practitioner's website at all about this - I can't find any qualifications. I realise that chiropractors can use the term Dr, I'm fine about this, but please be upfront to your patients! The patient then asked me if I was a doctor....got my back up slightly, but actually a fair enough question, who is the patient supposed to believe now that he has this revelation to deal with? I may as well not have bothered with my 5 yrs training for MBBS and 3 years for a PhD! Oh, and my BMedSci, MSc and MRCP. And my 18 years in the NHS.

Patients don't know that they may be seeing practitioners who are not actual medical doctors. It's not mentioned and an assumption is then made. Now I don't have a problem with patients seeing osteopaths or chiropractors; I think they have something valuable to providing an angle that we don't offer as rheumatologists. They can teach us a lot about aspects of musculoskeletal care we are not very good at. What I do mind about is when the boundaries become blurred and it is not made absolutely clear to patients who they are dealing with. Years of medical training allows us to create multiple iterations of possible diagnoses, associations and possible drug interactions during a consultation, so that when the patient is eventually referred on for more targeted treatments the relevant healthcare professional can target appropriate treatment on the back of an accurate diagnosis and more importantly exclusion of other stuff. If something goes wrong or a complication occurs as a result of treatment who is it that has the medical indemnity to cover themselves?-- it's the physician who pays large amounts for yearly cover.

I realise that optometrists, veterinarians, chiropractors can refer to themselves as doctors which I fully accept, but what I would request is that they clearly state that they are a doctor of their relevant specialty and not medicine. State what your qualifications are and make sure that this is visible to your patients on your stationary, website and consulting rooms.

Dr Hector Chinoy
BMBS PhD FRCP MSc BMedSci