Doctor emigration
It’s all well and good to announce increased medical school places to deal with the massive doctor shortages in the UK, but it’s pretty clear to NHS staff that there is also a big leak that needs to be fixed. A large number of colleagues I trained with are now practising abroad, and it is a trend that is regularly reported in the medical and lay press. The esteemed UK Medical Careers Research Group in Oxford recently reported a study that investigated the reasons why doctors are considering leaving medicine or the UK.1
They received over 5000 responses to their questionnaire survey. Among those considering working in medicine outside the UK, the most commonly cited reasons were to gain wider experience, that things would be ‘better’ elsewhere, and a negative view of the NHS and its culture, state, and politics. The authors conclude that, if policymakers want to retain doctors, they need to introduce real improvements to resources, staffing, and working conditions. Hear, hear.
Vitiligo
Vitiligo affects 1 in 100 people, and GPs therefore see it relatively often. It is important because it typically affects young people and has a significant impact on appearance. How people access information and help regarding vitiligo may influence how they manage such impact. A research team in Southampton investigated this through an online survey that was completed by 161 members of the Vitiligo Society, a UK-based charity.2
Participants felt that GPs had low awareness of treatment options, and some felt that both GPs and dermatologists dismissed their condition as ‘cosmetic’. The recommendations from the authors include a greater acknowledgement of the psychosocial impacts of the condition, and signposting towards credible and reliable information sources.
Canes
Strokes are the leading cause of disability in the world. Although most survivors eventually recover some walking ability, it is often impaired, leading to fear of falling, reduced confidence, and limited community and social participation. Walking aids, such as canes and walkers, are sometimes prescribed after stroke with the aim of improving safety and walking ability. A research team from Brazil recently studied what ambulatory stroke patients thought of canes, interviewing a purposive sample of individuals with fast, intermediate, and slow walking speeds.3 Positive perceptions related to improved independence and balance, and negative perceptions were of social stigma and concerns about arm function. The authors suggest that slower walkers are much more likely to be positive about using a cane.
From my own experience of talking to patients who have had strokes, I’d suggest that there’s probably an additional style and image factor that they haven’t captured.
Self-harm pictures on Instagram
About 1 in 10 young people will self-harm at some point, and rates are rising. In recent times, there has been much debate about the relationship between online activity and self-harm. Some have argued that there are benefits, including reduced social isolation and greater opportunities for self-disclosure. There have also, though, been concerns about normalisation, acceptance, and social reinforcement. A recent German study analysed 2826 Instagram pictures that directly depicted wounds from self-harm.4
The images, posted in a 4-week period in April 2016, commonly showed mild to moderate cutting injuries to arms and legs. More severe injuries received more comments. Although most comments were neutral or empathic, with some offering help, a few comments were hostile. The authors conclude that social reinforcement might play a role in the posting of more severe pictures and suggest that social media platforms need to take appropriate measures to prevent online social contagion.
- © British Journal of General Practice 2018