Clin Med
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The need to ensure patient safety in the National Health Service (NHS) is a national priority. However, it has long been recognised that a culture of blame impedes learning from previous adverse incidents. ⋯ A forum for learning from mistakes could also provide an opportunity to review past incidents in an open and supportive environment. This could, in turn, start to change the current culture of blame in the NHS and contribute to higher standards of patient safety in the future.
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Purulent pericarditis is now rare due to the widespread use of antibiotics. However, it is associated with significant morbidity and mortality, and non-specific symptoms and signs can make diagnosis difficult. We report a patient who presented with left-sided chest pain, mild fever and ST segment elevation on electrocardiography, who required prolonged organ support in the intensive care unit. This lesson highlights the diagnostic difficulties and management challenges that this condition can present.
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Obesity is a rapidly increasing problem that has wide implications for the National Health Service. At present, obesity is not being addressed in a joined-up and standardised manner. ⋯ As highlighted by a recent RCP report, there is a need for a new class of dedicated specialists who can evaluate individuals with health problems that are related to obesity, direct their care in a coordinated fashion, act as an advocate for their needs and be able to liaise with multiple different services to improve the provision of patient care. In this article, we discuss the role of this specialist - the bariatric physician.
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The development of leadership skills in doctors in training is essential to support both their professional development and the future supply of clinical leaders the NHS so desperately needs. There is, however, limited opportunity in current training programmes for trainees to learn and develop these skills, and what opportunity there is has often focused on management rather than leadership skills. Involvement in trainee-led supported quality improvement projects can teach these skills. We summarise the current limitations in leadership training and discuss how the College's 'Learning To Make a Difference' programme, and others like it, are helping to teach leadership.
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Biography Historical Article
Ethereal and material gain: unanticipated opportunity with illness or disability.
When caregivers address the positive aspects of illness or disability, there is a risk of patronising the sufferer. It is equally problematic when secondary gain is judged in a negative light and impedes an effective doctor-patient relationship. Changing attitudes, and particularly the negative perception of a patient's gain from illness, are reflected in biographies of artists, philosophers and other creative individuals. ⋯ The experience of continual sufferers may be more instructive. We examine contemporary examples of unanticipated advantage or gain arising from ongoing disability or illness. The contribution of disability/illness to remarkable achievement promotes enhanced self-appreciation for patients and may foster in others a better understanding of what it means to suffer and live with disability.