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Are you one of "The Trophy Generation"??

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    #62
    RobFowl
    Moderators, Science, Health & Environment Moderators Posts: 11,667 Mod ✭✭✭✭RobFowl


    resus wrote: »
    What, for telling the truth? Polarised it may be, but there is a whole lot of truth to what he writes. Yes it makes me fume, but the more I read YOUR replies, the more I side with his admittedly far right views.

    Not too sure which of my posts you're referring to. Would appreciate you explaining why my "replies" upset you so much !


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    #63
    Bella mamma
    Registered Users Posts: 379 ✭✭Bella mamma


    ZYX wrote: »
    The question is, what has Dr Luke done about it. Has he reported the GPs in question to the Medical Council or at the very least to the HSE? He is making serious allegations that if true should be investigated and the GPs involved reprimanded in some way and at the very least offered retraining.

    Has he been in discussions with local GPs (not simply dictate his views to them) about how to improve things in the emergency dept? Has he a system in place where patients seen in A&E get reviewed by their own GP? Has he discussed local needs? Has he joined forces with local GPs in trying to improve services for patients or has he just decided he is right and people who don't agree with him are wrong?
    He strikes me as the type of doctor who loves the sound of their own voice. Unless he has addressed these issues elsewhere and cannot get the issue resolved then I don't see why he is writing about it in newspapers.

    Agree. It's unlikely he's done the above because he would have been sure to inform The Masses. Obviously likes to blow his own trumpet.

    On Pat Kenny, a listenership in the 100s of 1000s, he was introduced as a consultant in MUH and CUH. By this people (like my mother) assume
    - He's speaking on behalf of both hospitals and his consultant colleagues
    - He's correct (as evidenced by the applause)
    - He's the head consultant of both these EDs (he's not at CUH)

    He would be better concentrating his energies on
    - Working
    - The above poster's strategy
    - Constructive criticism
    - Infiltrating FG


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    #64
    resus
    Registered Users Posts: 123 ✭✭resus


    There are a huge amount of assumptions going on here, let's stick to some facts and the "why" behind them:

    EDs are overcrowded
    EDs are understaffed
    NCHDs are leaving in their droves
    GPs frequently make inappropriate referrals to ED

    What are the the solutions to the above?

    Taking the GP referral point only, because it is upsetting many GPs on this thread. Have you considered how much it upsets both patients and ED staff? For a patient to have paid their GP €x, to wait a whole day to be seen for 5 minutes to be told, we can't get you that scan any faster than your GP? There is ridiculously poor access to investigations in the community, that I think we all accept. But dumping on ED is also inappropriate. I've had a referral to the ED for a fecking Clo test! FFS, we can't arrange that any easier than you can! And I know this surprises GPs, but NO I CAN'T ARRANGE AN USS ANY FASTER THAN YOU. Same booking process, same waiting list.

    One thing for sure, at least we debating these issues now !!


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    #65
    opinion guy
    Closed Accounts Posts: 11,001 ✭✭✭✭opinion guy


    ZYX wrote: »
    He strikes me as the type of doctor who loves the sound of their own voice.

    He definitely likes the media attention !!


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    #66
    resus
    Registered Users Posts: 123 ✭✭resus


    opinion guy wrote: »
    He definitely likes the media attention !!

    Don't think ANYONE is denying that :p


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    #67
    ZYX
    Registered Users Posts: 882 ✭✭✭ZYX


    The point is he can do plenty about it but is not. He should make formal complaints about the GPs he feels are responsible. I have no problem with the idea of there being poor GPs, but if he knows who they are and knows what they are doing wrong why doesn't he complain about them. If they are such a burden on his ED then why doesn't he sort them out. This problem could be solved if doctors like him got their finger out and actually did something.

    Secondly, why are these inappropiate referrals actually being seen. Why do any investigations on them? If they don't need to be in hospital ED then simply send them back to the GP and advise referral if necessary to relevant dept. That should take no longer than 5 mins per patient.


