Health Strife

Surely there’s a better way to end this succession of healthcare strikes and demos, writes Maurice Gueret as he heralds the end of a rude consultant

Pay Up

February has been a tough month on the industrialrelations front. Thousands of nurses have been picketing their own hospitals, demanding the same pay levels as physiotherapists. Hundreds of family doctors revved their bangers up to Leinster House for a second time to protest at their ever-dwindling slice of the healthcare cake. And there are rumblings, too, from younger consultants who are now paid in buttons, while their older colleagues get the brass. A health minister who cares more for the future than the next photo opportunity would take stock of this strife and sort it out once and for all. A citizen’s assembly has already acquitted itself well in Ireland by taking a brave stance, one that generation of politicians cowered in terror over. I vote that we let the same people have a say in how the State pays its healthcare employees for the next 25 years. And if they do a good job, as I trust them to do, they may be asked to have a look at every other State payroll, too.

GP Nixers

I couldn’t make ends meet when I worked in general practice. Doctors who talk too much rarely do. There are many temptations for doctors who run their own practices. One is to take on more patients than you can safely manage, and run through as many as you can in five-minute or 10-minute slots. You can get a reputation as a ‘Doctor Quickie’. Some patients like this. There was a parish priest where I grew up in south Dublin who could mutter a Sunday-morning service in just over 10 minutes. His Mass was so popular that even neighbouring parishioners would flock there. Another temptation is to hire in younger doctors to see patients for you, while you seek out more lucrative work in nixers or sidelines. Factory medicine, court and insurance reports, academic pursuits — that sort of thing. In the UK now, young doctors are being offered an upfront €23,000 bung just to train to be a GP in towns that cannot attract any. Of course, they don’t call it a bung. It is known in polite circles as the Golden Hello. This sum of €23,000 is twice as much as I turned over in my first year as a family doctor. Eventually, I too headed off for pastures new, and waved a Golden Goodbye to the least costly and most under-funded type of care. The sort that our masters pretend takes place in the community.

Scarborough Fair

Next year, I hope to find time to compile the final book of my Doctor trilogy. I still get letters about the first two books, which is nice, and the chapter on rude consultants often features. I think they are a dying breed. And while it can be funny to read about some of the excesses senior doctors used to get away with, we definitely live in more sensitive times, where a careless remark can end a career. When an obese lady told her physician that she only had the appetite of a bird, his subsequent mention of a vulture would surely lead him to a tribunal today. A bowel surgeon in Scarborough ended up in serious hot water recently, when nurses reported him for asking patients to adopt the ‘George Michael position’ when he wanted to insert his colonoscope. A fitness-topractice tribunal decided to suspend the surgeon, rather than erase him as a doctor completely. There were also allegations made that sexual innuendo filled his endoscopy suite. He told one nurse who had recently lost weight that he was falling in love with her again; and if late for work, he would brag about who he was with and what they were doing. If you do go to Scarborough Fair for parsley, sage, rosemary or a large bowel endoscopy, don’t worry. I don’t think he will be doing any fine needle work or scoping there this summer. The tribunal found that the surgeon’s conduct is remediable and that he can resume his career and professional development, in nine months. Probably somewhere else.

Scoot Away

Electric scooters are in the news, and not in a good way. Last year, an emergency room in Texas reported that they were seeing up to 10 injuries a day from the newfangled contraptions. Now a study of medical records in two Californian emergency departments documented almost 230 cases of injuries in a year. Fewer than 1 in 20 of the riders was recorded as wearing a helmet, and 15 patients had injuries severe enough to require admission, including some with brainbleed injuries. Bad enough that they hurt themselves, but this study found that 21 non-riders also needed to attend the emergency rooms.