Surely most patients see doctors for the sole reason of getting healthier. Can recording a consultation help? Does it harm? Even if the law permits patients to record their medical encounters, should they do it? Should doctors encourage it?
One thing seems certain: recording changes the behaviour of doctors as well as patients. Glyn Elwyn argues this could only be for the better; Laurence Buckman disagrees. Do have your say by submitting a rapid response; as usual, the best rapid responses are selected for publication in the letters section of the The BMJ.
One worry is that recording consultations might make doctors defensive and lead to too much medicine. Defensiveness is already well on the rise, as the UK regulator of doctors, the General Medical Council, told parliament this week. Among 10 012 complaints received by the GMC in 2013, 8591 concerned a doctor’s fitness to practise; an increase of 64% over what was seen in 2010. The regulator informed parliament of the cost of investigating these extra cases, as well as its actions to avoid defensive medicine. These actions include the education of students and postgraduate doctors.
We hope that junior doctors follow our Competent Novice series. The latest article explains how to prescribe intravenous fluids in hospital patients. It covers the 5Rs of fluids management—Resuscitation, Routine maintenance, Redistribution, Replacement, and Reassessment—including when to ask for help.
Some junior doctors might be interested in taking a year out of training to develop clinical leadership skills. Blogging about one such opportunity is Ahmed Rashid, this year’s only general practitioner on an NHS scheme.
The leaders of tomorrow might eventually know the answer to a question we pose today: should the vaccine against genital warts be given in two or three doses? Jit et al used mathematical modelling to help make this decision.
Meanwhile, the UK is finding out that its Cancer Drugs Fund hasn’t been paying enough attention to how successful the drugs were in improving survival or quality of life, relative to the toxicity they caused. “The CDF was a ‘cheap’ way to avoid the critical sociopolitical problem—which is why some cancer medicines cost so much when they deliver only marginal benefits in terms of clinical benefit,” says Richard Sullivan.
You can read more on how politics determines health and what to do about it in this editorial by Ilona Kickbusch.
Kristina Fišter is an associate editor for The BMJ.