Dear Toby,
"Vae victis!" (Woe to the conquered!) Brenno shouted at Romans,
throwing his sword onto the scales, while they weighing their
tributes.
"Woe betide aliens!" I said today morning while reading your
sentence: "OK, this 30 year old medical negligence solicitor who
jogs every day wants a provate referral for exercise ECG ....".
I cannot understand which kind of person is the one you are speaking
about.
Toby, you often hide crystalline concepts inside a cover of very hard
English ...
I would kindly remind you Britons that a lot of aliens are listening in
the list.
Thanks.
Giuseppe
Dr. Giuseppe Giocoli
Via Sarca, 19
25015 DESENZANO d/G (BS) Italia
At 11.01 21/03/01 +0000, you wrote:
In message
<[log in to unmask]>, K.Hopayian
<[log in to unmask]> writes
>I am booked to give an introductory talk to two groups of
general
>practitioners in this part of England, East Anglia. The first is a
group of
>GPs attending an annual refresher course, the second a group of
trainers and
>their trainees (called registrars in England). Both groups
contain
>individuals hostile to EBM (though none have had direct exposure,
I
>suspect).
>
>My plan is to use *educational aikido* - that is, let them attack and
I will
>use their own force or weight to floor them. I believe I can predict
what
>they will say and so have some examples to give to illustrate that
EBM is
>not the monster they believe and that it can help answer questions
that
>arise in general practice.
>
>I have never done this before so I wonder if any of you have
experience I
>could benefit from?
>--
I tend to give a broad historical introduction using examples of
failure
(or delay) in getting research into practice. The examples I use
are:
Lind's work on scurvy, Semmelweiss's work on puerperal fever (with
the
added twist that Oliver Wendell Holmes came to the same conclusion,
but
they were never in contact) then leap forward to CAST and
thrombolysis
(if they thought "of course WE are too sophisticated to ignore
evidence..."). Then I work through an example of diagnosis (exercise
ECG
for super-fit athlete with non-cardiac chest pain). All the time I
emcourage discussion. This seems to go down OK - it seems a common
misconception is still the old one about "cookbook medicine",
so it's
useful to cover ground where preconceptions can be challenged ("OK,
this
30 year old medical negligence solicitor who jogs every day wants a
provate referral for exercise ECG and will make a formal complaint
if
you don't comply...what do you do?" -there's always an honest one
who
says "OK, I'll refer - what harm can it do?!!")
Toby
--
Toby Lipman
General practitioner, Newcastle upon Tyne
Northern and Yorkshire research training fellow
Tel 0191-2811060 (home), 0191-2437000 (surgery)
Northern and Yorkshire Evidence-Based Practice Workshops
http://www.eb-practice.fsnet.co.uk/
