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Gold, incentives and meh

Babak Shokouhi

  • Doctors need resilience training like soldiers in Afghanistan, GMC head says

    Babak Shokouhi's comment 08 Jan 2015 3:49pm

    Something that I think is missing is the lack of specificity in the GMC’s pronunciation of problems and solutions. It’s easy to be ‘general’ and therefore ‘ambiguous’ while not wrong; however, this does not serve the real purpose, which is specifically the combination of processes that caused our colleagues to commit suicide. I am also surprised to see the GMC think doctors lack resilience! A doctor needs to study hard to get into the medical school, then study and work hard to acquire the knowledge and skills required for the job and then face with 120-hour working weeks, night shifts, being treated as an underdog, watch his/her social and personal life (to be looked at as a professional and hence avoid disciplinary), not even have time to have a beer with a friend at the local pub, and so on. Isn’t that resilience? Maybe not.

  • GMC to introduce 'emotional resilience' training after finding 28 doctors under investigation committed suicide

    Babak Shokouhi's comment 23 Dec 2014 12:47pm

    Dr Anonymous | GP Partner | 23 December 2014 9:47am

    Thank you for mentioning my name. I was actually expecting this to come along at some point so that I speak out.

    I would like to make a few points here. The first being the unprofessional and low-level commenting of an anonymous comment which apparently is a GP partner but has no name. For the first thing, I do not buy it that you are a GP partner. I think you are the type of GMC or those who actually do not listen to what people say and judge them by their 'google' profile.

    If at any point, I would feel that my story would help others, I'd share it with others, but what you see on media is not usually an accurate reflection of the truth. Having said that, I did not justify any of my mistakes here, but in fact shared my experience of the MPTS hearings and the way GMC treated me. I am not self pittying and I have not written anything to reflect narcissicism. Please Dr anonymous, prove me wrong if you have read anything that you think is self pittying narcissism, or otherwise, use your frontal lobe before using your tongue.

    If you are implying that people like me are trolls, this obviously shows your attitude, and I leave the judgement to those with higher intellectual understanding.

    As a last point, if you keep using google as your reference, you will end up with the GMC. Or maybe you're not worried about that, because you are either not a doctor or have a friend at the GMC.

    Something to remember for your new year: listen to what is being said, not to who says it! I could have posted anonymous like you have done, but I at least stand up for what I believe. If you have a problem with me personally, I would post anonymously!

  • GMC to introduce 'emotional resilience' training after finding 28 doctors under investigation committed suicide

    Babak Shokouhi's comment 22 Dec 2014 10:57pm

    I think editing comments in a professional forum like this is not acceptable especially when the posy is not even anonymous. This is freedom of speech, as long as there is no vulgarity!

    Anonymous | Other healthcare professional | 22 December 2014 10:13pm
    This is not about doctors who have harmed patients; this is about the doctors who have just been referred to GMC and are being investigated, and are therefore 'innocent until otherwise proven' (human rights). So, it's about the undue pressure and unfair assumption of guilt until otherwise proven, and then lack of compensation or apology after clearing, and the defamation that is not reparable and the unreasonable 'solution to the problem' of suicide. What you can see above is the doubted efficacy of 'resilience training' and similar political exercises in response to the investigation of a significant number of doctors who have committed suicide while subject to GMC investigation.

    So, this is not about doctors who have harmed patients with mental health problems and suicidal ideation; these two groups are both vulnerable and your comment is totally irrelevant to the discussion here.

  • GMC to introduce 'emotional resilience' training after finding 28 doctors under investigation committed suicide

    Babak Shokouhi's comment 22 Dec 2014 5:11pm

    Hi again Una,

    Well this is politics. And you need to make up your mind if you like a social system or you prefer a capitalist one! The 'social' NHS is turning to the 'privately owned' capitalist system. The same way the council houses are sold and any capital that can be liquidated to make revenues for the government and 'shift the responsibility' to anyone but the government.

