CONTENTS IN THIS ISSUE


HUGH Miller was a remarkable man by any standard – a Victorian populariser of science, a Brian Cox or David Attenborough of his day, though the subject being geology. He was born in 1802 and dropped out of formal education after a violent row with his schoolmaster, apprenticing then as a stonemason where the fossils he encountered sparked a passionate interest in palaeontology. Self-taught he became an expert in the field, discovering several important species of Devonian Age fish – one bearing his name, the placoderm Pterichthys milleri – though geology was only one facet of this complex man.


Miller ended his own life with a pistol in 1856 and the event


shocked the nation and beyond, not least given his firm evangelical faith. On page 12 James Finlayson looks at one surprising aspect of that tragic event – Miller’s friendship with an Edinburgh professor of surgery later criticised for overstepping professional boundaries.


12 12 On page 14 we profile QC Christina Lambert in her role as


barrister representing MDDUS members facing legal and regulatory proceedings – it’s a job that calls for cool nerves, quick thinking and a certain “love of performance”. Phil Higton of Terema is well known among risk consultants, applying his experience of “human factors” training as a former airline pilot to improving patient safety. On page 18 he addresses “authority gradients” in dental practices. Are staff comfortable speaking-up when they spot a potential disaster? Our Q&A in this issue (page 10) features Professor Helen


Lester who leads a team developing clinical indicators in QOF. Is it just a box-ticking exercise or has the QOF lead to significant improvements in health? And on page 16, Dr Jonathan Berry considers the fraught question faced by all GPs at one time or another – to refer or not to refer in a patient suffering with acute abdominal pain.


Jim Killgore, editor


THE FINAL DAYS OF HUGH MILLER


James Finlayson looks at the death of the Victorian science popularist Hugh Miller and draws an important lesson in medical professionalism


14


TAKING SIDES Last in a series of profiles on


professionals who work with MDDUS – Jim Killgore chats with QC Christina Lambert


16 18


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Cover image: Rathmelton by Lynn McGregor


Lynn McGregor was born in Pittenweem, Fife and trained at Edinburgh College of Art. Lynn’s semi-abstract paintings are influenced by the Scottish and Irish landscape. Rathmelton


is a small town situated at the mouth of the River Lennon in County Donegal, Northern Ireland.


Art in Healthcare (formerly Paintings in Hospitals Scotland) works with hospitals and healthcare communities across Scotland to encourage patients, visitors and staff to enjoy and engage with the visual arts. For more information visit www.artinhealthcare.org.uk, Scottish Charity No: SC 036222.


WINTER 2013


CLINICAL RISK REDUCTION GP Dr Jonathan Berry considers


when to refer in acute abdominal pain


CONSIDER YOUR DENTAL CO-PILOT


Risk training consultant and former pilot Phil Higton highlights “human factors” in safe and effective dental team working


Editor:


Jim Killgore Associate editor: Joanne Curran


Editorial departments: MEDICAL Dr Gail Gilmartin DENTAL Mr Aubrey Craig LEGAL RISK


Simon Dinnick Peter Johnson


Please address correspondence to:


Summons Editor MDDUS Mackintosh House 120 Blythswood Street Glasgow G2 4EA


jkillgore@mddus.com


Design and production: CMYK Design 0131 556 2220 www.cmyk-design.co.uk


REGULARS 4 Notice Board


6 News Digest 8 Employment Law: Amending contracts


9 Ethics: You think what? 10 Q&A: Professor Helen Lester 20 Case studies: Bleeding gums… again, A matter of opinion, Just a tummy bug?


22 Addenda: Principled sacrifice?, Roman vaginal speculum, Crossword and Vignette: Sir James Whyte Black, doctor and pharmacologist


Printing and distribution: L&S Litho


Summons is published quarterly by The Medical and Dental Defence Union of Scotland, registered in Scotland No 5093 at Mackintosh House, 120 Blythswood Street, Glasgow G2 4EA. • Tel: 0845 270 2034 • Fax: 0141 228 1208


Email: General: info@mddus.com • Membership services: membership@mddus.com • Marketing: marketing@mddus.com • Website: www.mddus.com The MDDUS is not an insurance company. All the benefits of membership of MDDUS are discretionary as set out in the Memorandum and Articles of Association.


The opinions, beliefs and viewpoints expressed by the various authors in Summons are those of the authors alone and do not necessarily reflect the opinions or policies of The Medical and Dental Defence Union of Scotland.


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