Doctors fail to report incompetent colleagues

http://qualitysafety.bmj.com/content/early/2011/02/07/bmjqs.2010.048173

BMJ Qual Saf doi:10.1136/bmjqs.2010.048173

Original research
Professional values and reported behaviours of doctors in the USA and UK: quantitative survey

  1. Martin Roland1,
  2. Sowmya R Rao2,
  3. Bonnie Sibbald3,
  4. Mark Hann3,
  5. Stephen Harrison3,
  6. Alex Walter3,
  7. Bruce Guthrie4,
  8. Catherine Desroches5,
  9. Timothy G Ferris5,
  10. Eric G Campbell5

Author Affiliations
1Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Cambridge, UK
2Massachusetts General Hospital, Biostatistics Center and Mongan Institute for Health Policy, Boston, Massachusetts, USA
3National Primary Care Research and Development Centre, University of Manchester, Manchester, UK
4Centre for Primary Care and Population Research, University of Dundee, The Mackenzie Building, Dundee, UK
5Harvard Medical School, Massachusetts General Hospital, Mongan Institute for Health Policy, Boston, Massachusetts, USA

Correspondence to Professor Martin Roland, Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge, Robinson Way, Cambridge CB2 0SR, UK; mr108@cam.ac.uk
· Accepted 20 December 2010
· Published Online First 7 March 2011

Abstract

Background
The authors aimed to determine US and UK doctors’ professional values and reported behaviours, and the extent to which these vary with the context of care.

Method 1891 US and 1078 UK doctors completed the survey (64.4% and 40.3% response rate respectively). Multivariate logistic regression was used to compare responses to identical questions in the two surveys.

Results
UK doctors were more likely to have developed practice guidelines (82.8% UK vs 49.6% US, p<0.001) and to have taken part in a formal medical error-reduction programme (70.9% UK vs 55.7% US, p<0.001). US doctors were more likely to agree about the need for periodic recertification (completely agree 23.4% UK vs 53.9% US, p<0.001). Nearly a fifth of doctors had direct experience of an impaired or incompetent colleague in the previous 3 years. Where the doctor had not reported the colleague to relevant authorities, reasons included thinking that someone else was taking care of the problem, believing that nothing would happen as a result, or fear of retribution. UK doctors were more likely than US doctors to agree that significant medical errors should always be disclosed to patients. More US doctors reported that they had not disclosed an error to a patient because they were afraid of being sued.

Discussion
The context of care may influence both how professional values are expressed and the extent to which behaviours are in line with stated values. Doctors have an important responsibility to develop their healthcare systems in ways which will support good professional behaviour.

CONCLUSION

Doctors fail to report incompetent colleagues

“Niall Dickson, chief executive of the UK’s General Medical Council is worried by the survey. “Doctors have a clear duty to put patients’ interests first and act to protect them”, including raising concerns about colleagues, he says.”

Thus, the question arises (among lots of other questions), whether or not patients THEMSELVES should report incompetent doctors/physicians, respectively those doctors who produced “medical errors” on them. And if so, in which way it would be helpful for them?

Anyway, based on the quoted and (hot) discussed new research paper/study above, I would like to report a little bit about INCOMPETENCE in the hair research field in general and about “(hair) stem cell experts” in particular – a really nasty topic, I actually tried to avoid to talk about it here on HairSite in the past …

The reason, why I (mostly) tried to avoid to talk/report about this issue is – plain and simple – “nobody is perfect” in general, and, in full awareness about that “NOBODY knows everything”, not even “experts” and especially “experts” in the stem cell research field on one hand, HAIR stem cell research field in particular know everything. But the main reason is, and to make this point (hopefully) clear, that it simply makes no sense to “attack” scientist & researchers in general, especially the “legit” ones – and especially HAIR RESEARCHERS, because unfortunately we do not have that much on our planet … (!)

By the way: WHERE (exactly) is the difference between

  • a “hair transplant doctor/physician” and
  • a “hair researcher/scientist”?

This question (among lots of others) has been recently discussed too during a court hearing (February 17, 2011) in the Netherlands. A bunch of hair transplant doctors/clinics (= plaintiffs) once again (after losing of the 1st process) against Dr. Coen Gho’s Hair Science Institute (HSI) …

SOURCE

Anyway, as already mentioned, those doctors/clinics lost the 1st lawsuit against Dr. Gho’s HSI (about 8 month ago). Sad, but true, they, indeed, made immediately an appeal against the courts former decision (!) and - finally lose again in court …

To make THIS issue as short as possible, below just some extracts (and translations) from the appeal court’s decision paper:

Translation (Dutch/English)

Thereby, the Court of Appeal notes in the first place, Prof. Dr. P. van Zuijlen, professor of burn recovery at the VUMC-University, regarding the “clinical relevance of the HairStemcellTransplantation” as follows:

“Not only our great patient-satisfaction, but also the technique itself appears remarkably well working in scarred skin. To date, we have not seen any complaints about hair loss or problems with the donor area, nor have we heard obout it. We are impressed of the possibilities with HairStemcell Transplantation for burn victims. In particular about the conservation of the donor-area, which is limited for burns patients, the clinical relevance of this method, especially for this patient group, is very high.”

