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C7RKY's profile
John Clarke
John Clarke
John Clarke
@C7RKY

Tweets

John Clarke

@C7RKY

Of course views all mine. All without prejudice. Just a regular chap after all. Oh...and RT's may equally imply ridicule as endorsement.

UK
Joined December 2011

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    1. Dr Ros Taylor‏ @hospicedoctor 5 Aug 2014
      Replying to @doctorcaldwell

      @doctorcaldwell @RCPLondon @gmcuk @DrGrumble @DrUmeshPrabhu @acorns47 Yes so 'opt in ' only offered to clinically relevant - default no CPR

      2 replies 1 retweet 2 likes
    2. Dr Gordon Caldwell‏ @doctorcaldwell 5 Aug 2014
      Replying to @hospicedoctor

      @hospicedoctor Autonomy is not the right to demand a treatment particularly when the clinical judgement is that treatment is doomed to fail

      1 reply 0 retweets 0 likes
    3. Stephen Evans‏ @Stephenpublic17 5 Aug 2014
      Replying to @doctorcaldwell

      @doctorcaldwell @hospicedoctor (Pesky lawyer again!) Absolutely, Tracey case did not say any different to that. Also agree with the paper.

      2 replies 0 retweets 0 likes
    4. Dr Ros Taylor‏ @hospicedoctor 5 Aug 2014
      Replying to @Stephenpublic17

      @Stephenpublic17 @doctorcaldwell We are not obliged to discuss all else that doesn't work !

      5 replies 0 retweets 1 like
    5. Stephen Evans‏ @Stephenpublic17 5 Aug 2014
      Replying to @hospicedoctor

      @hospicedoctor @doctorcaldwell 3/? That is why I agree with that paper - perceptuon needs changing. That comes through dialogue.

      1 reply 1 retweet 1 like
    6. Dr Ros Taylor‏ @hospicedoctor 5 Aug 2014
      Replying to @Stephenpublic17

      @Stephenpublic17 @doctorcaldwell But now set in stone for another generation of doctors?

      1 reply 0 retweets 0 likes
    7. Stephen Evans‏ @Stephenpublic17 5 Aug 2014
      Replying to @hospicedoctor

      @hospicedoctor @doctorcaldwell What is problem, in principle, of disc the appropriateness of any treatment patient wants to know about?

      3 replies 2 retweets 1 like
    8. Dr Ros Taylor‏ @hospicedoctor 5 Aug 2014
      Replying to @Stephenpublic17

      @Stephenpublic17 @doctorcaldwell You need to do a ward round with Gordon or I. You will see how silly/ irrelevant these discussions are..

      2 replies 0 retweets 3 likes
    9. Stephen Evans‏ @Stephenpublic17 5 Aug 2014
      Replying to @hospicedoctor

      @hospicedoctor @doctorcaldwell Never doubted futility of CPR in many situs. Don't think it follows disc not needed perhaps esp with family

      2 replies 2 retweets 0 likes
    10. Dr Ros Taylor‏ @hospicedoctor 5 Aug 2014
      Replying to @Stephenpublic17

      @Stephenpublic17 @doctorcaldwell CPR futile in >90% We dint discuss all other futile interventions. Judges watched too many medical soaps??

      2 replies 0 retweets 1 like
      John Clarke‏ @C7RKY 10 Aug 2014
      Replying to @hospicedoctor

      @hospicedoctor @Stephenpublic17 @doctorcaldwell Futility is a matter of judgement/opinion. Discussion is pt's only means to challenge that.

      7:34 AM - 10 Aug 2014
      5 replies 0 retweets 0 likes
        1. Dr Gordon Caldwell‏ @doctorcaldwell 10 Aug 2014
          Replying to @C7RKY

          @C7RKY @hospicedoctor @Stephenpublic17 if patients want to discuss DNACPR status the situation is very straightforward, almost easy.

