Ski Club 2.0 Home
Snow Reports
FAQFAQ

Mail for help.Help!!

Log in to snowHeads to make it MUCH better! Registration's totally free, of course, and makes snowHeads easier to use and to understand, gives better searching, filtering etc. as well as access to 'members only' forums, discounts and deals that U don't even know exist as a 'guest' user. (btw. 50,000+ snowHeads already know all this, making snowHeads the biggest, most active community of snow-heads in the UK, so you'll be in good company)..... When you register, you get our free weekly(-ish) snow report by email. It's rather good and not made up by tourist offices (or people that love the tourist office and want to marry it either)... We don't share your email address with anyone and we never send out any of those cheesy 'message from our partners' emails either. Anyway, snowHeads really is MUCH better when you're logged in - not least because you get to post your own messages complaining about things that annoy you like perhaps this banner which, incidentally, disappears when you log in :-)
Username:-
 Password:
Remember me:
👁 durr, I forgot...
Or: Register
(to be a proper snow-head, all official-like!)

Any doctor's on here???

 Poster: A snowHead
Poster: A snowHead
rayscoops, but you wouldn't go private, you would be in A&E.
snow report
 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Rayscoops, firstly - as Frosty the Snowman points out - outside London you would not encounter a private A&E set-up and attendances would be by referral only. Secondly - if I worked full-time at a such a private hospital I would be likely to be part of a culture of over-investigation and billing and subtle organisational pressures might be brought to bear... wink but I don't so I don't know how I would respond.

Lastly - this actually a matter of legal requirements - and - having got into a fight recently with a department who refused to do a necessary x ray I had requested - because they felt the legal criteria were not met - I can tell you there is also a legal obligation on those taking the xrays.

Your Back Pain is a good example . For the most part except post-trauma - or in certain conditions in younger people or the elderly - or under specialist supervision - Lumbar Spine plain xrays are pretty useless and have a huge radiation dosage and CSAG and national guidelines say do not do them, yet some patients expect them, some physios push for them, some chiropractors do them. What is really needed often is the more expensive test - an MRI (or sometimes a CT) - so that is what we try and get.
snow conditions
 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
I craked my ribs surfing a few years ago. I'd say my symptoms were very similar to yours in that I had lots of pain, gradually easing over time (about 3 months before it completely went). I had real problems sleeping as everytime I moved I woke up, and getting out of bed was also a struggle as the movement seemed to make things worse.

I was able to "live a normal life" though! If I ran it hurt as my upper body moved.

If I were you I would go for maximum rest between now and holiday - warm baths, relaxation etc. Just so you can heal your body. I'd probably not take too many pain killers in the hope that saving them will make their effect more dramatic when you use them all skiing. I'd also listen to your body and take it easy when you do ski. Since holding the injured part of my rib cage helped a little I would imaging strapping it up in somewhat might also assist you; maybe even a corset or something to stop the jarring.

I wouldn't like the thought of puncturing your lungs and I suppose I can see how this might happen.

My view would be that by the time you ski, if you've not done further damage between now and then you'll really be just managing the somewhat lessoned pain. But it does take a while and seems to only get better ever so slowly.

Best of luck.
ski holidays
 You need to Login to know who's really who.
You need to Login to know who's really who.
Quote:

Lastly - this actually a matter of legal requirements - and - having got into a fight recently with a department who refused to do a necessary x ray I had requested - because they felt the legal criteria were not met - I can tell you there is also a legal obligation on those taking the xrays.


Stoats, you might be over-egging the "legal requirements/obligations" pudding a bit there. My memory is that a dose of irradiation from a typical CXR is equivalent to about 2-4 weeks of natural/background irradiation that we all are exposed to day in day out. Thus, while there is no doubt that some firm of clever solicitors drafted a wonderful set of "best practice" guidelines to reduce potentail exposure (and, lets be honest, potential costs), there is little or no chance that a patient who ended up with cancer would succesfully sue a hospital for a few unneccessary xrays - there is no way they could show that the xrays were the cause of their cancer unless you are literally strapping down your patients and taking hundreds of xrays at a time (hopefully you are not doing that...).

