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SIR DERRICK DUNLOP
1301 It can be predicted that professional reactions to the Bill will be the same as they were towards its predecessor. The wider powers of the medical
adviser, shifting the emphasis away from policing to advice, will be welcomed, and there are few defenders of the wholesale examination of young persons as at present practised. On the other hand, there will be regret that responsibility for the service is to remain with the Department of Employment rather than that of Health and Social Security (particularly now that Health is developing occupational health services for hospital staff). If indeed the new advisers are to be specialists in occupational medicine, all will applaud -but many will watch critically to see what criteria will be held to justify the title of specialist, and where the new recruits, particularly the part-timers, will be found. It is unfortunate that the Government apparently does not intend to await the report of the Robens Committee, which might well have recommendations to make which would be pertinent to the proposed legislation; and assurances will again be sought from Government that the advisory service provided by this limited measure will not be passed off as a national occupational health service.
BREAKTHROUGH
RELATIONS between medicine and the mass media seldom easy and may become distinctly strainedfor example, when hearts are transplanted or Siamese twins separated. The greater the public interest, the more potentially explosive the situation. The faults in both camps and the friction that sometimes arises were given a good airing at a meeting arranged by the of Edinburgh last month. Royal College of Physicians One problem is the " breakthrough " story. Experience has taught the medical profession that it is difficult, if not impossible, to assess the true worth of any new claim until it has been further tested in practice or confirmed by other workers. Recognition is usually a very gradual process. How many genuinely sensational medical breakthroughs-quickly, widely, and convincingly recognised as such, with no subsequent disappointment-have there been in the past 100 years ? X-rays, insulin, and penicillin would perhaps qualify, but the total is surely very small. Yet excessive caution can be irritating to journalist and public alike, and some compromise is needed, however much we want to avoid raising false hopes. Bad news causes as much trouble as good news. If an epidemic breaks out, if a food or pill is suspected of having harmful effects in some of those who take it, or if serious deficiencies in the care of patients are alleged, the doctor’s immediate instinct is always to reassure, to play things down, to lower the temperature of the situation in the same way that he seeks to lower his patient’s temperature, however serious his private views and however strongly he privately urges drastic action. The popular-newspaper editor sees things differently. Occasionally his readers are grateful for reassurance. More often they want to be stimulated, even frightened, by sensational stories that give everybody something to talk about. Few members of the are
little exaggeration that adds colour the situation. Rather than criticise journalists for being realistic about this very human failing, the doctor would do well to try and understand it and come to terms with it. He should also think twice before complaining about oversimplification. Let him remember how grateful he himself is for an oversimplified account by a medical expert from a different specialty; and how impatient he is with too much specialised jargon, with too many ifs and buts and long-winded details. Oversimplification is usually better than total failure to communicate. It is easy to dwell on the gulf that separates the motives and aims of the doctor from those of the popular medical journalist, and to despair, as one journalist did at the Edinburgh meeting, of ever completely bridging it. But the advantages of a free and competitive Press far outweigh its disadvantages. Moreover, the responsible medical journalist not only has his own ethical code, but also has something to say to all doctors about the difficult art of communication with the layman, be he patient, relative, politician, or journalist. And on occasion he or she can help-and often has helped-to publicise or explain something that the medical profession is anxious should be put across to the public-for example, the dangers of smoking or the need for corneal-graft donors. Perhaps the greatest single contribution that each can make to good relations is for the journalist, whenever possible, to have his story checked by the right kind of doctor, and for the doctor to try to see each situation from the point of view of legitimate public interest.
public object and drama
to a
to
SIR DERRICK DUNLOP
retiring from the chair of therapeutics Edinburgh, Sir Derrick Dunlop was chairman of the newly formed Committee appointed on Safety of Drugs. His v’as an unenviable task: a shocked public demanded a guarantee that nothing like the thalidomide tragedies should ever happen again, yet common sense (reinforced by early warnings of the effects of bureaucracy in the Food and Drug Administration in America) required that the system of supervision of drug safety be flexible. For the first five years relations with the pharmaceutical industry were based on voluntary cooperation; and it says a lot for the confidence that Sir Derrick inspired that the industry recognised the challenge of living with Dunlop " by bringing in new people, not to man the political barricades but to staff science-based WITHIN
a
year of
at
"
units set up to liaise with the committee. When the Medicines Commission was formed in 1969, there may have been doubts about how the ending of the voluntary arrangements would affect the spirit of this relationship; but there can have been little doubt about who was the best man to chair the new body in its early days. Sir Derrick retires from this post on Dec. 31. Bidding farewell to his Edinburgh students in 1962, he remarked: " Were I honest I should say, ’Don’t please in innumerable respects behave as I have done’ ": to his successor at Finsbury Square he could give no worse advice.
