Hospital consultants

looksee

I'm not sure that this is the most suitable place for this, but I can't see anywhere better so I will try here and maybe the mods will move it if necessary.

Years ago (around 30 or so) Consultants were seen as arrogant, god-like figures who could do anything they wanted and get away with it. Eventually there was a kind of public revolt to this attitude and somehow things improved, they became more human and approachable.

Sadly the whole thing has swung back and we again have arrogant and at times incompetent people who have the whole health system sewn up and their little cash registers kachinging every 15 minutes at 150 to 200 euro a time.

There are some exceptions. I recently had the pleasure of dealing with a very pleasant, relaxed and knowlegeable cardiac consultant whom I felt I could trust.

However without going into details I have for various reasons had, over the past 5 years or so, Consultants whose mental capacity was in some doubt. One lost his temper and shouted abuse at me when I calmly asked a simple question. One looked bored, didn't examine me in any way at all, but lectured me on a matter entirely unrelated to why I had gone to see him. One misread results, twice, and caused me considerable expense as I had to go to other medics to establish that what I knew was wrong with me, actually was. Another one took two phone calls while examining me, and snapped at me when he felt that I hadn't answered precisely enough. And one brought his entire tribe with him while I lay in A&E, not because he could be of assistance to me, but because (I figured out later) he had found a specimen (of an unimportant syndrome unrelated to my illness) and treated me like a performing monkey without actually telling me what he was interested in.

The last one at least didn't cost me anything, the two rude ones got as good as they gave, and I am still trying to work out what to do about the misdiagnosis.

What is going on here. I know it's not just me, I hear other people, including medical people talking about these same people, and their eccentric, untouchable ways.

Maybe if they were not paid so much they would not have such inflated opinions of themselves, and might be a bit more concerned about hanging on to their jobs. Unless they actually kill or maim someone they cannot be challenged and challenging them is a serious undertaking.

There should be some way of putting in a complaint such as those listed, without expectation of monetory compensation beyond, possibly, the return of the fee, and if enough complaints of a similar nature came up then the consultant should be asked to account for his behaviour.

Perhaps it is time for another groundswell of opinion to protest about these people; sadly with so many others of our leaders falling from grace they are going unnoticed at the moment, but after politicians, bankers and the Church, they seem like a group that could be next in line.

drkpower

looksee wrote: »

There should be some way of putting in a complaint such as those listed, without expectation of monetory compensation beyond, possibly, the return of the fee, and if enough complaints of a similar nature came up then the consultant should be asked to account for his behaviour.

You could have googled complaint + doctor in a fraction of the time it took compose your post.

You can complain to the:
- the Medical Council -
http://www.medicalcouncil.ie/Professional-Standards/Making-a-Complaint-/Making-a-Complaint.html
- Hospital
- HSE (in most cases)
- (possibly) HIQA
- (perhaps) the National Consumer Agency for certain aspects of your care (ie. pricing complaints)

That should keep you occupied for a while.

irishh_bob

looksee wrote: »

I'm not sure that this is the most suitable place for this, but I can't see anywhere better so I will try here and maybe the mods will move it if necessary.

Years ago (around 30 or so) Consultants were seen as arrogant, god-like figures who could do anything they wanted and get away with it. Eventually there was a kind of public revolt to this attitude and somehow things improved, they became more human and approachable.

Sadly the whole thing has swung back and we again have arrogant and at times incompetent people who have the whole health system sewn up and their little cash registers kachinging every 15 minutes at 150 to 200 euro a time.

There are some exceptions. I recently had the pleasure of dealing with a very pleasant, relaxed and knowlegeable cardiac consultant whom I felt I could trust.

However without going into details I have for various reasons had, over the past 5 years or so, Consultants whose mental capacity was in some doubt. One lost his temper and shouted abuse at me when I calmly asked a simple question. One looked bored, didn't examine me in any way at all, but lectured me on a matter entirely unrelated to why I had gone to see him. One misread results, twice, and caused me considerable expense as I had to go to other medics to establish that what I knew was wrong with me, actually was. Another one took two phone calls while examining me, and snapped at me when he felt that I hadn't answered precisely enough. And one brought his entire tribe with him while I lay in A&E, not because he could be of assistance to me, but because (I figured out later) he had found a specimen (of an unimportant syndrome unrelated to my illness) and treated me like a performing monkey without actually telling me what he was interested in.

The last one at least didn't cost me anything, the two rude ones got as good as they gave, and I am still trying to work out what to do about the misdiagnosis.

What is going on here. I know it's not just me, I hear other people, including medical people talking about these same people, and their eccentric, untouchable ways.

Maybe if they were not paid so much they would not have such inflated opinions of themselves, and might be a bit more concerned about hanging on to their jobs. Unless they actually kill or maim someone they cannot be challenged and challenging them is a serious undertaking.

There should be some way of putting in a complaint such as those listed, without expectation of monetory compensation beyond, possibly, the return of the fee, and if enough complaints of a similar nature came up then the consultant should be asked to account for his behaviour.