          0 replies 1 retweet 1 like
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        1. Dr Gordon Caldwell‏ @doctorcaldwell 10 Aug 2014
          Replying to @C7RKY

          @C7RKY @hospicedoctor @Stephenpublic17 in 34yr inpatient work I can only recall 1 patient initiating that DNACPR discussion with me

          0 replies 1 retweet 1 like
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        1. New conversation
        2. Dr Gordon Caldwell‏ @doctorcaldwell 10 Aug 2014
          Replying to @C7RKY

          @C7RKY @hospicedoctor @Stephenpublic17 that's despite leaving many openings "Anything else you want to ask? Need to know? Etc"

          3 replies 0 retweets 0 likes
        3. Kate Masters‏ @katemasters67 10 Aug 2014
          Replying to @doctorcaldwell

          @doctorcaldwell @C7RKY @hospicedoctor @Stephenpublic17 >ask 'is there anything else that could be considered that you hv not discussed w me'

          2 replies 0 retweets 1 like
        4. Dr Gordon Caldwell‏ @doctorcaldwell 10 Aug 2014
          Replying to @katemasters67

          @katemasters67 like seeing financial adviser "give your £ to your children" then ask him "Why didn't u advise me buy £1m of lottery tickts?"

          4 replies 1 retweet 2 likes
        5. Kate Masters‏ @katemasters67 10 Aug 2014
          Replying to @doctorcaldwell

          @doctorcaldwell maybe doctors could use same method- give a risk factor for individual patient to explain why it's not being offered?

          1 reply 0 retweets 0 likes
        6. BrianJarman‏ @Jarmann 10 Aug 2014
          Replying to @katemasters67

          It’s possible to calculate risk factor for every patient on admission using age, sex, emergency, 1st Dx, etc @katemasters67 @doctorcaldwell

          2 replies 2 retweets 2 likes
        7. Dr Gordon Caldwell‏ @doctorcaldwell 11 Aug 2014
          Replying to @Jarmann

          @Jarmann @katemasters67 very difficult most clinical coding completely overlooks severity+factors such as immobility, incontinence "frailty"

          1 reply 1 retweet 1 like
        8. BrianJarman‏ @Jarmann 11 Aug 2014
          Replying to @doctorcaldwell

          Only the Japanese hospital data includes that - on admission they record Activities of Daily Living (ADL). @doctorcaldwell @katemasters67

          6 replies 5 retweets 4 likes
        9. Dr Gordon Caldwell‏ @doctorcaldwell 11 Aug 2014
          Replying to @Jarmann

          @Jarmann @katemasters67 I wonder how Japanese culture approaches DNACPR "decisions"?

          1 reply 0 retweets 0 likes
        10. 1 more reply
        1. New conversation
        2. Dr Gordon Caldwell‏ @doctorcaldwell 10 Aug 2014
          Replying to @C7RKY

          @C7RKY @hospicedoctor @Stephenpublic17 in NHS patients are always meant to have a right to a second opinion, and should ask if they want

          1 reply 0 retweets 0 likes
        3. Kate Masters‏ @katemasters67 10 Aug 2014
          Replying to @doctorcaldwell

          @doctorcaldwell @C7RKY @hospicedoctor @Stephenpublic17 that's not widely known to patients.

          0 replies 0 retweets 0 likes
        4. End of conversation
        1. New conversation
        2. Dr Gordon Caldwell‏ @doctorcaldwell 10 Aug 2014
          Replying to @C7RKY

          @C7RKY @hospicedoctor @Stephenpublic17 in 34y NHS work I have more often suggested patient has a 2nd opinion than patients asking for one

          1 reply 0 retweets 0 likes
        3. John Clarke‏ @C7RKY 10 Aug 2014
          Replying to @doctorcaldwell

          @doctorcaldwell @hospicedoctor @Stephenpublic17 Appreciated, but pt can only know they need a 2nd opinion, if informed that the 1st exists.

          0 replies 0 retweets 0 likes
        4. End of conversation

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