tag:blogger.com,1999:blog-4149957315810348152.post1456250341531126219..comments2024-01-01T00:45:41.758+00:00Comments on Wishful thinking in medical education: Social media, black humour and professionals...Anne Marie Cunninghamhttp://www.blogger.com/profile/05289974924032448531noreply@blogger.comBlogger59125tag:blogger.com,1999:blog-4149957315810348152.post-88128038670766508722011-11-15T20:07:03.208+00:002011-11-15T20:07:03.208+00:00Well, those really look offensive at a glance. But...Well, those really look offensive at a glance. But black humor is apparently not that bad. A study by Medical Humanities and Bioethics at Northwestern University, Illinois shows that "treating serious and painful subjects in a light, satirical way, improves the doctor’s surgery performance and the patient’s treatment and recovery." So there, but we must remember that every patient is different and that the joke should not have the patient as its butt. Rather, it should be "death". More of this study here: http://www.huffingtonpost.co.uk/2011/09/28/joking-about-death-could-benefit-doctors-and-patients_n_984555.html<br /><br />-------------------------------------<br />By Students for Students!<br /><br />The Smarter, Faster, More Compassionate and Less Expensive way for students to invest in all the medical equipment they need!<br /><br /><a href="http://www.stethoscopesforstudents.com" rel="nofollow">S4S</a>Millie.Grahamshttps://www.blogger.com/profile/15031834702075773019noreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-38271074897615713032011-11-15T19:32:56.106+00:002011-11-15T19:32:56.106+00:00As long as my doctor is doing his/her job well, I ...As long as my doctor is doing his/her job well, I don't need him/her to act good. Humans are horrible, anyway. I would prefer a doctor who is an A-Hole but is really great than one who is goody-goody but is not competitive. It would be a bonus if the doctor is nice and skillful at the same time, but I put higher priority on his/her skills. Be a jerk all he/she wants, as long as he/she does his/her job, I don't care.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-48531649053829428252011-11-03T13:11:58.196+00:002011-11-03T13:11:58.196+00:00I think everyone realises that comments such as th...I think everyone realises that comments such as those cited are used for stress relief and while we may not like the particulars of that, it is the reality. I think many people have missed the point, though, that to make such comments in a public forum is taking it to another level. To assume that it is OK does say something about the attitudes of the people willing to do that, I think, and that they are perhaps ignoring the potential hurt and disrespect that such language can carry. I'm sure that all of us have said things in the privacy of our own homes or under stress at work that we wouldn't say to the people or groups of people directly. It is not 'banter' if people are deeply hurt by it. I suspect that people said the same things about ethnic jokes in the past that would be seen as completely unacceptable now in a public forum. As several people have said, it is about being aware how it might come across if you are choosing to put it out for everyone to see.<br /><br />I also find the attack on Ann-Marie by other doctors rather astounding. If she found the comment misogynistic, then that is her opinion. You may not, but to directly attack her post as 'rubbish' I find quite dismissive. I didn't see it as implying that medicine is a mostly male profession at all. However, there are many aspects of the profession of medicine that are still stacked against women and I think these attitudes can be held by females as well as males. Just declaring your "feminism" doesn't change anything.JMhttp://www.gmail.comnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-25608425096530413732011-09-29T10:10:11.973+01:002011-09-29T10:10:11.973+01:00I was drawn to this on reading a thread on a docto...I was drawn to this on reading a thread on a doctors' group that you yourself subscribe to. All fascinating stuff. Demonstrates a need for constant circumspection. Best not to say anything in these discussion groups that you wouldn't be happy saying to your own grandmother, I think.Dr Henry Tegnerhttps://www.blogger.com/profile/09066781800926576413noreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-65854745604124814272011-09-22T14:48:56.980+01:002011-09-22T14:48:56.980+01:00Come on, get real. Please. Medicine is an incredib...Come on, get real. Please. Medicine is an incredibly stressful occupation. It isn't just the responsibility for people's health, and indeed lives, it is also trying to cope with this whilst tired, hungry, stressed, dying to get to the toilet, and having to do all this in an overstretched and understaffed service. Black humour is a stress release valve, and a survival mechanism. But there is more to it than that. The forms of language used are one of the last vestiges of the tools of camaraderie that have traditionally helped to keep junior doctors sane. The New Deal and EWTD may have reduced hours (yes, I've worked the old 72 hours plus long shifts), but they also broke up the old firm system<br /><br />*raises eyebrow* I think you miss (an important part of the) point, signalled by **the very title of this post**. This is not about medics slagging off patients in