Perhaps it is time for another groundswell of opinion to protest about these people; sadly with so many others of our leaders falling from grace they are going unnoticed at the moment, but after politicians, bankers and the Church, they seem like a group that could be next in line.

the medical profession are the snobbiest of all professions in this country and consultants are the top of the tree in the doctor fraternity , thier is an inherent elitism among thier community , that most doctors come from doctor stock doesnt help to change this

i had a particulary distastefull experience with a well known consultant <SNIP>

i had an appointment for 5.15 pm with this particular big wig on particular weekday a few months back , the cost of the consultation was 250 euro , anyway , i got delayed in traffic due to having run into a minor road accident in south dublin , i parked my car upon arrival at the hospital and ran as fast as i could , i arrived in the hospital at 5.20 pm , only to be told that mr consultant had gone and that i was late , i then looked up at the clock in the waiting room , only to discover that the hospital clock was five minutes fast , Q , myself and hospital staff arguing about the degree to which i was late , they claimed i was ten mins late when in fact ( due to fast clock ) i was five mins late , anyhow , the point is , anytime in my the past when ive had appointments with doctors , consultants etc , without exception , the doctor has been the one who has held me ( the patient ) up , i would usually have to wait anything from ten mins to half an hour before i would get to see the consultant - doctor , yet in this rare instance when i the patient was late , the consultant walks and stands me up , i learned two lessons from this encounter , 1stly , anyone who can afford to walk out on an appointment - job for 250 euro is earning too much money and secondly , doctors - consultants have an arrogance so profound , that they believe its perfectly fine for a patient to wait up to half an hour beyond thier schedueled appointment but when the shoe is on the other foot , they turn into divas and decide to walk off stage

drkpower

Anytime i have been 5 minutes late for a doctor's (or dentist or an appointment with any other professional's) appointment, they have seen me. And I never had to get involved in an argument with Hospital staff.

Perhaps it is your attitude that has caused you difficulties?

Edit: and when i practised as a doctor, I would always wait (often for considerably longer than 5 minutes) if a patient was late and called ahead to explain. Except, for one reason and one reason only: if the guy was a d!ck and was giving the staff hassle.

irishh_bob

drkpower wrote: »

Anytime i have been 5 minutes late for a doctor's (or dentist or an appointment with any other professional's) appointment, they have seen me. And I never had to get involved in an argument with Hospital staff.

Perhaps it is your attitude that has caused you difficulties?

Edit: and when i practised as a doctor, I would always wait (often for considerably longer than 5 minutes) if a patient was late and called ahead to explain. Except, for one reason and one reason only: if the guy was a d!ck and was giving the staff hassle.

my attitude , ??? , what do you know of my attitude , i think it is you who is being unduly offensive and presumptious i might add in your reply

the doctor ( who i took half a day off work to go and see ) in question , never got to meet me so he has no experience of my charm or attitude one way or another , he had vacated the building when i arrived , as for the hospital staff , pointing to the fact that a waiting room clock is reading wrong is not causing hassle in my book , on the contary , it is a most helpfull suggestion and one which would most likely prevent misunderstanding between patients and hospital staff in the future , your reactionary response is typical of the doctor mindset , whereby the patient is always wrong and doctor knows best

Permabear

This post has been deleted.

drkpower

irishh_bob wrote: »

my attitude , ??? , what do you know of my attitude , i think it is you who is being unduly offensive and presumptious i might add in your reply

I apologise if you were offended; i didnt intend to.

What I would say is that, from my expereince, very few doctors would refuse to see someone who was 5 minutes late unless one of two things happened:
1. the doctor literally had to go deal with something else that could not wait
2. the patient had been 'difficult'

Generally speaking, consultants are pretty hard-working and dedicated; in particular, they are used to being late and people being late for them. A doctor who refused to 'go past 5pm' wouldnt get too far.

Obviously, i have no idea what happened in your situation and maybe the doctor just pissed off to watch Neighbours, but i am just speaking in generalities.

irishh_bob

drkpower wrote: »

I apologise if you were offended; i didnt intend to.

What I would say is that, from my expereince, very few doctors would refuse to see someone who was 5 minutes late unless one of two things happened:
1. the doctor literally had to go deal with something else that could not wait
2. the patient had been 'difficult'

Generally speaking, consultants are pretty hard-working and dedicated; in particular, they are used to being late and people being late for them. A doctor who refused to 'go past 5pm' wouldnt get too far.

Obviously, i have no idea what happened in your situation and maybe the doctor just pissed off to watch Neighbours, but i am just speaking in generalities.

doctors tend to have big egos , perhaps the consultant took great offence by my not arriving on time

as for consultants being hard working , thier hard working when thier seeing private patients , who wouldnt be for 250 quid per appointment , they put in the bare minimum amount of hours in the public sector for thier 220 k per year which is one of the main reasons why waiting lists are so long in the public arena

drkpower

irishh_bob wrote: »

they put in the bare minimum amount of hours in the public sector for thier 220 k per year which is one of the main reasons why waiting lists are so long in the public arena

That is a very simplistic analysis of the ills of the health services, to say the least!

Anyone with any experience of the health service will tell you that the vast majority of consultants put in far far more than the bare minimum amount of hours in the public sector.

prinz

The 'system' as they say is totally messed up for public patients here. My OH had medical problems last summer and I really couldn't speak highly enough of the doctors and nurses and staff in the A&E, but the administration and running of the whole thing, coupled with a ridiculous experience with a consultant was disgraceful. She saw a consultant for a few minutes and in that time he managed to put her off seeking medical help in this country again tbh. She had been in and out for three days after being referred for a particular problem, blood tests, ultra-sound, after finally getting a consult on the third day he suggested doing the examination which had brought her to the hospital in the first place. When she queried the need for this, he took offence and left. Mind boggling stuff.

drkpower

prinz wrote: »

..... after finally getting a consult on the third day he suggested doing the examination which had brought her to the hospital in the first place. When she queried the need for this, he took offence and left. Mind boggling stuff.

No doubt there are strange consultants out there. The job and the calibre of individual required to suceed attracts its fair share of Type A & Type Crazy personailities.

Out of interest, was your OHs issue the suggestion of doing a physical examination that had already been done by someone else? It would be standard practice for a doctor to repeat any physical examination for himself.

