BMJ: Chronic fatigue syndrome and Long Covid, moving beyond the controversy, 2021, Newman

rvallee said:
Seems likely there is a Wessely connection. Gerada is completely obsessed with patient complaints, believes patients should not even have the right to lodge complaints (because it makes physicians feel bad) and yet again a few days ago in a discussion over physician suicides blamed patient complaints as the most common cause of physician suicides (according to her anyway). This is deeply personal to her for reasons that likely have to do with their own experience, I have no doubt both have been the target of many complaints.
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Possibly also connected to her father's experience: https://www.bmj.com/content/373/bmj.n1575
 
MSEsperanza said:
Has this been posted yet?

Godlee F. How can we manage covid fatigue? BMJ 2021; 373 :n1610 doi:10.1136/bmj.n1610
https://www.bmj.com/content/373/bmj.n1610





Over to Postcovid & ME:

"Up to 376 000 people in the UK have reported ongoing symptoms more than 12 months after contracting the virus, with persistent mental and physical fatigue a troubling reality for many (doi:10.1136/bmj.n1559).2

"This presents clinicians with a range of challenges.

"Should patients with fatigue follow the dominant advice of the CFS/ME communities: that pacing rather than graded exercise therapy is the safest route, as is now also recommended in controversial draft guidance from the UK National Institute for Health and Care Excellence?

"Or does this risk sentencing patients to a lifetime of symptom monitoring and long term disability?

"What of the researchers braving this often toxic academic terrain?"
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My response to Godlee's editorial, focusing on pacing, has been published, https://www.bmj.com/content/373/bmj.n1610/rr-1
 
Dx Revision Watch said:
Possibly also connected to her father's experience: https://www.bmj.com/content/373/bmj.n1575
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Oh, FFS. :facepalm:

And of course like the vast majority of complaints it was dismissed, so that's basically textbook excessive worry over an unlikely event that carries little if any real consequences, because like everything it's all projection.

I have no idea what is the purpose of this... uh... biographical tidbit? What purpose is there to write it? Or to publish it in a medical journal? There is nothing of substance here.
 
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rvallee said:
Oh, FFS. :facepalm:

And of course like the vast majority of complaints it was dismissed, so that's basically textbook excessive worry over an unlikely event that carries little if any real consequences, because like everything it's all projection.

I have no idea what is the purpose of this... uh... biographical tidbit? What purpose is there to write it? Or to publish it in a medical journal? There is nothing of substance here.
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I note it was commissioned, too:

"Provenance and peer review: Commissioned; not externally peer reviewed."
 
Dx Revision Watch said:
I note it was commissioned, too:

"Provenance and peer review: Commissioned; not externally peer reviewed."
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Basing from the tone of discussion of not just Gerada but others, the objective seems to be that patient complaints are awful and unnecessary and basically need to stop happening entirely.

There's something weird about many comments saying the GMC does not support physician during complaints when they actually only protect physicians, not patients. Like every professional medical association it is their primary purpose. It's like having 99% of the power imbalance and whining about the remaining 1%. Actually strike that it's not like it it literally is.


Imagine demanding no accountability when there already isn't any. Completely disconnected from reality.
 
rvallee said:
Basing from the tone of discussion of not just Gerada but others, the objective seems to be that patient complaints are awful and unnecessary and basically need to stop happening entirely.
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Gerada, et al, wouldn't be catastrophising, would they? Surely not.

I mean if intelligent, highly educated and resourced and privileged professionals are having trouble coping, imagine what it is like for the ungrateful peasants patients they treat.
rvallee said:
It's like having 99% of the power imbalance and whining about the remaining 1%.
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Exactly. They want blanket immunity because getting it wrong is so hard on the doctor.

And they reckon patients are the snowflakes?
 
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The trouble with Gerrada's article is that the fact that a complaint was made against her father is not very good evidence of professional misconduct. The fact that he was cleared by the GMC is not very good evidence of innocence.

So that seems to be the normally accepted standard of proof for the journal.
 
Charles Shepherd's Rapid Response has now been published as a Letter to the Editor,

"Charities, patients, and researchers are working together to find the cause and effective treatments for ME/CFS

As a charity that funds biomedical research into myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), we are not aware of any researchers who hold negative views about the patient community.1 Patients, charities, and researchers are all working together on research initiatives such as Decode ME (https://www.decodeme.org.uk), the ME Biobank (https://cureme.lshtm.ac.uk/the-uk-mecfs-biobank), and cardiorespiratory exercise testing.2"

https://www.bmj.com/content/374/bmj.n1854.full
 
Another Rapid Response has been published as a letter to the Editor,

Chronic fatigue syndrome and long covid: individualisation, not compartmentalisation

"Newman’s investigation of chronic fatigue syndrome and long covid supports the development of specialised multidisciplinary support for patients with long covid.1 But compartmentalisation of a problem like chronic fatigue syndrome can sometimes miss the point."

https://www.bmj.com/content/374/bmj.n1863
 
Long covid: reshaping conversations about medically unexplained symptoms

"Newman’s article, a linked patient commentary, and the tranche of rapid responses show how “long covid” has reignited debate about the causes and management of chronic fatigue syndrome.1 Rather than moving beyond the controversy, most of the ensuing arguments have fallen back into familiar grooves deepened by confirmation bias and dualistic thinking.123 On a more positive note, the intense media attention on and public interest in long covid present a golden opportunity to reshape and extend discussions about medically unexplained symptoms."

