Given Baby P/Shipman whats more important, evidence based medicine or admission ?

[addy1]

Yes but herein lies the rub. As you must know, the GMC demands that doctors don't just 'know' things but are also aware that their are limits to what they 'know'. It would appear that you are unaware of the psychological evaluation that goes on already in public and private settings, the methodologies used and the resultant referrals to geneticists.

Doctors are also expected to have integrity and be honest. In all honesty, how long was your psychiatric rotation ? Have you ever been on even a 10 week counselling course, let alone become qualified in one of the therapeutic and assessment methodologies currently used in UK hospitals such as CAT therapy ? There is a limit to your competence here which you are not accepting.

In your case the needs and state reflected in 'silly little ideas' would tell the therapist about your childhood, how your father or parental figure attempted to put you down in this way etc. True, this doesn't make you a baby killer - just someone resistant to the ideas that might prevent babies being killed.

I have given a very clear answer to the questions. If you are prepared to admit that you have never researched psychomedical issues, don't know the names of the journals or relevant search engines I am happy to help. However, as I say, within the field the notion that psychology/psychodynamic interventions can be both preventative and predictive is old news. Surely you have at least heard of the debate surrounding forced detention of those people with personality disorders ?

Ultimately, the 'powers that be' were the electorate. Democracy is the reason why admission processes will change. You may or may not know that psychodynamic/pychological approaches have begun to be trialled in some medical schools, albeit in an immature form. Current admission procedures, to med school, the med register and of overseas doctors to the med register survive only because of lack of examination - unlike Baby P. who didn't survive because of lack of examination.

I do want to correct myself though. Working as a doctor in a hospital is not equivalent to having knowledge of the system and I do accept that to be the case. Your hospital may not even have 'in house' psychological services as such and you may never have made a referral to a department specialising in assessment and group individual therapy.

Hilarious. Absolutely hilarious. You've hit the nail on the head there. My Father figure put me down as a child so I have sought you out on an internet forum to do the same to, whilst waiting for my paeds rotation in order to kill all the little children I can lay my hands on. Spot on. Well done you and your psychoanalysis.

It is clear that you have no ability to properly discuss things, and therefore there is no point in posting further response to you.
You still haven't said what you do though (although I suspect it mainly consists of sitting in your bedsit in the dark trawling the internet and not having much human contact).

Good night. Some of us have patients to see in the morning.

[ipsiLoquitor]

Wow !

Re: 'Fully Qualified Doctor'

On examination, the doctor presented as a defensive man who utilised the projective defence of ridicule and distortion in order to prevent a thorough examination. However, although 'cranky' I noticed an absence of reply to questions around limitations of competence although knee jerk was positive.

Recommend for consultant review tomorrow.

[Granny Midges]

Aha, Granny Midges is back.

Of course I know who you are. Unless 'Giella' changes his/her profile you are one of his/her 5 friends and have consistently 'ganged up' with her throughout this thread.

GMon't be paranoid.

I have offered the keywords to anyone wishing to research the issues I am claiming but I have to say that for those within the field, the concept that psychodynamic/psychological interventions on med students at the pre-admission stage could be preventative is akin to saying that some diabetics benefit from Metformin.

GM:I did look it up...there was diddly-squat evidence to what you've been suggesting. Can't find a single citation anywhere.


If its really difficult for posters to do psychomedical research I will of course help but simple humility prevents me from spelling things out to a forum with so many doctors, med students (who I believe are still required to read at least one psychological or psychodynamic research report).

GM:Or perhaps you realise that the silly notion you conjured up as a knee-jerk reaction to watching the Baby P case on T.V might actually be a waste of time but can't bring yourself to admit it ?? Give me a reference I dare you.

I could forsee helping by giving specific articles, particular journals and /or keywords. However, there is some research which shows that knowledge that is 'given' is valued and trusted less than that which is independently 'discovered'.

GM: WTF ???? I usually hate this expression but in this case I think it's appropriate.

Please let me know which area, if any, of psychomedical research you would like help with.

GM:Give us a reference to support you hair- brained idea.

Yes, I repeat. The information is already out there indicating that those students more likely to make mistakes through 'contaminated ego states' and similar can be identified, successfully treated with minimal intervention and thereby help protect babies.

GM:Ridiculous.




Interestingly, the same results will be given utilising these approaches regardless of the 'status' of the person assessed, provided it is carried out professionally by 'blind' assessors.

GM:Intriguing.

My conclusion: you've been watching too many Hannibal lecter movies. Time to switch the channel.

[ipsiLoquitor]

Ok Ms Midges I can see the problem you face.

Lets first of all be clear about where you looked :- did you try Pubmed, for example, where at the very least you should have found evidence in general for psychological approaches in a wide range of settings including 'medical conditions' such as diabetes and others.

Or did you consider asking - where is predictive psychotherapy already practised ? In NHS Outpatient Departments, Departments of Forensic Psychiatry etc And if non-interventional tools are already being utilised on/for patients what would the harm be in simply referring would-be doctors for the same tests ?

