18 Sep, 08 | by BMJ Group
Some months ago I was invited to the Anglo-German Medical Society’s 49th annual meeting, to be held in Cologne on 11-14 September 2008. As a German national who trained as a technical editor with the BMJ and who translates medical papers from German into English in her spare time I accepted.
According to the society’s website (www.agms.net), “the idea for the Anglo-German Medical Society (AGMS) was born after 1945 in order to rebuild the professional and personal relationships that had significantly cooled down between medical doctors of the two countries. Achieving a ready exchange of ideas, knowledge and personnel has been the aim of the AGMS ever since its foundation in 1959.” Its two national committees consist of practising doctors based in both Germany and the UK. The society encourages collaboration between doctors and medical scientists in the two countries, as well as a constant exchange of knowledge and ideas. It provides grants for international projects and also has practical advice on how to go about finding work.
The theme of the Cologne meeting, which followed a bilingual and bicultural format, was palliative care, and the three blocks of sessions were grouped around pain, hospices, and miscellaneous, followed by a debate on euthanasia/physician assisted suicide. The first day was given over to the subject of pain. Traditionally the brief for speakers is to speak in their mother tongue, with their slides appearing in translation. A few actually stuck to this brief, which I like because I find it easier to remember things that are explained in two languages.
The day’s topics included neuromodulators for pain management, pain therapy in malignant disease, and the concept of a “pain-free clinic,” outlining the surgical training and quality assurance standards and measures that are necessary to put this into practice. Pain therapy after outpatient hernia operations introduced the practitioner’s perspective; “pre-emptive” analgesia (given before the actual procedure) and the application of modern business management techniques had led to a lean and mean organisation, yielding good results for both doctor and patients. The lively discussion touched on national differences in medical training and grades, as well as semantics (“clinic” versus “Klinik”).
Saturday’s theme was hospices, and again it was the comparisons between the two countries that made the contributions fascinating. Hospice doctor Susanne Hirsmüller from Düsseldorf gave a historical overview of hospices in Germany – an idea that caught on some 20 years after Dame Cicely Saunders founded the first hospice in the UK. She explained funding – from health insurance, one of the fundamental differences from the UK – and how far hospices in Germany have developed. By contrast, Barbara Downes, palliative care consultant and medical director at Bolton Hospice, gave an overview of the UK system and followed with a case report. Barry Miller, consultant in pain management and anaesthesia at the Royal Bolton Hospital, added the interventional anaesthetist’s perspective to the case report, after giving an overview of the integration of interventional and palliative care in the UK and outlining requirements for this to work.
Dorothea Kingreen, oncologist and haematologist from Berlin, reported on a project that integrates outpatient and inpatient hospice services in the city, using a whole range of affiliated specialists. The service is available only in Berlin and only to people whose health insurance covers Berlin.
“Vorsprung durch Technik”?
For me, Saturday’s session was one of two highlights of the meeting – Germany’s methodical approach to developing systems and delivering to an extremely high standard is impressive. But the NHS has 20 years’ more experience with hospices and has made greater inroads into palliative services and training, and patient care does not depend on location in the same way. Then there is the British sense of humour …
Sunday’s mixed bag included what it takes to look after Germany’s (gold medal winning) national hockey team, the work of the Forum for International Health (www.foring.org), and two presentations on paediatric palliative care (for me the second highlight of the meeting): Christoph Kramm from the University of Halle/Saale presented an impressive collection of data comparing systems in Germany and the UK, and retired Professor Klaus Eugen Bonzel spoke about paediatric nephrology and terminal care at the university hospital in the Essen and showed a short TV feature film about a teenage girl and her kidney transplantation at his centre.
Although I missed the concluding debate, my impression was that the society more than delivers on its aims. The conference was interesting, informative, and above all, great fun. Members of health professions or professions allied to medicine can now take out associate membership. Editors and translators, take note.
- The Anglo-German Medical Society (Deutsch-Englischer Ärzteverband) provides bilingual services and advice tailored to both countries; visit www.agms.net
- Birte Twisselmann is assistant editor, bmj.com