Quote:

FWIW - I'm a doctor. Two pieces of advice 1) Don't ask for medical advice on a skiing forum. 2) Don't take advice from a doctor willing to give it on a skiing forum.


actually, i'd be more inclined to take advice on a (good) forum like this one - when docs are freed from the potential consequences of an adverse outcome, they tend to give more practical, honest and real advice - it's the "down the pub" phenomenon - you always get better advice from your mate who is a doctor in the pub than from your GP who gives you the most conservative advice possible just in case...... admittedly, advice on the best Sweedish pumps on the market on a pint enlargement forum would be less reliable but we all make mistakes.... Embarassed
ski holidays
 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
Chect

I do a bit of mountain biking and whacks to the the ribs are fairly common. Seems to be a general philosophy among that fraternity (I'm no medical expert of course) that if when sitting up out of bed, sneezing, coughing or such other activity that engages the ribs - if the pain is so extreme you want to pass out or scream out loud then there is a break or substantial damage. If on the other hand it is painful/ uncomfortable/ generally sore then the damage is bruising/ muscle damage and nothing to get overally worried about and take it easy as pain dictates. Sounds like you are at the latter stage and can make the decision yourself wether to go or not Puzzled

Cue professional slating coming up. Little Angel
snow report
 You'll need to Register first of course.
You'll need to Register first of course.
stoatsbrother, thanks for that and thanks for staying on this topic, I understand that when you are giving advice and some muppet gives you a bit of stick that that it is easier to sat 'to hell with it', but i do recall getting a bit of flack from you on a few property issues Laughing which is my profession so maybe we are even wink

I must point out that I have spent a lot of time away from UK so most of my medical cover has been ‘private’ or paid for by me out of my own pocket, so please take that in to consideration.

I tend to avoid doctors and hospitals, but whilst playing rugby in Asia we had a doctor who played for us and was also a consultant at a major hospital (and earned his money based upon what he charged his patients) and as is the case for anyone working abroad we all tended to support each other, so if we had a sports injury we would go and see him, and in return he would give us a discount on medical treatment. I hurt my back (compression of the discs as I now know) and went to see him and he sent me for an x-ray, which showed no damage (I am now led to believe that an x-ray is little more than useless in such circumstances), anyway what the x-ray did show was my previous two snapped ribs and, the big blob where they had healed and that they had not really healed in a straight line. Now in this example whereby I was paying at the 'point of service', if i had gone to him with sore ribs he would have x-rayed me (in the same way he had done so for the back pain) with out a second thought, the issue of irradiation would obviously not have been a 'real issue' and I also would have known not to have been too hasty in getting back in to training because of the two snapped ribs, and the team (our team) would have had to take this in to consideration (and made alternative arrangements for loose-head prop cover), so it would be have been useful to have had the x-ray. It was not a necessity to have had the x-ray but it would have been a preference.

In comparison under NHS/A&E protocol I can believe that if an x-ray is not a necessity then it should not be instructed, but that protocol must have as much to do with expenditure as anything else (one doctors'/countries 'over prescription' is another’s 'under prescription'), in the same way that instructing an x-ray under 'private' medical care in exactly the same circumstances is also driven by similar but opposite financial considerations.

I am not saying that you, as a NHS doctor, actively refrain from instructing x-rays as a means of saving money, but the basic principal of NHS service is without a doubt influenced by financial factors, and as such, the protocol under which you operate (as dictated by NHS) is likewise influenced by financial matters.

Specifically whereby some one comes to you with a suspected broken rib, you may not instruct an x-ray but your overseas 'private' equivalent may well instruct an x-ray under exactly the same circumstances, so the basic fundamental and underlying factor must be influenced by 'financial' rather than medical reasons, otherwise doctors working under the 'private' medical care protocol would not, in direct and conflicting comparison, be sending such patients for x-rays Puzzled

So I respectfully stand by my statement ‘The only reason UK doctors do not xray for possible broken ribs is for financial reasons’
ski holidays
 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
rayscoops, read the background to the european regulations. Your last sentence is both wrong and insulting. Our first principals include beneficence and non-malefeasance. Plain CXRs in minor chest trauma are unethical on both grounds.
snow report
 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Quote:

‘The only reason UK doctors do not xray for possible broken ribs is for financial reasons’

stoatsbrother has explained exactly why this was wrong, rayscoops. He is correct.

