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UK cardiology societies issue joint policy statement to stamp out unacceptable behaviors

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The British Junior Cardiologists’ Association (BJCA) and the British Cardiovascular Society (BCS) have issued a joint position statement in a bid to stamp out bullying, harassment, discrimination and other “unacceptable” and “unprofessional” behaviors in the specialty.

The statement, published online in the journal Heart, urges every cardiology team member to call out these behaviors to drive culture change.

Endorsed by 19 organizations affiliated with the BCS, the statement represents a specialty-wide response to the issue.

It comes in the wake of evidence suggesting that these behaviors are common in UK cardiology departments, and may be indicative of longstanding cultural and practice issues, fueled by previous training and unconscious biases, says the statement.

Data from the General Medical Council trainee survey suggest that bullying in cardiology is almost double the average across all medical specialties: 12.3% vs. 6.9%, highlights the statement.

Bullying is associated with poorer performance, a heightened risk of medical error, lost productivity, burn-out and absenteeism. It accounts for half of all stress-related workplace illness, the statement points out.

Inappropriate in cardiology departments has a detrimental ripple effect, including on the recruitment and retention of staff, patient care, and other bystanders, says the statement.

“As such, improving the culture and professional behaviors within UK cardiology departments is of paramount importance,” it insists.

The statement sets out examples of inappropriate behavior. These include bullying; sexist, racist, homophobic or belittling language; discrimination; harassment; providing or depriving individuals of opportunities based purely on personal characteristics; outbursts of uncontrolled anger; and unconstructive criticism of performance.

And it highlights the common misconception in the specialty that intimidation helps to ‘build character’ and is how cardiologists were trained in the past.

“This is an anachronistic and flawed concept: intimidating language or actions do not build character and have substantial negative impacts on those affected. Furthermore, role modeling and learnt behaviors lead to perpetuating the cycle of bullying,” it emphasizes.

“While mistakes happen in medicine and may require frank feedback to aid learning, they are not an excuse for intimidating or belittling behavior or language,” it adds.

Senior team members should lead by example, and act swiftly to respond to concerns. But every member of the cardiology team has a duty to call out inappropriate behaviors to drive culture change and foster a positive working environment, says the statement.

Informal feedback for one-off episodes may be appropriate, but serious events or repeat offenses warrant escalation through formal channels, it says.

Ignoring such behavior simply helps to perpetuate it, emphasizes the statement, adding that safeguards are needed to protect those who raise concerns from being penalized.

Several strategies are required at the individual, departmental, and national level to improve the culture within UK cardiology, concludes the statement. These are:

For departments and individuals

  • Set out clear standards and expectations of behavioral norms from all members of the cardiovascular team
  • Encourage the reporting of inappropriate behaviors
  • Ensure clear policies, practices and procedures are in place for dealing with inappropriate behavior, iteratively reviewed, and included in induction and staff handbooks
  • Designate and train a behavior lead with whom concerns can be raised
  • Consider any episodes of inappropriate behavior in the selection process for promotions and
  • Make routine use of multi-source feedback where evidence of all behaviors can be raised
  • Provide mandatory training for all on workplace culture; how to give and receive structured feedback; unconscious bias; and cardiology-specific human factors

For universities and national bodies

  • Develop a positive organizational culture and ensure that similar standards of behavior are expected of members (national bodies)
  • Establish a transparent cardiology reporting strategy for inappropriate behavior
  • Incorporate Freedom to Speak Up Guardians into the reporting and responding strategies in NHS Trusts
  • Include a person tasked with promoting professional standards on committees (national bodies)
  • Consider incidences of inappropriate behavior when allocating funding and advancement in cardiovascular research (universities and funders)
  • Include past inappropriate behavior when considering people for roles within their organization, at meetings, or the presentation of awards (national bodies)
  • Ensure that appropriate mentors and advisors outside of the direct supervisory chain are available to everyone taking part in cardiovascular research (universities)
  • Develop appropriate training packages to improve accessibility to departments and individuals that are reasonably priced and included in study budgets (national bodies)

“As with clinical standards, professional societies have a role in developing a standard for appropriate behavior and a responsibility to ensure that is shown to be unacceptable,” says the statement.

BCS President Professor John Greenwood comments: “No-one should be discriminated against at work, bullied, harassed or undermined. In cardiology we have had this pervasive culture for far too long. This statement and its practical recommendations represent a concerted effort to stop bullying in its tracks and put measures in place to stop it happening in the future. We will be taking the statement to our annual conference at the beginning of June to raise awareness and discuss implementation of the recommendations across the UK.”

