Rapid Responses to:

PRIMARY CARE: William T Thompson, Margaret E Cupples, Caryl H Sibbett, Delia I Skan, and Terry Bradley Challenge of culture, conscience, and contract to general practitioners' care of their own health: qualitative study BMJ 2001; 323: 728-731 [Abstract] [Full text]

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Rapid Responses published:

" Superhuman Martyrs"

Eleanor Anderson   (28 September 2001)

not super-human but....

Chris Ducker   (2 October 2001)

Mind your neural gaps

Chris Manning   (3 October 2001)

Are you really doing the best for your patients?

Susan E Kersley   (3 October 2001)

" Superhuman Martyrs" 28 September 2001
Eleanor Anderson, GP Prinicipal Saltcoats Group Practice Send response to journal: Re: " Superhuman Martyrs"	Ofcourse GPs do not want to "dump" on their colleaques by going off sick, but there is another attititude which pervades this issue.How often have you heard a group of doctors each blighted with varying degrees of colds or flus quip, " of course if we were patients/ receptionist/ nurses we'd all be off for atleast a week" To paraphrase Basil Fawlty, do I detect the faint hint of singeing martyr? Or the other John Cleese/Pythonesque analogy, "My temperature was 110 and I still went to work. That's nothing! I came to work still attached to the ITU ventilator . That's nothing! I defibrillated myself with a set of old jump leads and got the patient to "bag and mask" me while I auscultated his chest. That's nothing!" etc etc. These attitudes imply that those who succumb to ill health are quite literally lesser mortals.We don't think we're superhuman, it's just that every one else is weak.We ignore our own health to our peril, but we do gain a shared, smug sense of martyrdom.We know we are human individually , but can we admit this to each other or the rest of society ?Obviously this is all mere anecdote and opinion. It is interesting to consider if even qualitative research methods would have the ability to disclose these or similar attitudes, perhaps a fly on the wall during coffee break ?
not super-human but.... 2 October 2001
Chris Ducker, GP principal Wigtownshire Send response to journal: Re: not super-human but....	We do put our patients first. In large parts of the NHS there is no effective cover for colleagues who are off. If we don't attend when suffering mild to moderate illnesses some of them will simply not be seen, clinics are not run and targets are not met.
Mind your neural gaps 3 October 2001
Chris Manning, Chair Depression Alliance and CEO PriMHE (Primary care Mental Health and Education) Teddington Send response to journal: Re: Mind your neural gaps	Dear Sir As the lengthy list of references demonstrates - we probably know enough about this subject now to be doing something about it. It seems rather ironical that just after the CMO has birthed the "Expert Patients Initiative", with its firm nailing of the self-management flag to the mast of healthcare as a model of best practice for punters, we have an article demonstrating the Dark Ages of Medical Man. Service users are being given a model that we as doctors can and also need (not exclusively) to use. In the end not all service users are going to be doctors but all doctors are going to be service users. Getting the NHS right is not just about more money - it is about changing the sort- everything-out-in-the-NHS mentality (whilst ensuring that this does not also become an easy cop out to excuse under-resourcing by introducing a nebulous type of DIY culture). And if you want to sort your local services, just see yourself as a potential user of them and ensure that, as a top priority, your PCO has a strategy for looking after your mental health and your life-long learning needs (protected time and space help here). Also, since everyone is supposed to be registered with a GP (and GPs not with a GP partner), that goes for all you secondary care doctors too! Remember - "Your brain is not just for Christmas". Synaptically Yours Dr Chris Manning Conflict of interest; an interest in conflict.
Are you really doing the best for your patients? 3 October 2001
Susan E Kersley, Retired Medical Practitioner - now Life Coach Send response to journal: Re: Are you really doing the best for your patients?	How effective or efficient are you being when you struggle to cope with the demands of work while ill? Isn't it time to put your own self care way top of your prioritites? How many of the patients you see when ill could have waited? And will someone say at your funeral 'He or she kept to the government targets.' When you look after yourself you will be a much more effective doctor and will give out the message that it's OK to look after yourself. That can only be a good example to your patients.