    And you mentioned two doctors with the same accusations having different verdicts: the keyword is 'showing remorse and insight', Apparently the white British doctors have a better way of showing remorse but in fact IMGs have 'cultural' and 'language' difficulty in showing remorse. We need to be fair to the GMC the same way they are fair to us IMGs!

  • GMC to introduce 'emotional resilience' training after finding 28 doctors under investigation committed suicide

    Babak Shokouhi's comment 21 Dec 2014 11:52pm

    Dear Dr Barrett,

    I'm not sure how you think that salaried GPs are paid when suspended or investigated by the GMC. You might be referring to lthe regulations before 1 April 2013 where GPs were eligible for 90% of their monthly payment (at the local PCT/performance advisory group's discretion). Since 1 April 2013, there is no such payment; in other words, any GP for any reason being suspended, does not receive any payment. In my case, this was called by the LMC chair and the MP 'an aberration in the new regulations that needs to be addressed'. If you are sure of this 'aberration' addressed, please enlighten us too. With regards,

  • GMC to introduce 'emotional resilience' training after finding 28 doctors under investigation committed suicide

    Babak Shokouhi's comment 20 Dec 2014 1:48pm

    Anonymous | Sessional/Locum GP | 20 December 2014 1:39pm
    Whatever you do, you will be asked why you are changing careers, and then before you know, you will be dismissed; noone would take any risks hiring a 'doctor in difficulty'.

    After 3 years of investigation, even after being cleared of the charges against me by the Crown Court, the GMC decided that I should be struck off. I tried teaching English, volunteer work for ADDACTION and so many others, but even with a clear enhanced CRB, I am not employable.

    I suggest you look at either self employment/enterpreneurship or immigration.

  • GMC to introduce 'emotional resilience' training after finding 28 doctors under investigation committed suicide

    Babak Shokouhi's comment 19 Dec 2014 8:44pm

    Re: Arrogance and insight

    Hi there. Another point I find interesting is the fact that GMC believes that the doctors who are reported ‘are not resilient enough’ to withstand ‘the protective measures that are necessarily taken to protect members of public’. This is what I call ‘lack of insight’ into GMC’s own shortcomings and accusing all those who GMC deals with, as ‘insufficient’.
    Dear GMC, doctors are humans. They often become stressed because of their substandard work conditions. They also are members of public. They also need to be protected. They are not expendable. They are not easy to get. They are easy to lose. We have a shortage of them. Please kindly keep more of them alive.
    I am now moving to another profession; I initially though veterinary medicine, after I was sabotaged in a teaching job. But I’m now turning to information technology. What is interesting is that even if you want to work in McDonald’s, you will be asked why you are changing your career from medical practice, and you won’t have time to answer the question: you’re not fit for work! I’m afraid the bullying wouldn’t stop there. Even if you try to get work in another sector, even if you have a clear ‘enhanced CRB’, you are still not fit for purpose; so all you are left with is to leave the country or become a Heisenberg! Anyway, be well. Merry Christmas.

  • GMC to introduce 'emotional resilience' training after finding 28 doctors under investigation committed suicide

    Babak Shokouhi's comment 19 Dec 2014 8:20pm

    Hi Anonymous | Junior doctor | 19 December 2014 7:11pm

    I can clearly read your distress, and I am so sad to see someone worse than me. You obviously need help, but don't know where to look for it.

    I interestingly noticed that whatever is claimed to be the case, is actually not: when you fill in a form to 'make sure you would not be a subject of discrimination for your race, gender, or sexual orientation', it is actually the other way round!

    As you mentioned vulnerability, the GMC do not care if you are a vulnerable doctor; the duty of care is to 'protect the members of public and public opinion of the profession', so there is nothing about doctors; I am so surprised we are expecting this 'new GMC' to advocate people like us. We are 'criminals until otherwise proven' and we are 'liars as long as what we say is different from anyone else, no matter who'.

    The 'system' is clear enough. The GMC is for protection of the public, which we are not part of (as individual 'operators'), and the public reputation of the profession (so anyone who could be made 'a message to the others or to the tabloids').

