David Kerr: Man of the people

David KerrSo David Cameron does not know the meaning of the phrase Magna Carta (The Great Charter) or who composed the music to Rule Britannia (Thomas Arne). The prime minister was appearing on the David Letterman show in the US following in the footsteps of his political adversary, Boris Johnson who also made a similar appearance back in the summer. On social media sites the overall impression of Cameron’s performance seemed to be mildly positive with the general impression being that it was slightly dull and wooden with a few light hearted moments. For politicians dull is probably perceived as good. However, one American wit commented the following day on Radio 4 that most Americans wouldn’t have a clue who he was anyway as they were still under the impression that the UK prime minister is Tony Blair or Margaret Thatcher.
Doing the “public engagement” rounds is also increasingly seen as part of the job description of senior medical staff. The idea is to organise gatherings of patients in various venues outside of the hospital to listen to the “latest service developments” or “ground breaking research” from local consultants or specialist teams. Despite advances in information technology, these types of presentation have recurring features which all new consultants need to be aware of.

Firstly, the venue is almost always unsuitable in that it is either very warm or very cold. The public address system invariably produces deafening amounts of feedback and the projection screen is proportionately tiny compared to the size of the venue. The lighting is all or nothing—bright spotlights illuminating the silver screen so much that slides are impossible to discern or the speaker is plunged into the darkness of Hades. Almost always the meetings are scheduled in the afternoon so this will attract the retired and the curious unemployed—this may not be the target audience. Most importantly no matter how whizz-bang the presentation or how earth shattering the latest research findings are, when it comes to the questions these are more often than not related to the personal experiences of the questioner. In my own area of diabetes, the topics are always about food, weight, “why my GP does not understand me” and “why can’t I have enough blood glucose testing strips.”

However, like David Cameron these meet and greet sessions are generally positive and seem to be appreciated by participants with the feedback scores are nearly always A or A*. There is also usually a transient increase in referrals to the specialist centre. Public engagement meetings also make consultants more visible although this can backfire for example when a patient asked why after coming to the diabetes clinic for 10 years this was the first time he had ever seen me.

I am always bemused how often patients re-admitted to hospital after a gap of only a few days or weeks are stumped when asked for the name of the consultant who was in charge during their last admission. Actually given the current approach to emergency care in the UK this may not be so surprising and is also reflected in the inability of NHS IT systems to accurately track the changing responsibilities of the different teams encountered during a “patient journey.”

In the UK, knowing the name of the prime minister is also a standard question used as part of the Abbreviated Mental Test Score or Mini Mental State Examination to assess cognitive performance. Recently we received a complaint from a relative that a junior doctor kept asking an elderly relative who the prime minister was—the relative quipped that his father didn’t have a clue about this before he developed his dementia.

David Kerr wears many hats, sometimes at the same time—diabetologist, editor of Diabetes Digest, researcher, and founder of VoyageMD.com, a free service for travellers with diabetes. You can follow him on Twiitter (@GoDiabetesMD) and Linkedin. He holds a small amount of stock in CellNovo (a new insulin pump company) and Axon Telehealth.