Monday, 23 July 2012

Is Testing for UnSafe Behaviour patronising? #meded

When it comes to work I can show my age and be a BOF sometimes! I have 2 bugbears that all junior doctors working for me know about and which date back to lessons I learnt during my time as a medical student in Sheffield in the early 1980s.
The first is the danger of indiscriminate and liberal use of antibiotics. Now maybe this was me rebelling against my father. He is a doctor who qualified at a time when antibiotics were very new and were going to save humankind from all sorts of terrible diseases. That generation of doctors were brought up to see antibiotics as harmless and were encouraged to prescribe them like fabled Smarties!
Failure to stress the dangers of antibiotic therapy to medical students over the past 10-20 years in the way it was to me all those years ago,  has been associated with a high cost - both in terms of lives lost and blighted but also in health dollars required to turn the tanker around.
I was reminded about the other bugbear recently when I read this Twitter conversation between 2 medics.  I understand why some might feel that what is essentially a handwriting test by the deanery is patronising - after all it is what 4 year olds are tested for isn't it? However illegible entries in drug kardexes REALLY bug me. When and why did the medical profession become associated with illegible handwriting and why has it taken centuries to realise that the inability to communicate clearly could be dangerous in medicine?
It has always seemed obvious to me that the teaching of risk and patient safety should be a huge priority in medical school curricula and yet clearly for decades it has not been. Even now the emphasis seems to be on the training of NHS staff with medical school involvement being brought in as an after thought.
As opposition leader Blair once said anyone's priority should be Education, Education & Education.