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July 2010

Schrödinger Decisions

Up and down the land, clipboard operatives guided by local PCTs are stomping through care home lounges, offering, as is the way these days, the Gilberts and Biddies all manner of advice and assessments. Those who are found to have mental capacity are read their rights, including the right to refuse treatment; and, if they are so minded, offered a DIY death warrant, or Advance Decision to Refuse Treatment (ADRT), as they are more formally known.

For some, no doubt, an ADRT will be just the ticket. No more futile and burdensome treatment; and no more gratuitous delays at the departure gate. Dr No has no trouble with such arrangements when they are the right arrangements: they are humane and sensible. Indeed, given certain circumstances, Dr No thinks he might even sign his own ADRT.

The GPs’ Den

By a coincidence last week saw both the announcement of the coalition government’s shake up of the NHS, and the start of this summer’s season of ritual humiliation in The Dragons’ Den. On the face of it these two events have little in common, but it does not take long to see that The Dragons’ Den is in fact the model for the coalition’s vision of GP based commissioning. Most jobbing doctors will see it as an irritation and a diversion, but a hardcore of latent fundholders will emerge – indeed already have emerged – to grasp what some have called a poisoned chalice, but what Dr Dollar will see – indeed already has seen - as a Golden Opportunity. Before we know it, Dr Dollar and his pals will form up into consortia, and the BBC will spot a chance for another easy reality show. The GPs’ Den will be the new Dragons’ Den.

The Ultimate Quack Remedy

Top Prize in the recent busting homeopathy stakes undoubtedly goes to Simon Singh for his wonderfully effective puncturing and deflating of the pompous David Tredinnick MP on the Today programme. Tredders was wind-bagging on about how they do homeopathy better in France, but he hadn’t bargained on Singh doing his homework. The best selling homeopathic remedy in France, said Singh, is a ’flu remedy made from the mashed up entrails of a single Muscovy duck that generates a staggering $15 million of revenue. It was, said Singh brilliantly, ‘the ultimate quack remedy’. Tredders had more than his wings clipped: he was permanently grounded; while Humph was reduced to muttering something about getting his hands on ‘that duck’.

Happenstance Coincidence and Enemy Action

Readers who frequent the pages of the UK medical blogosphere cannot fail to have noticed the decline in blogging activity. Almost a year ago, Dr Rant posted ‘Farewell Lord Darzi’ which was a farewell post in more ways than one. Earlier this year, the sun set spectacularly on Dr Crippen, and more recently The Jobbing Doctor turned off his steady flow of posts in mid-stream. Many of those who are still posting are doing so at reduced frequency. Only L'Oréal Pal continues to post regularly, presumably because she thinks she’s worth it.

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