Rude Health: Initials are not enough - give us names
Replacing names with initials, says Maurice Gueret, is back, and results in patients not knowing the gender of our medics
A substantial part of my day job for 20 years has been to write to public hospitals up and down the land. I make enquiries as to how many beds have gone missing, and ask if they have any new services, rules or superbugs for patients.
I also try to ascertain whether they have been fortunate enough to acquire more medical staff, and the names of the disciplines in which they are practising. With careful prising, followed by gentle needling, if necessary, they send me details of Mr Lancelot Bowel's recent retirement as colorectal surgeon or the appointment of young Dr Mary Au Contraire to the new dermatology clinic. I then compile my new lists of staff and pass this information on to a few thousand GPs, who are very pleased with the service, because nobody but their patients really cares about GPs. In my job, as in yours, there are gripes. Last week, one hospital undertook a wide excision of all the first names from its staff without warning. Thus, Fenella Eckalluse in Endocrinology became Dr F Eckalluse, and 3,000 doctors and their patients were deprived, not only of the first name of this eminent specialist, but also of her gender. This disguising of staff names was a traditional phenomenon in Ireland. In recent times, it had begun to die out, but, alas, I have noticed it creeping back. J Reilly needs to stamp it out.
Heard a lovely non-medical malapropism just the other day. There was a recent public meeting in rural climes to deal with the local evil of 'boy racers' who were terrorising gently-inebriated farmers as they trod miles home from the pub. The great and the good of the parish, and beyond, were there, as were all the local constabulary of the Garda Siochana. One member of the public was getting particularly irate, and told the meeting, in no uncertain terms, that unless the guards tackled the boy racers head-on and right now, "it would be like opening a Tandoori's Box". I made my own blooper before Christmas. Our good and kind Italian friends in the Bord Gais Energy Theatre district of Dublin invited the family over to a room with a view for some excellent coffee and a big slice of panettone. Yours truly confirmed the date with a text suggesting we were looking forward to digging into the pancetta.
My recent musings on dentistry, and whether the field is going to be crowned with an array of new specialities, has drawn a great deal of correspondence. Let me explain, first, how Irish dentistry is currently set up. Basically, there are only two types of dental specialist in Ireland. There are about 50 oral surgeons registered here and about 130 orthodontists. All the other dentists are on a general register and, though they may be practising in special areas, like paediatrics, endodontics (root canal stuff) and implantology, they are not actually recorded on a specialist register. Leinster House could have a big and important role here as a new Dental Act is anticipated, perhaps in the next two years. There is a lot of pressure from sectors within Irish dentistry to register more specialities. It does seem somewhat odd that the field of orthodontics has a specialist register, but the more invasive and, dare I say, riskier field of implant dentistry does not. The problem with increased specialisation – and medicine is a prime example of this – is that specialists train for more hours (10,000 of them, according to writer Malcolm Gladwell) and, therefore, charge a lot more for their services. They also pay much higher insurance premiums in case things go wrong. One dentist, who has been in correspondence, tells me that there has been a 200 per cent increase in dento-legal claims in the past five years, and a number of courses are being held around the country to protect dentists from these. I have been wondering what the future may hold for the ordinary general dental practitioner if the number of specialities does increase. I am told that they currently administer 80 per cent of all dental treatments, and this figure may be increasing in the recession as dentists try to retain work within their own practices, and patients choose not to be referred to specialists. This may, in turn, be increasing the number of claims. Our politicians have long fingered major cavities in dental legislation – this year would be a good one in which to fill in the gaps and stop patients falling through them.
Mary has been around a while, and she writes to me about her experience of Galway Paediatric Hospital almost 60 years ago. She remembers a "wee boy of about eight, who was so thin, being given a half-pint glass of stout and milk at about 8pm when we all got milk". She recalls that he absolutely detested it, and would go around asking the other children for a biscuit or a piece of cake that he could wash down with his Guinness. Mary tells me that Guinness was a regular tonic for "building up" people following illness, and she remembers her late mother trying very hard to drink some when one of her sisters was a baby. She also recalls that stout and milk were often mixed and given to children after a bout of rheumatic fever. And she remembers one child who could not understand why his stout was being ruined by the addition of milk. I wonder how he turned out! Always delighted to hear about your tonics at firstname.lastname@example.org, or get in touch by post at PO Box 5049, Dublin 6W.