Saturday 27 December 2014

Smarten up, doc: Medicine is a prestigious profession

So why do so many in the medical field dress as though they work in second-hand shops

Dress to impress
A visit to the doctor can be expensive
Maurice Gueret

The matron of Dublin's old Adelaide Hospital wouldn't let us through the entrance hall of her Peter Street domain without shiny shoes and a heavily-starched coat in brilliant white.

Alas, high sartorial standards in non-consultant doctors seem to have fallen by the wayside. An old Rotunda Hospital colleague of mine now dresses for work each morning as a consultant gynaecologist down the country. She was an excellent clinician – straight as they come – and wouldn't be shy about telling you a home truth. And she has a large bee in her obstetric bonnet about the way young Irish doctors are dressing for work in hospitals.

She says some non-consultant doctors dress worse than pyjama ladies at the shops, citing a predominance of blue denim jeans worn with theatre scrub tops. Recently, she attended an educational meeting in Barcelona and, while taking notes at the city's Hospital Clinic Maternitat, spotted that all the medical staff were quite identifiable in their roles. You could actually tell the doctors from the nurses because the former all wore traditional, well-cut and creased white coats, with smart garb underneath.

She has also been to Sweden, where she says doctors also dress like professionals. She cites the hospital conference in the wake of the Boston Marathon bombing, when American doctors came out to the world's cameras wearing smart white coats. My friend says things are at a low ebb, and we should be rethinking this professional code in all Irish hospitals. Now, she didn't welcome my suggestion to raise it with Dail TD, Deputy Mick Wallace. And she says it's not an issue that's easy to raise at work – bullying and dignity in the workplace could be cited – so I'll raise it here. Your thoughts on how doctors present themselves today are most welcome at mgueret@imd.ie or letters to PO Box 5049, Dublin 6W.

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The nation's press fetes the new Reverend Mother Whitty building at Dublin's Mater Hospital every time it opens a new section. They even had Dr James D Watson, the Nobel prize winner, who discovered DNA, in to cut one of the double helix ribbons. A few hundred million went into the Mater's recent redevelopment, and the flagship edifice was this newly built Whitty extension. It houses outpatients, casualty, theatres, and over 100 en-suite bedrooms.

There was much fuss about an integrated design, which supported low energy and sustainability. Now, I haven't been in it yet, but my information is that some staff and, more importantly, patients, regard it as something of an endurance test. "Home for the Bewildered" is one description I have heard. The low-energy sustainability may apply to the bricks and mortar, but it doesn't seem to pertain to human beings, who can expend a day's supply of calories just getting about the place.

Apparently, the building looks lovely, and may well win prizes in glossy architectural magazines, but it seems to be getting a thumbs down from those who wanted a building that's easy for frail and lost people to navigate. Rev Mother Whitty herself suffered from bronchitis and might not have approved. If any of you have used the Whitty, do let me know of your experiences.

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I have written before about how user-unfriendly some hospitals have become, but occasional patient error also needs to be taken into account. A very senior lady recently sat in the queue outside a hospital cardiology department. When it came to her turn, and she was asked the purpose of her visit, she told the nurse she was there for the IVF! Just a few letters out. I think her GP letter was requesting an ECG.

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The British Medical Journal ran an interesting poll last month, and the results have just come to hand. Medical readers were asked whether doctors should be taught to consider treatment costs as part of their training and 79 per cent said yes, which makes me wonder what planet the other 21 per cent cast their votes from. The days of infinite resourcing are gone, and I would argue that any medical school that in six years does not teach its students modules in both health economics and the history of medicine is guilty of serious dereliction of duty.

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Thanks for all your recipes and stories about cures from generations past. Eithne wrote to me about black ointment, but she also remembers carefree days before health and safety inspectors, when gangs of children would pile on to the hay cart for its trip to the meadow for haymaking. They would bring a couple of big bottles of fresh buttermilk (from the churning) with them to drink, and she remembers it as "gorgeous", and tells me that any buttermilk left over was used to rub on the children's sunburn. She remembers it as a great cure. A smelly one, I'd say!

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