Im probably misinterpreting your post though.

Truley

Hi OP I see where you're coming from, like you I have had very bad experiences with consultants. This one in particular wasn't only extremely gruff and impatient, but resorted to nothing short of name-calling me due to the stigmatized nature of my illness. He remarked, and I quote, that my problem was probably a result of my 'playing the field,' (which wasn't infact the case.) Implied that I was lucky to be treated for it at all. He also deliberately avoided answering my questions or answered them as ambigiously as possible, and I actually believe he was trying to tease or frighten me.

He also gave me some (extremely) confidential medical information about my OH, unprompted or requested by me.

I was only with him for about fifteen minutes but it was a truly upsetting experience. If I had received that treatment in a restaurant or shop I would have complained immediately. I think his high status, and my dependancy on him as a specialist was the only thing that prevented me doing so.

drkpower

Truley wrote: »

If I had received that treatment in a restaurant or shop I would have complained immediately. I think his high status, and my dependancy on him as a specialist was the only thing that prevented me doing so.

Unfortunately, this is part of the reason why those few consultants, who are problematic, continue to act in this way. It sounds like you had a pretty awful experience with this guy - and i presume that there are other consultants out there well qualified to deal with your issues? So why would you not (1) change consultant, (2) +/- make a complaint.

I appreciate that complaining about an individual within a service who is continuing to treat you can be daunting, but continuing to be treated by someone who clearly dealt with you in an appalling fashion is bizarrre.

Until people actually complain when someone treats them in this way, how can you expect to modufy the behaviour of a few bad apples?

prinz

drkpower wrote: »

Out of interest, was your OHs issue the suggestion of doing a physical examination that had already been done by someone else? It would be standard practice for a doctor to repeat any physical examination for himself. Im probably misinterpreting your post though.

It was doctor. Unfortunately after three days in and out of hospital (along with a string of Fawlty Towers-like admin cock-ups) being asked to repeat the initial examination which led her to being referred to hospital in the first place, standard practice or not, was the straw that broke the camel's back...and his reaction to her question was not what I'd describe as professional.

On the other side my father is a patient under another consultant and she couldn't be nicer/better.

drkpower

prinz wrote: »

It was doctor. Unfortunately after three days in and out of hospital (along with a string of Fawlty Towers-like admin cock-ups) being asked to repeat the initial examination which led her to being referred to hospital in the first place, standard practice or not, was the straw that broke the camel's back...and his reaction to her question was not what I'd describe as professional.

I hear ya; it is often very hard for people to appreciate why a particular examination has to be repeated by every doctor you meet, particularly if it is a sensitive one. But the reality is that it must be. The subjective nature of any physical examination (as opposed to a CT, for example) means that it must be repeated by the doctor to whom a patient is referred, even if it has already been done by the referring doctor. To do othewrwise would be negligent.

looksee

prinz wrote: »

It was doctor. Unfortunately after three days in and out of hospital (along with a string of Fawlty Towers-like admin cock-ups) being asked to repeat the initial examination which led her to being referred to hospital in the first place, standard practice or not, was the straw that broke the camel's back...and his reaction to her question was not what I'd describe as professional.

On the other side my father is a patient under another consultant and she couldn't be nicer/better.

Do you know, that sounds very familiar. I suspect I know who the consultant was and possibly what his issues were. Got the teeshirt.

Truley

drkpower wrote: »

Unfortunately, this is part of the reason why those few consultants, who are problematic, continue to act in this way. It sounds like you had a pretty awful experience with this guy - and i presume that there are other consultants out there well qualified to deal with your issues? So why would you not (1) change consultant, (2) +/- make a complaint.

I appreciate that complaining about an individual within a service who is continuing to treat you can be daunting, but continuing to be treated by someone who clearly dealt with you in an appalling fashion is bizarrre.

Until people actually complain when someone treats them in this way, how can you expect to modufy the behaviour of a few bad apples?

You are completely correct, and if I didn't take it upon myself to complain I have only myself to blame when nothing changes. Part of the reason I didn't do anything at the time is the fact that I was getting the necessary treatment for my problem, and I sort of feared boycotting this man would have hindered that treatment. You are right though, I should have stood up for myself.

looksee

Truley wrote: »

You are completely correct, and if I didn't take it upon myself to complain I have only myself to blame when nothing changes. Part of the reason I didn't do anything at the time is the fact that I was getting the necessary treatment for my problem, and I sort of feared boycotting this man would have hindered that treatment. You are right though, I should have stood up for myself.

In addition to the fact that when you have a health issue the last thing you need is the hassle of taking on the medical service, or anyone else.

marienbad

I have had a lot of experience with consultants in this country and that has varied from one lot nearly costing me my health and my career to another guy being alsolutely brilliant and saving the day.

All of them,both good and bad work extraordinary hours and I have no doubt are committed to their profession and their patients.But there is a lot more to it than that .

They are a law unto themselves and are effectively beyond regulation. Anyone who doubts that should look again at the Neary case .

Self-regulation is little better that no regulation and has to go, not just for consultants but for all these cartels.

Any profession that can denouce 250'000 as ''mickey mouse money'' are just so divorced from reality as to be irredeemable.

The Health Service needs to really put patients first, not consultants,nurses and unions and this will only happen from external pressure. It is too far gone for any kind of meaningful internal reform.

irishh_bob

marienbad wrote: »

I have had a lot of experience with consultants in this country and that has varied from one lot nearly costing me my health and my career to another guy being alsolutely brilliant and saving the day.

All of them,both good and bad work extraordinary hours and I have no doubt are committed to their profession and their patients.But there is a lot more to it than that .

