Tuesday, 14 September 2010

Educationalists, inspections and computers.

There are a lot of thick people in medical education who think that the way “forward” is by using the computer. We at ND Central recently have had a load of educational and local Soviet “inspections” and the recommendations of these have all been along these same lines namely that:

"You are doing everything right and everything that you are doing needs “to be put online” to meet “quality” standards."

Does that mean tick one of our boxes?

This is a classic example of ill informed administrators, both educationalist and local Soviet ones, dumbing down to the point of blind incompetence, and even greater, ignorance.

We take issue with this complete load of bull for the following reasons:

1) If you are doing things right you are doing them right.

2) If you have the information and it is available then it is there.

3) If an educationalist is sufficiently anally challenged that all they can see is up their dark ar*e for information that is their problem, not ours. We can read and see points 1 and 2. (Think about it).

4) Ticking boxes is not the same as treating patients.

5) Those of us on the front line do not take a memory stick from our patients and plug it into our computers to get the diagnosis.

6) The presence of protocols, audits and e-portfolios on our desktop are of no relevance to our treating of patients. If the truth be told the time taken to find, load and read a resuscitation protocol will kill a patient. If you need to read an electronic protocol you haven’t been trained or are an educationalist and should not be treating patients period.

7) GPs do not have access to a huge amount of electronically stored data that (may be) useful when they are consulting but can still do their jobs despite of this “apparent” newly discovered “shortcoming”.

8) Anything online is hackable, and therefore is both compromisible and corruptible. We still have a duty of confidentiality, and of care, as GPs.

9) How does putting information on a computer improve medical care? Do we talk and look at our patients or spend our time clicking on protocols instead?

If a doctor/nurse sees and ignores anything on a computer it is there but maybe useless. If a doctor/nurse sees and ignores anything on patient it is there but maybe useless. Which is more important?

That which is on the patient, the alleged centre of healthcare professionals’ activities, is surely more important that which is on the screen?

Basic training to high standards, not loads of crap on computers, is the key to quality patient care. You can take quality training anywhere, computers are less portable than medical staff and their acquired knowledge.

It is the acquisition and application of medical knowledge that is the skill needed to deliver high quality medical care not the alleged “quality issue” of protocols being on a computer that (allegedly) “represents quality care”. An unread file on a computer may be there but if not used it may as well be in the Mekong delta of NHS computer clarity.

Treating patients in the field, for example at a roadside crash, a remote farmhouse with no piped water or oxygen, only what you have in the boot of a car or in a remote valley with limited, or no mobile phone and internet coverage and no phone lines is not the same as your average GP educationalist trying to demonstrate their complete lack of electronic skill when their memory stick does not work for a lecture given to medical students.

One such doctor is a waste of space, the other such doctor might be able to do things useful albeit at the handicap of no protocols loaded onto a PC to read while they treat a patient in the field. One is providing hands on care the other is a . . . ?

And finally most of the educationalist twats insisting on these changes are so old and backward they went to Universities whose medical schools did not have computers for them as students to use. Some of them will have gone through the whole of their training with no undergraduate teaching on MRI and CT scanning.

Some of us did not have this handicap that current educationalists have for we know that the computer is a tool. Most GP educationists have more computing power on their desks, or their barely used iPhones, than the astronauts in Apollo 11 had in their spacecraft.

What separates the astronauts from UK GP educationalists is the ability to use what is available on the ground as a tool. Storing information is not the same as using it or processing it. One is a clerical task the other requires thought and ability.

Medicine used to be a process that required thought but increasingly has become a clerical task via the “protocol” and the ignoramus’ tick box called QOF whereby “populations” = group of individuals rather than “individuals” = patients are treated. Hence the corporate drive to tick boxes to demonstrate “quality”.

Should we not be removing all of the pre electronic garbage from UK medicine as it is clearly substandard as they trained without the benefit of any electronic storage of data that all new doctors have to deal with?

Medical students, F2s and registrars hate e-portfolios and we at ND Central hate duplication of crap for no gain whatsoever other than a box ticked.

Praise be to the Party of all things electronic and how what used to be a simple process called education has been turned into an electronic nightmare.

Are the doctors now produced electronically any better than those produced using paper records? And are those who insist on electronic records for training actually fit for purpose for they have no e-portfolioes but insist that juniors should have them?

The hypocrisy of ignorance stinks and generates loads of useless work for those forced to use them for no useful purpose.


Anonymous said...

Thanks for the common-sense post!

Northern Doc said...

Thank you for reading and taking the time to comment.

Dr Aust said...

As an ageing scientist who spends a lot of time working on a computer can I say that this gave me the best laugh I've had so far this week? Brilliant stuff.

Mrs Dr Aust, the medical member of the family, is no great fan of computers - she is currently having to dictate her letters to a Trust-prescribed speech recognition programme, which is slower than her typing them with two fingers - and certainly no fan of protocols.

"If you could do medicine with just protocols, you wouldn't need doctors"

- is a favourite saying of hers.

Come to think of it, though, that might explain your educationalists and the NHS's enthusiasm for the things.

Anonymous said...

N.Doc.Spot on. NHS / govt completely deranged in touching faith in IT.
Keep posting

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