tag:blogger.com,1999:blog-631567898928853978.post5420253537873883553..comments2023-07-18T15:27:42.958+01:00Comments on A fortunate man: Being a doctorDr Andrew Brownhttp://www.blogger.com/profile/13858213625632400403noreply@blogger.comBlogger22125tag:blogger.com,1999:blog-631567898928853978.post-70217768451687630892010-04-07T01:45:30.546+01:002010-04-07T01:45:30.546+01:00I came across this post when I tried to search for...I came across this post when I tried to search for House, MD. I am just so addicted to the series. And I find the post quite interesting, Dr. Brown. Just a question though, if you were House, would you be doing the same decisions to your patients?<br /><br /><br />I believe he (House) is able to save many lives at risk especially those with very unique illnesses, but does this end justify his means?Annehttp://www.christiansteven.com/noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-17286596934717818222009-09-10T20:55:52.090+01:002009-09-10T20:55:52.090+01:00Dr. Brown,
Thanks for choosing to be a General Pr...Dr. Brown,<br /><br />Thanks for choosing to be a General Practitioner! Not a lot of people find the courage or even have the <a href="http://www.spyeyes.it/sito/catalog/" rel="nofollow">localizzatori gps</a> to make a difference.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-84272329472953330602008-09-19T23:56:00.000+01:002008-09-19T23:56:00.000+01:00No One: It's true that hospital visiting by GPs is...No One: It's true that hospital visiting by GPs is almost unheard of nowadays, and that is a shame. It is quite simply a matter of lack of time, due to ever increasing demands. There are more doctors per head in the countries you mention where GP visits still occur.<BR/><BR/>Your criticisms are reasonable, and welcome. I'm not promoting complacency or trying to defend bad or incompetent doctors. I'm just describing how it is for me.<BR/><BR/>David: Thanks for your kind words. I'm always glad to have visitors from WA as my father now lives there.Dr Andrew Brownhttps://www.blogger.com/profile/13858213625632400403noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-6528072789474847502008-09-15T02:32:00.000+01:002008-09-15T02:32:00.000+01:00Fantastic post. I first had the difference between...Fantastic post. I first had the difference between saying "I am a doctor" and "I work as a doctor" pointed out to me by a very learned professor of General Practice here in Western Australia. It is well worth considering how the shift in the way doctors describe themselves correlates with the problems with the medical workforce, though which precipitates the other is beyond me.David Adam (zanchey)https://www.blogger.com/profile/10379623756075520912noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-69703677072393906422008-09-14T18:43:00.000+01:002008-09-14T18:43:00.000+01:00theres nothing sentimental about good levels of ca...theres nothing sentimental about good levels of care<BR/><BR/>if GPs in Italy, Belgium, New Zealand to name but a few can take the time to occasionally visit their patients in hospital I dont see why its impossible in the UK<BR/><BR/>too few docs, dealing with too many dross cases, and doing too much stuff that should (and would be elsewhere on the planet) done by consultants<BR/><BR/>im sort of on your side<BR/><BR/>but i feel a little sanity from the patient point of view is missing<BR/><BR/>i have great sympathy with the best GPs, tolerance for the middling GPs, but feel the bottom %'s of GPs should be stopped from practising<BR/><BR/>i really dont see any good answers here that will improve the service to patients<BR/><BR/>and I'm really hacked off with a system that allows folk to die for want of treatment that should be routine<BR/><BR/>so hopefully i wont snap, but hopefully you understand where im coming from<BR/><BR/>http://notdrrant.blogspot.com/No Onehttps://www.blogger.com/profile/01441448586081929872noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-2115101862722443842008-09-14T12:56:00.000+01:002008-09-14T12:56:00.000+01:00Dear Mr no oneYou sound very hurt and angry and ma...Dear Mr no one<BR/>You sound very hurt and angry and may snap at this but has it occurred to you that the reason today's GPs don't visit their patients in hospital is that their time is filled up with other things. If you read this blog you will see how Dr Brown spends his long hours at work. Many doctors - including older ones like me - used to visit their patients in hospital in the day between surgeries. Now there is no time - it is back-to-back clinics, meetings, audit groups, training courses, inspection visits, paperwork etc. <BR/><BR/>I remember the good old days when I had time to visit the hospital. These days, it's a miracle if I am even aware someone has been admitted to hospital until days after they come home. Regret for the passing of this sort of thing is regarded as sentimental twaddle by the modernisers.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-52300411178939711052008-09-13T20:56:00.000+01:002008-09-13T20:56:00.000+01:00yea maybe GPs should go round hospitals a little m...yea maybe GPs should go round hospitals a little more like the used to do in the old days<BR/><BR/>i remember the family GP randomly turning up on the wards and keeping the hospital on its toes in my youth<BR/><BR/>i am very sure large numbers of people die from dehydration in nhs wards every day<BR/><BR/>it cannot be that big a secret in the medical world<BR/><BR/>or maybe youd all just prefer to look the other wayNo Onehttps://www.blogger.com/profile/01441448586081929872noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-8883245182342767302008-09-12T23:47:00.000+01:002008-09-12T23:47:00.000+01:00Wow! This post really has generated a lot of comme...Wow! This post really has generated a lot of comments. Thank you everyone. I was particularly pleased to see many of my favourite bloggers making comments.