their own private boozer, or wherever, it's about them using these terms *in public*. The word "unprofessional" springs to mind.ptlnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-27151481637174276472011-09-22T10:29:43.767+01:002011-09-22T10:29:43.767+01:00I find it a bit ironic that the much criticism of ...I find it a bit ironic that the much criticism of the doctors who posted these tweets was that they posted in the public domain, yet the only reason most people are aware of the tweets is because Dr Cunningham made it public and the story ended up in national newspapers as a result. I do agree that the comments should have been kept private, but I think that was their only error. <br /><br />Comments are being made about how this behaviour impacts on patient care; that if we, as doctors, will somehow care less about patients if we use these jokes to help lighten a stressful day at work. What a load of rubbish, I may make comments such as these myself, but it in no way impacts on how I deliver care.<br /><br />Many surgeons are criticised for their attitude and relationships with patients, but from my perspective as an anaesthetist who works with many different types of surgeon, is that how well they perform surgery is by far the most important part of their job. I work with surgeons who are crass and could appear uncaring but who are excellent at the skill that truly matters, the surgery. I also work with surgeons who are very friendly and great with their patients, but who lack the skill to make them a good surgeon. Academics and communication experts like Dr Cunningham would no doubt come along to observe these guys at work and praise the lovely guy whose a rubbish surgeon, and criticise the brilliant surgeon for his inability to communicate. The difference is, you don't see the nice surgeon's patient die on ITU a few weeks later from an anastamotic breakdown, I do. <br /><br />Whilst in the ideal world, every surgeon would be technically brilliant and a good communicator, but for now, if I need surgery I know who I would want to do my operation.<br /><br />I realise that I have gone a bit off topic, but my point is that there are much greater things to be worried about than this petty banter that seems to be blown way out of proportion. Technically poor doctors who are good communicators and 'nice guys' are much more dangerous to our patients than doctors who aren't as PC as you'd like them to be.<br /><br />Perhaps if Dr Cunningham had any idea what it was like as an anaesthetist to deal with obstetric emergencies in the 'birthing shed' and critically I'll patients on the 'cabbage patch' (I do find this one slightly offensive!), she could sympathise with usAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-43892831342422144682011-09-21T00:11:01.534+01:002011-09-21T00:11:01.534+01:00get a life...get a life...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-69163084797198230702011-09-20T20:40:44.204+01:002011-09-20T20:40:44.204+01:00Bravo for shining light on this. Everyone needs t...Bravo for shining light on this. Everyone needs to remember that twitter is a public space, so what you're not prepared to say to your mum, you should not tweet about. Totally agree with your stance on this and am glad that not all doctors, especially newly trained ones, agree with this use of language.Strictlyhttps://www.blogger.com/profile/09091194063147628491noreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-39963818961015040922011-09-20T20:16:27.075+01:002011-09-20T20:16:27.075+01:00Anne Marie, You raise some under-discussed points ...Anne Marie, You raise some under-discussed points here. The implications extend well beyond social media.Elaine Schattner, MDhttp://www.medicallessons.netnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-34395274558683477852011-09-19T19:35:23.032+01:002011-09-19T19:35:23.032+01:00Are these comments effective as humor or stress re...Are these comments effective as humor or stress reducers only if they target individuals or classes of people whom the speaker perceives to be "less"--patient, underling, female, cognitively injured, aged, disabled? I've been concerned about the power of this language to decrease empathy and its potential effect on patient care, but never expected to hear an open discussion about it. Social media has unexpected ways!Cjkinthebaynoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-67859782457282307692011-09-19T14:16:32.045+01:002011-09-19T14:16:32.045+01:00Alot of discussion about this between the docs. He...Alot of discussion about this between the docs. Here is my perspective as a patient.<br />http://childbirthptsdandme.wordpress.com/2011/09/19/labia-wards-and-birthing-sheds-a-patients-perspective/Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-57181804720236216382011-09-19T08:21:55.726+01:002011-09-19T08:21:55.726+01:00As a member of a multidisciplinary healthcare team...As a member of a multidisciplinary healthcare team, egalitarian and respectful relationships should be the order of the day. Of course these professional courtesies translate into every dimension of practice and to the central focus of care, that being the client.<br />Have a read about the principle of Subtle Elegance of Birthing Women which contradicts any crudity about Mothers.