Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
As Iona Heath is well aware there are serious pitfalls attached to
the practice she advocates.When doctors start asking patients
intrusive questions about their personal life style, family history etc. -
it is important that they are just as open with patients as to the reason
they are requesting such information. Cruciually patients should not be
deceived about the limits to confidentiality offered in the NHS - to
manipulate and deceive in order to encourage disclosure is not the right
of any doctor, however well meaning they assert themselves to be. Many
patients do not want this kind of intimacy with a doctor at all.If
information is being recorded it should be openly offered to patients to
check for accuracy. Any assumptions on the part of doctors should not be
on file. Doctors should gain permission from patients should they wish to
disclose to others amd it is encouraging to see the BMJ is very
straightforward about this in their guidelines . Doctors should remeber
there are laws and guidelies which govern their practice with regard to
the information they gain in consultations. - many are too arrogant
to read or comply with them. Those who have breached GMC/Data protection
laws/human rights laws/common law rights to privacy laws/even the guidance
of their own trades union the BM- in recent years have been medically
trained therapists. Patients should not disclose to doctors before asking
questions to protect their own well - after all doctors themselves are
very careful not to disclose personal information themselves to other
doctors. Iona Heath neglects important aspects of the debate.
Interestingly her colleague has an article published in the following
edition on talking therapies - declaration of interest?
"What's a doctor, after all? - A legitimized voyeur, a
stranger whom we permit to poke fingers and even
hands into places where we would not permit most
people to insert so much as a finger-tip, who gazes on
what we take most trouble to hide; a sitter-at-bedsides,
an outsider admitted to our most intimate moments..."
Not all patients want to talk
As Iona Heath is well aware there are serious pitfalls attached to
the practice she advocates.When doctors start asking patients
intrusive questions about their personal life style, family history etc. -
it is important that they are just as open with patients as to the reason
they are requesting such information. Cruciually patients should not be
deceived about the limits to confidentiality offered in the NHS - to
manipulate and deceive in order to encourage disclosure is not the right
of any doctor, however well meaning they assert themselves to be. Many
patients do not want this kind of intimacy with a doctor at all.If
information is being recorded it should be openly offered to patients to
check for accuracy. Any assumptions on the part of doctors should not be
on file. Doctors should gain permission from patients should they wish to
disclose to others amd it is encouraging to see the BMJ is very
straightforward about this in their guidelines . Doctors should remeber
there are laws and guidelies which govern their practice with regard to
the information they gain in consultations. - many are too arrogant
to read or comply with them. Those who have breached GMC/Data protection
laws/human rights laws/common law rights to privacy laws/even the guidance
of their own trades union the BM- in recent years have been medically
trained therapists. Patients should not disclose to doctors before asking
questions to protect their own well - after all doctors themselves are
very careful not to disclose personal information themselves to other
doctors. Iona Heath neglects important aspects of the debate.
Interestingly her colleague has an article published in the following
edition on talking therapies - declaration of interest?
Competing interests: No competing interests