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The New GMC – The Spanish Inquisition?

The GMC was set up by an act of the Parliament in 1858. Since then there have been several modifications and changes to its role. The Medical Act 1983 (amended) notes that, “The main objective of the General Council in exercising their functions is to protect, promote and maintain the health and safety of the public”.
The GMC website states that it is concerned with ensuring that doctors are safe to practise. Its role is not, for example, to fine doctors or to compensate patients following problems.

What the GMC can’t do
The GMC cannot:
deal with concerns or complaints about nurses, pharmacists, dentists, opticians, hospital or practice managers or administrative staff, or anyone who is not a registered doctor;
normally give you a detailed explanation of what happened to you. This can only come from the doctor or health provider;
order a doctor to provide the treatment you want;
pay you compensation;
fine a doctor;
order a doctor to give you access to your records;
make a doctor apologise to you.

An independent report cleared the GMC of racial bias in 2000 despite finding 50% of doctors struck off in 1999 were from overseas qualification whereas only 38% were UK qualified.  While the overall number of complaints received about overseas-qualified doctors was roughly representative of the group as a proportion of the medical profession (about 27%-29%), the number of cases, which were then referred up to the Fitness to Practice Panel, was extremely disproportionate. The study found this bias “impossible to explain”.  Several excuses were put forward for this anomaly – doctors working in pressure areas, locums, high-risk specialties and even the influx of doctors from the commonwealth in the fifties and sixties when the regulation was not as strict as it is now.  Concern has also resulted from several studies, which have shown that GMC handling of complaints appear to differ depending on race or “overseas qualification”.

Mortality among doctors referred to FTP:

In a response to a request for information using the Freedom of Information Act, the GMC revealed that 68 doctors had died during FTP proceedings.  The mortality and morbidity amongst doctors going through these procedures is one of the highest of any profession going through similar investigation.  In 2003/4 between 4 and 5% of doctors undergoing fitness to practice scrutiny died.

Dr Clare Gerada, chairperson of the Royal College of General Practitioners warned of over-regulation in 2011 (http://www.pulsetoday.co.uk/gerada-warning-on-over-regulation-after-documentary-secretly-films-gp-consultations/12822006.article#.VGjJGfmsWX8):

We already spend up to £1bn regulating doctors. We are one of the most over-regulated professions around and there will always be people who fall through. If we pile on more and more regulation, we will never win.

Sir Liam Donaldson, the then Chief Medical Officer, echoed concerns about the FTP procedures in his report “Good Doctors, Safer patients” in 2006 – In his view, complaints were dealt with in a haphazard manner; the GMC caused distress to doctors over trivial complaints while tolerating poor practice in other cases. In his report, which was broad ranging, he accused the GMC of being “secretive, tolerant of sub-standard practice and dominated by the professional interest, rather than that of the patient”.  (http://webarchive.nationalarchives.gov.uk/20130107105354/http://dh.gov.uk/en/publicationsandstatistics/publications/publicationspolicyandguidance/dh_4137232).

The GMC has now released this new guide to sanctions, which goes a long way to make it draconian to say the least.  There is nothing in the document to safe guard doctors against incompetent assessment.  We have seen that any doctor referred to the FTP is more often than not treated as guilty unless proven otherwise.  In a court of law, the accused is treated as innocent until proven guilty.  I would not be surprised if the statistics of deaths and morbidity among doctors referred to the FTP will increase due to the new sanctions guide.

Changes to our sanctions guidance

Reviewing how we deal with concerns about doctors:

A public consultation on changes to our sanctions guidance and on the role of apologies and warnings


Our proposed changes guide panels to:

  1. Take appropriate action to protect the public interest without being influenced by the personal consequences for the doctor.
  2. Take action in all cases where a doctor’s fitness to practise is impaired, unless there are exceptional circumstances which meet a specific definition.
  3. Take appropriate action to maintain public confidence in doctors even when a doctor has remediated.
  4. Consider more serious action where cases involve a failure to raise concerns, failure to work collaboratively, discrimination or abuse of professional position involving predatory behaviour.
  5. Consider the factors that may lead to more serious action where specific issues arise in a doctor’s personal life, which undermine confidence in doctors (e.g. criminal or civil proceedings).
  6. Consider specific aggravating and mitigating factors when deciding on the action to take in cases involving addiction or misuse of alcohol or drugs.