The Court of Appeal also relates to the declaration of Dr. C. Lafaire, Medical Burn Center, as follows:

“Some of my patients have been successfully treated with this technique as wished by me and my patients. With this method, which is very effective, there is no scarring and ongoing hair growth. Thus, you can clearly speak of hair multiplication, because the total number of the hair increases thereby in the scalp.”

Furthermore …

Translation (Dutch/English)

Also [besides the already mentioned experts], from other expert-declarations, which have been submitted in this lawsuit-procedure, show that Hair StemCell Transplantation can lead to hair multiplication. The Court of Appeal thereby refers to the declarations of Dr. Woods, Dr. Mohebi and the (rectified) declarations of Dr. Boersma on January 25, 2010. It is neither alleged nor proved that these persons have a business relationship with HSI. The declatations of Dr. Boersma thereby explicitly refers to the HST-method and thereby we hold on:

“A closer look reveals that the HAIR SCIENCE INSTITUTE with the HairStemcell Transplantation has certainly the ability to make 2 follicles from 1, so that little or no hair loss occurs in the donor-area.”

Anyway, it seems that the plaintiffs tried again to bring comments made by Prof. Dr. Christine Mummery in a video into focus - besides some other really ridiculous arguments against Dr. Gho’s HST method. In that particular VIDEO (produced December 2009), they interviewed BOTH, Prof. Dr. Christine Mummery as well as Dr. Coen Gho concerning Dr. Gho’s “HairStemcell Transplantation” (HST) technique in general and about “hair stem cells” in particular …

SCENE #1 (01:54):

The interviewer introduces her (Dr. Mummery) as “an international authority in the field of stem cell research”. He is asking her about stem cells in general, and finally, the interviewer is asking her WHERE exactly in a hair follicle the “hair stem cells” are located. Dr. Mummery immediately uses her right hand and fingers for shaping a hair follicle, and explains with her left hand, that the hair stem cells are definitely located in the bulbar region of the hair follicle. Thereby, she clearly points with her digit (pic above) to that specific point (outer root sheet in the hair follicles’ bulbar region).

RIGHT or WRONG?

Anyway …
Moreover, she declares that once (hair) stem cells are removed from the (human)body, that the cells are dead, and there is now way for any survival. She says, that a survival of the (hair) stem cells (for transplantation) is not known by stem cell experts in general, and it’s also not known by any “hair stem cell experts in America” …

SCENE #2 (02:45):

This time, the interviewer is asking Dr. Coen Gho about the exact location of the hair follicle stem cells. And what is Dr. Gho (gentleman-like concerning a “she-researcher”) saying?

Dr. Gho is saying (more or less) “YES, that’s right what Dr. Christine Mummery is saying, BUT that has just been a PREVIOUS belief, that hair follicle stem cells reside in the bulbar region of a hair follicle”, and points to the discussed area on his monitor (pic above). Moreover, he explains that in the meanwhile (through his own research etc etc), it is known that in a (anagen) hair follicle hair stem cells reside almost EVERYWHERE along the hair follicle canal and points along the hair follicle on his monitor.

RIGHT or WRONG?

Among LOTS OF other sources (stem cell research papers), below you’ll find the answer about which expert is right and which expert is wrong. And finally, who is THE hair follicle stem cell expert since a long time (1996) …

http://www.jdsjournal.com/article/S0923-1811(06)00359-8/abstract

EXCERPT

Hair follicles reconstitute themselves though the hair cycle, suggesting the presence of intrinsic stem cells. In contrast to the previous belief that stem cells reside in the bulbar region of hair follicles, stem cells were detected in the bulge area, a contiguous part of outer root sheath, that provides the insertion point for arrector pili muscle and marks the bottom of the permanent portion of hair follicles. The bulge cells are morphologically undifferentiated and slow-cycling under the normal conditions.
Later, studies successively demonstrated that bulge cells possess stem cell properties such as high proliferative capacity and multipotency to regenerate not only hair follicles but also sebaceous glands and epidermis.