<br />https://docs.google.com/document/d/1lUwweGGqo4b6pKcbAWAnZUMfPdzmmZxwM1fleuN84dE/edit?hl=en_USAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-88049216008494287702011-09-18T20:47:17.845+01:002011-09-18T20:47:17.845+01:00so if you dont like the way that junior doctors a...so if you dont like the way that junior doctors are expressng themselves, then could it be a failure of the educational process and those who are being paid to teach them ?<br />A better way of influencing the might be to come down from your Ivory tower of Excellence and be a role model that they can work alongside at the coalface.<br />Whilst you may think yourself a success as you go to meetings and hob-nob with like-minded people it seems you are failing in your task of educating the next generation of doctors if they arent behaving as you wish. Have you considered resigning , as you seem to be useless?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-63567485545341304372011-09-18T17:19:30.085+01:002011-09-18T17:19:30.085+01:00Stasi PC bigots like Cunningham who avoid patients...<i>Stasi PC bigots like Cunningham who avoid patients by becoming "academics" and start telling people (who do the real work) what to do make me sick. </i><br /><br />Well said.<br /><br />The day I stop using black humour to get through my days is the day I resign (which won't be a minute too soon).<br /><br />The NHS, pre-MMC/MTAS/EWTD bollocks, cultivated and supported a team culture in hospital medicine. One was part of a firm, 'brought up' by the bosses, supported by peers... working longer hours with more on-calls and less 'shift' work. It was a healthier working environment than today's NHS. Junior doctors were much happier and perhaps more inclined to keep their black humour within the profession.<br /><br />Now all juniors do shifts, they treat the job as a 'job' instead of a profession (one can hardly be surprised - it's how their work is treated). It is no surprise to me that those who are still working hard and dealing, daily, with situations which would leave many people claiming benefit through post-traumatic stress, find an outlet in humour which some don't like.<br /><br />Don't read it if you don't like it.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-337551339403032262011-09-18T12:30:49.932+01:002011-09-18T12:30:49.932+01:00Hello Anne-Marie, here is my response:http://sarah...Hello Anne-Marie, here is my response:<a href="http://sarah-stewart.blogspot.com/2011/09/what-is-acceptable-language-from-health.html" rel="nofollow">http://sarah-stewart.blogspot.com/2011/09/what-is-acceptable-language-from-health.html</a>Sarah Stewarthttps://www.blogger.com/profile/00480597227427423793noreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-77944464941930463612011-09-18T04:56:50.736+01:002011-09-18T04:56:50.736+01:00i generally avoid internet debates, but i just hav...i generally avoid internet debates, but i just have to jump in here.<br /><br />to all the people who argue this is harmless humour or are comparing dr. cunningham to the thought police, consider that language has a strong impact on the way we think (check out http://bit.ly/svcSa). if doctors use disrespectful, dehumanizing language to describe their patients, it could very likely impact their care. it doesn't take a genius to realise that if you think of someone as less than human, you're not going to be as compassionate or careful as you would otherwise be.<br /><br />doctors do certainly have a right to free speech, but they are in a huge position of power over their patients both rhetorically and practically. doctors are are trusted and held in high esteem more than any other profession. many patients will ever question what their doctor tells them what to do. and, it goes without saying that doctors make life and death decisions for patients. such a role comes with huge responsibility. so, doctors should know better than to make disrespectful comments about patients and colleagues on twitter.<br /><br /><br />thank you dr. cunningham for bringing this to public attention. as a patient, i would not feel comfortable knowing my doctor was thinking about me in such dehumanizing terms.kate raynes-goldiehttp://k4t3.orgnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-83597835390380678512011-09-17T18:32:02.428+01:002011-09-17T18:32:02.428+01:00I found this a fascinating discussion. I remember ...I found this a fascinating discussion. I remember when I was a junior doctor patients being termed ‘rubbish’ because their case didn’t have any interesting or unusual features, and the use of ‘plumbus oscillans’ etc. in the writing of notes in patient records.<br /><br />I had hoped that the widening of entry to medicine, the change in gender balance and the gradual development of modern ethical codes would have changed things so that in wasn’t acceptable to refer to patients in disrespectful terms.<br /><br />Having been brought up in the Catholic community in the North of Ireland, one learnt all about discriminatory and derogatory language. I was however surprised on moving to England to find that it was acceptable in the most surprising of quarters to make fun of ‘thick Paddies’ and use terms like ‘bog wog’. Of course if I criticised such language I was always told that it was just a bit of fun and not to be taken seriously.