The conference was opened by Ruth Shipsey, Medisec CEO and chaired by Jim Glennon, Medisec Chairman/Director.
The conference schedule included national and international speakers and the topics were of interest to General Practitioners countrywide who are committed to reducing their level of exposure to everyday risk in general practice
First speaker to the podium was Professor Andrew Murphy who spoke about the Trials and Tribulations of benzodiazepine prescribing, the practicalities and difficulties, and the need to adhere to current guidelines. He discussed counselling the patient, discussing alcohol and driving, suggested delaying prescribing and the importance of recording, as well as exploring other aspects of anxiety management. A telling video was shown illustrating how street drug users knew how they could obtain prescriptions easily without question from some medical professionals.
Prof. Murphy was followed by Eileen Barrington S.C. who spoke about the mechanics of a Medical Council Complaint from preparation for Preliminary Proceedings to appearing at a Fitness to Practice Inquiry and the possible sanctions imposed. A difficult subject for any GP to listen to, and all were grateful for the advice given.
Dublin City Coroner Dr Myra Cullinane was next to the podium, clarifying the relationship between the GP and the Coroner’s office, from preparing a Coroner’s Report to preparing for appearing at inquest. The Coroner gave down to earth practical advice and illustrated how the Coroner is generally happy to engage with the GP should any queries arise regarding the death of a patient. If in doubt, call the Coroner was the abiding message.
Guest speaker, academic, scientist and campaigner Ben Goldacre leapt to the stage after his Medisec Barista double espresso (now we know how he does it) and launched into the forensics of how scientific research studies can be falsified and misrepresented by the study originators and by the media reporting them. Outcome switching and composite outcomes can sway the reality and misrepresent the science therein. When reading a comparative study pay attention to the dosages of the new versus old drugs- low doses of new drugs are much less likely to cause the side effect that the high dose of the old drug might cause! An interesting slide was the PHd Certificate of qualification earned by his dead cat, Hettie, illustrating how some media personalities obtain their degrees!
After lunch Prof Walter Cullen presented on ‘Dropping the Ball’ between primary and secondary care. He referred in depth to a Medisec 2016 study investigating risk in the interface between the two , and emphasised the learning points. 14% of claims were due to difficulties in communication between primary and secondary care. The main issues concerned referrals, discharges, GP follow up and medication reconciliation. If in doubt – Check, Consider and Call.
Four sessions of ‘Ten Top Tips’ provided a useful finale to the day.
Dr Ronan Boland, General Practitioner reflected on the difficulties he sees when writing expert reports, and emphasised the importance of keeping good records, and the difficulties in defending a doctor when the records were poor or absent.
Dr Conor O’ Shea GP and National Coordinator HSE/ICGP GPIT Group, gave the most terrifying account of how easy it is to be invaded by kidnappers who take over your patients and charge enormous amounts of money for you to retrieve them – virtually that is. Ransomware is now a fact of life and he kept us hanging on a thread as he built the suspense around what happened as his finger hovered over a dodgy email attachment! Even Conor can be caught unawares.
His top tips were: don’t open it, pay a professional to guard your software, back up your Data, think before you click and have unique log ins for all staff, along with many more pearls of wisdom.
Senior Medisec Legal Counsel Deirdre McCarthy gave her top tips on handling complaints in the practice, and emphasised the importance of open disclosure and having a complaints policy. Don’t ignore the complaint and keep it internal. Have a protocol for complaints handling and stick to it. Take all complaints seriously and investigate. Ensure all staff are on board.
Senior GP Risk Advisor Mary Davin-Power gave her top ten hazards in prescribing and her top ten medications to watch. Transcribing between primary and secondary care scored high in the risk register, as did the lack of a repeat prescribing protocol, paediatric doses, polypharmacy and toxic medications. The top ten troublesome drugs included NSAIDs (renal damage, cardiac risk) NOACs, Benzodiazepines and Iron injections (skin staining). Monitor toxic medications and consider auditing your repeat prescribing or auditing even one troublesome drug.
The final speaker of the day ICGP CEO Fintan Foy described how the College are aware of the problems today in general practice, have come up with solutions, but getting the message across and being listened to was a difficulty in today’s climate. He illustrated how the college is addressing the problems of recruiting and retaining younger GPs. He also had some top tips – change is opportunity, be leaders not victims, and that the College aspires be a home for diversity and unity of purpose and intention in General Practice.
Medisec wish to thank all their speakers and attendees for contributing to a very successful and thought provoking conference.