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

[rvallee]

The other reason for the search was the suggestion that Sharpe was still actively involved in the Oxford LC clinic (I thought he'd retired?).

There was an article about this in the early days saying he'd gone back when Long Covid started pushing funding to those clinics. Which I guess I kind of missed. Of course they follow the money. Their research is all finely crafted to produce more research.

So I guess we should eventually see yet another article about him retiring, for the 3rd time?, from "chronic fatigue" research. Maybe with some rude tiktok video, or whatever, as evidence of just how bad people we all are.

 

[Lucibee]

There was an article about this in the early days

This was more recent: https://www.ouh.nhs.uk/news/article.aspx?id=1826&returnurl=/news/default.aspx&pi=0

But if he is now Emeritus (or Honorary), I guess he still has influence?

 

[Sly Saint]

Michael Sharpe
MA (Oxon), MB BChir, MD (Cantab)

Emeritus Professor of Psychological Medicine

• Consultant in Psychological Medicine at Oxford University Hospitals.
• President, European Association of Psychosomatic Medicine, Consultation-Liaison Psychiatry and Integrated Care.(EAPM).
• Recipient of the Eleanor and Thomas Hackett Award of the Academy of Consultation-Liaison Psychiatry (ACLP) and the American Psychiatric Association's Adolf Meyer Award for research achievement.

Integrating medical and psychiatric care ; multi-morbidity; clinical trials; service implementation

Current activities
I aim to improve health by developing and evaluating novel ways to integrate psychiatry into medical care.

My current work focuses on depression in people with medical conditions such as cancer and on complex multi-morbidity in elderly medical inpatients (the HOME study).

I am particularly interested in creating real-world solutions to the challenge of delivering integrated care

https://www.psych.ox.ac.uk/team/michael-sharpe

 

[Jonathan Edwards]

This was more recent: https://www.ouh.nhs.uk/news/article.aspx?id=1826&returnurl=/news/default.aspx&pi=0

But if he is now Emeritus (or Honorary), I guess he still has influence?

It looks as if he has simply resigned as Clinical Lead, which is just a nominal administrative chore. If he is still Honorary Consultant he is likely to be working just as before. That is the usual clinical title for an academic doctor.

 

[rvallee]

Yikes. Someone sees a very different image of themselves when looking in a mirror.

I aim to improve health by developing and evaluating novel ways to integrate psychiatry into medical care.

My current work focuses on depression in people with medical conditions such as cancer and on complex multi-morbidity in elderly medical inpatients (the HOME study).

I am particularly interested in creating real-world solutions to the challenge of delivering integrated care

 

[TiredSam]

I am particularly interested in creating real-world solutions to the challenge of delivering integrated care

I kid you not, at first take I read that as " ... cremating real-world solutions ... ".

 

[Hutan]

This article (of which this thread is about, which I'd entirely forgotten about) appeared in a search for something else this afternoon, and it occurred to me that we so often pounce on the bits that we disagree with, but not the parts that are better? This extract from the grey box section stood out:

Meanwhile, in the community rehabilitation arm of the Oxford long covid clinic, Rachael Rogers, a CFS/ME specialist who works alongside a respiratory medicine consultant, has seen some patients with PEM. She says, “We are not advocating exercise for them—we try to establish a baseline of activity that stops the relapsing pattern, the boom and bust. But it’s certainly not all long covid patients who get PEM, and there is another set of patients for whom exercise is appropriate.”

The key is careful screening, assessment, and individualised treatments, explains Rogers, as “it’s not one size fits all.” Difficulties may arise, she says, where services are not funded to screen patients properly.

You are right, it is better than some approaches; there is recognition of PEM. However, there's the issue of whether it is sensible for money to be allocated to these "individualised treatments". I don't think there is any good evidence that the rehabilitation approaches, for both people with and without PEM, produce any better outcomes than would be achieved by the GP being sympathetic and giving the patients with PEM a pamphlet on pacing and the patients with lung damage a pamphlet on, I don't know, maybe, singing.

There's an opportunity cost for the health system. Money spent on useless rehabilitation is money not spent on buying MRI machines, and ensuring people with cancer are seen quickly, and that people who need a hip operation get one, and that there are enough nurses.

These rehabilitation services also fill a void; they keep patients trudging through the process with hope for a while. Some of the patients at the end of the rehabilitation process do improve, almost certainly just because of the passage of time, and they become exponents of more mostly useless rehabilitation services. They are the patients who write the glowing testimonials. The patients who don't improve may well feel that they have failed. The rehabilitation services delay these patients realising that there really isn't anything to help them. The services consume the time when many patients still have influential connections and support and money and burning indignation about what has befallen them, spitting out the non-improvers to sink quietly into a state of shame and resignation.