The Hippocratic Oath

You might think this is going to be a 'poor doctor under so much pressure' blog.  But it is not.  The principles of medicine are just the same as they were pre-austerity as they are now, post austerity.  The Hippocratic oath used to be sworn by all doctors but I believe Irish Doctors no longer swear it. Such a pity. 

Basically most people believe it's perfectly simple: "I swear to do no harm" .  Yet daily we hear that Doctors may not do 'any harm' by actions performed but MAY by actions NOT performed! In others words ignoring issues does harm, but does not constitute , necessarily, misconduct. 

Not referring a patient to physiotherapy, or not agreeing for a letter of referral may not be seen as 'misconduct' as doctors can usefully argue "it was not necessary - in my view" .  Thus they save government money by keeping clients away from these services.

Part of good doctor-patient medicine is communication.  but this is not happening in the public sector. you email, you write, you phone but in the public sector RARELY does a doctor respond.  This is true in Ireland as well as in the UK.  I know.  However if you are a private patient the 'communication' link keeps the patient engaged so that the patient comes back and gives you MORE money, so it's in the best interest of private doctors to 'communicate'...and they DO. I know.

It is NOT in the best interests of public doctors to communicate with patients (outside their outpatients appointments - which can be 6 months to a year apart) because they are not rewarded for doing so. It takes up his/her time, the patient is not paying you and sure as hell the public sector HSE won't be paying you...so don't bother communicating.

Take an example of a patient who persistently rings her public consultant's secretary to seek a few words, even an appointment with her consultant to have continuing, to them urgent or at least distressing and important, issues 'sorted'. Well it doesn't happen.  Endless emails and phone calls are ignored and the patient becomes more and more distressed, more and more frustrated, more and more feeling abandoned, isolated, rejected. Such rejection sets up a deep hurt and further deep need to 'connect' with the consultant who can help him/her. So the cycle continues....more emails from patient.

What happens then.  The consultant becomes raging and angry and sends a letter to his/her GP to say if the patient is 'unhappy' he/she should seek another consultant. Perfect.  How to win friends and influence people.

I know this consultant and I was not happy with this communication to the GP. cc'ed to the patient. The patient was NOT contacted directly.  This is not nice, in fact this is horrible.

But such is the position of 'austerity'; austerity is creating very poor practice indeed.  Consultants and GP's take it out on their patients and somehow create a scenario that it's all the patients fault, and nicely gets off the hook as the patient is blamed.

Bring back the Hippocratic Oath before the ethics of doctors becomes so bad that the patient dies.


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