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2022

RUARY

Carmel Sparke IT is a handy descriptor that seems to capture virtually anyone with a medical degree when journalists are in need of a snappy headline .

But exactly how is the media defining a ‘ top doc ’? Is there any coherent basis for it ?

According to UK research published in The BMJ , the term began appearing in newspaper headlines around 1985 and has grown increasingly popular , especially from 2015 on .

After excluding recently deceased doctors , long-dead practitioners and advertisements masquerading as news , the authors discovered 303 headlines published in 2019 featuring references to ‘ top doctors ’.

One in five ‘ top docs ’ were found to be GPs , with paediatricians ranking second . There was only one reference to an orthopaedic surgeon as ‘ top doctor ’.

On average ‘ top doctors ’ had been registered for 31 years and frequently held positions of status in the UK ’ s NHS , the British Medical Association or medical colleges .

They were also predominantly male ( 80 %).

But when it came to a separate analysis of headlines about ‘ top doctors ’ facing disciplinary proceedings , they were overwhelmingly male ( 92 %), working in hospital specialties and less obviously eminent in their field .

“ In consideration of criminality and disciplinary measures , a much lower threshold seems to be required , and journalists seem happy to refer to relatively undistinguished medical practitioners as a ‘ top doctor ’,” said the study authors , led by Glaswegian palliative care specialist Professor Mark Taubert .

“ We assume that this was purposefully done to weave a powerful ‘ fall from grace ’ narrative — that is , a doctor who

was once at the top [ but ] was now sentenced to a life in prison , for instance .”

The authors drew up a British league table of ‘ top docs ’, with former chief medical officer Professor Dame Sally Davies at number one , NHS England ’ s medical director at two and a former chair of the UK Royal College of GPs in third .

A brief and completely unscientific analysis of Australian Doctor stories found similarly that chief medical officers — notably , Victoria ’ s former ‘ top doc ’ Dr Brett Sutton , college presidents and AMA presidents — were commonly conferred the title in our headlines . The study authors did issue a

AAP

One of Australia ’ s genuine ‘ top docs ’, plastic surgeon

Professor Fiona Wood .

warning about the dangerous use of ‘ top doc ’ to push supposed miracle cures or to pump up stories when the doctor ’ s opinion aligned with the newspaper ’ s publisher .

But what selection criteria did the authors think should be employed for ‘ top doc ’ status ? Their suggestions included :

• Doctors working in difficult conditions , including conflict zones .

• Scientists who are leading authorities in their specialty .

• And ( somewhat bizarrely perhaps ) curators of medical college museums , gardens and wine cellars .

BMJ Lead 2023 ; 9 Jul .

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HIGH STRENGTH NOW PBS LISTED FOR SEVERE

ASTHMA 1

Carmel Sparke POST-incident support for GP receptionists can significantly reduce the emotional toll of the growing workplace violence they are facing from patients , a review suggests .

Australian researchers assessed 20 studies , dating back 40 years , exploring the abuse directed at frontline staff , which revealed that patient aggression had become so frequent it was now accepted as a normal workplace hazard .

Staff reported being called “ dumb ” and “ lazy ”, being subjected to shouting , screaming , cursing , racist language and sexist insults , as well as accusations of malicious behaviour .

Several strategies to tackle abuse appeared to help , such as reducing frustration for patients , like simplifying appointment scheduling .

One study also found that public messages suggesting injunctive consequences ( eg , “ Hostility can be subject to criminal penalties ”) were more effective in preventing hostility compared

with descriptive messages ( eg , “ Please be mindful of your words and actions ”).

But while visible safety measures , such as clear acrylic barriers and lockable doors at reception areas , made staff feel safer , they also fuelled their concerns about the risk of abuse and violence .

Lockable doors fuel concerns about the risk of abuse and violence .

“[ However , there was evidence that the ] availability of post-incident support ( debriefs , external counselling ) affected how safe staff felt at work and significantly moderated the effects of workplace violence on emotional wellbeing and physical health ,” the researchers wrote in The BMJ ’ s Family Medicine and Community Health .

Led by Dr Fiona Willer ( PhD ), from the University of Queensland , they said the apparent reliance of GP clinics on receptionists to “ develop their own de-escalation strategies and independently build resilience ” against patient aggression was concerning .

“ Several studies mentioned that part of a receptionist ’ s role , either formally or informally , is to engage with patients positively , de-escalate challenging situations , keep patients calm and maintain composure .

“ Studies from hospitality literature describe that good client rapport reduces instances of client misbehaviour , yet prioritising this as a de-escalation tool is ineffective long term and actually led to clients misusing their rights later .”

Receptionists in general practice deserved evidence-based measures to improve their working conditions and wellbeing for their own benefit and that of the community , they concluded . Fam Med Community Health 2023 ; 6 Jul .

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References : 1 . Pharmaceutical Benefits Scheme ( PBS ). Available at : www . pbs . gov . au . 2 . Approved Trimbow Product Information . Chiesi Australia Pty Ltd , Hawthorn East , VIC . 3123 . Tel : + 61 3 9077 4486 ; Email : medicalaffairs . au @ chiesi . com ; Website : www . chiesi . com . au . Copyright © Chiesi 2022 . All rights reserved . Date of preparation : January 2023 . AU-TRI-2200169 . CHIE00042o .