Should he have been struck off?

r3nu4l

See here for the story.

In summary, at the height of the SARS epidemic, a patient on a plane from Hong Kong to London was suffering from coughing and sneezing. This was deemed bad enough that a doctor was called to the plane upon landing.

He boarded the plane wearing full protective gear despite having been told that the patient was breathing normally and had no fever. As a result he was struck off by the General Medical Council in Britain for inappropriate behaviour and scaring passengers.

Now, we don't have the full story here as I'm sure that there must be more than is in the report but do you think it was wrong of this doctor to behave in this way?

Taking only the information we have I would say that he was merely being vigilant. Here's why:

He was called to a scene of a respiratory illness. The plane was flying in from a source close to the SARS epidemic. At the time little was known about SARS other than a high rate of infection and subsequent mortality. Even if the patient was breathing normally at that time not enough was known about SARS to tell if this was part of the early stages of disease that would progress rapidly.

The doctor had no idea what he was facing. How could he believe that the patient had no termperature and was breathing normally? He only had the word of people on board the aircraft and it is highly likely none of these people were medically qualified (first-aid is not the same as medical qualification and does not substitute for years of medical experience!).

What would you have done? Personally I would have liked to reassure passengers that the suit was precaution only but I would still have worn it!

Those are the reasons why in this case, based on the information we have, I think he was wrongly struck off, however I realise that the article doesn't provide us with the full story and also realise that his behaviour had been called into question before. Perhaps this was just one in a long line of incidents that proved to be too much.

As they say in many exam questions, Discuss

InFront

Yeah like you say there are obviously circumstances that we aren't aware of, but I don't see any lasting in harm in what he did. Now if he had walked on and caught SARS, things could have been different.
Perhaps the airline could have advised the passenger to just remove himself from the plane for the examination, or perhaps the doctor should have suggested so.
I don't think what he did could should have caused dismissal or should have added to a dismissal case against him. Then again, I don't even have a medical degree yet, let alone a legal one:D

r3nu4l

I wonder what prevented the passenger from being moved to the tail section of the plane and having the doctor examine him there? There is usually a curtain that can be drawn.

I would certainly rather be preventative and protect myself against infection rather than walk on in my t-shirt inhaling deeply as I walk down the aisle of the plane

[speculation]It could be that the doctor wanted to be seen in a high-profile manner in his gear and draw attention to himself. That would be grounds for a severe warning[/speculation]

InFront

Yeah that's possible, especially when he didn't even move the guy for the exam. One thing I do know, if I were the sick guy and I saw somebody coming on in that gear, I'd be writing my memoirs! I'm sure other passengers were pretty upset too.

tallaght01

There's a lot of anger here in the UK about this case amongst doctors. Our regulatory body (The GMC) strikes doctors off for fun, and they certainly don't have the trust of the medical profession. Having said that, this particular hearing was held in private becasue there were other issues that it was thought weren't suitable to be heard in public, so I guess we don't know the full story.

Wisheress

I read that concerns had previously been expressed about this doctor.

The following is from the BBC's news website (three days ago)

Dr Panis was also found guilty of other charges of inappropriate conduct between 1997 and 2005.

Concerns were raised among Metropolitan Police officers when he advised them to wear gloves and gowns when attaching identification tags to coffins from the 2004 Boxing Day tsunami.

So maybe it was a number of things rather than solely the SARS incident

r3nu4l

Whatever about the GMC striking doctors off for fun (I doubt it ) I agree that there are other issues that people were unaware of.

[speculation]It looks to me that this incident was the excuse that the GMC were loking for to dismiss this guy. Sort of like the 'straw that broke the camels back'. [/speculation]

If that is the case then the GMC are wrong and should have found a legitimate reason for striking him off.

What I'm really looking for is debate here. Based SOLELY on the information we have and taking it almost hypothetically should he have been struck off?

I would be tempted to say 'no' but would wonder if there wasn't a better way for the doctor to handle it to avoid the incident in the first place.

Can I ask the medics here, during your training, how much emphasis was put on 'bedside manner' and was there ever emphasis on brining bedside manner out into the field and appropriate ways to react in certain situations? How often was your judgement of these matters tested?

tallaght01

The problem is that we don't have all the information, so it's difficult to debate the facts.

As for "bedside manner". During medical school, we had small group tutorials twice per week. Actors would come in and play the patients. Each student would be filmed as an actor walked into our "surgery" and basically flung anything at us from "I have an itchy shoulder" to "I'm gay".

After the consultation, the whole group and the supervising doctor would watch the videos and we'd all dissect it, and talk about how different people would have approached the situation. It was a good way to learn though, albeit scary.

Actors were also used in our yearly exams, where they would usually play people with psychological distress of some sort.

Of course, much bedside manner is learnt on the job too.

For the record, wearing gloves and aprons in a foreign country with significant flooding and lots of corpses would be reasonable, in my opinion. Certainly not worthy of being struck off. But with the GMC anything is possible.