I was deliberately negative initially because I knew loads of people would say, 'don't worry, it'll be fine'. It probably will be (& I'd probably be still going skiing if it were me) but chect2000 hadn't considered what might go wrong in the OP. You do need to take care & accept that you won't be able to ski as hard as normal.

Sometimes people need to be told the absolute worst that might happen, to see if it changes their attitude to the risks. I would have been back on sooner but I was busy (skiing Razz ).
latest report
 You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
stoatsbrother, my sentence may be wrong but it is not insulting, but in any case why are the x-ray facilities here in Swansea clogged up full of Ospreys rugby players and Swansea footballers having x-rays for bruised ribs and minor stomach/rib muscle tears and the like (and lets not even talk about access to MRI facilities otherwise I might blow a gasket - especially when the decision whether or not to refer me recently for an MRI scan was governed by my answer to my GP's question 'do you have medical insurance'?)

Is it that because they are paying for x-rays that these european regulations, beneficence and non-malefeasance (good words btw wink ) are not implemented or recognised in such cases?


Last edited by You'll get to see more forums and be part of the best ski club on the net. on Thu 8-01-09 15:25; edited 1 time in total
snow conditions
 Ski the Net with snowHeads
Ski the Net with snowHeads
Quote:

rayscoops, Pro sportsmen often take courses of treatment that are not in their long term best intertest.

as Frosty says - although personally I spell it 'interest' Very Happy
latest report
 snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
what...snow, I have no problem with the idea that a rib injury does not need an x-ray and that we should all just get on with and continue with our recreational sports when our bodies and pain levels allow, but when doctors are happy to make x-ray referrals for sportsmen & women and half the world’s doctors are happy to refer a patient for an x-ray I do not think it unethical, but the principal as a whole of administrating medical care that is not necessary may well be.

stoatsbrother, so are UK doctors that refer such sports men for an x-ray when they have taken a knock to the ribs acting unethically ? and in conflict with european regulations ? are they breaking some law? if you were a team (Olympics) doctor would you refer a javelin thrower for a chest x-ray to find out if he had hair line fracture of a rib? Are ethics subject to degree and circumstance?
snow report
 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
Quote:
actually, i'd be more inclined to take advice on a (good) forum like this one - when docs are freed from the potential consequences of an adverse outcome, they tend to give more practical, honest and real advice - it's the "down the pub" phenomenon - you always get better advice from your mate who is a doctor in the pub than from your GP who gives you the most conservative advice possible just in case......

Don't take advice from a doctor in a pub either. I'll tell you all sorts of nonsense once I've had a pint or two. Oh - and by the way definitely don't take advice from me over dinner in a ski chalet.
I don't want to sound pompous but medicine should really only be practiced face to face when in possession of all the info you might need and when both of you are sober. The crime of negligence is not in your decision/ advice being wrong but in not putting yourself in a position where you have enough info to make that decision/ give that advice. Not all of us have given in to a culture of defensive medicine and we are willing to do what is right rather than what will satisfy the "customer".
ski holidays
 So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
Quote:

rayscoops, read the background to the european regulations. Your last sentence is both wrong and insulting. Our first principals include beneficence and non-malefeasance. Plain CXRs in minor chest trauma are unethical on both grounds.


Stoats, I think you are being a little disingenuous now!

1. The ethical principles of beneficence and non-malefeasance essentially mean "Do no Harm" - a chest xray, for all practical purposes, does no harm - it is more dangerous to walk into a hospital than to have one xray.

2. Rayscoops has raised a genuine point about the financial considerations in the practice of medicine. You reply to his and others similar points by`blindly quoting sections of the GMC's guide to ethical conduct. This suggests you are a) Mother Teresa, b) deliberately taking the wee wee or c) very inexperienced/naive.

