GP Stage 3 Simulated Consultation - Healthcare Professional 3
You are an orthopaedic SHO and one of the physiotherapists, Alice would like to speak to you about your new Consultant Mr Andon.
You are Alice, a physiotherapist on the orthopaedic ward specialising in lower limb physiotherapy. You have arranged to speak to one of the SHOs regarding Mr Andon, the Orthopaedic consultant. You have been a physiotherapist for over 20 years, and you have never seen so many patients from one consultant requiring corrective surgery following an elective knee replacement. You are concerned that Mr Andon’s technical ability as a new consultant may not be fully accomplished, and you would like the SHO to speak to some of the other orthopaedic consultants regarding your concerns. You have not discussed this with anyone else and would prefer not to be involved in discussing with the other consultants, as previously when one of your colleagues raised concerns about an orthopaedic consultant, they were not offered a contract renewal.
At home, you live with your partner and three young children. You fear that if Mr Andon discovers that you first raised concerns, you will lose your job and not be able to provide for your family.
If asked about additional concerns, you also report that you overheard Mr Andon talking about a ‘new knee replacement technique’ and you fear that Mr Andon may be trialling this on patients, without informed consent.
This case highlights the importance of careful but detailed probing. Whilst patients and colleagues often freely volunteer one concern; without explicitly asking about additional concerns or ideas of what’s contributing to the concerns, candidates will only be provided with half the required information, hence failing to establish that Mr Andon is potentially trialling an unproven approach, without suitable consent.
As an SHO, appropriate solutions include mentioning this to your Clinical Supervisor or an appropriate Consultant who can review the concerns further as a matter of urgency (to minimise further patient harm). It would also be important to thank Alice for bringing this information to your attention, hence reinforcing her positive behaviour. Candidates may also reassure Alice that they will endeavour to maintain confidentiality to avoid any repercussions for herself, as well as arranging a follow up meeting with her in 5-7 days to discuss the progress as well as potentially any additional concerns.