Dr Crippen

I like Dr. Crippen, I think that he writes well and with passion about the NHS. He also hates Patricia Hewitt. So he isn't all bad.

But there are two things that do annoy me somewhat about him. I thought it was only one, but I have since discovered a new annoyance.

The new annoyance would be an ad hominem attack on another blogger criticising their spelling and grammar. Disagree with the persons views, but to moan about grammar in a blogpost is the province of the forum troll, not that of reasoned debate.

And to quote,

Please feel free to criticise me in any way you like. I have but one request. Your spelling, your use of commas and apostrophes and your general grammar are embarrassing. All doctors have passed “O” level or GCSE English. Could I suggest you get one of them to glance at your copy before you publish?

Two small points – do all doctors pass “O” Level or GCSE English? Even our foreign doctors, including the ones who do not speak enough English to call for an ambulance or have not been properly tested? Secondly, there is a reason why the handwriting of doctors is traditionally seen as poor, and that is because it often is. I write my notes in the back of a moving vehicle and I would be hard-pressed to obfuscate the meaning as easily as your average doctor can.

But the one thing that I have the most problem with is the “I met a bad example of this profession, therefore all member of this profession are idiots”. Take for example his recent post on grief that his partner got from an ambulance worker. When someone posts a comment that perhaps some GPs don't have much of a clue what they are doing he tells us that we shouldn't engage in 'playground insults'. Which I believe translates into “I can see more clearly than you, I am more intelligent, you are foolish and how dare you disagree with me”. Or rather a shouted “Am not!”

He then goes on to call one of his commenters a fuckwit. Which obviously elevates the conversation above playground insults. He then says in reply to the 'fuckwit' commenter that he never used the phrase 'Ambulance driver'. For your entertainment I present a short excerpt,

Only yesterday we had trouble with an ambulance crew. My partner had assessed a patient, discussed him with the hospital physicians, arranged an admission and called an ambulance. The ambulance driver arrived, carried out his mickey mouse medical “assessment” and then told my partner, in front of the patient, that he did not see why an admission was necessary.

I may have accidentally bolded a word or two in that quote. I did resist putting <sic> by the uncapitalised 'Mickey Mouse'

There is a reason why ambulance crews do what they do, for most of us it is for an easy life. If we do as we are told to do then we won't get the sack, as we cost less to train than a doctor it is very much cheaper and easier for us to be sacked. A doctor has 8+ years of training to stand up in front of a coroner and explain why the patient's blood pressure wasn't measured – we ambulance crews don't.

The seeming belief that Dr. Crippen has is that the best nurse practitioner in the world is far worse than the most idiotic doctor. This is something that I do not agree with.

Take today for example, I went to a GP referral where the patient was sitting in the surgery waiting room. She was to see the psychiatrist at the local hospital. The doctor had written a letter explaining that the patient had a bottle of water with many pills dissolved in it. The patient had not only fainted in the consultation, but has also been allowed to keep the bottle. When I got her in the ambulance and took the bottle from her (handed to me when I asked for it) she told me that she had drunk half of it before entering the surgery.

The GP had taken no vital signs, had left the bottle in the patients possession and had written a referral letter that neglected to mention the faint.

If the doctor had told me that taking her observations was a waste of time and that I shouldn't bother, or that my 'Mickey Mouse' assessment of asking the patient if she had drunk from her overdose bottle would be a waste of time. If the patient died in the hospital from the unknown overdose, then you can imagine that the coroner would have some severe words for me and the LAS would probably sack me for negligence.

Finally on this post,

Ambulance crews are valuable, and have an important role at the scene of road traffic accidents but, in the domestic environment, when the problems are medical rather than truamatological, they often apply inappropriate protocols to problems they do not understand.

Which would be why GPs in my area refuse to see patients and instead tell them to 'just call for an ambulance', and this for obviously non-emergency reasons. It would also be why I have seen GPs doing CPR on patients who are feigning a fit. Why I have seen GPs taking brittle ninety year old asthmatics off oxygen because they need the examining room to see the child with a nappy rash. It's also why I've seen GPs sending people with a pulse rate of 220 walking home to wait for the ambulance and also sitting heart attack patients on the brick wall outside their surgery.

