If I ruled the world
BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7375.1309/a (Published 30 November 2002) Cite this as: BMJ 2002;325:1309
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Nurses and therapists who fail to adapt the day/date/time board when
attempting to re-orient a patient after head injury or in dementia - and
then expect the patient to get it right.
Newspapers that do not declare competing interests eg their
proprietor's or editor's shares in a private health insurance company.
Sycamore trees.
Competing interests:
None declared
Competing interests: No competing interests
Dear Dr Smith,
It’s a while since Woody Allen’s film Bananas was screened on TV.
The last time it was, I recall a scene in which a newly appointed Latin
American dictator announces to the waiting crowd that, from now on,
underpants are to be changed every six hours. To ensure this rule is
obeyed they were to be worn on the outside.
There is quite of lot this going on in the NHS at the moment. Whole
armies of earnest people bearing clipboards roam around doctor’s surgeries
asking to see patient’s records to make sure the latest set of Government
targets on mental health or heart disease is being met.
It irritates the hell out of me as a GP. But I've also been a patient
and I am not at all sure I should like my records to be pored over by
someone whose knowledge of medicine wouldn’t cover the back of a small
postage stamp.
So, if I ruled the world, I would make sure that patient’s records
were read only by those responsible for their care.
Yours sincerely,
John Hopkins
Competing interests:
None declared
Competing interests: No competing interests
Just thinking about what all I would ban left me dizzy. Nevertheless
let me try. I would for starters ban all Bcomplex injections and run the
risk of getting assassinated by the General Practitioner groups. I would
ban overt or covert taking of cuts and will earn the wrath of both givers
[Institutions and Drug companies] and takers [doctors] who will then use
their undoubted clout to try and dethrone me. I will compulsorily teach
doctors how to talk to patients as they would to the men who do their
cars. I will not allow them to qualify unless they develop some other
interest other than medicine and hold periodic examination to see that
they practice that interest. I would ban patients who try and cadge free
consults by describing their problems on telephone. I would ban
Consultants from seeing patients directly with out referrals from General
Practitioners and would ban doctors from chasing patients to their graves
and gynecologists from practicing pediatrics and neurosurgeons from
practicing psychiatry and the list appears endless.
Of course all this applies only to my own much loved country.
Competing interests:
None declared
Competing interests: No competing interests
I would be very severe with clocks in public places showing
inaccurate times
Competing interests:
None declared
Competing interests: No competing interests
If I was part of the Dunea Empire, one thing I would definitely do
would be to ban anyone - patient or relative coming to see me in hospital
whilst wearing a baseball cap.
Wearing any hat indoors is rude and insulting to anyone. Wearing a
baseball cap is not only so, but also looks silly and not in the least way
"cool".
Constantine the Great was well remembered and respected for having
good morals. I may be wrong, but I think he may have been the Emperor who
decided and did reverse the hedonism of Ancient Rome. There is precedent
in history in restoring manners in the people and I for one would like to
see it happen again.
Competing interests:
None declared
Competing interests: No competing interests
. . . a few more laws to be enacted:
- that all elected members of government be required
to fill out their own tax returns without assistance
- that they be required to use the same state health
services as the people who elected them (or, if there is
not state health service, that they have to buy their own
private medical insurance out of their own pocket)
- that direct-to-consumer drug advertising would only
be permitted if the ad states the retail cost of a course
of the drug and its nearest generic equivalent
- that journals not be permitted to publish relative risk
reductions (RRRs), nor drug companies to quote
RRRs
- that findings that are not statistically significant must
be reported as negative findings, not as "trends
towards significance"
- that newspapers not be permitted to print headlines
saying that there is a "link" between variable X and
disease Y when there is nothing more than a
correlation or statistical association without evidence of
causation
- that pharmacies who do not have the 20mg tablet
dose of a drug available be fined if they call the doctor
and ask if they can give 2 10mg tablets instead
Competing interests:
None declared
Competing interests: No competing interests
.... as rising will be the number of missed intracranial hemorrhages
and neoplasms, and the associated swift deaths or painful indolent
spirals. All the ruler Yoda hail!
Competing interests:
None declared
Competing interests: No competing interests
Drug company sponsored studies are already closely scrutinised for
inherent biases in their protocols. This is done (in the UK) by the
ethics committees which Dictator Dunea will limit to 30 minute meetings on
Saturdays.
But then absolute despots are not required to be consistent.
T.L. James
Competing interests:
Member of the West Midlands Multi-centre Research Ethics Committee
Competing interests: No competing interests
if lord dunea ruled the world
individual consultations will be banned: if you are really sick you
shouldn´t de embarrassed; if not, you deserve it. Family of patients who
die at home will receive a tax revenue. Medical equipment and drugs
industries will be state-owned. And last, but not the least, George Dunea
will be overthrown after 70 years of dictatorship, crucified in Acapulco
and all the lawyers male children will bear his name for another 70 years.
Competing interests:
None declared
Competing interests: No competing interests