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    #68
    RobFowl
    Moderators, Science, Health & Environment Moderators Posts: 11,667 Mod ✭✭✭✭RobFowl


    resus wrote: »
    There are a huge amount of assumptions going on here, let's stick to some facts and the "why" behind them:

    GPs frequently make inappropriate referrals to ED

    Your "fact" is not supported by evidence.

    Here are some references which you may find interesting.

    http://www.biomedcentral.com/1471-2296/8/46/
    http://www.biomedcentral.com/1471-2296/8/46/
    http://fampra.oxfordjournals.org/content/15/1/23.abstract

    You may be surprised to find that the most recent research suggests approx 8% of GP referrals are considered "inappropriate" a term which in inself is controversial as it is usually made retrospectively after examination and tests.
    In Ireland over 90& of patient episodes are dealt with by their GP alone. In an out of hours setting between 5 and 8% only are referred to AE. Although by definition the sickest and most complex cases will often end up in Ae the vast majority of work is done in the community by GP's.

    I'd suggest you back up any future "facts" with some references......


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    #69
    resus
    Registered Users Posts: 123 ✭✭resus


    RobFowl wrote: »
    Your "fact" is not supported by evidence.

    Here are some references which you may find interesting.

    http://www.biomedcentral.com/1471-2296/8/46/
    http://www.biomedcentral.com/1471-2296/8/46/
    http://fampra.oxfordjournals.org/content/15/1/23.abstract

    You may be surprised to find that the most recent research suggests approx 8% of GP referrals are considered "inappropriate" a term which in inself is controversial as it is usually made retrospectively after examination and tests.
    In Ireland over 90& of patient episodes are dealt with by their GP alone. In an out of hours setting between 5 and 8% only are referred to AE. Although by definition the sickest and most complex cases will often end up in Ae the vast majority of work is done in the community by GP's.

    I'd suggest you back up any future "facts" with some references......

    eh, your 1st 2 references are from the Netherlands where there really only exists an Emergency Department (in the Irish context) in Amsterdam, which is really for tourists and those without a GP !! Everything else is done direct specialty admission...

    your last reference is about perception of appropriateness. Perhaps there in lies the problem, as I've written before, clearly some referrers don't know what can and can not be achieved by the ED. So if you going to lecture about references, please ensure your own are relevant 1st !

    I'm not for a second doubting that the majority of patient encounters are in the community. What you seem to be in hot denial about is that some of your colleagues are frequently capable of inappropriate referrals. Do you want more examples ?


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    #70
    RobFowl
    Moderators, Science, Health & Environment Moderators Posts: 11,667 Mod ✭✭✭✭RobFowl


    resus wrote: »
    eh, your 1st 2 references are from the Netherlands where there really only exists an Emergency Department (in the Irish context) in Amsterdam, which is really for tourists and those without a GP !! Everything else is done direct specialty admission...

    your last reference is about perception of appropriateness. Perhaps there in lies the problem, as I've written before, clearly some referrers don't know what can and can not be achieved by the ED. So if you going to lecture about references, please ensure your own are relevant 1st !

    I'm not for a second doubting that the majority of patient encounters are in the community. What you seem to be in hot denial about is that some of your colleagues are frequently capable of inappropriate referrals. Do you want more examples ?

    GP in the Netherlands is similar to the UK and Ireland (as opposed to France and Spain for example where it is quite different.)
    I thought the article on perceptions of inappropriate referrals was particularly relevant ....

    I can't criticise any of yours though, every one you've quoted to back up your comments has been ... well completely absent !

    http://fampra.oxfordjournals.org/content/15/1/33.abstract

    This one was based in Galway FTR

    "CONCLUSIONS: Rather than vainly attempting to make the patients appropriate to the service, future initiatives should concentrate on making the A&E service more appropriate to the patient."

