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

**ipsiLoquitor** · 16-11-2008 10:10 PM

Are Chemistry, Biology or Physics really more important than IQ ?

Perhaps personality profiling and IQ tests should be mandatory with those scoring below a certain percentile being rejected.

Baby P was missed by a fully qualified doctor who doubtless had all the grades - did she have a high IQ or EQ ? Somehow I doubt it.

Doctors have to stop choosing candidates in the image of themselves and apply evidence based practice to admission without deleting those aspects of it that don't suit - such as common sense and IQ.

**Airtones** · 16-11-2008 11:33 PM

Shipman was an incredibly intelligent man, as good as any other doctor with regards to brain power. The fact he killed 215 people isn't because he was some sort of moron, its vastly more complex than that.

The question with Baby P is how a child managed to have 60 visits with health care professionals yet none identified that he was being harmed. One even managed to fail to identify that he had 8 broken ribs and probably a broken spine... great doctoring there. Now haringey are banding round saying they support the system - well obviously they do, they want to make it seem like everything was done by the book when clearly there were repeated failings in the process.

**ipsiLoquitor** · 16-11-2008 11:38 PM

Originally Posted by Airtones

Shipman was an incredibly intelligent man, as good as any other doctor with regards to brain power. The fact he killed 215 people isn't because he was some sort of moron, its vastly more complex than that.

The question with Baby P is how a child managed to have 60 visits with health care professionals yet none identified that he was being harmed. One even managed to fail to identify that he had 8 broken ribs and probably a broken spine... great doctoring there. Now haringey are banding round saying they support the system - well obviously they do, they want to make it seem like everything was done by the book when clearly there were repeated failings in the process.

You missed the point and in so doing perhaps made it. Mr Shipman was not personality profiled and you have no proof at all that he was intelligent except for successfully completing his doctorate etc which many of my friends have done without claiming exceptional intelligence.

The entry exams you quote are only evidence of taking an exam. I am told by reliable sources that many people score below the 88th centile and are still admitted.

Get real. Two major points: tested intelligence and personality profiling. Combined !

(I take it that by suggesting Shipman was intelligent you are implying that based on his PhD - again get real. We all know doctor's who 'forget' the significance of inflammatory markers, or in the case of Baby P. the clues of severe abuse.

**BeanOfJelly** · 17-11-2008 12:20 AM

I don't think high IQ makes you any less loony. As for personality tests... do any of them work? Don't you remember that dodgy report on you inner workings that the UKCAT people gave you at the end of the test? It hardly seems fair to assess people on something that is largely unreliable.
The best way to detect a creep is to talk to them.. which they do already. Its called interviewing.

**ipsiLoquitor** · 17-11-2008 12:51 AM

To label these personalities 'creeps' is to show extraordinary ignorance of the work that already goes on in UK hospitals up and down the country. The interviewers you mention are normally not qualified to any significant degree in the subjects required. It is entirely subjective for the most part, with medically qualified doctors/consultants/GPs choosing and selecting on non-medical criteria. This will change. It is just a matter of time.

I am doubly worried that you don't seem to know any of the techniques for establishing reliability in psychological data ? Do you think medical doctors need any psychological/psychiatric training at all ?

**AimsRJ** · 17-11-2008 01:08 AM

I'm not quite sure why you started a debate to completely dismiss other poster's views.

Any hoo- in both cases it was failings by many people/ the system as much as one particular Dr in the baby P case and many people/ the system for shipman continuing as long as he did. No test will ever be totally reliable, especially when you are testing intelligent people who may be able to get round it anyway. instead of testing to the nth degree anyone who expresses an interst in medicine, surely it is better to ensure that concerns are reported and everyone is fully trained in the 1st place (in the case of baby P) and able to act on suspicious actions (as in the shipman case).

**BeanOfJelly** · 17-11-2008 01:09 AM

If you assessed people with a psychiatrist, yes you'd be more likely to find out if they had any worrying personality traits... but does that not go to further stigmatise anything "abnormal" in people's personalities, as well as being of dubious reliability?
I just don't trust so called personality tests, of any kind. To truly judge someone's personality, I think you have to spend a long time with them. I can't see Med Schools forking out for every single candidate to be assessed by psychologists/psychiatrists over a long period of time (Is this what you're suggesting/ have I missed something?)
Interviewing isn't perfect, but it is the best (affordable/realistic, dare I say fair) way to assess whether candidates are psychologically suitable.. in my humble opinion.
Besides, the most dangerous are those who are not detectable (by all accounts Shipman was outwardly a pretty nice guy, up until they found out he was killing people).

Creeps: I was being idiomatic/ not referring to any specific personalities/illnesses, you know what I mean by the word creep perfectly well

And IQ tests, I mean really? They've never actually been tested to show anything conclusive, except the ability to do well at IQ tests.
Common sense.. you could be onto something there, but it already features in the interview process

**Hughman** · 17-11-2008 01:12 AM

The doctor should go infront of a tribunal - he didn't check the kid because he was 'cranky'. No good enough really.

So should the social worker that saw the kid when it had chocolate over its face - my mom worked in social services a while ago and said they were all trained to automatically look under/clean up any sort of covering if appropriate, such as creams, chocolate, loose bandages etc etc

But the comparison of the doctor and Shipman is poor. It is two completely different situations

**ipsiLoquitor** · 17-11-2008 01:18 AM

One particular doctor in the Baby P case was certainly to blame. If a local authority requests a report from a hospital there is a duty encumbent on that hospital to discharge the duty. In the case of child health any trained doctor cannot excuse a non-examination on the absence of being told to look carefully. The status quo which you like so much is failing patients repeatedly. It is normally because of 'predictive answers' such as yours that no change is made. I suspect that you also have limited knowledge/experience of forensic psychology and suggest that you get some. It is not a case of starting a thread only to discount other's opinions. That is like saying that to start discussing tumor markers means I should agree with those who say they are unimportant. I didn't, as you will notice if you read carefully, discuss one test but a spectrum. This surely has to be better than the current system, the main predictor of selection of medical students being that they are female, under thirty and haven't worked for the NHS previously. A particular set of people interviewed Shipman and I wonder if any research has been done on them. Predictively, though, I would say that they would say 'no one test...'. Isn't it time that doctor's started taking seriously the concerns of the patients and learned to look critically at themselves, seeing the value in other ways of working, rather than maintaining the status quo and perpetuating preventable deaths as occurred with Baby P. I wonder if anyone will examine that Paediatrician's entry route to medicine ? Perhaps this question should be more widely advertised. What do you think ?

**Airtones** · 17-11-2008 01:25 AM

Originally Posted by ipsiLoquitor

(I take it that by suggesting Shipman was intelligent you are implying that based on his PhD - again get real. We all know doctor's who 'forget' the significance of inflammatory markers, or in the case of Baby P. the clues of severe abuse.

I honestly think yours is a nieve position. Its easy to say someone like shipman did what he did because he was stupid and that a simple personality profile would have exposed him. But the truth is he was a 1 in a million individual. Someone who wasn't crazy, someone who was very morally developed, who was by many accounts a competent doctor throughout most of his career (despite a minor drugs addiction for which he was previously penalised). But he also had a major god complex and I dare say he enjoyed killing people. Its been suggested though in a few cases he may actually have been putting people out of their misery.

I think shipman is vastly more complicated than a simple personality test. hes the kind of guy who would literally piss all over one of those tests and come out looking like the best thing since sliced bread, because he had being 'normal' down to a fine art.

A schoolyard thug and a petty theif are one thing, but you cant equate that sort of criminal mind up to the likes of shipman, hes a whole other kettle of fish.