They are a law unto themselves and are effectively beyond regulation. Anyone who doubts that should look again at the Neary case .

Self-regulation is little better that no regulation and has to go, not just for consultants but for all these cartels.

Any profession that can denouce 250'000 as ''mickey mouse money'' are just so divorced from reality as to be irredeemable.

The Health Service needs to really put patients first, not consultants,nurses and unions and this will only happen from external pressure. It is too far gone for any kind of meaningful internal reform.

you only have to look to the recent case where a doctor was found to have bungled an operation on a guard , he took out the wrong lung or something , the guard later died , bar a doctor is found with a body in the trunk of thier car , its impossible to face any real lasting discipline , ffs , neary in drogheda who was removing womens wombs , didnt even loose his pension

a law unto themselves

Robxxx7

marienbad wrote: »

I have had a lot of experience with consultants in this country and that has varied from one lot nearly costing me my health and my career to another guy being alsolutely brilliant and saving the day.

All of them,both good and bad work extraordinary hours and I have no doubt are committed to their profession and their patients.But there is a lot more to it than that .

They are a law unto themselves and are effectively beyond regulation. Anyone who doubts that should look again at the Neary case .

Self-regulation is little better that no regulation and has to go, not just for consultants but for all these cartels.

Any profession that can denouce 250'000 as ''mickey mouse money'' are just so divorced from reality as to be irredeemable.

The Health Service needs to really put patients first, not consultants,nurses and unions and this will only happen from external pressure. It is too far gone for any kind of meaningful internal reform.

You hit the nail on the head there ....

They should be independently regulated and the onus should always be on Patient Care first and foremost.

Some of these consultants/Doctors/Nurses etc need to take some time out and brush up on their customer care skills ... you are dealing with people who are nervous as hell in the first place without having to go through some of the crap these people throw at ye.

drkpower

marienbad wrote: »

Self-regulation is little better that no regulation and has to go, not just for consultants but for all these cartels.

Robxxx7 wrote:

They should be independently regulated and the onus should always be on Patient Care first and foremost.

irishh_bob wrote:

its impossible to face any real lasting discipline .

...and more uninformed comment.....!

Self-regulation?!:rolleyes: The Irish Medical Council is the only Medical Council in the world to have a lay majority.
http://www.irishtimes.com/newspaper/health/2010/1123/1224283917538.html

Could ye at least do a little cursory googling before you come to uninformed conclusions..

Robxxx7

http://www.medicalcouncil.ie/What-we-do/The-Medical-Council/?pageNumber=1

12 medical members and 13 'lay' members paid for by doctors ... hardly independent is it ?

drkpower

Robxxx7 wrote: »

http://www.medicalcouncil.ie/What-we-do/The-Medical-Council/?pageNumber=1

12 medical members and 13 'lay' members paid for by doctors ... hardly independent is it ?

How are they 'paid for by doctors'? Do you mean because the Medical Council is paid for by the compulsory annual registration payments of every doctor.....?! Are you suggesting that they are less likely to strike a doctor off the Roll because the Medical Council might then lose one of many thousands of subscriptions...?!!!!!:D:D
Would you prefer if registration was free and the Medical Council was paid for by the central exchequer? Would that make a difference to you? What is it that you want?

And what would you consider to be a truly independent Medical Council?

For those, like yourself, who complain about doctors regulating doctors, even the Irish system being the only one in the world where a lay majority exists, isnt enough......

marienbad

drkpower wrote: »

...and more uninformed comment.....!

Self-regulation?!:rolleyes: The Irish Medical Council is the only Medical Council in the world to have a lay majority.
http://www.irishtimes.com/newspaper/health/2010/1123/1224283917538.html

Could ye at least do a little cursory googling before you come to
uninformed conclusions..

What an arrogant post,synonymous with the profession really. I'll tell you what , while I am doing ''a little cursory googling'' could you come down out of your ivory tower and meet at least halfway and stop giving dismissive one line replies to genuine concerns.

As for the Irish Medical Council and its ''lay'' majority , well, what a curious expression in this day and age -''lay'' - meaning us qualified, you sheep.

We don't want a medical council with a lay majority, we want the profession regulated independantly like everyone else. Why would you object to this ?

That same Medicial Council let Neary skate on previous investigations and it took an outsider who refused to be bullied to make the medical establishment face up to their responsibilites. During all this time he was allowed to carry on like some latter day Jack the Ripper destroying the lives and potential of countless women. But that Ok , you did the right thing in the end , by the Consultant that is , and retired him a few years early with full pension. Bravo !

And in case you thing this just using one appalling case to beat you over the head with, I can continue this discussion without ever mentioning Neary again .

I am not anti consultant in the slightest, If I could I would give some of them medals , but I want them to concentrate on what they are good at and trained for- medical matters.

- not dictating public/private patients ratio
- not dictating the number or location of consultants required.
- not adjucating in any shape or form on compaints

and that is only for starters ..,

Robxxx7

a cursory search via google will show you

http://www.medicalcouncil.ie/What-we-do/

The Medical Council is funded exclusively by the annual payments of registered doctors; no funds are received from government or other sources

So ... by being independent means exactly that .... predominately 'lay' persons with a few medical people thrown in for good measure .. funded by the taxpayer at a cost of 9m a year (20,000 doctors currently paying 490eur)

Still make the doctors pay a registration fee but this is not used to fund the medical council but put in pot to cover claims of malpractice, customer service training etc etc

but of course you know all that anyway

just noticed you changed your response obviously after doing a little bit more research

drkpower

marienbad wrote: »

What an arrogant post,synonymous with the profession really. I'll tell you what , while I am doing ''a little cursory googling'' could you come down out of your ivory tower and meet at least halfway and stop giving dismissive one line replies to genuine concerns.