    And this one in St James, Dublin

    http://www.bmj.com/content/320/7239/903.full

    "Comment

    The decision of patients to attend an accident and emergency department is complex and involves social, psychological, and medical factors.3 Attempts by health services to decrease the numbers of patients attending accident and emergency departments have generally failed    "


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    #71
    opinion guy
    Closed Accounts Posts: 11,001 ✭✭✭✭opinion guy


    RobFowl wrote: »

    http://fampra.oxfordjournals.org/content/15/1/33.abstract

    13 years old and......
    http://www.bmj.com/content/320/7239/903.full

    11 years old respectively.

    I would question the relevance of these paper to today's situation - would you not ?


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    #72
    RobFowl
    Moderators, Science, Health & Environment Moderators Posts: 11,667 Mod ✭✭✭✭RobFowl


    opinion guy wrote: »
    13 years old and......



    11 years old respectively.

    I would question the relevance of these paper to today's situation - would you not ?

    Resus wanted Irish data specifically......

    I have more up to date references but none are based in Ireland. They all come to much the same conclusions as has almost all the research work dating back as far as 1847..


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    #73
    Traumadoc
    Registered Users Posts: 2,523 ✭✭✭Traumadoc


    resus wrote: »
    eh, your 1st 2 references are from the Netherlands where there really only exists an Emergency Department (in the Irish context) in Amsterdam, which is really for tourists and those without a GP !! Everything else is done direct specialty admission...

    your last reference is about perception of appropriateness. Perhaps there in lies the problem, as I've written before, clearly some referrers don't know what can and can not be achieved by the ED. So if you going to lecture about references, please ensure your own are relevant 1st !

    I'm not for a second doubting that the majority of patient encounters are in the community. What you seem to be in hot denial about is that some of your colleagues are frequently capable of inappropriate referrals. Do you want more examples ?

    I am sure you have referred to inhouse teams patients that the in-house teams have called inappropriate.

    I like to think of the patient who comes to emergency with a sore throat as he cannot see his GP- the NCHD looks at the triage note and rolls his eyes and utters " inappropriate attender"
    When he examines the patient he finds the patient has a pertonsilar abcess!

    If a gp fails to refer he can be found negligent, so until appropriate pathways for acute medicine and surgery are put in place , accident and emergency will continue to have to take the urgent (as opposed to emergency) cases.


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    #74
    ZYX
    Registered Users Posts: 882 ✭✭✭ZYX


    I had a letter from an A&E doctor the other day about a boy they had seen in A&E. He was the son of a haemophiliac and the letter basically criticised me for not having had the boy investigated for haemophilia and that they would refer him for investigation.
    So GPs get stupid letters from A&E as well as the other way around.


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    #75
    Traumadoc
    Registered Users Posts: 2,523 ✭✭✭Traumadoc


    ZYX wrote: »
    I had a letter from an A&E doctor the other day about a boy they had seen in A&E. He was the son of a haemophiliac and the letter basically criticised me for not having had the boy investigated for haemophilia and that they would refer him for investigation.
    So GPs get stupid letters from A&E as well as the other way around.


    Yes it goes both ways , I really think a&e guys should do some GP locums and get a feel of what the other side is like, I am not sure they can because of stupid new med council rules.

    But it shows you how things get messed up with the two tier system , if you are private you don't need to go through the A&e experience unless you really are an emergency.


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    #76
    RobFowl
    Moderators, Science, Health & Environment Moderators Posts: 11,667 Mod ✭✭✭✭RobFowl


    Traumadoc wrote: »
    Yes it goes both ways , I really think a&e guys should do some GP locums and get a feel of what the other side is like, I am not sure they can because of stupid new med council rules.

    But it shows you how things get messed up with the two tier system , if you are private you don't need to go through the A&e experience unless you really are an emergency.