3. You gote the European Guidelines on Imaging, page 96. Take a closer look....

In minor trauma, a CXR is not "routinely indicated". This does mean it is not indicated. Putting my legal hat on, the proper legal interpretation is that, if a patient has any symptom that MAY indicate more significant pathology, a chest xray should be considered. Such symptoms would include pleuritic pain, difficulty or shortness of breath or excessive pain (some of which i believe Chect had).
In addition, a chest xray is indicated in moderate trauma. I dont see a definition of moderate trauma which leaves this very open to interpretation and, again, if the trauma was anywhere close to a moderate level, a chest x-ray would certainly be indicated.

There is nothing worse than when one parties' own evidence does not support their argument.....
ski holidays
 You know it makes sense.
You know it makes sense.
Quote:

Don't take advice from a doctor in a pub either. I'll tell you all sorts of nonsense once I've had a pint or two. Oh - and by the way definitely don't take advice from me over dinner in a ski chalet.


I find that I do everything better after a couple of drinks on board.....
snow report
 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
rayscoops, I think I agree with what I think you are trying to say.

By p96 of the Europen Guidelines on Radiological Imaging, my attention had started to slip zzzzzz.......
snow report
 Poster: A snowHead
Poster: A snowHead
rayscoops wrote:

stoatsbrother, so are UK doctors that refer such sports men for an x-ray when they have taken a knock to the ribs acting unethically ? and in conflict with european regulations ? are they breaking some law? if you were a team (Olympics) doctor would you refer a javelin thrower for a chest x-ray to find out if he had hair line fracture of a rib? Are ethics subject to degree and circumstance?


They are certainly subject to circumstance.

I would imagine that in the example of the javelin thrower for instance, it would be more useful to know whether the ribs were actualy broken than it would be with a general member of the public, because while it won't affect "general" treatment, it may affect sports physiotherapy treatment.
snow report
 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
rayscoops wrote:
stoatsbrother, serious question, if you were working in a private hospital and I turned up with suspected broken ribs (and I had not had an x-ray for a few years) and I was going skiing in one/two weeks time, bearing in mind I would be paying for my x-ray on a 'cost-plus' basis that would be generating revenue for the hospital, would you refuse my request for an x-ray ?


Absolutely yes.
latest report
 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
Kramer, right answer Very Happy but you would not last wink what if I was JW before a rugby world cup final, or Chemmy with a chance of winning (stretching it a bit here Laughing ) a skiing title of some sort?
snow report
 You need to Login to know who's really who.
You need to Login to know who's really who.
I don't think that knowing whether a professional sportsperson has a rib fracture or not would affect the advice given to them either. Again it would be to return to training, and sports as pain allowed. The idea that you can tell how long they would be out compared to a serious contusion is incorrect IMO, people are so variable.

One area where sportsmen do get treated very differently is with knee injuries, getting acute MRI scans. rayscoops is right, partly the reason that we don't do acute MRI scans on everyone with a knee injury is due to cost-effectiveness issues, but I can honestly say when it comes to plain x-rays, cost is not a factor in deciding whether to do one or not.

foggy I don't see giving advice on here being terribly different to telephone consultations, something which works quite well for us in General Practice (although I admit there's little research on it). Often you'll see the advice given on here that the person needs to see their own (or a 'real') doctor, but often I think that people get their concerns clarified, something that's not always done particularly well by us doctors in face to face consultations. I don't think that there's a big problem with that.

The main problem with asking for medical advice on a skiing forum is that you have no way of knowing the providence of the advice that you are getting.
snow conditions
 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
I am so glad that i opened this can of worms up yesterday by mentioning the x ray word!!!!
ski holidays
 You'll need to Register first of course.
You'll need to Register first of course.
Kramer, JW could play rugby in two weeks if his ribs are just bruised and he does not have cracked ribs , if he does have cracked ribs he would not play until the fracture has healed (say 6 weeks) for fear of them snapping and pucturing a lung or whatever upon impact, so it is not necessarily a pain issue, it is a medical issue whether he plays or not, so in which case would you refer him for an x-ray?
snow report
 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
rayscoops, how would you know when the fracture had healed? How could you be sure that he didn't have a fracture if his first x-ray was 'normal'?

Also like I said, I'm not sure how much a risk the idea of further trauma to the area puncturing a lung is.