As for the Irish Medical Council and its ''lay'' majority , well, what a curious expression in this day and age -''lay'' - meaning us qualified, you sheep.

We dont want a medical council with a lay majority, we want the profession regulated independantly like everyone else. Why would you object to this ? ..,

How is it arrogant to point out a factual error in your post that could have been resolved by a minimum of googling...?

But, on topic, what do you mean by 'independently regulated'?
Who should do the regulating?
And what do you mean by 'regulated independantly like everyone else'?
What other professions are 'independently regulated' in the manner in which you suggest?

And can you explain, or think of a reson, why no medical system in the world has what you are asking for?

If you are going to suggest an alternative system, you need to consider it in more detail than you already have and come up with genuine solutions, rather then knee-jerk reactions against what is there at present.

marienbad wrote: »

I am not anti consultant in the slightest, If I could I would give some of them medals , but I want them to concentrate on what they are good at and trained for- medicals matters.

- not dictating public/private patients ratio
- not dictating the number or location of consultants required.
- not adjucating in any shape or form on compaints

and that is only for starters ..,

Consultants dont do any of the above...... Seriously, if you want to discuss these issues, at least start from a position of some knowledge about what consultants dictate and what others dictate. Otherwise, its just a waste of time.

Robxxx7

Robxxx7 wrote: »

a cursory search via google will show you

http://www.medicalcouncil.ie/What-we-do/

The Medical Council is funded exclusively by the annual payments of registered doctors; no funds are received from government or other sources

So ... by being independent means exactly that ....

How does a group being funded by who they're supposed to regulate = independent? It equals quite the opposite as I see it

drkpower

Robxxx7 wrote: »

The Medical Council is funded exclusively by the annual payments of registered doctors; no funds are received from government or other sources

What is the difficulty with this?

Are you suggesting that they are less likely to strike a doctor off the Roll because the Medical Council might then lose one of many thousands of subscriptions...?!!!!!
they are compulsory payments; its not like a doctor can refuse to pay if they dont like what the Medical Council is doing...!?!?:D
Would you prefer if registration was free and the Medical Council was paid for by the central exchequer?
Would that make a difference to you?

Robxxx7 wrote: »

So ... by being independent means exactly that .... predominately 'lay' persons with a few medical people thrown in for good measure

So you want a bigger lay majority?
The present majority isnt good enough?
What size majority are you looking for? 66%, 75%?
And what will giving the Medical Council a 75% majority actually achieve as opposed to the current 54ish% majority?

Robxxx7

I shall say dis only wernce

The primary factor here is the patient. Doctors/Consultants regulating themselves is bad ..... 99% 'lay' person would be fine with me then atleast with the right 'lay' person in place we may get a bit more parity with the primary factor that the patient is what matters !!

drkpower

bluewolf wrote: »

How does a group being funded by who they're supposed to regulate = independent? It equals quite the opposite as I see it

How does the fact that the Medical Council is funded by compulsory non-negotiable registration fee applicable to every doctor affect the independence of the Medical Council?

And Im sure consultants & all doctors would be delighted if the central excequer paid for the Medical council from now on........

drkpower

drkpower wrote: »

How does the fact that the Medical Council is funded by compulsory non-negotiable registration fee applicable to every doctor affect the independence of the Medical Council?

Well I'm not entirely sure, he's the one who made the link in the first place - but if it affects it at all I would assume it would be the other way!!

What if a doctor gets struck off and they lose out on the fee?

drkpower

Robxxx7 wrote: »

I shall say dis only wernce

The primary factor here is the patient. Doctors/Consultants regulating themselves is bad ..... 99% 'lay' person would be fine with me then atleast with the right 'lay' person in place we may get a bit more parity with the primary factor that the patient is what matters !!

You might try and explain why a 99% lay majotity is better than 54%?

Because otherwise all we have to go on is your view that 99% is better than 54%, with no actual argument to back that up?

And if 99% lay is best in your view, why not 100%?

drkpower

bluewolf wrote: »

What if a doctor gets struck off and they lose out on the fee?

Like losing out on 1 €500 fee, leaving another 19,999€500 fees intact...?! Hardly a disincentive to strike anyone off!!:D

Anyway, this is a non-issue; doctors would welcome their registration fee being scrapped, im sure!

Robxxx7

Thats a great idea .. we should go 100%, you just made my mind up

and how would it be better .... well Complete impartiality with regards Consultants/Doctors and completely biased towards the patient ... Wonderful

drkpower

Robxxx7 wrote: »

Thats a great idea .. we should go 100%, you just made my mind up

and how would it be better .... well Complete impartiality with regards Consultants/Doctors and completely biased towards the patient ... Wonderful

...and do you see any difficulty with a pure lay Medical Council adjudicating on the appropriateness or otherwise of medical treatment...? Any at all?

Robxxx7

drkpower wrote: »

...and do you see any difficulty with a pure lay Medical Council adjudicating on the appropriateness or otherwise of medical treatment...? Any at all?

That was your suggestion, i was quite happy to give you 1% but oh no, that wasn't good enough for you ... just take take take

anyway made my point, time to go onto my high horse somewhere else once you've vacated it

marienbad

drkpower wrote: »

How is it arrogant to point out a factual error in your post that could have been resolved by a minimum of googling...?

But, on topic, what do you mean by 'independently regulated'?
Who should do the regulating?
And what do you mean by 'regulated independantly like everyone else'?
What other professions are 'independently regulated' in the manner in which you suggest?

And can you explain, or think of a reson, why no medical system in the world has what you are asking for?