    I think personally all GP's should rotate through AE and vice versa. My opinions as an SHO in AE (1996 cough cough) were completely changed at the end of the first 6 months. After working a few years in GP land (and part time as a Staff grade in AE) you really get a feel for the problems with appropriate access pathways.

    The policy where I worked was that there was no such thing as an inappropriate attender simply another patient who's needs were different. Very admirable and the case mix was no different to surrounding units.

    The worst thing about being a GP in Ireland is definitely the two tier system. Great if you have insurance and can be bloody awful without.


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    #77
    drzhivago
    Registered Users Posts: 926 ✭✭✭drzhivago


    opinion guy wrote: »
    13 years old and......



    11 years old respectively.

    I would question the relevance of these paper to today's situation - would you not ?

    Have been round the casualty pit a lot longer than that and would have to stay i am with fowl on this one


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    #78
    drzhivago
    Registered Users Posts: 926 ✭✭✭drzhivago


    Traumadoc wrote: »
    I am sure you have referred to inhouse teams patients that the in-house teams have called inappropriate.

    I like to think of the patient who comes to emergency with a sore throat as he cannot see his GP- the NCHD looks at the triage note and rolls his eyes and utters " inappropriate attender"
    When he examines the patient he finds the patient has a pertonsilar abcess!

    If a gp fails to refer he can be found negligent, so until appropriate pathways for acute medicine and surgery are put in place , accident and emergency will continue to have to take the urgent (as opposed to emergency) cases.

    with you all the way like the norwegians say "theres no such thing as bad weather only bad clothing"

    In this instance I truly believe no such thing as an inappropriate attender rather an inappropriate response

    NOT everyone is registered with a GP
    NOT everyone understands what an emergency is, they do not have the same training as doctors do and definition of emergency very different
    NOT every GP is an expert in EVERY area of clinical practice
    NOT every GP has a surgery 24 hours a day

    every clinical contact in an ED can be used to educate patient about some chronic health maintenance and encouraging contact with GP, in a nice manner


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    #79
    drzhivago
    Registered Users Posts: 926 ✭✭✭drzhivago


    Traumadoc wrote: »
    Yes it goes both ways , I really think a&e guys should do some GP locums and get a feel of what the other side is like, I am not sure they can because of stupid new med council rules.

    But it shows you how things get messed up with the two tier system , if you are private you don't need to go through the A&e experience unless you really are an emergency.

    In the bad old days with no overtime did quite a few GP locums, unfortunately the way registration is nowadays that is unlikely to happen again

    Quite useful for docs to do both, for GP to do time in ED after they are a GP and SHO to do some time in GP land while they are in ED

    Have to laugh when SHO comes to em with case about inappropriate referral that they have spent 6 hours working up with multiple blood test/xrays and consultations with other SHOs

    At this point I usually explain that GP has 7-15 minutes and none of the above services and sometimes penny drops


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    #80
    drzhivago
    Registered Users Posts: 926 ✭✭✭drzhivago


    Of Note Mr Luke has issued an apology to docs, ED and GP for his comments

    saw it in an email doing the rounds

    Humble pie, I knew he would he is after al quite honourable and doesnt actually set out to inflame but speaks his mind publicly which some will not like


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    #81
    opinion guy
    Closed Accounts Posts: 11,001 ✭✭✭✭opinion guy


    drzhivago wrote: »
    Of Note Mr Luke has issued an apology to docs, ED and GP for his comments

    saw it in an email doing the rounds

    Humble pie, I knew he would he is after al quite honourable and doesnt actually set out to inflame but speaks his mind publicly which some will not like

    Seems like the apologies should be made in person on the radio/tv no ?


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    #82
    drzhivago
    Registered Users Posts: 926 ✭✭✭drzhivago


    opinion guy wrote: »
    Seems like the apologies should be made in person on the radio/tv no ?