So no I wouldn't.
latest report
 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
If it was either JW or that blonde bird, I'd see them the day before the final/race, and spring their ribs, see how they reacted.

rayscoops, you seem to have this belief in the magical ability of an x-ray to diagnose and give prognosis on problems, whereas the truth is, in many areas they're not particularly good.
snow conditions
 You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
drkpower, several of us here who routinely see chest/rib injuries have said we do not routinely do xrays. There needs to be a justification. The whole issue arose because empinky implied they were necessary and useful - when in most cases they are neither - espescially in the lower ribs. I made my point about costs quite clearly - plain xrays are so cheap cost is not the issue - it may be for some other interventions. The bottom line is - if a potentially harmful test is not going to alter management - it is unethical to do it. If you cannot appreciate that - I would love to know which clinical area you work in. I also suspect you need to speak to a radiologist about current UK ionising radiation recommendations too.

Far from rayscoops rasing a genuine point about costs and medicine he actually said "‘The only reason UK doctors do not xray for possible broken ribs is for financial reasons’ despite several Drs on this thread having previously given very clear other reasons.

Nice bit of troll-feeding btw rolling eyes

rayscoops, Unlike Kramer I think it does make a difference it was a professional sportsman, as one of the things they sign up to effectively - is a higher and more dangerous level of medical intervention with earlier and more risky return to activity. Some US NFL stadiums have MRI scanners in the sick room.

empinky, nice one!
latest report
 Ski the Net with snowHeads
Ski the Net with snowHeads
stoatsbrother, when I said 'The only reason UK doctors do not x-ray for possible broken ribs is for financial reasons’ I did not mean you (as a doctor) sit in A&E and go through some quantitive thought process, count up how many x-rays you have referred that day and think better keep the numbers down to save a few bob, I was talking about the 'umbrella of the NHS' under which doctors operate (and specifically made reference to UK doctors) and the financial regime which is in place to run hospitals. Some UK doctors would refer some one with chest pain for an x-ray (sportsmen) and some some UK doctors (private) would refer Joe Public for an xray if they were paying for it.

but earlier you said
stoatsbrother wrote:
In an ambulatory patient - not involved in a high energy/ multi-trauma scenario - if they have localised tenderness, and no signs of pneumothorax and/or surgical emphysema - and they come and see me as a GP - or if I were still in A&E - they ain't getting an X ray.
. A sportsman plying his/her trade will in all likelihood be referred for an x-ray under their medical insurance, but a bricklayer or scaffolder covered by NHS 'ain't going to get one' and I do not see the distinction between the two unless it is money related.
ski holidays
 snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
Quote:
I don't see giving advice on here being terribly different to telephone consultations, something which works quite well for us in General Practice (although I admit there's little research on it). Often you'll see the advice given on here that the person needs to see their own (or a 'real') doctor, but often I think that people get their concerns clarified, something that's not always done particularly well by us doctors in face to face consultations. I don't think that there's a big problem with that.

At the risk of turning this into a tired old GPs thread - the great difference between this and a telephone consultation is that with the latter you know who you are talking to and generally will have access to their notes (notwithstanding the constraints of OOH etc). I am concerned that the advice that should appear as "YOU HAVE A BROKEN RIB YOU WOULD BE DAFT TO FLY AND/OR SKI" "but being reckless I might be tempted to give it a go" will be taken as "blah blah blah blah" "GIVE IT A GO". In personal (better expression than face to face) consultations we should be putting great effort into making sure the recipient of our pearls of wisdom understands them and their potential consequences which is just not possible with advice cast into the ether.
latest report
 And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
foggy, let the buyer beware Laughing
snow report
 So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
So if you're just off somewhere snowy come back and post a snow report of your own and we'll all love you very much
foggy, very fair points.

rayscoops, nope you are still missing the point and ignoring what I and others said - so not really any point in discussing it any further is there? rolling eyes
latest report
 You know it makes sense.
You know it makes sense.
rayscoops, please stop annoying the doctors - lots of us on here find their professional contributions entertaining, interesting and useful. (I agree with you on the 'buyer beware' point, though.)
snow conditions
 Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
Quote:
let the buyer beware