If you are going to suggest an alternative system, you need to consider it in more detail than you already have and come up with genuine solutions, rather then knee-jerk reactions against what is there at present.



Consultants dont do any of the above...... Seriously, if you want to discuss these issues, at least start from a position of some knowledge about what consultants dictate and what others dictate. Otherwise, its just a waste of time.

Are you for real ?? if you are going to discuss like this , you are correct it is a waste of time.

By the way what was the factual error in my other post ?

drkpower

Robxxx7 wrote: »

That was your suggestion, i was quite happy to give you 1% but oh no, that wasn't good enough for you ... just take take take

anyway made my point, time to go onto my high horse somewhere else once you've vacated it

You have just stated that 99%/100% lay majority is better that 54% lay majoirty without making any argument to back up that position; and you havent been able to identify any possibility of a problem arising when lay people exclusively adjudicate on what is and what is not appropriate medical treatment.

I dont think you have made any point.

Robxxx7

drkpower wrote: »

You have just stated that 99%/100% lay majority is better that 54% lay majoirty without making any argument to back up that position; and you havent been able to identify any possibility of a problem arising when lay people exclusively adjudicate on what is and what is not appropriate medical treatment.

I dont think you have made any point.

The point i've made is that i have made you look like an ass

drkpower

marienbad wrote: »

Are you for real ?? if you are going to discuss like this , you are correct it is a waste of time.

I have asked you to clairfy what you mean by 'independently regulated'. If you are interested in this topic and have a point to make, an explanation of what you mean by 'independently regulated' is quite important. If you dont want to explain it, thats fine though.

marienbad wrote: »

By the way what was the factual error in my other post ?

You said 'Self-regulation is little better that no regulation' ; as I explained to you, the Medical Council is majority lay, so the description of 'self-regulation' is factualy incorrect (or at best, misleading).

drkpower

Robxxx7 wrote: »

The point i've made is that i have made you look like an ass

By asking you to elaborate on the point you are struggling to make?:D Do you have anything of substance to add?

marienbad

drkpower wrote: »

I have asked you to clairfy what you mean by 'independently regulated'. If you are interested in this topic and have a point to make, an explanation of what you mean by 'independently regulated' is quite important. If you dont want to explain it, thats fine though.



You said 'Self-regulation is little better that no regulation' ; as I explained to you, the Medical Council is majority lay, so the description of 'self-regulation' is factualy incorrect (or at best, misleading).

Ok then , self regulation is no regulation . When you say ''the independant medical council'' it has a nice ring to it , but independant from what ??
From public scrutiny ? government oversight ? How can you possibly be objective enough to regulate yourself ? and forget about the ''lay'' majority, that a bit like the school boards argument, but when push come to shove you know which way they will go.

Every grouping allways thinks that only they are qualified to understand and regulate their own profession, it has always been thus and it has always been wrong.

From the priests with their canon law above the law, the Guards objecting to an independant investigative body.

Such arrangements have at best led to slow justice and at worst to no justice.

Why, it is virtually impossible to get one doctor to testify against another in Ireland and we are left with the expense of bringing experts in from abroad.

Why could the medical profession not be regulated by an independant statuary body with no medical members and call experts witnesses as required.

Afterall how does a judge do it in a malpractice suit ?

Now can I ask you a question, why are you against outside regulation ?

Going back to my other post and saying consultants have no imput into
those items I listed is just disingenuous and to say otherwise is just semantics. Nothing happens in the Irish medical system without being ''run past'' the consultants .

drkpower

marienbad wrote: »

Ok then , self regulation is no regulation . When you say ''the independant medical council'' it has a nice ring to it , but independant from what ??
From public scrutiny ? government oversight ? How can you possibly be objective enough to regulate yourself ? and forget about the ''lay'' majority, that a bit like the school boards argument, but when push come to shove you know which way they will go..

What? 'Forget about the lay majority.....when push come to shove you know which way they will go'.... is that an argument..?:D

The reality is there is a number of doctors struck off every year, and many more censured and suspended. So the facts go against your argument which is an argument based merely on your own prejudices.

marienbad wrote: »

Why, it is virtually impossible to get one doctor to testify against another in Ireland and we are left with the expense of bringing experts in from abroad..

Welll, factually, it isnt virtually impossible; although I grant you, it can be difficult. In many fields in Ireland, there are only a handful of experts with the requsiite experience to give an opinion, so they are very likely to be reluctant to publicallly criticse a colleague, who they are likely to have worked with and still work with. They will do it in private though! Anyway, this is a problem for all small countries and is quitepeculiar to the medical profession where the manner in which consultants were trained and work means they tend to have a close relationship with many of their peers, particularly in more niche specialties.

marienbad wrote: »

Why could the medical profession not be regulated by an independant statuary body with no medical members and call experts witnesses as required..

Now, that is a reasonable suggestion. And in some/most Fitness to Practice enquiries, expert opinion is sought and produced to the Council. One of the reasons why this may not be practical is (AFAIK) is because it hears thousands of complaints per year and it is simply not practical to seek independent expert opinion (presumably from another country - as per your previous post) in each case. The MEdical Council also has a multitude of other (ie. non-disciplinary) functions which require the knowledge of medicine.

But I have sympathy for this suggestion, particularly for cases that have reached the Fitness to Practice stage. And I wouldnt be against it.

But before scrapping a system that was brought in a couple of years ago(against the objections of many in the medical profession, i might add!!), you do really need to give a proper reason why a body composed of 100% lay members will do a better job than one composed of 54% lay members (other than 'because it will'....).

marienbad wrote: »

Now can I ask you a question, why are you against outside regulation ?.

I'm not. You should be careful of assumptions.

