Tom Yeoman, one of the 5th years at Dundee at the moment wrote an interesting article in the Lancet Student this week which caught my attention (Not the Flu - March 2010). He describes reports of patients being diagnosed with having swine flu who have ended up being treated from a range of conditions including appendicitis, malaria, acute myeloblastic leukaemia and meningococcal meningitis! It just goes to show that it's always important to think about the differential diagnosis even if the cause seems obvious. Whenever we write up case reports, we always list the differential diagnosis and this is the reason why, to rule out the alternative causes through methods such as investigations. In the cases of swine flu, due to the possible diagnosis of swine flu this patient had not been given a full assessment by the GP.
Reading on doc2doc this week, the medical professionals forum posts included doctor's handwriting - where a study carried out by Diabetes UK found one in six case notes to contain errors in written notes, and a guy who asks the question 'Why is Transgender still classed as a Mental Disorder'. This does seem to be medicalisation of a choice that someone might make and surely does not mean to imply that they have a mental health problem. I guess it comes back to that question which I posed earlier as to whether completed suicide implies that the person had a mental health problem. Homosexuality was deleted from DSM IV in 1973. Another article asks the queston, Would you change career after medical school? I answered yes. To tell the truth I am feeling a bit disillusioned at the moment, the same phrases do seem to be coming up alot 'burn-out', 'don't do it' etc. But a respondant put in a good quote afterwards:
“…Medicine arose out of the primary sympathy of a man with man; out of the desire to help those in sorrow, need and sickness”. …
-Sir William Osler, “The Evolution of Modern Medicine”, Yale University, April 1913.
Perhaps I need to remember this, although I do wonder if there are other ways I can help. The Dundee University Medical School MSC Symposium this week is titled "Medicine - Beyond the 9 to 5". I'll try and get along to some of this, it might give me some ideas!
Osler was great physician, one of the founders of the Johns Hopkins. He was the first person to fully describe bronchiectasis.
ReplyDeleteThen he died from it.
And he has nodes.