<br /><br />The use of terms that people would find insulting and offensive is always unacceptable and should be particularly unacceptable in the exercise of a profession that holds such power over vulnerable people. I understand that many doctors and nurses have stressful lives and that humour is an escape valve. But it is not humour about and between equals if it is insulting to patients. It is both unethical and unprofessional. Those that indulge in insulting patients (whether the patients hears or not) demean themselves and us all.Gabriel Scallynoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-64090836287532238412011-09-17T12:32:33.413+01:002011-09-17T12:32:33.413+01:00I find the attitude of the blogger and most of her...I find the attitude of the blogger and most of her sycophants on this blog to be unsettling. People have the right to express themselves as they wish. It's called freedom of speech. Stasi PC bigots like Cunningham who avoid patients by becoming "academics" and start telling people (who do the real work) what to do make me sick. The tide is hopefully turning though, and soon Cunningham's brand of PC scapegoating, thought-control and vilification will be out.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-31083967861101023272011-09-17T12:23:05.043+01:002011-09-17T12:23:05.043+01:00It's a truism that most humour can be regarded...It's a truism that most humour can be regarded as being offensive - to someone, somehwere. <br />Subgroups of society develop their own form of humour - in-jokes that help establish group identity. When you become a member of such a group, it can be difficult to avoid joining in and using such humour. You can end up feeling like an out-sider if you don't join in the banter. So there is peer group pressure to conform; something we learnt in our playgrounds. This humour can be either offensive or difficult to understand for outsiders. It probably has to be to provide the group's need for cohesion.<br />We all subject ourselves to potentially offensive humour every day on television and the radio. If one scrupulously censored programmes such as "Have I Got News for You", "Mock the Week", with reference to anybody who could potentially be thought of as experiencing offence, there would be nothing left to put on air. Yet most of us love these programmes and the world would be a worse place without them. <br />The important thing is that potentially offensive humour works if it is clever, and delivered with wit and style. It often helps if there is a dollop of self-deprecation to hurry it along. So, a joke that would be homophobic can be really funny told by a gay comedian. "Queer" is offensive coming from a straight mouth. <br />However, Jeremy Clarkson's recent recent attempts at humour, proposing the abolition of the Welsh language were crass and offensive as they lacked style and wit, coming across as rants from a boorish bully. <br />The series of tweets I saw, in general, seemed to fail the style, wit and cleverness test, and I think did have the potential to offend - something that would be extremely difficult to get right in 140 characters anyway.A New Kind of GPhttps://www.blogger.com/profile/17305232243592201684noreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-55333516724735472602011-09-17T10:35:22.674+01:002011-09-17T10:35:22.674+01:00I think the term 'labia Ward" is brillian...I think the term 'labia Ward" is brilliant and for all the reasons the anaesthetic reg listed - I just wish I'd thought of it first. It's completely the right name for the place I work - the place I like to refer to as either "the gulag" or "the factory". I do this with blatant disregard for the positive marketing/spin that the administrators are attempting by calling the place " the birth centre". Sure, births do take place there, but a high tech, high security, 16 room ward that pushes women through as if on a production line to facilitae 20 births a day is not the family-freindly, intimate and shanti space that comes to mind when I think of a birth centre. I like to call things as they are, and like MaturinUK, I was a huge fan of Shem's "House of God" and actually think those plays on words are funny.<br /><br />I think a much greater risk to our profssional reputation is the increasing obesity levels among (so-called) health professionals - particualrly the 20-somethings, and the multitude of staff who smoke and insist on doing it IN UNIFORM and out the front of hospitals (invariably RIGHT UNDER the "this is a smoke free facility" sign.Madwife and proud of itnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-63116880212739325222011-09-16T22:46:37.738+01:002011-09-16T22:46:37.738+01:00Very interesting blog, and also comments. Thanks f...Very interesting blog, and also comments. Thanks for raising this, Anne-Marie. <br /><br />(I posted a comment earlier but it seems to have gone astray- apologies if this is repeating myself).<br /><br />Social Media is breaking down the barriers between us: what may have been acceptable in a Doctor's room 30 years ago is simply not acceptable today, in full public view.<br /><br />But I wonder, was misogyny, or derogatory commenting about patients *ever* acceptable? or did the culture of the Doctor's room impede the expressions of discomfort of people who recognized the anti-social nature of such discourse?<br /><br />I blogged a fuller response to this, linking to some bits of evidence in support of using and analyzing social media use for healthcare professionals.