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19 Feb, 16 | by Ian Wacogne

20140320-145928.jpgIn an #ADC_JC from the dawn of time we discussed a paper concerned with the outcome of retrievals of children with bilious vomiting.  We spent a disproportionate amount of time discussing the meaning of the word bile.


Naming culture

13 Oct, 14 | by Ian Wacogne

I’ve written lots here in the past about names – the issues of how we address each other, and how we permit patients and their families to address us.

During the process of writing those posts I made some changes to how I thought, which altered some of my behaviours. I wanted to share here some other thoughts that have accompanied this, and points that have been made to me.


Naming of Reviewers

29 Jun, 14 | by Ian Wacogne

Peer review has controversies. There are numerous criticisms, but when it comes down to it, to paraphrase Churchill on democracy, it’s the worst way of doing it, except for all the others. I don’t want to discuss the whole process of peer review here, except to state that when we publish something, because we’re not always experts in that field, we ensure that there has been peer review.  The question I want to pose here is around the degree of anonymity.


What’s in a number? (Part 2)

18 Jun, 14 | by Bob Phillips

Picture1 A quick task.

Grab a sheet of paper or open a blank screen on your computer.

Write down:


  • Your phone number
  • Your partners or a family members phone number
  • Your National Insurance Number
  • The sort code from your primary bank account
  • Your NHS Number

How did you do? Were you able to remember them all? Which did you struggle with? (hopefully you can remember more than just your own phone number!) more…

What’s in a number?

18 Jun, 14 | by Ian Wacogne

Picture1 Here’s a brief summary of a question put to me by Vin Diwakar, stimulated by the Children and Young People’s Health Outcomes Forum Summit 2014, and my response.

Importantly, in the original discussion I made an error; the NHS number does in fact have a check number.  For more info, and an explanation, read on.

The question was:  Why do hospitals use their own hospital numbers instead of their NHS number if the NHS number is a unique identifier? more…

Time to rename the terrible twos?

4 Jun, 14 | by Ian Wacogne

There are many phrasings which make me wince.  Some of them are obviously pedantry – I inherited a dislike of the phrase “septic screen” from Peter Daish, preferring the more correct “sepsis screen”.  Folks who have worked with me could probably list another dozen easy ways to press my buttons.

A more recent phrase which niggles is “terrible twos”.  I’ve spent enough time with two year olds to know that they can behave pretty poorly, can be challenging and are generally extremely tiring to be around.  (Come to think of it, I suspect there are few who might describe me the same way.)  But have we paused to think of the effect we have when we spend a third of a child’s life – or half of their life given that we begin talking about it at 18 months – or the whole of their life, if you consider it in terms of what they remember – as being terrible?  Or referring to the fact that they are terrible? more…

What’s in a name, Part III

19 May, 13 | by Ian Wacogne

I’ve written previously about how doctors should refer to each other, and also about how patients and their families might refer to doctors.  It reminded me that there are ways that people need doctors to be – to behave, dress, talk – in order to get the best out of a professional relationship. more…

What’s in a name Part II

14 Apr, 13 | by Ian Wacogne

Following my previous post on the use of first names, and entirely by coincidence, the folk over at St Emlyns blogged on a very similar subject, but extended the discussion a little to what your patients should call you.  I pulled up short about in discussing this before and I’ve been wondering why since.  

How do I introduce myself to patients and their families?  Well, in some ways the choice is easy, since I have an entirely unpronounceable surname.  So, I tend to say “Hello, my name’s Ian Wacogne, and I’m one of the consultants here”.  Interestingly they then use a variety of forms of address back – many of them use Doctor, fewer use my given name, and a few are brave enough to have a crack at my surname. more…

What’s in a name?

7 Apr, 13 | by Ian Wacogne

Much of the time I’m called Ian, and at others I’m called Dr Wacogne.  I do get called some other things, but I can’t write them here.

We’ve just greeted a new group of foundation (intern) doctors, and I have, as ever, entirely befuddled on them by emphasising that I am Ian, at all times unless I’m in front of a patient.  There is light hearted fun to be had from this – the refusal to hear them if they address a question to “Dr Wacogne”, for example.  (I call it fun, I guess they probably find it downright irritating.)  I should emphasise that this is a team rule, not one of my own invention.

They find this very difficult.  This is most evident when they’ve come from a particularly rigidly structured area of medicine – and is also resurgent when they’re about to return to a similar sort of area.

I’ve asked this group to try and work out why we, as a team, insist on it.  Of course, if they read about here, then they could win an extra prize.  These are some of my reasons. more…

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