Andrew Burd on meltdown at Guy’s

Andrew BurdEach morning in Hong Kong I have a routine to check emails and visit a select number of websites to update myself on the world’s events. Naturally one of these websites is the BBC. And so it was this morning that my attention was drawn to a short video clip, which I predict may well go viral, showing a “senior orthopaedic surgeon” losing his cool with a poor BBC television crew. For those who haven’t seen this clip, it was basically showing David Cameron, the British prime minister, and Nick Clegg, the deputy prime minister, of note both properly tie-less and with shirt sleeves rolled up, talking to a patient in Guy’s Hospital. There are shouts off camera and then a bow tie-clad, short-sleeved-shirt wearing, rather angry man comes into view. This gentleman announces that he is a senior orthopaedic surgeon and basically tells the camera crew to get out as they are not properly attired. The orthopaedic surgeon is bustled out by a nurse and more shouting continues from the corridor while a very composed prime minister suggests the camera crew withdraw.

I was a little mystified by this and thought there must be other agendas at work but decided to investigate more. In the course of my enquiries I heard about the “BBE” edict. It does seem that there is an element of French farce in the current NHS and “bare below the elbows” smacks of another crazy management ploy to further humiliate the now “white coat-less” doctors. But in their turn the doctors do not seem to be responding with much sense and I was rather distressed to come across an article in the Guardian from 2008, where the new government dress codes for NHS staff were being attacked as dangerous because doctors could no longer take a pulse using a wrist watch. As a reality check I decided to look up the history of the nurses fob watch and came across an interesting thread.

But, going back to the BBE, I thought this only applied to staff and even then only to those with patient contact so I do not know why the poor camera crew were victimized as such.

I am sure that the “senior orthopaedic surgeon” is going to become a celebrity and more details will emerge, but my other question from this short video clip regards the bow-tie. I thought the new NHS was a no-tie NHS? Am I missing something?

Back in Hong Kong we have personalized white coats; wear ties and long sleeved shirts and our unit has just received an award for achieving a zero tolerance for meticillin resistant Staphylococcus aureus (MRSA). My wife, who is Chinese, attributes the difference to the cultural attitudes towards cleanliness such that it is easier in Hong Kong to unite all staff, visitors and patients in anti-MRSA strategies. This derives from a greater societal awareness. In the West, where individuality has a stronger influence, compliance has to be achieved by control. But where will it all end? Will the comic farce of dress control continue to evolve such that staff wear less and less? One wonders what effect that will have on the pulse pressure in the orthopaedic wards for staff and patients alike!?

Andrew Burd is professor of plastic, reconstructive and aesthetic surgery at the Chinese University of Hong Kong. His major clinical interests involve paediatric burns care and the role of plastic surgery in the palliation of advanced malignancy. Academic interests include pragmatic ethics related to the practice of medicine including research and publication.