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In Praise of Bad Writing

This a post Re-Blogged from Russell Blake.  I like the clear writing style.  Mr Blake tells all of us something we had known for a long time, but afraid to say it out loud!! Rules of writing often ruins creativity!!  Read on if you want to know more!!

19 October 2012by Published in:Uncategorized57 comments 

Some of the biggest selling books in recent memory are not only popular, but also break a host of hallowed rules that many authors believe to be sacrosanct. Probably because they took a lit course in school, or read a book on writing, and were offered a host of these commandments that differentiate supposedly good writing from bad. You can always tell a budding author by the reviews they leave – when they start in on story arc, or showing instead of telling, or how bothered they are by adverbs, you know what you have – either a failed author, or worse, an aspiring one who believes that the counsel he/she received in the course of their study of craft is dogma, not loose suggestion. They know, KNOW, I say, what good writing is, because they were taught what it was, and insist on using all that wisdom to demonstrate their superiority.

The only problem is, many of the best-selling books of our time are poorly written, according to that dogma. Which means that if the authors had chosen to believe that they had to follow the rules, then the books would have been written differently, which would have made the books much different, and likely would have joined the millions of other “good” ones that fail to sell squat.

Because most readers could give a shit about the rules. They just want a good story, told in a compelling manner. They aren’t particularly interested in the two years of questionable advice authors might have gotten in college, or the five books on writing they’ve read. In other words, most readers either don’t know, or don’t care, about most of the rules.

That rankles certain personality types, I know. Because they are sure they understand what is good and what isn’t.

Put simply, as popular literature is concerned, what is popular is what is good, at least in crass commercial terms. Great literature that fails to find an audience over time is just slush pile. Nothing more. It’s a failed attempt to find readers. It happens. Sometimes those damned readers have their own ideas about what they like, and they might not have spent the time becoming an expert on craft like the authors have.

Now, I’m not saying that we as authors should toss the rule book aside. Many grammatical and punctuation rules are sound; based on clarity, efficiency and coherence. But writers have a lot of odd notions that dictate terms to them, to their detriment. Many supposedly-hallowed rules for good writing are simply preferences, or guidelines, to be applied or discarded on a case-by-case basis.

What are some of these rules?

Probably the most oft-heard differentiator of good writing from bad writing is, “Show, don’t tell.” Well, I’m here to tell you that rule is for asshats. Or rather it can be. Like everything in life, there are exceptions.

Want some examples? How about Fifty Shades of Gray, orHarry Potter, for starters? How about Twilight? Ever heard of those? You might have. One author is making a million bucks a week right now, and the other two are billion dollar franchises. Guess what? They violate the show/tell rule right and left. Almost from the get go, there’s lots of telling and very little showing. Far too little for the rules. Not nearly enough to be “good” books.

And yet people love them. And buyem in droves. And they sell. A ton. They are successes. Whether or not I would personally read one has far more to do with my taste and interest than it does with whether they are “good” or not. They are successes in a business where the overwhelming number of “good” books fail miserably. The Da Vinci Code is another that is rather pedestrian, prosaic  and heavy on telling. Characters come into the action and do monologues that feel as wooden as a dime store Indian to explain to the slow readers what’s going on. Tell tell tell. Bad bad book.

Except it’s one of the most successful books ever. They all are. And they all are “not good” according to many who purport to “know.” This notion is based, BTW, on Hemingway’s philosophy of eliminating most of the story, including exposition, so that the reader can be imparted the essence of it with hints the careful storyteller drops. A fine ideal, but one which isn’t practical in many cases. Showing is exhausting – not for me, but for readers. It’s also often inefficient. I respect Hemingway (and Orwell, who also was big on the idea of showing, not telling) but the truth is it’s a guideline, nothing more. When you see it used to criticize in reviews, it’s usually an unsuccessful author trying to assert superiority by showing off how much dogma he’s memorized (successful authors generally don’t have the time or interest in leaving negative reviews full of blather about showing vs. telling, adverb use, character arcs and the rest). As an example of the inefficiency of showing vs. telling, consider this: “His ass hurt.” Or, “Simon shifted on the seat, trying to get comfortable, the flare-up wreaking havoc on his piles again.” Sometimes “To be or not to be” is more efficient than showing us why it is important to question one’s essence. Good writing is generally efficient, entertaining writing.