    How exactly would he do that

    He was asked to comment on a show about something and said what he did
    He doesnt get to choose when he goes on radio/tv

    He has said it directly to staff in hospital, emailed it to colleagues for dispersal and i believe spoken to local GPs

    There are only so many lengths one can go to in fairness

    He has done the honorable thing


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    #83
    TC80
    Registered Users Posts: 33 ✭TC80


    drzhivago wrote: »
    How exactly would he do that

    He was asked to comment on a show about something and said what he did
    He doesnt get to choose when he goes on radio/tv

    He has said it directly to staff in hospital, emailed it to colleagues for dispersal and i believe spoken to local GPs

    There are only so many lengths one can go to in fairness

    He has done the honorable thing

    Zhivago

    Your posts are usually the best on here by a distance but I can’t agree with you on this one.

    Maybe Luke should be commended for apologising but something about this whole affair stinks.

    I simply cannot believe he is genuinely sorry for disparaging a generation of hard working doctors. The reason for this is because this is by no means the first time he has attacked them, in fact this was the latest attack in a sustained national media campaign against NCHDs that he has been conducting since last summer.

    Irish Times July 2 2010

    "In truth, it requires a bold and necessary development of the Fottrell prescription, employing the growing number of medical graduates at the frontline, as was the norm until Bondi Beach proved irresistible and “work-life-balance” made the stability of our health service somewhat, er, subsidiary for many of our young doctors"

    "advanced nurse practitioners (ANPs), who already provide a more satisfactory service than many of our inexperienced “junior” doctors."

    This was quickly followed up by an interview on the George Hook show where similar comments were made

    Irish Times January 25 2011

    "Dr Luke said although young Irish doctors won’t say it publicly but will admit to it privately, many don’t want to work in Irish emergency departments because they find the work too arduous despite the fact that terms and conditions have improved greatly in recent years."

    "They have an obsession with their own work-life balance rather than serving the citizens of the country"

    His comments here about improving conditions in the irish times were at variance with his sermon in the.....

    Sunday Business Post April 11 2010

    "Dr Chris Luke, a consultant in emergency medicine at Cork University Hospital, said the single biggest factor driving Irish doctors overseas was their dramatically reduced earnings, with pay reductions of up to 30 per cent after the HSE reduced overtime and other payments"

    There have also been several articles in the medical press peddling the same populist canards.

    If Luke is genuinely sorry where were the apologies after his George Hook remarks? Or any of these newspaper interviews? I’m offering an alternative theory. Chris Luke annoyed the GP’s big time with his remarks. His hospitals got spooked and wrote a letter to each GP in the region distancing them from his remarks. Disgustingly the hospital failed to issue any such communication to their own hard working NCHDs. Luke himself was compelled to write to the newspaper in which some of his remarks were contained apologising to GPs. His apology to NCHDs was merely an afterthought which going on the past form I have outlined above would never have happened if he hadn’t had a cut off GPs.

    If Chris Luke thinks I am lazy, he’s entitled to his opinion but I’d like to see him come on the 36 hour shift I’m commencing in 5 minutes. If Chris Luke thinks I’m obsessed with my own work-life balance, he’s entitled to his opinion I’d like him to come and explain his position my fiancée next time we have a massive row over me getting home from work at 9.30 pm when we had plans at 7 for the second or third time in a week. It’d sure as hell make my life easier.

    What I will accept as an apology from Dr. Luke is for him to call off his SUSTAINED media campaign against NCHDs. I know he can’t exactly dictate the content of the programmes he goes on and the questions he is asked, but be fair here, in so many of his recent media outings he has managed to work NCHDs into the discussion, by disparaging them. Perhaps the next time, if he really wants to do the honourable thing, he could say “I made some comments about NCHDs recently, which I now regret and I apologise to them for the hurt and offence caused”.

    If he really means it….




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    #84
    drfrank
    Registered Users Posts: 34 ✭drfrank


    Well put !!

    It is one thing to honourably apologise, it is entirely different when the hospital board is on your back along with the IMO forcing an apology out of you !