    What I can tell you my dear, is that you won't get anything from politicians; do not allow a narcissistic, masochistic 'little man' to despair you into darkness. Instead, get help, get well, and fight back! You are not alone, you are not meaningless, you are not nil. Do get well, come along and make it a better world.

  • GMC to introduce 'emotional resilience' training after finding 28 doctors under investigation committed suicide

    Babak Shokouhi's comment 19 Dec 2014 2:36pm

    Sorry I used to be a GP partner. I am no longer...

  • GMC to introduce 'emotional resilience' training after finding 28 doctors under investigation committed suicide

    Babak Shokouhi's comment 19 Dec 2014 2:36pm

    Thanks Una for bringing this up. I did contact you a few months ago to have a discussion, but I didn’t realise you have been dealing with all this. There are a lot of comments up till here and one can readily read the frustration between the lines. What is more interesting is no comments from the ‘other side’! One of the reasons could be ‘anything you say could be used against you in a court of law’, and that is ‘you have the right, actually not the right, you are bound to be silent!’
    My story is similar in some points and I might write it down further down, but I would like to just comment here, as someone who has been through the FTP process, for right or wrong, and has felt suicidal in many occasions, and still does every now and again, with flashbacks of harsh accusations and unfair judgements; how about those who have been through the process and been badly traumatised and left to rot?!
    There are several layers in Una’s comments and the following discussions. Looking at the matter in an ‘MRCGP exam-type’ manner(!), I could say the problems are at different levels of:
    Personal and professional relationship between colleagues, and between doctors and RCGP, and at a different level with the GMC.
    The next level is the way GMC treats doctors, with a mention of IMGs and the question whether they are treated differently.
    The next one is how we as a ‘non-union’ are dealing or can deal with this.
    Let’s look at the facts and figures: once a doctor is referred to the GMC, regardless of who has done it, the accusations start exponentiation; the poor chap becomes a monster and if all the start was a whistle blow, things turn around with colleagues’ concerns, several patient complaints, fraud investigation and all different sorts of bullying. You will even get emails from colleagues you haven’t even heard of, raising concerns about you. And all this happens, after 20 years of practice with no complaint, in a very short time of a few months. This will be viewed by the GMC as repetitive failure to meet the standards of a registered medical practitioner, although 6 months and 20 years are ‘significantly different’. In a way, it really doesn’t matter who starts the referral, Una, and I take it as the 54% referred by the college is a biased undervaluation of the depth of the calamity.
    The GMCs report on the failure rate of the IMGs in the RCGP exams is one thing, and the view of the sanctions and tribunals is the other. Surprisingly the number of IMGs who have shown ‘enough insight’ into their problems and might be able to rehabilitate back to work is ‘significantly’ lower than the corresponding white British group, as is the number of overall referrals to GMC. And of course, these are all due to ‘cultural differences’ and ‘language problems’, but still not accepted as an excuse in the FTPs.
    How are we dealing with this? Well, I guess nagging and moaning is part of the initial steps towards action; this shows there is a problem and we all recognise it. So the next step would be what to do about it. I for one, am doing nothing about it, as I don’t know what to do, I don’t have time, as I have to look for some cheap work to feed my family and pay my debts, and even if I did have time, I know I won’t be taken seriously unless I commit suicide.
    So, let’s carry on doctor…. And hope you are not one of those 1 in 4. With kindest regards and thanks for speaking up.

  • Replace GP out of hours with GP-fronted A&E departments, Monitor urges

    Babak Shokouhi's comment 08 Dec 2014 11:52am

    With what GPs could we do that? Do we have sufficient workforce to implement this? What happens to existing services that GPs provide?

    I think you need to consider a few more factors when comparing systems. How about increasing the A&E minors units?

  • Life as a GP in Nova Scotia is so much better

    Babak Shokouhi's comment 06 Nov 2013 6:05pm

    I thought students pay for education in the UK. I paid very little where I educated but I had to work for the government to compensate for the benefits of free education.
    As a separate issue, I think it's the government of the countries who need to look at their policies so that they keep doctors or other professionals around. What I see now, I can see the present government is not much interested in retaining the workforce. The reason? I don't know!
    Anyway, if we come down from our chair of politics, we are all humans and we move where we are better appreciated and more respected. After all, I should repeat Darwin's sentence that was one of my friend's pet expression: the most intelligent of species are not the survivors, but those who adapt with change (with a bit of modification).