And another example from today – GPs who are unable to refer a patient to hospital in the correct manner (writing a little letter and phoning the hospital) rather than just dialling 999 and running out the house. I like Drs letters, they tell me what is wrong with the patient as I assume that they know a lot more about medicine than I do.

Uh-oh, I think I just descended into that 'playground insult' game…

There are idiots at all levels of the NHS and while the fight against the dumbing down of the NHS is an admirable one, we should perhaps stop making such sweeping generalisations.

We should concentrate more on white elephants similar to the one that he mentions in this post. And that is why I keep reading his site, because when he isn't being a arrogant twit he is being absolutely right.

29 thoughts on “Dr Crippen”

  1. Your comment that Dr Crippen can be arrogant seems true of a great many doctors, especially GPs. What really annoys me is when I go to consult one about a complaint, and they just give me the symptomatic name for it in Latin. Yes, I know I've got a rash, they don't have to feed the same information back to me in Latin to try and make themselves look more intelligent than I am.Many members of my own profession are among some of the most arrogant and opinionated people I know – but they often mix it with insight and common sense. I wonder if lawyers are the same? No, I doubt it. I think they stick to arrogance.

  2. Bravo Tom. Yet another superbly written and finely balanced post. I admire the way you can put your (and my) views across so succinctly without getting angry or descending into the gutter.I confess that I have noticed a recent increase in diatribes from Dr C against all Health Care Professionals, which I have found rather disquieting. I have refrained from posting a 'flaming' comment on his blog but your post has said everything I wanted to say and with a far more reasonable voice than I could have managed.

    Thank you.

  3. I can't understand anyone who makes comments like that about the ambulance service! There's far too much of this sort of “I'm a (whatever) so I'm obviously superior to you” business going on. My daughter is a hospital porter and she comes across that attitude a lot. Her badge doesn't read “Hospital Porter= no brain”. There's a particular person where she works who doesn't like her reading her medical books in her spare moments(some play computer games, some skulk off and sleep).I think it's jealousy and a fear of being threatened professionally.

    When I did a Nurse Practitioner course we talked about roles and how Doctors have passed on their “toys” eg. stethoscopes on to nurses over the years and the nurses then pass them on to health care assistants.

    What should happen is that we should all think of patient care first, respect each other's knowledge and work as a team.

    I think that there should be a core training for doctors, nurses, EMTs, paramedics and then specialisation in the rest of the training.Perhaps then we would understand each other better.

    The only good thing about this is that is has fired you up so you've written an excellent post which should get us all fired up too!

  4. ps re doctors handwriting. I suspect the problem dates back to the era where the doctor disguised the prescription so the patient wouldn't understand it in the same way as writing in latin. Often all the prescription was for was “the brown medicine” or similar. This again maintained the elevated status. Sometimes now the status of the professional is eroded and there is little respect, this applies to NHS staff, Police, teachers etc.I've been lucky enough to work for several doctors with neat handwriting and I've learned to decipher the writing of the not so neat! Nowadays it is just careless not to write properly. I used to object to nurses who took blood pressures and then recorded them illegibly- what was the point of taking them in the first place?pps just had a call from aforementioned daughter who has been asked to do overtime as charge hand tonight .

  5. I shouldn't let the likes of Dr Crippen goad me, (but they do) because that's exactly the reaction they are looking for.They like to give the impression that they are willing to engage in lively debate and are willing hear another side of the argument,but realistically you know they will always pull the 'superior intellect' and 'seven years at medical school' card's; and dismiss your thoughts or comments as valueless.

    What I have often witnessed is a highly developed sense of confidence and self righteousness that tip's over into arrogance.

    I have seen this in both social and medical situations.

  6. As a patient, I have zero patience (pun intended) for the arrogance attitude from anyone in the medical profession.Only one GP has had the temerity to pull the “X years of medical school” card on me – which I promptly trumped with “50 years inside this body – which gives me MUCH more insight into what is “normal” for me than your pathetic 7 years drinking and carousing with your school mates.”

    Needless to say, I no longer patronise that medical office. (Am in the States, no NHS here)

  7. Anyone who's worked in the NHS for a time can relate many tales of incompetence on the part of doctors, but that doesn't mean they're all useless. Some doctors are trained better than others – not all medical schools (here or abroad) are equal. And some doctors are simply more intelligent or better suited to their posts than others.The same applies to nurse practitioners – some are better experienced, better trained, or just better than others.