By the way, as long as you do not know WHERE exactly the hair follicle stem cells (or related cells) reside in a hair follicle, you will not be able exactly to determine how and how much of the hair follicle (stem cells) you can extract/isolate to produce more of them. And without HAIR FOLLICLE STEM CELLS, you will hardly be able to produce more hairs (you can add “growth factors” to something without healthy HAIR STEM CELLS as much as you want, it will not let grow a damn thing!) …

Anyway, among lots of other reason, “the extraordinary knowledge and the substantial accuracy displayed by the international authority Prof. Dr. Christine Mummery” has not been really helpful for Dr. Gho’s plaintiffs …

On the other hand, I really can’t find any reason to blame Dr. Christine Mummery, because at least at the end of the video she claims that she “doesn’t have any problems with bald men” – and is getting (with some sense of shame) red in her face. But is she red in her face concerning the question by the interviewer about bald men or about her incompetence? That’s the question …

To be honest to you guys, i really like Iron.Man as a person even when i keep fighting with him. Yes i mean it like i say it.

And i am very thankful that one user here actually gave both of us a thank you.

So i will hereby keep myself away from overly posting here, but the reasons are not Iron.Man, its more likely the fact that it seems that stuff like Iron.Man posted here, is not much appreciated even when it is “The Mother of all prooves”

And what you guys should learn here is, one single hair even plucked contains the needed stem cells PERIOD. If someone tells you otherwise he is just lying.

Its sad that nobody will put attention to this thread here, i really think its great and it shows Dr Gho from another more serious side and i appreciate this.

But it would be nice if you Iron.Man could possibly answer some questions i have.

  1. Does this rsearch stuff here mean exactly what i said? That plucked hairs could and also should be uses as an addition or replacemnt of normal hair transplants

  2. Is it true, that almost everyone who is WILLING to do something for the patients (instead of stealing their money) to adapt the Gho technique?

» To be honest to you guys, i really like Iron.Man as a person even when i
» keep fighting with him. Yes i mean it like i say it.
»
» And i am very thankful that one user here actually gave both of us a thank
» you.
»
» So i will hereby keep myself away from overly posting here, but the reasons
» are not Iron.Man, its more likely the fact that it seems that stuff like
» Iron.Man posted here, is not much appreciated even when it is “The Mother
» of all prooves”
»
» And what you guys should learn here is, one single hair even plucked
» contains the needed stem cells PERIOD. If someone tells you otherwise he is
» just lying.
»
» Its sad that nobody will put attention to this thread here, i really think
» its great and it shows Dr Gho from another more serious side and i
» appreciate this.
»
» But it would be nice if you Iron.Man could possibly answer some questions i
» have.
»
» 1) Does this rsearch stuff here mean exactly what i said? That plucked
» hairs could and also should be uses as an addition or replacemnt of normal
» hair transplants
»
» 2) Is it true, that almost everyone who is WILLING to do something for the
» patients (instead of stealing their money) to adapt the Gho technique?

To be honest I want to so badly believe everything going on with Gho, I want to believe that his methods are working 100%, I just am skeptical that all the donor grows back, that the hairs that do regrow are the same strength and diameter as they were prior and that all the hairs that grow in the recipient are terminal and of the same diameter as a regular terminal hair, on top of that we’d have to know if the hairs lasted. I really do want his methods to work though.

… but at least sometimes users report about incompetent users:

Ach ja? Welche wäre denn das, du unterbelichtetes Schwanzgesicht?

Meinst du diese Vergangenheit?

http://www.linkedin.com/pub/coen-gho/27/b21/198

Na ja, mit dieser Vergangenheit können in der Tat wohl die wenigsten von der ganzen HT-Saubande auf unseren Planeten mithalten …

… genau genommen, auch nur GANZ wenige aus der Haar(stammzell-)forscherszene. Daher IMMER schön vorsichtig sein (besonders wenn man nicht viel in der Birne hat so wie du), über WEN man WAS daherlabert. Ganz besonders dann, wenn man keinen blassen Schimmer über irgendwen oder über irgendeinen Sachverhalt hat.

Mann oh Mann, so viele unterbelichtete Trotteln auf einem Haufen wie in diesem verfickten Alo-Forum, sieht man aber wirklich echt selten. Echt nicht zu fassen. Bei manchen wundere ich mich glatt, dass die überhaupt in der Lage sind eine Website aufzurufen.

ICH BIN NICHT LARRY DAVID.

Ich habe dir ganz ernsthaft Fragen gestellt und ebenfalls gefragt wer diese FUE Europe sind, die den Gho wohl dreist kopieren wollen aber das ganze unter dem Begriff “Studie” legitimieren wollen