I am against people making ill informed objections to a system without actually making a proper argument for why the system does not work. I have yet to hear a proper argument as to why 54% lay majority cant work while 100% lay majority will.

marienbad wrote: »

Going back to my other post and saying consultants have no imput into
those items I listed is just disingenuous and to say otherwise is just semantics. Nothing happens in the Irish medical system without being ''run past'' the consultants .

Consultants do not dictate public/private patients ratio; where are you getting this from?
Consultants do not dictate the number or location of consultants required; in fact, consultants in most specialties have been vocal about increasing numbers substantially yet Government has not delivered.
Consultants do not adjucate on compaints; where are you getting this from?

Im afraid your list of complaints is simply incorrect. And it is another example of where you simply assume them to be true, without having actually sought to verify if they are or not.

marienbad

There really is'nt much point really , but lets give it one more try

The current system was brought in as you say against the objection of many of the medical profession, why was that ?

The truth of the matter is that you can have outside regulation or quasi self-regulation and what we have now is a compromise .Do you accept that at this point in time the medical profession are opposed to 100% outside regulation ? That is the nub of the matter.

The fact that lots are struck off etc proves nothing. It may well be effective but we have no way of knowing. Surely you cannot deny that in those high profile cases that have come to light the whole process looks antiquated and self interested.

Your next paragraph is just astonishing ! You to accept that it can be ''difficult'' to get a colleague to ''publickly criticise a colleague'', but they will do it ''in private though'' and then you say ''this is a problem for small countries'' and ''is quite peculiar to the medical profession''. I dont know where to start , every thing you say is a case for independant statuary regulation.

As for the mechanics of it and your objections- rubbish, time you did a bit of googling youself, there are loads of occupations/professions/ that have unique requirements and can be regulated, Medicine is no different.
It is the objectivity and independance that such mechanisms bring to the table that counts , for the knowledge experts can be called and if necessarry compelled to testify thus getting over -''I work with him or he trained me'' syndrome.

As for giving a proper reason ,as you ask. ok lets try shall we.

We have no way of knowing how effective the current system is, it may well be 100 per cent effective , but that is not good enough if it is not seen to be so.

International best practice has shown that in every endeavour involving the publick independant regulation is the only effective means of regulation.
That every profession/union/caste/clique/religion /industry whatever has opposed such regulation and without exception there were wrong.

What makes this case any different ? Remember it is not us that has to make a case to you. You are accountable to us.

drkpower

Its very hard to follow your post, and what specific points of mine you are commenting on, because of the way you have structured it. Suffice it to say that doctors are against non-medical regulation of their industry. There are many reasons - the main one is because they do not want someone who has no understanding of medicine being the sole arbiter of whether they are entitled to practice medicine, and thus to provide for them and their families. That seems pretty reasonable.

And re: the high profile cases (like Neary), they were a disgrace; but they were actually before the curent system of regulation was introduced (which changed majority medical to majority lay), so why would you see those as relevent to assessing how the current regulatory system is functioning?

marienbad wrote: »

We have no way of knowing how effective the current system is, it may well be 100 per cent effective , but that is not good enough if it is not seen to be so..

Well, we have the experience of every other country whose medical regulatory bodies are majority medical; are you saying that the UK, US, European, Australian systems (as well as every other country) are wrong? And that their systems are 'seen to be' wrong?

What evidence do you have for this assertion other than your own prejudice?

marienbad wrote: »

International best practice has shown that in every endeavour involving the publick independant regulation is the only effective means of regulation.
What makes this case any different ?.

As I have explained to you, no other country regulates its medical system in the way you suggest; in fact, as far as lay membership is concerned, Ireland is way ahead of other countries. International best practice in respect of medical regulation seems to involve more self-regulation than we have in this country.

So what 'International best practice' are you talking about...?:D

marienbad wrote: »

Remember it is not us that has to make a case to you. You are accountable to us.

Whats with the 'you' and 'us'.....?

I would suggest that if one person wants a system (in any sphere) that exists nowhere else in the world, the onus is on that person to (a) show that the international system is wrong, and (b) your proposed system is better.

marienbad

drkpower wrote: »

Its very hard to follow your post, and what specific points of mine you are commenting on, because of the way you have structured it. Suffice it to say that doctors are against non-medical regulation of their industry. There are many reasons - the main one is because they do not want someone who has no understanding of medicine being the sole arbiter of whether they are entitled to practice medicine, and thus to provide for them and their families. That seems pretty reasonable.

And re: the high profile cases (like Neary), they were a disgrace; but they were actually before the curent system of regulation was introduced (which changed majority medical to majority lay), so why would you see those as relevent to assessing how the current regulatory system is functioning?


Well, we have the experience of every other country whose medical regulatory bodies are majority medical; are you saying that the UK, US, European, Australian systems (as well as every other country) are wrong? And that their systems are 'seen to be' wrong?

What evidence do you have for this assertion other than your own prejudice?


As I have explained to you, no other country regulates its medical system in the way you suggest; in fact, as far as lay membership is concerned, Ireland is way ahead of other countries. International best practice in respect of medical regulation seems to involve more self-regulation than we have in this country.

So what 'International best practice' are you talking about...?:D



Whats with the 'you' and 'us'.....?

I would suggest that if one person wants a system (in any sphere) that exists nowhere else in the world, the onus is on that person to (a) show that the international system is wrong, and (b) your proposed system is better.

You are choosing to confine the argument on regulation just to the medical sphere, which as you point out is the last bastion of self regulation . Every other profession made the same assertions that you do
against independant regulation and they were all wrong.Why is your profession any different.

