Saturday, 17 November 2012

Tick a box train a doctor.

Many many years ago when you were trained as a doctor you were given information, it was called training and you spent time in different areas of medicine in order to see how different specialties worked and in doing so you learned. This is not a difficult concept for it is  a simple system which worked once and amazingly continues to do so.

 There are, however, those who benefited from this simple system but who now practice self colonoscopy the process by which by staring deeply into your own dark black hole full of Sierra Hotel India Tango you gain enlightenment by completely ignoring the wider world. As a result of such practices they change medical education not for the better but for the worse as we hope a recent experience will illustrate.

An email from one of our doctors in training has prompted we elderly grunts to pass comment for many years ago we did something called audit.

It was not called audit then it was called good medical care and analysis. As a junior grunt we were once asked by a very learned Professor to keep a record of all their patients admitted over a 3 month period either as an emergency or a routine admission and to record every procedure done and every complication a patient had so that they could see how well they were doing (or not).

We were then asked to analyze this information which we did and discussed this with our seniors called registrars who suggested ways that we could present this information.

We did so to a group of fellow medical teams at our first world university and it generated loads of discussion regarding the results. What followed was a discussion between professionals, not managers, regarding the results and the team we were on did rather well and it led to changes for the better.

We did this because we were asked to and it was to our and to our future patients' benefit(s). We still have this presentation and its results.

We did this because it was right. The paper records and acetate slides could form part of a historical record of medical practice at that time and we guard them well for there is the issue of patient confidentiality of the cases presented. Please note patient, not commercial, confidentiality.

Fast forward to the "new" NHS training of junior doctors and we have been asked to complete an electronic template for an audit, not an analysis, presented at a meeting we were not present at in order to satisfy an electronic tick box exercise that achieves what?

We did not do that decades ago so what has changed? Do an audit present and learn from it then move on. Now do an audit present and learn from it then move on but ask everyone at the audit (or not) to waste time filling in an electronic tick box. Is this for the better or for the worse?

What matters is the analysis of the data not collecting a load of electronic ticks on an e-portfolio afterwards. Afterwards one should be concentrating on the results and looking for improvement in patient care not looking up a dark passage at an e-portfolio.

And worse we were not present at the presented audit. So if we complete the template how good is the e-portfolio at representing that doctor's medical "training"? Tripadviser medical education anyone?

Praise be to the Party for continuing to improve medical standards by training new doctors to tick boxes and ignore patients. A complete waste of time and a useless exercise of no benefit to the doctor to be or their patients.

Still it is cheaper than treating patients or teaching doctors face to face. And you can be assured that if the box is ticked that the doctor will be a good one won't they?

1 comment:

Anonymous said...

The trouble is that they ae applying the tick box principle to the Liverpool Care Pathway.