adviser, shifting the emphasis away from policing to advice, will be welcomed, and there are few defenders of the wholesale examination of young persons as at present practised. On the other hand, there will be regret that responsibility for the service is to remain with the Department of Employment rather than that of Health and Social Security (particularly now that Health is developing occupational health services for hospital staff). If indeed the new advisers are to be specialists in occupational medicine, all will applaud -but many will watch critically to see what criteria will be held to justify the title of specialist, and where the new recruits, particularly the part-timers, will be found. It is unfortunate that the Government apparently does not intend to await the report of the Robens Committee, which might well have recommendations to make which would be pertinent to the proposed legislation; and assurances will again be sought from Government that the advisory service provided by this limited measure will not be passed off as a national occupational health service.
BREAKTHROUGH
RELATIONS between medicine and the mass media seldom easy and may become distinctly strainedfor example, when hearts are transplanted or Siamese twins separated. The greater the public interest, the more potentially explosive the situation. The faults in both camps and the friction that sometimes arises were given a good airing at a meeting arranged by the of Edinburgh last month. Royal College of Physicians One problem is the " breakthrough " story. Experience has taught the medical profession that it is difficult, if not impossible, to assess the true worth of any new claim until it has been further tested in practice or confirmed by other workers. Recognition is usually a very gradual process. How many genuinely sensational medical breakthroughs-quickly, widely, and convincingly recognised as such, with no subsequent disappointment-have there been in the past 100 years ? X-rays, insulin, and penicillin would perhaps qualify, but the total is surely very small. Yet excessive caution can be irritating to journalist and public alike, and some compromise is needed, however much we want to avoid raising false hopes. Bad news causes as much trouble as good news. If an epidemic breaks out, if a food or pill is suspected of having harmful effects in some of those who take it, or if serious deficiencies in the care of patients are alleged, the doctor’s immediate instinct is always to reassure, to play things down, to lower the temperature of the situation in the same way that he seeks to lower his patient’s temperature, however serious his private views and however strongly he privately urges drastic action. The popular-newspaper editor sees things differently. Occasionally his readers are grateful for reassurance. More often they want to be stimulated, even frightened, by sensational stories that give everybody something to talk about. Few members of the are
little exaggeration that adds colour the situation. Rather than criticise journalists for being realistic about this very human failing, the doctor would do well to try and understand it and come to terms with it. He should also think twice before complaining about oversimplification. Let him remember how grateful he himself is for an oversimplified account by a medical expert from a different specialty; and how impatient he is with too much specialised jargon, with too many ifs and buts and long-winded details. Oversimplification is usually better than total failure to communicate. It is easy to dwell on the gulf that separates the motives and aims of the doctor from those of the popular medical journalist, and to despair, as one journalist did at the Edinburgh meeting, of ever completely bridging it. But the advantages of a free and competitive Press far outweigh its disadvantages. Moreover, the responsible medical journalist not only has his own ethical code, but also has something to say to all doctors about the difficult art of communication with the layman, be he patient, relative, politician, or journalist. And on occasion he or she can help-and often has helped-to publicise or explain something that the medical profession is anxious should be put across to the public-for example, the dangers of smoking or the need for corneal-graft donors. Perhaps the greatest single contribution that each can make to good relations is for the journalist, whenever possible, to have his story checked by the right kind of doctor, and for the doctor to try to see each situation from the point of view of legitimate public interest.
public object and drama
to a
to
SIR DERRICK DUNLOP
retiring from the chair of therapeutics Edinburgh, Sir Derrick Dunlop was chairman of the newly formed Committee appointed on Safety of Drugs. His v’as an unenviable task: a shocked public demanded a guarantee that nothing like the thalidomide tragedies should ever happen again, yet common sense (reinforced by early warnings of the effects of bureaucracy in the Food and Drug Administration in America) required that the system of supervision of drug safety be flexible. For the first five years relations with the pharmaceutical industry were based on voluntary cooperation; and it says a lot for the confidence that Sir Derrick inspired that the industry recognised the challenge of living with Dunlop " by bringing in new people, not to man the political barricades but to staff science-based WITHIN
a
year of
at
"
units set up to liaise with the committee. When the Medicines Commission was formed in 1969, there may have been doubts about how the ending of the voluntary arrangements would affect the spirit of this relationship; but there can have been little doubt about who was the best man to chair the new body in its early days. Sir Derrick retires from this post on Dec. 31. Bidding farewell to his Edinburgh students in 1962, he remarked: " Were I honest I should say, ’Don’t please in innumerable respects behave as I have done’ ": to his successor at Finsbury Square he could give no worse advice.