Another rule that I hear all the time is regarding the use of adverbs. Many authors believe that adverbs are to be eschewed – that they are a sign of poor writing. This stems from the opinions of a few influential authors, most notably Stephen King (in my generation), who in his tome, “On Writing,” voices the opinion that adverbs are bad. Specifically, he dislikes them in dialogue tags. So what do most writers believe? Adverbs are bad. Just as a rule. Don’t want to be a bad writer, now do you?

Look. Adverbs are words or phrases that modify verbs. I understand that they can be overused in dialogue tags. But adverbs convey useful information, and to eliminate them to the extent possible, as some do, makes about as much sense as a designer declaring she won’t use a primary color (that last bit was plagiarized – brilliant, though, isn’t it?).

It reminds me of the wine business. I know a little about wine, and have friends that are wine makers, and they know how to make and judge a good wine. They spent years in school learning how. They have rules. They are rigid rules, about acidity, alcohol levels, residual sugar. And guess what? Most wine drinkers, including the experts in blind studies, like badly-made wines. They prefer those with too little acid and too much alcohol and sugar. My favorite example is Yellow Tail Shiraz – the most popular red wine in the world for a decade. Guess what? It has staggering amounts of residual sugar and hardly any acidity or tannin. It is universally  understood to be a bad wine, from a technical perspective.

It’s probably a good thing that the makers don’t care. Imagine if they had followed the rules and dropped the sugar levels to what “good” wines should be, and boosted the tannin and acid? They’d have a “good” wine like all the other good wines out there that aren’t selling.

I think one needs to know the rules, and then judiciously apply them, and chuck them if you feel the need. You’ll get some bad reviews, sure. Other authors, mainly, will critique your work and go on about insufficient character development, showing instead of telling, clunky dialogue tags, adverbs…

So what is the takeaway here? That your first job as an author is to craft a compelling story, well told. The well told part is up to your taste. Readers will ultimately decide whether you had a compelling story, well told. If they don’t want to buy it and read it, it probably isn’t. If they do, then you can laugh your way past all your haters that “know” your book isn’t “good.”

That’s not to say you shouldn’t know the rules. You should have The Elements of Style memorized, and take its counsel to heart. Rule number one: eliminate unnecessary words. I am not counseling ignorance. Rather, I’m saying that you should know all the rules, and then feel free to chuck as many of them as you feel like if it will make your story better told or more compelling. Not to an English professor. To readers. Because at the end of the day, readers decide what is good and what isn’t, voting with their wallets.

And speaking of voting with their wallets, a little horn tooting here. JET has been in the Amazon Top 500 paid for two solid weeks now, and JET II – Betrayal is closing in on it. Thank you to all the readers who have voted for JET – I can only hope that keeps up. If you feel inspired to give a book I describe as “Kill Bill meets Bourne” a whirl, you can get JET here. And on a final self-promotion, I’m happy to report that JET III – Vengeance should be ready for release by Nov. 1, mas o menos. I guess I better get busy on JET IV for X-mas, huh?

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5 Common Writing Blunders that Can Annoy or Bore Our Readers

5 Common Writing Blunders that Can Annoy or Bore Our Readers.

This is a must read for all aspiring authors.  I wish some of the “established” authors had read this before producing some awful “classics”.

This is probably useful read for those book addicts as well.  Have you ever come across a book that you hate so much, but cant really tell why?  If you read this brilliant post by Kristen Lamb, it will all become clear.

Have you ever come across a bore in the friends new-year’s party who kept on and on about numerous people he or she had fights with in the past year!!  Now you will be able to recognise before they can launch into the second version.


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