"Well, your honour, I gave him a load of useless advice and then he died but - hey - caveat emptor" I really can't see that running well in a law court - can you?
latest report
 Poster: A snowHead
Poster: A snowHead
Quote:

drkpower, several of us here who routinely see chest/rib injuries have said we do not routinely do xrays. There needs to be a justification. The whole issue arose because empinky implied they were necessary and useful - when in most cases they are neither - espescially in the lower ribs. I made my point about costs quite clearly - plain xrays are so cheap cost is not the issue - it may be for some other interventions. The bottom line is - if a potentially harmful test is not going to alter management - it is unethical to do it. If you cannot appreciate that - I would love to know which clinical area you work in. I also suspect you need to speak to a radiologist about current UK ionising radiation recommendations too.

Far from rayscoops rasing a genuine point about costs and medicine he actually said "‘The only reason UK doctors do not xray for possible broken ribs is for financial reasons’ despite several Drs on this thread having previously given very clear other reasons.


Stoats, I take your point that a test that will not alter management is a test, all things being equal, that should not be performed. What i take issue with is that the basis for not doing so is on legal grounds (i think you referred to legal obligations/requirements). That simply doesn't stand up in respect of a test (chest xray) that has such minimal adverse effects. It is fair to say that one of the primary reasons for guidelines of the nature of the ones you quoted is in order to best manage healthcare resources which is ultimately a matter of expense/cost/money/whatever.

BTW,im a former/ex/disillusioned/failed/incompetent doctor (take your pick) who is now a medical lawyer so that is the background to my intervention but i will gladly bow to your (and the other docs) clinical judgments.....
snow report
 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
Any of you old 'uns remember Clarks shoe shop X-ray machines? Now the shoes had, supposedly, 3 months growing room. So every 3 months, (school holidays so you always had to queue!) your mum dragged you off to Clarks where your feet were X-rayed, to see if you needed new ones. This went on from about age 2 to 14 (when we refused to wear Clarks anymore Laughing ). Thousands of kids had dozens of X-rays during our childhoods Shocked .

My dentist X-rays my mouth every 3 years too. Should I object?
ski holidays
 Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
maggi, I remember those...

drkpower, Yes the dose per person for a CXR is small ( 3 days background exposure compared to 7 months for a Lumbar spine xray) and living in Cornwall (Radon exposure) would be far worse. But what counts is the total population exposure, and the overall risk to the population. We have a duty - and one which our radiology department tell me is now enshrined in both regulations and law, to minimise unnecessary exposure to ionising radiation.

Not a bad career move - a friend of mine headed that direction and is now a judge
ski holidays
 You need to Login to know who's really who.
You need to Login to know who's really who.
foggy, are there many cases of doctors giving advice in a non-medical internet forum and being successfully sued? Haven't seen any reported myself and I think it's a pretty unlikely scenario, unless the doctor giving the advice has been exceptionally stupid - which snowHead doctors do not seem to be. Perhaps drkpower can opine (this is well outside my own specialities.)

maggi, my dad wouldn't let me have my feet x-rayed in those machines and of course they were abolished in the end. I think some dentists are a bit happy-go-lucky with x-rays, but every three years doesn't sound too bad (not that I know the actual technicalities of the dangers.)
ski holidays
 Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
stoatsbrother,
Quote:

Not a bad career move - a friend of mine headed that direction and is now a judge

See here from today's Thunderer, especially
Quote:
highly qualified lawyers are put off from applying to be High Court judges because the job requires a big cut in salary and the lifestyle is seen as unattractive and lonely.
snow conditions
 You'll need to Register first of course.
You'll need to Register first of course.
Hurtle, does it part time - collects more money at the Bar.
snow report
 Then you can post your own questions or snow reports...
Then you can post your own questions or snow reports...
Kramer, I am fully aware that an x-ray may well be inconclusive, but if JW is shown to have a fractured rib then he will not be playing in the WC final and the team can get on with organising things without him and it would limit any further distractions and this is, in some ways, more valuable information than if the x-ray shows no fracture and may therefore be inconclusive; this is not the point though - I am more interested in the fact that JW will, with out a shadow of a doubt, be given that x-ray, whereas a steel erector with the same symptoms will not get that x-ray under NHS, and certain reasons have been put forward as to why an x-ray is not routinely prescribed under NHS, which is what I am disputing and why I suggested that there were financial reasons underpinning the issue (institutional rather individual ‘doctor’ driven reasons)

