How does the Doctor actually know that?

How does the Doctor actually know that? We all have one thing in common – that is one day we will pass away. Until that day comes, every one of us is unique. On a basic level, male or female; tall, or small; overweight or slim. From birth we inherit certain characteristics from our parents such as eye colour or hair colour. Add into the mix socio-economic factors, random exposure to pollutants, disease and injury and there you are – a unique human being. Moreover, one of the definitions of life is that we are all dying anyway. Sooner or later we will all pass, usually preceded by a period of decay or perhaps better termed degeneration where the body slowly but surely ages. So if we are all unique and if we are all slowly falling apart anyway, how does a medical examiner working within the context of medico-legal reporting differentiate between these background characteristics and the trauma caused by an accident? Medical science has come an awful long way in a comparatively short time. Only 150 or so years ago Florence Nightingale advocating cleanliness as a means of infection control really was ground breaking stuff. Nowadays hardly a month goes by without some startling new medical technique being publicised. Did we really read that within 2 years medics expect to be able to transplant a human head? Truly rem

Scarlet fever. Ask anyone of a certain age to describe the illnesses that blighted their childhood and a name will crop up that chances are you have never heard of before – Scarlet fever. You might think this illness is something consigned to the past, but recent reports are that there has been a spike in cases within the Midlands this year. In fact, according to the NHS there are between 2,000 & 4,000 case annually in the UK, so not as rare a condition as you might think.   Scarlet fever is a bacterial condition that typically presents itself as a pink/red rash that is rough to the touch. The rash may start in one area before spreading to other parts of the body, such as the ears, neck and chest. The rash may also be itchy. Other symptoms include a high temperature, a flushed looking face and red, swollen tongue.   Scarlet fever is highly contagious and you are at risk of transmitting the disease to others for 2-5 days before you actually show signs of any infection. The first signs of infection are a sore throat, headache & high temperature. The rash normally follows within 2 days of these initial signs. Thankfully most cases are mild, but sufferers can go on to have swollen neck glands, a loss of appetite, nausea or vomiting, red lines in the folds of the body, a white coating on the tongue that peels afte

The recent passing of The Criminal Justice and Courts Act 2015 has imparted into law the concept that a Claimant who seeks to progress an injury claim that contains any element found to be “fundamentally dishonest” will lose their whole claim for compensation. In many respects the examining medical expert is at the forefront of pinpointing cases where, how to put it delicately, the Claimants complaints of injury just defy belief. So how does the examiner go about establishing a Claimant might not be genuine? Is it just an “educated guess; ” or is there a more scientific approach? In 1980 Scottish Orthopaedic Surgeon Gordon Waddell observed “inappropriate” signs in the behaviour of some patients claiming to be injured. His subsequent article published at the time lead to recognition of a series of tests, known collectively as “Waddells tests” that would indicate whether the Claimant was genuine in their complaints or not. Waddell suggested 5 separate categories tested that remain in use today. These are:-  

1. Superficial and widespread tenderness or Nonanatomic tenderness – basically discomfort caused by the lightest of touch, or pain crossing over anatomical boundaries (ie pain which cannot physically exist given the area tested);
2. Simulation tests – making the patient move in a way that cannot cause pain to the area affected. The most use

Ask anyone, other than a sufferer what they know about Alzheimer’s disease and apart from little to nothing the one thing everyone will say is that it is the inevitable consequence of ageing. Recent evidence however suggests the opposite. In fact, according to experts, only about 1% of sufferers were genetically predisposed to suffer from the disease. Moreover, more than half the risk can be influenced by lifestyle and dietary changes. Roughly a fifth of cases are due to low levels of B vitamins, most notably vitamin B12, which becomes harder to absorb with age. A similar number are due to low levels of omega-3 fats and fish consumption. Other risk factors are an inadequate consumption of fruit & vegetables, lack of exercise and insufficient stimulating activity. So, if the current research is anything to go by, a balanced diet including meat and fish, exercise and mental stimulation should help prevent the disease altogether. Charity Food for the Brain has set up an online test to check whether you are at risk of the disease. This tests Cognitive Function and also assesses the lifestyle risks. A link to the test appears here http://www.foodforthebrain.org/. The charity says they want people over the age of 50 to routinely take the test to thereafter implement any changes needed to avoid onset of the disease.   Though ver

Struggling to get out of bed? Feeling down, or just tired and achy? You are not alone. Visit your doctor at this time of the year and doubtless they will tell you they have seen an endless stream of patients all suffering from the same complaints. January is a depressing month for many. Christmas and New Year have come and gone leaving little to look forward to. Many families have overstretched their finances buying presents and are struggling with an ever increasing pile of bills to pay. Add short winter days, cold and bad weather into the mix and you have a toxic cocktail of “feel bad factors.” Whilst feeling a bit down is normal for this time of year, recent years we have increasingly heard the term “Seasonal Affective Disorder” or “SAD.” This is a type of depression associated with the winter months and this time of year symptoms are likely to be at their worst. SAD is not yet fully understood, but in common with other types of depression symptoms include a low mood and a lack of interest in life. Sometimes also being less active than normal and sleeping more. If you are feeling a bit low, NHS Choices offers the following advice on beating winter blues: –  

1. Get as much sunlight as possible. Open curtains as early as possible and get out and about even if for only a short time.
2. You may be suffering from a lack of vitamin D since this is

Ask a question like “what’s new in medico-legal reporting?” and almost always the resounding answer will be “well, nothing.” This year however we see a continuation of the governments crusade against the so called “compensation culture” with the proposed introduction of the controversial Medco portal. The changes will affect road traffic accident (RTA) claims submitted to the Rapid Portal from 6^th April 2015 onwards. The definition of whether a case is caught by the new regime or not is that it applies to “ a claim brought by an occupant of a motor vehicle where the significant physical injury caused is a soft tissue injury and includes claims where there is a minor psychological injury secondary in significance to the physical injury”. In other words, “whiplash claims.” So what is Medco? In essence, a taxi-ranking of experts willing to prepare the medico-legal report to support whiplash claims. So, if your claim falls into the definition above and you need expert evidence in the form of a medico-legal report there will be no choice about which expert will prepare that report. You are “allocated” the next expert. Like it or lump it. Moreover, if the rhetoric surrounding this planned process is anything to go by, the Government wants the experts to be “robust” and “tough” on the Claimants. The next st

Know your expert When bringing an injury claim in the UK the Claimant will need to be examined by one or more medical experts. The role of these experts is to produce an impartial report for the Court so that the Court can assess the injuries and as a consequence decide how much compensation to award. Moreover, the medical reports can also work as a building block towards proving other accident related losses such as loss of earnings and care and assistance. The most common experts used are:-   General Practitioner (GP) As the name suggests, a General Practitioner or GP as they are commonly called is a doctor who practices all types of medicine. In some countries they are called physicians because they can diagnose illnesses and dispense drugs. With a soft tissue injury case a GP is the most likely type of expert instructed at the outset.   Consultant in Accident & Emergency Medicine In medical terminology the word “Consultant” denotes a type of doctor who has achieved a senior level of status as a specialised practitioner. A Consultant in Accident & Emergency Medicine is the most senior doctor working in an Accident & Emergency department. They can diagnose and provide an opinion about most types of traumatic injury.   Consultant Orthopaedic Surgeon A Consultant Orthopaedic Surgeon is a specialist in musculoskeletal problems ie bones and the tiss