    Nurses have been taking over roles that were once the remit of doctors for decades – IV drug administration, cannulation, venepuncture, nasogastric intubation, urinary catheterisation and defibrillation to name just a few. If things hadn't “dumbed down” to allow them to do so, our A&E doctors would never do anything else – they simply wouldn't have the time!

  8. TomExcellently put. I read your blog and Dr C's and enjoy both. I'm not part of the medical profession so have no axe to grind. Since I read his post I've been waiting to see your reply – it is as well thought out and dignified as I expected it to be – which is more than can be said for some of his recent ones. The “ambulance driver' comment was completely uncalled for.

    And Magwich – you're back!! is the blog going to reappear?

  9. From an experience last week, I much prefer a Nurse or Paramedic to get a venflon in me!I have brittle asthma and ended up with a big splat last week – In rescus the Dr tried 4 times to get a venflon in – he was a total muppet – tried – flapped – tried again – flapped some more.

    By then I managed to convey that my friend (who was on shift there) who is a Paramedic / Nurse should try – He got a vein 1st time! ( and soon I could breathe again!)

    I think paramedics are just as good at medical emergencies as well as all the trauma. I have rarely had problems with the paramedics or EMTs coping with my spectacular spatty asthma!

    Kate

  10. I have been seething since reading his post with regard to the ambulance service. I was very tempted to subscribe to the blog just so that I could have a rant about what he had said. I am glad I didn't as it wouldn't have been anywhere near as good as yours.I hope he reads your blog today and posts his own comments here as I think he has a lot to apologise for. His playground insults aside I also agree that he has a great deal of sensible things to say, but he cannot tar everyone with the same brush, just like your posts where you make a statement but are always quick to add that there are good 'nursing homes, gps etc' out there.

    There are good ambulance staff out there, there are brilliant pro-ambulance GPs as well, there are also lots of people with the same dim and un-educated view that Dr C has with regard to ambulance staff and other health care practitioners. If everyone where perfect then this world would be a very boring one.

    I make no apologies for my spelling and grammer, I am not an english teacher and I have a good enough grasp of the language and spelling etc to get by. I am sure everyone can read what I write and understand it.

  11. I agree – I nearly subscribed as well, but then decided I wouldn't know what to say. Tom has put it very well. Apart from spelling twit wrong in this last paragraph. I would have spelt it with an “a” 🙂

  12. Why has no one pointed out that the reason everyone is countering Dr Crippen's attack on other HCP with anecdotal accounts of doctor stuff-ups is because anecdotal accounts is all he uses to base his argument on?His (and some colleagues) bad experiences does not make the whole gradual international (not just NHS) change in how medical service is provided, wrong. Has he got research evidence to show that society is medically worse off because of this inescapable change?

  13. I had a 2 month ongoing argument with my GP – i basically had Compartment Syndrome (fascia of muscle is too tight for the muscle) from to much exercise – he told me it cant be that, because he was a surgeon for 15 years and has never heard of it, so therefore cant exist. I took him proof (one of my brothers medical text books that states it is possible), and he said that textbook is wrong, and he is right, because hes a fellow of the royal college of surgeons.After paying for a private diagnosis, he reluctantly put in my referal, saying that he didnt believe it was so because I “just found the information on the internet” and “he had no symptoms when he was sitting in my office” (Ofcourse I wouldnt, its EXERCISE induced).

  14. Re the spelling: Erroneus spelling makes things much harder to read – whether it be an admission note or a blog post. Most doctors, at least here in Norway, luckily write rather well.I know I have a bad handwriting. I claim it comes from my years of taking notes in the high speed med school lectures. But I never have so bad a handwriting as when I try to be a journalist, which I have done a few times.

    There certainly are differences between doctors. Some are better than others at diagnosing and writing admission letters. Or judging who should go to hospital and who not. But many don't like being critisised, especially if it happens right in front of the patient.

  15. Exactly.I used to love Dr CRippen's blog, I readit avidly… but not anymore. I cannot abide tha man's attitude towards Midwives, Nurses, Paramedics, EMT's etc, etc.

    His views are outdated & offensive.