stoatsbrother, you have been twisting and turning like a twisty turny thing wink , but you firstly suggested there was some European guideline that prevented doctors requesting an x-ray to look for a broken rib (quote - The European radiology guidelines (based on the UK ones) say do not do a CXR routinely in minor chest trauma) but that guideline is non specific to the point in question and has been nicely ‘batted back’ to you by drkpower, you also suggested that x-rays which do not help with diagnosis are refused because of the risk of cancer (quote - and I think you say to patients that your rib may be/is probably cracked/broken, but since an X ray will not alter the treatment and may give you cancer - we don't do one) which is quite ridiculous when we consider the proliferation of x-rays in modern medicine and shoe fitting (maggi, Laughing ), you then change tack a little suggest that there may be circumstances whereby an x-ray is appropriate to inspect for a broken rib (quote - I can see that if someone "needed" to play football (because of their cost to the club) at a professional level 3 days later, the situation might be different) and then criticize European doctors who do refer patient for x-ray for potential broken ribs (quote - sometimes maybe it is because it is easier than spending time explaining the situation. Sometime perhaps it is because of unjustified fear of legal consequences) which has again been batted back by drkpower, there has been also been examples on here of peeps who have been given x-rays to check for broken ribs (abc, in USA [I presume], Patch, in France, myself in Asia, maybe some others but I became bored looking).

I understand that it seems pointless referring a patient for x-ray whereby the subsequent treatment has no bearing upon the out come of the x-ray, and that it is good practice to minimize exposure to radiation, but nevertheless it seems a fairly common place practice outside of UK NHS , You had proffered such reasons as cancer, to stop snowheads expecting an x-ray, the radiology department would refuse it any way, that you may not even get a good view of the rib, European radiology guidelines, foreign doctors have other motives etc. etc, etc. and this is why I made the comment ‘The only reason UK doctors do not xray for possible broken ribs is for financial reasons’ , (and I wish I had expressed my self a little better at the time). The reasons you gave seemed fanciful and sometimes the simplest explanation is the real explanation - that in all probability the reason that it is not common place (now or historically) in UK NHS is simply to avoid unnecessary expenditure when it could better be used elsewhere, and nothing you have said suggests otherwise Very Happy
snow conditions
 After all it is free Go on u know u want to!
After all it is free Go on u know u want to!
Quote:

foggy, are there many cases of doctors giving advice in a non-medical internet forum and being successfully sued? Haven't seen any reported myself and I think it's a pretty unlikely scenario, unless the doctor giving the advice has been exceptionally stupid - which snowHead doctors do not seem to be. Perhaps drkpower can opine (this is well outside my own specialities.)


Interesting Q., Hurtle. Ordinarily, because there is no official contractual (doctor-patient) relationship created in a non-medical forum, an action wouldnt be possible. But there is a specific tort in negligence of negligent misstatement (which doesnt require this contractual relationship) where someone relies, to their detriment, on incorrect information provided by someone who holds themselves out to have a particular skill/profession. I dont think a case has ever been (succesfully) taken in respect of information provided over the internet but, in theory, its possible.

The difficulty for any sponger hoping to rely on this tort is that they would need to show that a reasonable person would have relied on this information in the manner in which the sponger did and that would be tricky to say the least!!

I charge about £300 an hour so i'll send you the bill......
latest report
 You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
rayscoops, you just don't listen do you... I have - as you said - given many many reasons - all of which are reasonable (and there can be more than one reason) - none of which are financial (it is a very cheap x-ray) - and you insist on assuming that the financial reason is the only one.

You are either trolling or the property crash is doing your brain in. I suspect the former.

over and out
snow report
 Ski the Net with snowHeads
Ski the Net with snowHeads
drkpower,
Quote:

I charge about £300 an hour so i'll send you the bill......
Er, please don't bother, particularly since your answer is exactly the one I would have given, after a short period of gazing through a glass darkly at the law of tort I learned many moons ago! (Just checking. wink )
snow report



Terms and conditions  Privacy Policy