Month: March 2015

Supersize supermodels: which way do they tip the scales?

Adam Staten is a GP trainee in Surrey and is on Twitter @adamstaten. For years there has been deep concern about the dangers to health of girls and young women aspiring to the figures of ‘size zero’ models. How odd then that the signing of a morbidly obese model to a top modelling agency was heralded by many in the press as a triumph despite the vast array of health issues associated with obesity. Tess Holliday, the size 24 model in question, is a champion of the ‘body positive’ campaign which aims to destigmatise obesity and challenge conventional perceptions...

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Essential law for GPs: discussing treatment risks

Adam Sandell is a GP in Cumbria, and a barrister at Matrix Chambers. A Supreme Court judgment last week changed the law about the discussions we need to have with patients about the risks posed by treatment. “Doctor knows best” has just suffered another stroke. The busy-doctor version: We must discuss with patients any material risks involved in proposed treatment, as well as reasonable alternative approaches. A risk is ‘material’ if the patient is likely to attach significance to it. Ask yourself whether knowing about the risk might alter the patient’s decision: if so, tell the patient about it. If you’re more interested: Remember the Bolam test? Bolam’s the case about breaching your duty of care. You’re not negligent if you act in accordance with a practice accepted as proper by a responsible body of medical opinion, so long as the practice isn’t nuts. Until now, Bolam was how the courts determined what we have to tell our patients about the risks of treatment. You didn’t have to discuss a particular risk if there were other suitably-qualified doctors who wouldn’t have done so. That’s been changed by Montgomery, a Supreme Court case last week. Mrs Montgomery was small, diabetic and pregnant with a large baby. Her obstetrician didn’t normally warn such women of the risk of shoulder dystocia because she believed the risk of serious harm to be small,...

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The elephant in the room: how are we going to fund the NHS?

Professor Roger Jones is editor of the British Journal of General Practice. Last weekend The Times published a leading article which described the financial straitjacket in which the NHS finds itself, and suggested that the additional funding required to keep the service going should be found from sources outside general taxation. I wrote a letter supporting this view, pointing out that other healthcare systems, with perfectly respectable health outcomes, some better than ours, work on a combination or some variation of co-payment and insurance mechanisms. none of which, importantly, equate to privatisation. I described this discussion as an elephant...

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NHS and astrology: GP with a special interest in witchcraft

Adam Staten is a GP trainee in Surrey and is on Twitter @adamstaten. When MP and member of the health select committee David Treddinick suggested that the NHS should offer astrology to its patients he was widely ridiculed. To me it seemed wildly unfair that this man was so heavily criticised for expressing his personal views. Although he has no experience in healthcare provision, and although he holds beliefs that are almost universally disparaged, I see this as absolutely no reason why he shouldn’t hold a position on the most influential health committee in the House of Commons. If...

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NHS and astrology: a morning zodiac clinic

Tim Senior trained as a GP in Sheffield, and now works in Aboriginal and Torres Strait Islander Health in Australia. He is a Scorpio, whatever that means. He can be found tweeting from @timsenior News reaches us from the UK Health Select Committee that one of their members has suggested that there’s a simple solution to the woes of the NHS in the UK: astrology. Now, I’m as sceptical as the next doctor about how stars thousands of light-years away from Earth, that, with the trick of parallax error, suggested vague shapes to ancestors entertaining themselves on dark nights...

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