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Saturday, 14 December 2013

Medical problems in Hall

As many of you know, in addition to being your Warden at Connaught Hall, I am an accident & emergency doctor at University College Hospital. This often leads to residents asking me for medical advice, diagnosis, or treatment here in Hall.

With two small exceptions, I do not provide a medical service for Connaught Hall residents.

It can perhaps be a bit confusing or disappointing for residents when I say I cannot help with their medical problems ("But, you are a doctor, aren't you?"). So I hope this blog post will help explain why in most cases I am unable to diagnose or treat medical problems in Hall.

First, those two exceptions:

1. I can help with minor first aid problems like bruises, cuts, and burns in the same way that a first-aid trained layperson can.

2. I will provide an enhanced level of care -- as a doctor -- in immediately life-threatening situations such as a very severe allergic reaction (anaphylaxis).

I will not, however, take a proper medical history, perform a physical examination, take any tests, nor prescribe any drugs in my capacity as your Warden. I will be just as likely as any of the Senior Members to advise that you see your GP or attend hospital for proper medical attention.

This is why:

1. The University of London does not insure me to provide medical services. That means that if I make a mistake and you suffer harm as a result, you would not be able to claim compensation from an insurance policy - you could only claim against me personally, which unfortunately will not get you very much compensation!

2. A doctor cannot -- in most cases -- reach a safe, accurate diagnosis without performing a physical examination. But for me to do that would normally step over the line of acceptable physical contact between a Warden and a student resident. The University would not support me in doing that.

3. Furthermore, when I see patients in my hospital job, I have access to tests and diagnostic measures such as X-rays, ECGs,  and blood tests. It would be wrong for me to try and "guess" what is wrong with you without these tests.

4. In many cases when a doctor examines a patient, we will have a chaperone present for the protection of both the patient and the doctor. I do not have access to a chaperone in Hall.

5. Your GP has the benefit of access to your previous medical notes, which can be vitally important in making a correct diagnosis or deciding on the correct treatment plan. I do not have access to your medical history.

6. When you consult a doctor in hospital or a GP surgery, details of what happened will be recorded for future reference on your medical file. I cannot make entries in your medical notes from the Hall.

7. The General Medical Council requires that doctors in the UK must always keep contemporaneous medical records on every patient encounter, and communicate what happened in every encounter to the patient's primary care provider (usually their GP). I do not have the resources to do that in Hall, so I would be at risk of breaking my profession's rules of conduct.

Having said all of that, one last thing I can sometimes help with is in providing very broad, general advice about drugs you might have been prescribed by your doctor (i.e. how they work, how long it might take to get better, etc) or -- again -- broad and general information about medical conditions. But I must stress that I cannot provide private medical consultations in Hall.