In the past year you may have read BMJ Confidential, the weekly column that grills healthcare professionals on their backgrounds and inspiration, earliest ambitions, career mistakes, and guilty pleasures. For The BMJ’s bumper Christmas issue Nigel Hawkes has reviewed the first 50 editions of this probing column, and a round-up of his findings is published today on thebmj.com.
The question on the best and worst health secretary has provoked many an impassioned response, but the only person to have been named more than once as the worst has been Andrew Lansley, with 15 votes. Twenty people named Aneurin Bevan as the best, and several favourable mentions went to Frank Dobson, Alan Milburn, and Stephen Dorrell.
Today’s round-up also looks at respondents’ worst mistakes as confessed to BMJ Confidential throughout the year, and Hawkes notes that these occupy two groups: medical errors (wrong prescriptions, bad diagnoses) and what might be called career errors (failing to apply for jobs, taking a wrong turn, or failing to turn over an exam paper and missing the questions on the back).
Another regular question to the interviewees is whether they favour doctor assisted suicide. The first 50 columns have seen a notable split of 24 in favour to 15 against—the rest either declining to answer this question or offering an equivocal response. Meanwhile, “pet hates” included lying, bullies, risk averse bureaucracy, litter, arrogance, self pity, tinned tomatoes, men who struggle to hear women, and many others. Chocolate easily headed the “guiltiest pleasure” category.
Hawkes concludes his article by saying, “So, that’s the upper reaches of the NHS pigeonholed: a predominantly PC bunch who dislike pomposity in others but don’t always perceive it in themselves, whose rebellions have to be accommodated within quite a narrow shared ideology, and who, almost to a man and a woman, regard the private sector as the enemy.”
Also new today on thebmj.com is a report on a US study of the frequently incorrect use of adrenaline (epinephrine) autoinjectors for severe allergic reactions and of metered dose inhalers for asthma. It found that most people who are prescribed these devices make frequent and multiple errors when using them.
The lead author is Rana Bonds, of the University of Texas in Galveston, who says, “Most patients made multiple mistakes [when using adrenaline autoinjectors] and would not have benefited from self administration of the potentially lifesaving treatment if the need arose.” She suggests that patients were not properly trained in how to use these devices, did not completely understand the instructions even after training, or forgot the instructions over time.
John Waring, technical editor, The BMJ.