<br /><br />Thanks, Anne-Marie, for sticking your head above the parapet.<br /><br />http://claireot.wordpress.com/2011/09/16/social-media-and-the-medical-profession/Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-83162263246126211182011-09-16T20:20:55.157+01:002011-09-16T20:20:55.157+01:00Another thoughtful post, Anne-Marie, and as can be...Another thoughtful post, Anne-Marie, and as can be seen from the response this is very much a live issue that we should all be mindful of. <br /><br />I've blogged my response to this, because it just was too long to post as a comment. Please see http://claireot.wordpress.com/2011/09/16/social-media-and-the-medical-profession/<br /><br />Essentially, I agree with some of the posters above; we have to have a congruent identity, online and offline. We must maintain professional demeanour at all times, and what we assume is private may, in fact, become public.<br /><br />I refrained from getting into whether or not some of the debate has been unfortunately personalised and sexist- which itself doesn't present medical professionals is a great light!<br /><br />Thanks again for raising this issue, Anne-Marie.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-70927788759099411032011-09-16T18:27:58.652+01:002011-09-16T18:27:58.652+01:00While I feel that some of these terms were derogat...While I feel that some of these terms were derogatory in a way that communicates contempt and distaste without any value added, I can say from a more personal perspective with many years of ICU behind me that the black humor employed by many in critical care is simply a (rather crass, but effective) coping mechanism. Where there is humor, there is pain. <br /><br />No coincidence that staff and physicians have employed black humor in a setting where our emotional needs are rarely accounted for. I worked in an ICU in one of the best hospitals, period, in the world, and was at the morgue regularly. I had no outlet or support system for being slapped with death besides frequent vacations, then resigning upon full burn-out.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-49693645307616740192011-09-16T13:16:44.128+01:002011-09-16T13:16:44.128+01:00Some thoughts here, after looking over at the Face...Some thoughts here, after looking over at the Facebook conversation about this: http://runningahospital.blogspot.com/2011/09/storm-brews-across-pond.htmlPaul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-4149957315810348152.post-89702081986763820292011-09-16T10:18:27.732+01:002011-09-16T10:18:27.732+01:00Interesting remarks.
Last week an incident arose ...Interesting remarks.<br /><br />Last week an incident arose which you may have seen in the press. It was also remarked upon on the Today programme...<br /><br />A hospital manager emailed their HR team to post a job ad on NHS jobs. At the bottom of their message they added a comment about adding the "usual rubbish" about equal opps. Unfortunately, the HR department, who handle the job ads, posted the whole text to the NHS jobs system, where it was spotted and complained about by potential applicants who read it. From evidence we know that the applicants were likely to be precisely the kind of NHS professionals who really do suffer disproportionate discrimination, and for whom equal opportunities statements actually mean something.<br /><br />The manager who originated the ad was naturally embarrassed and their Chief Executive has had to deal with the fallout. But what does this tell us?<br /><br />When people are in normal social situations their guard is up, they will police their language, and we are unlikely to be able to gain an honest assessment of what they really think.<br /><br />In online social media, the speed and apparent isolation mean that people are likely to forget such caution ... and then we gain some insight into what they really think.<br /><br />I have a lot of sympathy for people working in stressful situations. It's not just clinicians ... many professions have evolved black humour and slang as ways to desensitise themselves from the horrors they deal with.<br /><br />That's not to excuse such language though, especially as it inevitably leaks into the public domain like this, where it is held up for scrutiny in a different context and may be considered in a different way to which the people uttering it probably meant.<br /><br />All of this suggests that the people using this language should examine their motives. It takes no more effort to say "Labour ward" than "Labia ward". ICU is even quicker to say than cabbage patch. So we are not looking at necessary jargon and brevity here. It means someone took the effort to think of such terms and their colleagues shared some kind of belief system which encouraged it to gain currency.<br /><br />Rather than defensively dismiss people calling them out on this, therefore, I think it behoves professionals to step back and analyse what they are doing and why. What does it tell them about themselves?<br /><br />Young people have slang too. Some of them might describe these clinicians' wives, sisters and mothers as 'slags'. Would they be so relaxed? Would they consider that a part of a group culture? Would they want to call it out?Christine Burns MBEhttps://www.blogger.com/profile/16125215357815655112noreply@blogger.com