<BR/><BR/>Just a few specific points.<BR/><BR/>Jellyhead: I have thought about going part-time. In the first place I am dropping some private commitments which will reduce my workload (and income). I'll see how things go after that.<BR/><BR/>Blue Spice: Yes, I think that "giving energy" has a lot to do with it. I often quote Luke 8:40-48.<BR/><BR/>No One: I'm afraid I don't have much experience of what goes on in hospitals nowadays. Your descriptions sound unlikely, or at least I hope they are. I was thinking of a time when GPs would sometimes give a large dose of morphine. I am sure that never happens nowadays.<BR/><BR/>Anonymous 23.01: I think doctors ought to balance doing and being. I am actually in favour of retired doctors being allowed to remain on the GMC Register.<BR/><BR/>Gareth: Thanks for suggesting my essay is worth submitting to the BMJ. I don't think they accept anonymous contributions and of course I couldn't submit it under my real name. No - people will just have to come here if they want to read my stuff!<BR/>I can't be more specific about what I was doing, except to say that it was immensely satisfying.<BR/><BR/>Ageing student: You are thinking of "The Latest Decalogue" by Arthur Hugh Clough, which was not intended as a serious contribution to ethics but was an ironic take on the ten commandments. Another line reads:<BR/>"Thou shalt not steal; an empty feat,<BR/>When it's so lucrative to cheat."<BR/>On the other hand it does neatly sum up the approach many doctors take to palliative care.Dr Andrew Brownhttps://www.blogger.com/profile/13858213625632400403noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-45804472017533975422008-09-12T21:47:00.000+01:002008-09-12T21:47:00.000+01:00Who was it who said (about doctoring) "Thou shalt ...Who was it who said (about doctoring) "Thou shalt not kill but need not strive, officiously, to keep alive."I have always felt that fitted the bill - do the best you can, try not to kill any patients, but when the time comes don't keep resucitating hopeless cases (or have I been watching too many hospital dramas?)ageing studenthttps://www.blogger.com/profile/16645590270175914544noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-12215793221183970422008-09-12T20:27:00.000+01:002008-09-12T20:27:00.000+01:00Very nice essay - I think you should submit this s...Very nice essay - I think you should submit this somewhere (eg BMJ), so that more people will see it than visit your blog.<BR/><BR/>BTW what was the project you were working on with the friends?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-85476566676553475182008-09-11T00:01:00.000+01:002008-09-11T00:01:00.000+01:00Goodness, has doctors net entered your blog Dr Bro...Goodness, has doctors net entered your blog Dr Brown? It seems you have attracated a campaigner!<BR/><BR/>On your main theme I am sure I have heard or read this phrase about different categories of doctors, those who do and those who are, so maybe your friend is not an original thinker (as well as getting you wrong). <BR/><BR/>Maybe the do-ers are more balanced and the be-ers more sentimental and nostalgic. Does this explain the number of "retired" doctors clinging onto GMC registration despite the absence of any reason to do so, as well as the number of doctors harking back to past golden ages rather than moving with the times.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-89219568071385753192008-09-10T16:42:00.000+01:002008-09-10T16:42:00.000+01:00come on we all know folk in the nhs with already a...come on we all know folk in the nhs with already adequate pain relief are often sedated and then have their drip removed (or none added as they are no longer able to drink)<BR/><BR/>who is kidding who?<BR/><BR/>id like to see some honesty in the death certificates, so that they list dehydration as the true cause of death<BR/><BR/>with the nhs incentivised to free beds up anyway they can its getting worseNo Onehttps://www.blogger.com/profile/01441448586081929872noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-3055322676843662242008-09-09T22:18:00.000+01:002008-09-09T22:18:00.000+01:00By 'sedating the patient', I guess 'No-one' means ...By 'sedating the patient', I guess 'No-one' means allowing the sedating side-effects of effective pain relief. What is the alternative then? Leaving patients with untreated, unrelieved pain?<BR/><BR/>I have never encountered a situation involving 'withdrawal of fluids' - just the decision NOT to penetrate the skin with a needle and artifically give fluids - a move which would only prolong the inevitable in a suffering patient with a terminal condition.<BR/><BR/>I agree that we should not hasten death, but nor should we use intrusive measures to keep a person 'alive' when they are at the end of their life. I understand what you mean Andrew, and rather than finding you self-satisfied, I've always thought you were quite self-critical.<BR/><BR/>Each to his own.Jellyheadhttps://www.blogger.com/profile/05344630172173199819noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-21644831591786982482008-09-09T20:12:00.000+01:002008-09-09T20:12:00.000+01:00re "After Shipman, quietly hastening the end of a ...re "After Shipman, quietly hastening the end of a suffering patient is inconceivable" oh so sedating the patient, withdrawl of fluids, and letting them die from dehydration isnt hatening the end?, as is practised by the nhs thousands of times a day?