    Either way he has apologised, the benefit of the doubt must be given, a line drawn under the matter........until the next time !!


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    #85
    drzhivago
    Registered Users Posts: 926 ✭✭✭drzhivago


    TC80 wrote: »
    Zhivago

    Your posts are usually the best on here by a distance but I can’t agree with you on this one.

    Maybe Luke should be commended for apologising but something about this whole affair stinks.

    I simply cannot believe he is genuinely sorry for disparaging a generation of hard working doctors. The reason for this is because this is by no means the first time he has attacked them, in fact this was the latest attack in a sustained national media campaign against NCHDs that he has been conducting since last summer.

    Irish Times July 2 2010

    "In truth, it requires a bold and necessary development of the Fottrell prescription, employing the growing number of medical graduates at the frontline, as was the norm until Bondi Beach proved irresistible and “work-life-balance” made the stability of our health service somewhat, er, subsidiary for many of our young doctors"

    "advanced nurse practitioners (ANPs), who already provide a more satisfactory service than many of our inexperienced “junior” doctors."

    This was quickly followed up by an interview on the George Hook show where similar comments were made

    Irish Times January 25 2011

    "Dr Luke said although young Irish doctors won’t say it publicly but will admit to it privately, many don’t want to work in Irish emergency departments because they find the work too arduous despite the fact that terms and conditions have improved greatly in recent years."

    "They have an obsession with their own work-life balance rather than serving the citizens of the country"

    His comments here about improving conditions in the irish times were at variance with his sermon in the.....

    Sunday Business Post April 11 2010

    "Dr Chris Luke, a consultant in emergency medicine at Cork University Hospital, said the single biggest factor driving Irish doctors overseas was their dramatically reduced earnings, with pay reductions of up to 30 per cent after the HSE reduced overtime and other payments"

    There have also been several articles in the medical press peddling the same populist canards.

    If Luke is genuinely sorry where were the apologies after his George Hook remarks? Or any of these newspaper interviews? I’m offering an alternative theory. Chris Luke annoyed the GP’s big time with his remarks. His hospitals got spooked and wrote a letter to each GP in the region distancing them from his remarks. Disgustingly the hospital failed to issue any such communication to their own hard working NCHDs. Luke himself was compelled to write to the newspaper in which some of his remarks were contained apologising to GPs. His apology to NCHDs was merely an afterthought which going on the past form I have outlined above would never have happened if he hadn’t had a cut off GPs.

    If Chris Luke thinks I am lazy, he’s entitled to his opinion but I’d like to see him come on the 36 hour shift I’m commencing in 5 minutes. If Chris Luke thinks I’m obsessed with my own work-life balance, he’s entitled to his opinion I’d like him to come and explain his position my fiancée next time we have a massive row over me getting home from work at 9.30 pm when we had plans at 7 for the second or third time in a week. It’d sure as hell make my life easier.

    What I will accept as an apology from Dr. Luke is for him to call off his SUSTAINED media campaign against NCHDs. I know he can’t exactly dictate the content of the programmes he goes on and the questions he is asked, but be fair here, in so many of his recent media outings he has managed to work NCHDs into the discussion, by disparaging them. Perhaps the next time, if he really wants to do the honourable thing, he could say “I made some comments about NCHDs recently, which I now regret and I apologise to them for the hurt and offence caused”.

    If he really means it….



