GPST Issue 12 Diary

  • Date: 24 March 2016

SCIENTIFIC GUESSING Statistics from the non-profit Perinatal Institute have shown how wildly inaccurate due dates are. It seems babies are born on their predicted due date just four per cent of the time, rising slightly to 4.4 per cent if you exclude premature births and pregnancies with complications. While this may leave some would-be parents scratching their heads and wondering if they’d be better off asking Mystic Meg when their bundle of joy will arrive, the Institute was quick to highlight the value of these predictions. Professor Jason Gardosi told BBC News that, while it may be helpful for parents to get an idea of when their child will arrive, the main purpose of the due date is to “define a metric for the care” of the mother during pregnancy. “So, for example, to interpret early pregnancy blood tests for the risk of congenital anomalies, it’s important to know how far gone the pregnancy is.” He went on to say that the advice to expectant mothers is that the baby is likely to come any time between 37 weeks (259 days) and 42 weeks (294 days), a period referred to as “term”, when the baby has reached full maturity. The prof has suggested the phrase “due date” is misleading and that “estimated date” would be more realistic.

EAR NO MORE Doctors have one man’s shyness to thank for the invention of the stethoscope. In 1816, when confronted with an overweight female patient complaining of heart problems, conservative French physician René Laënnec felt the usual practice of pressing one’s ear against the patient’s chest was not appropriate. A keen flute player, the idea came to him to roll up a piece of paper into a tube and press it against her chest. In a research paper published in 1819, he described how he was “not a little surprised and pleased to find that I could thereby perceive the action of the heart in a manner much more clear and distinct than I had ever been able to do by the immediate application of my ear.” His early hollow wooden prototypes were eventually improved upon in the 1850s into a design very similar to that used today. The pioneering Laënnec, who died of tuberculosis aged just 45, was celebrated in a recent Google doodle on what would have been his 235th birthday.

PRE-MORTEM Diary recently had a nightmare that we consulted the Ubble UK Longevity Explorer only to discover we are already dead. How welcome it was to awake Scroogelike and realise there is still time to make a change. This apparently is a key motivation behind the development of the online tool which uses self-reported information to generate a score that predicts the risk of death within the next five years for UK people aged 40 and 70. It is based on research from the Karolinska Institutet utilising health data from nearly half a million adults held in the UK Biobank. Researcher Dr Andrea Ganna said: “Of course, the score has a degree of uncertainty and shouldn’t be seen as a deterministic prediction. For most people, a high risk of dying in the next five years can be reduced by increased physical activity, smoking cessation, and a healthy diet.” Diary will honour these resolutions in our heart and try to keep them all the year!

BEASTLY REMEDIES Hearing loss is a common complaint in general practice and it is a problem that apparently was treated as far back as 1550 BC in Ancient Egypt. A recent article on historytoday.com by Sheffield University researcher Alison Atkin examined the Ebers Papyrus medical texts from the time which suggest some alarming early remedies for “Ear-That- Hears-Badly”. Highlights include injecting red lead, ant eggs, bat wings and goat urine into the ears. The earliest mention of the creation of a hearing aid comes in the Magiae Naturalis science writings from 1588 which references the use of horns shaped like the ears of animals known to have excellent hearing. But things didn’t seem to improve much for hard-of-hearing patients for a while longer until the first ear trumpets were developed in the 1610s.

FREE-FALL BURDEN Diary has learned that the recent HEE recruitment campaign featuring a GP filling out a sky-diving consent form for a patient has sparked reports from dozens of surgeries overrun with parachutists. One PM said: “Just last week our waiting room was stowed out. They turn up in their orange suits and demand emergency appointments. My staff can no longer cope.” Another GP commented: “Sure. It’s exciting for them but an administrative nightmare for us. No doubt there will soon be calls for a seven-day parachutist consent service.”

JUST NOT SORRY If you’re struggling to get ahead in your career, then it may be your choice of words in emails are to blame. Including phrases like “I’m just writing to say…”, “I’m no expert but…”, “does that make sense?”, or apologising too much could be causing colleagues to lose respect for you and undermining your authority at work. According to the Daily Mail, the habit has prompted New York-based entrepreneur Tami Reiss and the tech team at Cyrus Innovations to create the web browser plug-in Just Not Sorry. It acts like a kind of spell-check in flagging up self-demeaning language to encourage you to eliminate it. Tami advises email writers to “be nice, be polite and be direct. Be clear, honest and open – and that’s true if you’re asking someone to do something or if you’re responding to a request for something.” She says we should stop saying sorry but also be careful not to come across as too negative or aggressive... Sorry, but does all of that make sense?

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GPST is published twice a year and distributed to MDDUS members in GP training throughout the UK. It provides a mix of articles on risk, medico-legal and regulatory matters as well as general features and profiles of interest to trainee GPs. Browse all current and back issues below.
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