If you look up, as just one example, predictive assessment in psychiatry/borderline patients what do you find ?


Have you heard of ICD-10 and psychodynamic dimensions ?

Is it really odd to suggest (as one part of a multi-level assessment) that would-be doctors and those responsible for the care of children should not meet the same assessment standard as the patients who might harm the children ?

The evidence is clear that if you make your own 'discoveries' you will find them more convincing - but if you want more 'clues' please feel free to ask.

Baby P's case isn't about Hannibal Lecter figures. Medically, her case is about a fundamentally good person operating in a system that failed to keep up to date with psychological/psychodynamic knowledge.

Do you think an anonymous survey has gone around paediatricians asking - would you fail to examine a child who was cranky. I can tell you something, I have personal experience of it happening often in various settings.

Perhaps in PAediatric OPs, children should be 'pseudo-admitted' until an examination can be performed. Perhaps a goal could be that 'never again should a child with visible evidence of abuse enter a hospital only to leave again without it being seen'. ?

Now I have to go and find a bedsit to scour the internet to satisfy the projections of our 'fully qualified doctor'.

[BeanOfJelly]

Could you please stop saying "contaminated ego states"? It makes me giggle and I'm finding it difficult to concentrate

[BeanOfJelly]

Bravo on your amazing ability to assess people's childhood experiences based on a few posts over an internet forum. I must commend you and can't wait until this kind of reliable testing is used to decide between applicants.

[ipsiLoquitor]

Bravo on your amazing ability to assess people's childhood experiences based on a few posts over an internet forum. I must commend you and can't wait until this kind of reliable testing is used to decide between applicants.

Hi Bean of Jelly,

I can stop saying 'contaminated ego state' and also Type II Diabetes, dysdiadochokinesis and most hilarious of all 'child protection' Let me know if there are any other terms you are unfamiliar with.

Would you like to learn about how the interpretation of the posters 'results' was made ?

Although this may surprise you to know, there are already some 'assessors' who have transactional skills and to that extent you need wait no longer.

I would understand if you are uncomfortable with the inducted methodology of 'ego states', after all it is so easily associated with the famous 'tripartite conception'.

On the other hand, the evaluations that are currently carried out within healthcare settings already include trained assessment of responses and if you take the time to consider the range of possible adjectives used to describe the posters quoted expression you may be surprised not only by what words you use but by which words it is impossible to use.

You can define an elephant by what it is or by what it is not.

Assessment of entrants to med school, GMC registration and overseas docs coming to UK is a rather large elephant in a very small room.

[giella]

This is actually just funny. Can people keep provoking this person? I'm genuinely laughing out loud at this person's inanity.
I do actually have to deal with a fool like this who is incapable of giving straight answer to a straight question and who twists words like double jointed pretzels. But given that I just have to read it now, and not actually engage with it at all, it's just hilarious. I'm not even being sarcastic.

[BeanOfJelly]

Gotta warn ya... you're doing it again! You're babbling big words to sound important that have no relevance to anything, and saying crazy random stuff (in this case about elephants) that has.. no relevance to anything.
Didn't you learn anything about bad argument from that big sarcastic/impersonation post I did for you?
Either you're wrong.. or I'm all screwed up psychologically- hopefully your expertise should be able to sort out my issues though so I guess I'm dandy either way

[xXx H xXx]

wow. i cant believe this thread has gon on for so long. it seems we r going round in circles thats why i havnt bothered postin anyfink, its nt gna make a difference to anyone. but i jus gotta get this outta ma system.

it suprises me n scares me that sum of our medics ere r bustin out with highly catty comments reeking in bitchiness. irrelevant.

ipsi i admire the fact ur intentions to ur original post haz a gud reason behind it, but like any theory u need evidence, but dis reference to dis flamin research... y dnt u make it clear n easy for us by just telling us abwt a particular research supporting the validity of psychodynamic evaluation? the fact that u encourage us to make our own discoveries shows the general weakness in ur evidence...if this research waz of any relevance to the medical world we wud be readin it in da new scientist or any other publications, rather than 'googling' it. its not there for a reason. coz its plain bullshit.

im sory 4 my foul language, but it frustrates me that this pathetic argument waz allowed to go on for so long, i mean, im all in it for freedom of speech, but nt wen it consists of illogical n nonsensical theories that hav bin falsely acknowledged az facts, and twisted and turned to provide sum sort of solutions to problems faced in medical care in Britain...its just 2 far fetched n jus 2 ridiculous.

for anyone readin nw, i wud advise u to nt waste ur brain power tryna figure out the meaning to this discussion, ur better off readin an article on the developments in social care and the nhs to prevent wt happend to baby p happenin agen, or even just any article on something like the latest breakthroughs in cancer research, u know, something that focuses on saving human life as opposed to this mallarky.