    Thank you for the complement and sorry but was unaware of the previous comments in newspapers you refer to and was unaware hospitals had written to GPs

    The next time I meet him i will raise the issue and see if he can work an apology into his next media out let to NCHds, the difficulty is if it doesnt get flagged in advance will any of us hear it

    On a personal note I know how bad the hours are, have kids and for a number of years wasnt in the same house let alone same country as the kids as wife working and they were in school so we made that sacrifice for the goal hopefully of getting a consultant job in future.

    heard an interesting fact from a new consultant buddy recently

    when he was an intern he did on call to A&E

    when he was an SHO they stopped interns doing on call to A&E so he went back to doing it
    when he was a reg they stopped SHOs doing call alone to A&E so he went back to it
    AS an SPR they couldnt get SHOs so he was back to be 1st on call to A&E

    Now as a consultant cant get NCHDs so again he is on call to A&E

    We wont improve fighting with each other, we need to fight for each other to improve these lots and I do know Chris does fight to improve the lot


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    #86
    tallaght01
    Closed Accounts Posts: 5,778 ✭✭✭tallaght01


    drzhivago wrote: »

    heard an interesting fact from a new consultant buddy recently

    when he was an intern he did on call to A&E

    when he was an SHO they stopped interns doing on call to A&E so he went back to doing it
    when he was a reg they stopped SHOs doing call alone to A&E so he went back to it
    AS an SPR they couldnt get SHOs so he was back to be 1st on call to A&E

    Now as a consultant cant get NCHDs so again he is on call to A&E

    This reminds me of when I did paeds full-time.

    2 years as an SHO, where we did everything, and the reg would go to bed at night, and we'd call them if there was a dire emergency. My 2 SHO years wore me out, and I was an exhausted wreck when they were over.

    Moved to NZ/Oz as soon as I became a reg, only to find that the SHOs were literally not trusted to do anything in paeds (it's even pretty much supernumerary in some hospitals, where they don't even cannulate!!), so I was back to being basically the same as an SHO. No SHOs on nights, except in ED.


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    #87
    take everything
    Registered Users Posts: 9,800 ✭✭✭take everything


    Just an update on this FWIW.
    Chris Luke has apologised to NCHDs in a letter to Today's IMT here


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    #88
    Amnesiac_ie
    Registered Users Posts: 510 ✭✭✭Amnesiac_ie


    I think an audit of GP referrals to ED in the past 6/12 in both MUH and CUH which details how many patients were seen by ED NCHDs and how many were seen by ED consultants would be an interesting addition to this debate...


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    #89
    Traumadoc
    Registered Users Posts: 2,523 ✭✭✭Traumadoc


    Yes that should be helpful, the guy apologised but he is down now give him a few kicks.

    ::rolleyes:


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    #90
    opinion guy
    Closed Accounts Posts: 11,001 ✭✭✭✭opinion guy


    Traumadoc wrote: »
    Yes that should be helpful, the guy apologised but he is down now give him a few kicks.

    ::rolleyes:

    To be honest, given the language he used on the day, the attitude he had on the show of playing up to the crowd and the fact that he said similar things more than once in the past, I don't find this apology in any way convincing. This reads like a political statement from someone who knows they needs to say something in order to continue to work with people day to day, but who doesn't really have conviction in such an apology. His plain speaking and fervor on the day carried far, far more impact and I believe, reflected his true opinions.


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    #91
    resus
    Registered Users Posts: 123 ✭✭resus


    Amnesiac_ie wrote: »
    I think an audit of GP referrals to ED in the past 6/12 in both MUH and CUH which details how many patients were seen by ED NCHDs and how many were seen by ED consultants would be an interesting addition to this debate...

    Define what you mean by seen? Seen directly 1st off, seen as a 2nd opinion during visit, seen in ED clinic as a second opinion on subsequent visit, review of notes, x-ray decisions, etc. etc. etc. ? Not all Consultant work is face-to-face.

    But I do take your point, and do wish there were more ED Consultants in the system so that they could come out of the back office and onto the shopfloor (which is what I think you were getting at) more often.

    You need 6 persons to cover a 24/7 rota on the shop-floor. How many departments have this? So what about the clinical governance? Depends on numbers, but this is what most consultants spend their time HAVING to do.

    Bottom line, we need to stop fighting amongst ourselves and fight for patients, who need Consultant led care, delivered by properly trained doctors.


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