<BR/><BR/>what self satisfied bollocksNo Onehttps://www.blogger.com/profile/01441448586081929872noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-45358796091562518272008-09-09T07:09:00.000+01:002008-09-09T07:09:00.000+01:00Funnily enough, I had a similar conversation recen...Funnily enough, I had a similar conversation recently when I said that I have always enjoyed working with "patients" as opposed to another job in which they'd be "customers". We decided that our role becomes part of us or something being a part of us is what leads to taking on this role. If I think to what I'd be if I lived in any given period in history, I still would be a healer I think.<BR/>The best I can define it is that interaction bewteen people involves giving and receiving "energy" (knowledge, emotion, support, call it what you will.) Healers tend to be givers the majority of the time, I think, which I am sure is part of the reason behind becoming a healer, and then remaining a healer.<BR/>(Here endeth the waffle)<BR/>Anji - XAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-45137690929793334642008-09-08T18:44:00.000+01:002008-09-08T18:44:00.000+01:00Excellent post Dr. Brown. Thanks for your insight....Excellent post Dr. Brown. Thanks for your insight.XEhttps://www.blogger.com/profile/02522455400636588309noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-47277628050121890812008-09-08T14:27:00.000+01:002008-09-08T14:27:00.000+01:00Telling a story to an older physician about anothe...Telling a story to an older physician about another retired physician I noted that he "was" a doctor at which point I was stopped mid-sentence. <BR/><BR/>"Was?" he said. "Isn't he still a doctor?"<BR/><BR/>For better and worse this is who we are and I think I could have done a lot worse.The Country Dochttps://www.blogger.com/profile/10431930238256540903noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-12108022588106342052008-09-08T07:54:00.000+01:002008-09-08T07:54:00.000+01:00......underlying everything was the idea that we s.........underlying everything was the idea that we should do our best for our patients, even at risk to ourselves.<BR/>*********************<BR/>That's what I remember too. I wonder if we still inculcate that concept into today's students. If we are still respected it may be because patients recognise that vocational element to the job. <BR/><BR/>That was the element that used to drive GPs (and for that matter consultants) to be available day and night without the government or managers even knowing. And that was why the 'tougher' new contracts resulted in many of us getting paid more for doing less. <BR/><BR/>The government has done its best to destroy the vocational and goodwill element of medicine. It does not seem to understand that doctors have been trained from the day they first saw a patient that the rules of the game are always to put the patient first. Managers seem to want to teach us that as if it is something new. I rather think it is. To them.<BR/><BR/>A DoH civil servant told me that the government is baffled as to why doctors are not enamoured with the government. It's because they have done their best to damage the things that are best about our profession. And if we lose those things completely we will no longer continue to be respected as we are. We will become like the politicians and seen as being in our jobs just to get what we can out of them.<BR/><BR/>Excellent post.Dr Grumblehttps://www.blogger.com/profile/04417731064007601504noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-33951846502004795742008-09-08T07:39:00.000+01:002008-09-08T07:39:00.000+01:00I really liked this post. I hate those comments ab...I really liked this post. I hate those comments about it being not a job, being what you are. Something about it just rubs me wrong. <BR/><BR/>And I loved how you ended it. Nice work. I'm passing this one along.Sarahttps://www.blogger.com/profile/15606922510495018342noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-33069315064726153502008-09-08T04:41:00.000+01:002008-09-08T04:41:00.000+01:00Lovely post, Andrew. Thank you.JD.Lovely post, Andrew. <BR/><BR/>Thank you.<BR/><BR/>JD.Jobbing Doctorhttps://www.blogger.com/profile/15556376882759955757noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-73792589250456645862008-09-08T04:21:00.000+01:002008-09-08T04:21:00.000+01:00I agree that part of what makes doctoring so fulfi...I agree that part of what makes doctoring so fulfilling and so draining, all at the same time, is the giving of oneself. I can imagine you do more than the average doctor when it comes to empathising and taking time and being thorough.<BR/><BR/>Have you considered part-time work?.. just in case you were thinking of working as you do now vs retiring as the only two options. I work the equivalent of around 2 1/2 days, and I (mostly!) love my job. (When working full-time, I was dragging myself to work, completely stressed-out)<BR/><BR/>As always, it was very interesting to read your thoughts on 'doctoring matters'.Jellyheadhttps://www.blogger.com/profile/05344630172173199819noreply@blogger.comtag:blogger.com,1999:blog-631567898928853978.post-46556745266309855912008-09-08T01:24:00.000+01:002008-09-08T01:24:00.000+01:00Don't kid yourself, Dr. Brown. Both you and I will...Don't kid yourself, Dr. Brown. Both you and I will miss it if we can't practice medicine until we get called to appear before the Pearly Gates...Anonymousnoreply@blogger.com