  • RCGP faces legal threat over international GP trainee failure rates

    Babak Shokouhi's comment 14 Nov 2012 6:10pm

    Just wanted to add:

    The old MRCGP was an examination of excellence but the new one is an examination of qualification; this is, I think, the point that RCGP is missing.

    Deaneries are also responsible for this as the evidence shows they are failing to prepare international graduates for the exams they are supposed to pass. Maybe the IMGs need an intensive language and culture course or a quick skin bleach!

  • RCGP faces legal threat over international GP trainee failure rates

    Babak Shokouhi's comment 14 Nov 2012 6:07pm

    I am a GP who passed the previous MRCGP in 2006; I took the oral part of the exam 3 times. I am an international graduate. BUT I DO NOT AGREE THAT EVERYTHING IS RACIST!

    I passed the other parts of the exam in the first hit, but the oral exam, 2 failures. How did I manage to pass the third time? I tell you:

    There is a big cultural difference between examinations in the UK and other countries. The exams are focused and emphasise details in other countries, but all you should do in the UK is to be systematic and 'laterally-thinking'.

    However, I think the RCGP exam's validity and credibility is questionable as it does not measure what it's supposed to! (which I believe is clinical competence, efficiency and safety). I had the same experience with the IELTS: I scored 8.5 out of possible 9 before I came to the UK, but last year I scored 7.5 after living and practicing in the UK for 8 years!

    The message is simple: these exams need to be standardised to measure what they are supposed to. It's not a matter of racism or malevolence. After all, a large part of the health care manpower in the UK is international graduates.

  • A case that changed my practice - the man addicted to prescription drugs

    Babak Shokouhi's comment 18 Oct 2012 1:30pm

    The first session he came in, he was quite upset because he had to wait for 10 minutes before being called in. He shouted, 'you can't keep me waiting, I get worked up!' and I said I understand and will ask reception to make the first appointment of the day for him from now on, and politely asked him to calm down when speaking.

    This made him explode: 'I know you are going to tell me to stop diazepam, but a doctor like you prescribed it to me 20 years ago and he didn't care what happens to me later and I get addicted; you don't care either, no one cares!'

    I kept my temper, and told him that I do care and that is why I see him there and then and that is why I am tolerating his shouting and his intimidating behaviour; I also added I will not be intimidated and this is his choice to engage with me and come up with a plan to reduce his benzo use, or like the 'doctor 20 years ago' who didn't care, I could prescribe the 120mg/day of diazepam and get him out of the room.

    This approach made all the difference! After 2 years, with his 'good days and bad days' and taking more or sometimes less, with his honesty when he bought some off the black market and when he could proudly save a few pills at the end of the month, he is now taking 4mg/day of diazepam and the last time I saw him before leaving the surgery, he thanked me for being there for him.

  • Why I quit my partnership to become a locum

    Babak Shokouhi's comment 18 Oct 2012 12:49pm

    I meant health!

  • Why I quit my partnership to become a locum

    Babak Shokouhi's comment 18 Oct 2012 12:48pm

    I think it's good to have insight into what suits you best in your career.

    Many of us just know how to be a GP partner, and that's all! It takes so much to be a GP and get to know your patients and get old along them. That's nice, but not ideal for everyone.

    People like Libby enjoy varierty and more balance in work life interface. They would probably put their potentials into practice in various areas and I admire people who are brave enough to admit GP principal role as it is now, with all the pressures and challenges, is not for them.

    After all, people are different and it's good to find out what type of work makes you the optimal 'serving machine' in this world, keeping you healthy and productive at the same time! We should not misuse the concept of 'continuity' which is desirable but not always essential; we are not there to make people 'happy', just to help maintain their help.