https://www.bmj.com/content/374/bmj.n1859
 
Andy said:
Long covid: reshaping conversations about medically unexplained symptoms

"Newman’s article, a linked patient commentary, and the tranche of rapid responses show how “long covid” has reignited debate about the causes and management of chronic fatigue syndrome.1 Rather than moving beyond the controversy, most of the ensuing arguments have fallen back into familiar grooves deepened by confirmation bias and dualistic thinking.123 On a more positive note, the intense media attention on and public interest in long covid present a golden opportunity to reshape and extend discussions about medically unexplained symptoms."
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I read the whole letter, but actually all you need to do is read to the phrase "dualistic thinking" and you can guess the rest. It never ceases to amaze me that people who believe in "real disease" on the one hand and "psychological problems masquerading as medical symptoms" on the other hand - can actually accuse other people of being dualistic.

A couple of NZ psychiatrists, from Waikato. Obviously hoping to increase their slice of the MUS pie. Kiwis, beware...
 
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These consultations often carry the weight of decades of power imbalance, psychological stigma, and bitter dualistic debate, leaving both doctor and patient dissatisfied.
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Statements like this consistently and deliberately miss the point. There is no psychological stigma or dualistic debate. If PWME stigmatise or debate anything, it's Sir Simon and his ilk's empire-building horseshit. That's all. We have no problem with psychology and no interest in a "dualistic debate", we are just objecting to a fictional narrative being foisted upon us. Stop pretending this is more of an intellectual argument than it is, or that it has something to do with psychology or dualism. PWME, just like everybody else, don't like bullshit, especially when it's foisted upon them to their detriment. It's no more complicated than that, for all the posturing and deflection of the BPS crowd. They have invaded the field of psychology and polluted it, it's just their corrupt version of psychology where evidence and data count for nothing in their ideological quest that we "stigmatise".
 
Andy said:
Another Rapid Response has been published as a letter to the Editor,

Chronic fatigue syndrome and long covid: individualisation, not compartmentalisation

"Newman’s investigation of chronic fatigue syndrome and long covid supports the development of specialised multidisciplinary support for patients with long covid.1 But compartmentalisation of a problem like chronic fatigue syndrome can sometimes miss the point."

https://www.bmj.com/content/374/bmj.n1863
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About

Medical Doctor, Educator and Clinician in Homeopathic Medicine, within NHS and Private Practice. International experience of lecturing on Clinical Practice and methodology. Webinar and media developer. Integrated medicine / CAM.
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https://uk.linkedin.com/in/russell-malcolm-647a841a

I found the language in his letter pretty interesting.
 
Yes, it is intriguing @Esther12.

I have been having a discussion on HealthWatch (where a lot of people have worked to dislodge homeopathy from the NHS). Just this morning it came to me that the comment (source confidential but maybe now found in any BACME type mag), that it didn't really matter if PACE showed nothing because therapists now do everything on an individualised basis, was straight out of the homeopathy playbook. For years they have said randomised trials are no good because treatment has to be individualised (an invalid objection of course). I also commented to someone that having not so long ago given a seminar to the RLHIM (that was RLHomeopathicH) unit for fatigue that one might be tempted to quote from Animal Farm - it's back to two legs good now. Or maybe all singing all dancing multidisciplinary legs good.

This is precious: In the absence of objective data, the use of advanced and holistic history taking can explore the factors that perpetuate the clinical state.


I am slightly wondering if the people at the Royal London Hospital for Integrated Medicine may not thank Russell Malcolm for letting the cat out of the bag.
 
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I read that rapid response and thought it was just the usual - we are the experts who can design individualised treatments - that we are hearing more and more from rehab people running ME and long covid clinics.

I didn't realise he was a homeopath. That explains the approach - it's their standard practice - homeopathic remedies prescribed according to long lists of all sorts of 'symptoms' gleaned from lengthy questioning and including things most of us would not regard as symptoms, and different for each person even if they have the same disease. All hocus pocus of course.
 
Jonathan Edwards said:
Yes, it is intriguing @Esther12.

I have been having a discussion on HealthWatch (where a lot of people have worked to dislodge homeopathy from the NHS). Just this morning it came to me that the comment (source confidential but maybe now found in any BACME type mag), that it didn't really matter if PACE showed nothing because therapists now do everything on an individualised basis, was straight out of the homeopathy playbook. For years they have said randomised trials are no good because treatment has to be individualised (an invalid objection of course). I also commented to someone that having not so long ago given a seminar to the RLHIM (that was RLHomeopathicH) unit for fatigue that one might be tempted to quote from Animal Farm - it's back to two legs good now. Or maybe all singing all dancing multidisciplinary legs good.

This is precious: In the absence of objective data, the use of advanced and holistic history taking can explore the factors that perpetuate the clinical state.


I am slightly wondering if the people at the Royal London Hospital for Integrated Medicine may not thank Russell Malcolm for letting the cat out of the bag.
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And the bit before that quote talking about how clinicians individualise cases with a high degree of detail... but what exactly does that mean? Is there any good evidence it benefits patients to have these specialised teams do this?

"Specialised teams, such as the fatigue clinic at the Royal London Hospital for Integrated Medicine, routinely individualise chronic fatigue syndrome cases to a high level of detail. In the absence of objective data, the use of advanced and holistic history taking can explore the factors that perpetuate the clinical state."
 
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