  16. I read his blog now and again and have always wondered how such a busy gp has time to put all the gumph on his website that he does, every now and again he talks about the patients he has seen in his surgery but most of the time it's article after article and I lose the will to live after a while and log off!!! Not like this one, always interesting and to the point

  17. Yes, I've wondered that too. I'm a bone-idle student nurse and I'd struggle to find that much time to blog.Plus the non-stop buzzwords have been increasingly grating with me: “New Labour”, “dumbing down”, “quacktitioner”. The posts almost write themselves (maybe that's how he manages to have so much of an output). As time goes on the non-stop cynicism starts to look more and more like a case of professional burnout. After all, not EVERY new healthcare initiative is an idiotic, evil piece of political manouevring that will destroy the NHS. Just the majority of them.

  18. You do better than I do to keep going back for more. I've never really understood why Dr Crippen seems to be universally viewed as some kind of blogging god. I've glanced over his blog once or twice, but his poor attitudes were so glaringly obvious that I never feel the need to go back there.I'm just so glad that others are now starting to see the light.

    And I agree with others, a very balanced post. Bravo!

  19. Same here. The man epitomises the arrogant attitude that I (as an EMT) have encountered in a very small minority of the large number of GPs I have encountered at work. The rest, by and large, are polite, pleasant, and give a decent handover while treating me with apparent respect. Crippen's condescending attitude to anyone who isn't a doctor does him and his profession no favours whatsoever.

  20. “Crippen's condescending attitude to anyone who isn't a doctor does him and his profession no favours whatsoever.”I agree. I'm only just starting to recover from my 30 year hatred of GP's, now that I have met one or two who resemble something near human. His attitude takes me back 30 years.

  21. He used to be good…it used to be a mixed bag…comments on recent patients, bits of politics, explanations on how the latter affected the former etc….then he started on nurses…then midwives…then everybody except sainted fucking Crippen…I have posted asking him to restore the previous balance but the dipshit's ego is obviously now too powerful…To think in the med blogs I voted for this fucker – I wish now I hadn't…a case of the monster being well out of control

  22. I'm sorry but I find it harder and harder to read certain posts on this blog for similar reasons. I enjoy the posts about what you're doing and the challenges you face but I just find the rest, and even some of those posts, more and more reactionary and less balanced. By their nature blogs are self-centred and whingey, but this one tips over the edge into matyrdom. It also seems to me that you view some people as being more worthy of support than others.You do the same as Dr Crippen. GPs and their staff, care home staff, police, social workers, politicians, civil servants and so on – none of them must possibly work as hard as the long-suffering ambulance man, in fact they are out to make his life more difficult!

  23. I think that is really quite unfair. Reynolds posts about the good people he meets as well as the bad, posts about where 'if it wasn't for the GP/Passer by/relative' etc. So I think that is a bit harsh.I for one can't read Dr Crippen's blog because it incites me to violence. I will argue with anyone, no matter how opinionated, as long as they actually listen and respond to what I am saying. Dr Crippen just says 'I am not listening because you are a midwife and therefore a moron and unqualified to do anything' and won't listen to REASON (that actually I'd be a hell of a lot more use than him at an obstetric emergency!).

  24. Crippen is on shakey ground being so critical of other healthcare workers. Unfortunately we all know or have met someone who has had to deal with an arrogant and/or lazy GP.I lost a lot of respect for GPs after what happened to my grandmother:

    Apparently she had been generally unwell for quite a while – Nausea, Constipation, lack of appetite, vomiting etc. Each time she saw her GP she was fobbed off with various pills for nausia, or whatever system which never did anything to help. She was of the generation that would never question her doctor's advice so she did just do as he said.

    The last time I saw her she looked very frail, and the family were very concerned. It took the intervention of several family members accompanying my Grandmother and refusing to leave the doctor's consulting room until he referred her to Hospital, to get her GP to do something.

    Upon being seen at hospital she was rushed into surgery in pretty stort order for the removal of a tumor. Unfortunately by this time the tumor was too large and widespread to save her. She died 3 days later.

  25. Ironic, then, that he should use a quote from you “There are idiots at all levels of the NHS and while the fight against the dumbing down of the NHS is an admirable one, we should perhaps stop making such sweeping generalisations.” as part of his own justification and defence.I see that someone has chosen to give a detailed (and non-abusive) rebuttal to some of his more vitriolic comments about the ambulance service and the doctors who work with you.

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