You say why bring up Neary as that was the old regime. But under the old regime we were assued for years there was no need for change ,using the same arguments that you are using now. Before Neary the medical profession were competely opposed to reform and even after Neary substantial numbers in the medical profession still opposed reforms . Is that not so ? and If so what were their reason ?

But your statement that ''someone that has no understanding of medicine being the sole arbiter etc'' is really the crux of the matter, not best practice , not patients care . God forbid that an independant arbiter aided with the best expert assistance should be the judge.

drkpower

marienbad wrote: »

You are choosing to confine the argument on regulation just to the medical sphere, which as you point out is the last bastion of self regulation . Every other profession made the same assertions that you do
against independant regulation and they were all wrong.Why is your profession any different..

Thats wrong too!:D It isnt the last bastion.

But in any case, you havent shown how international regulatory systems have been a failure?
Or why a majority lay regulation can not properly regulate the system?
Other than to say they wont. Im open to arguments but you arent providing them.

marienbad wrote: »

You say why bring up Neary as that was the old regime. But under the old regime we were assued for years there was no need for change ,using the same arguments that you are using now. .

What relevence does the bad arguments of some people years ago about a different regulatory system have to different people today making different arguments about a different regulatory system, which is barely a couple of years old....?!:D:rolleyes:

marienbad wrote: »

But your statement that ''someone that has no understanding of medicine being the sole arbiter etc'' is really the crux of the matter, not best practice , not patients care . God forbid that an independant arbiter aided with the best expert assistance should be the judge.

And that expert assistance is coming from a doctor, right?

How do you asess what is 'best practice' other than by involving medics?
How do you asess what is best for 'patient care' other than by involving medics?

The medical system can never be fully regulated by non-medics. They do not have the skill-set to do so alone. There are two possibilities:

1. Regulation by a body which includes medics, preferably with a lay majority.
2. Regulation by a body of non-medics, who, on (almost) every occasion, must seek expert external advice, often expert advice from multiple specialties, to determine any issue before them.

I would suggest that the latter is entirely impractical. But if you can explain how the latter is practical, or produce an example of where the latter has succeeded in real life, I look forward to hearing it......

looksee

I am not particularly interested in international best practise. No matter how you cut it, the Irish medical board is the final arbiter in Ireland, they do not answer to any international group so far as I know.

My argument is not for the kind challenge made to the Irish Medical Organisation, that is a last resort, and an expensive and exhausting experience that most people would prefer to avoid.

I am suggesting a localised way of commenting on the kind of service provided by very expensive Consultants, who do not appear to answer to any one at a local level.

Something as simple as a card available in the hospital where you can comment on your treatment, good or bad. And I am sure that most people would express gratitude and appreciation for the treatment they have received. However if there were a significant number of returns coming in that said 'Mr X was off-hand and dismissive of my problem' 'Mr Y's attitude was rude and impersonal' 'Mr Z said that the test results showed nothing wrong, but I got them repeated elsewhere and they showed a problem, I have had to pay twice to get an answer', then the hospital should be able to say to the Consultant, this is the feedback we are getting, you need to look at your approach to your job.

This is not new or extraordinary, many jobs have this sort of review, and given the importance and cost of consultant visits there should be some way of giving feedback.

And incidentally, I had a routine hospital appointment this afternoon, it cost me €100 for a follow-up, but the service was efficient and the Consultant was efficient, professional and courteous.

drkpower

looksee wrote: »

I am not particularly interested in international best practise. No matter how you cut it, the Irish medical board is the final arbiter in Ireland, they do not answer to any international group so far as I know..

You mean the Medical Council? The final arbiter is the High Court.

But the point is not about whther they answer to an international body; the point is that if the type of regulatory system some here favour is reallly the ideal, does noone wonder why no other country has followed that system. Are we to believe that the medical systems and Governments of every country are corrupt and anti-patient?

looksee wrote: »

I am suggesting a localised way of commenting on the kind of service provided by very expensive Consultants, who do not appear to answer to any one at a local level...Something as simple as a card available in the hospital where you can comment on your treatment, good or bad

That is a perfectly good idea; and im sure that some departments of some Hospitals have a comment card in place.

However, every Hospital has a 'patient advocacy' department (of some sort) whose sole function is to act as a liason between patient and Hospital and to explain, and/or apologise for service issues that have arisen, and to resolve, where it can, disputes between them. Have you ever thought to contact these people before you suggest they dont exist?

irishh_bob

marienbad wrote: »

Ok then , self regulation is no regulation . When you say ''the independant medical council'' it has a nice ring to it , but independant from what ??
From public scrutiny ? government oversight ? How can you possibly be objective enough to regulate yourself ? and forget about the ''lay'' majority, that a bit like the school boards argument, but when push come to shove you know which way they will go.

Every grouping allways thinks that only they are qualified to understand and regulate their own profession, it has always been thus and it has always been wrong.

From the priests with their canon law above the law, the Guards objecting to an independant investigative body.

Such arrangements have at best led to slow justice and at worst to no justice.

Why, it is virtually impossible to get one doctor to testify against another in Ireland and we are left with the expense of bringing experts in from abroad.

Why could the medical profession not be regulated by an independant statuary body with no medical members and call experts witnesses as required.

Afterall how does a judge do it in a malpractice suit ?

Now can I ask you a question, why are you against outside regulation ?

Going back to my other post and saying consultants have no imput into
those items I listed is just disingenuous and to say otherwise is just semantics. Nothing happens in the Irish medical system without being ''run past'' the consultants .

guards , priests etc , none of those can hold a candle to the doctor fraternity in terms of cliqueeness , a doctors loyalty is always to his or her colleague which is why every investigation into medical malpractice in this country results in a virtual whitewash