Dr. Christian Fielder Camm, BJCA President, adds, “The detrimental effect of inappropriate workplace behavior can be profound and all those involved in UK and cardiovascular medicine have a responsibility to face up to this longstanding problem.”

“This document is a significant step forward in acknowledging this important issue and providing clear recommendations for individuals, departments, and national bodies to tackle this problem.”

More information:
Consensus statement: Joint British Societies’ position statement on bullying, harassment and discrimination in cardiology, Heart (2023). DOI: 10.1136/heartjnl-2023-322445

Journal information:
Heart
 

Provided by
British Medical Journal
 

Citation:
UK cardiology societies issue joint policy statement to stamp out unacceptable behaviors (2023, May 30)
retrieved 30 May 2023
from https://medicalxpress.com/news/2023-05-uk-cardiology-societies-issue-joint.html

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Health-care announcements expected with two weeks to go in N.B. election race

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New Brunswick‘s Liberal and Green parties are set to make announcements about health care on the campaign trail today as the provincial election race enters its second half.

Liberal leader Susan Holt is scheduled to hold her announcement this morning in Saint John, N.B., followed by lunch at the city’s market.

A spokesperson with the Progressive Conservative party shared few details about the event scheduled for leader Blaine Higgs in Fredericton this morning.

Green Party Leader David Coon will hold a news conference this morning about “local health-care decision-making” alongside deputy leader Megan Mitton in her Sackville, N.B. riding.

On Saturday, Coon said he was proud to put forward a gender-balanced slate among the party’s 46 candidates.

While the Liberals and Progressive Conservatives are running with full slates, the Greens are three candidates short and will not have full representation when the province’s residents go to the polls on Oct. 21.

This report by The Canadian Press was first published Oct. 7, 2024.

The Canadian Press. All rights reserved.

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Alberta Health Services’ snag leads to potential delay of patient referrals

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EDMONTON – The Health Quality Council of Alberta is investigating how some medical referrals weren’t properly processed, potentially affecting 14,000 patients over the last five years across the province.

The referrals were made to specialists outside of Alberta Health Services, such as physiotherapists and dietitians.

The health authority’s CEO, Athana Mentzelopoulos, says it does an average 100,000 referrals per year, but in some cases it can’t confirm if patients received referral services.

She says the problem was flagged in late September, and a preliminary estimate suggests 31 patients may have experienced a potential negative outcome due to the delays.

The provincial government requested the investigation, and the quality council is to find out how the snag occurred and how it can be prevented in the future.

The health authority says it has begun notifying patients who may have been affected by the disruption, and the cases could date back to 2019.

This report by The Canadian Press was first published Oct. 4, 2024.

The Canadian Press. All rights reserved.

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Don’t fall for fake dentists offering veneers and other dental work on social media

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WASHINGTON (AP) — If you have stained or chipped teeth, you might be considering veneers, customized teeth coverings that can restore a photogenic smile without more extensive dental work.

But dentists warn that these pricey cosmetic enhancements are at the center of a worrisome online trend: unlicensed practitioners without proper training or supervision offering low-cost veneers.

These self-described “veneer techs” often promote themselves on Instagram and TikTok, promising a full set of veneers for less than half of what dentists typically charge. Some also market their own training courses and certifications for people looking to get into the business.

It’s misleading, health professionals warn — and illegal. All states require dental work, including veneers, to be performed under the supervision of a licensed dentist.

On Thursday, Georgia law enforcement officials arrested Brandon Diller, who promoted himself to 158,000 Instagram followers as “Atlanta’s top veneer specialist and trainer.” Diller practiced dentistry without a license and sold “training and certificates, which were worthless” and “provided no legitimate or legal credentials,” according to an arrest warrant from Fulton County’s District Attorney’s office.

Here’s what to know about veneers and how to avoid bogus providers and services:

What are dental veneers?

Veneers are thin, custom-made dental coverings used to hide minor imperfections or to fill in gaps between teeth. Unlike crowns or more invasive dental implants, veneers are almost always considered cosmetic dentistry and generally aren’t covered by insurance.

Dentists usually charge between $1,000 and $2,000 per tooth for veneers, with higher prices for those made from porcelain compared with lower-grade materials.

Placing veneers involves stripping some of the natural enamel from the tooth and bonding the new covering into place. Because of that process, getting veneers is considered an irreversible procedure, according to the American Dental Association. They are not permanent, and can be expected to last between 5 to 15 years before they degrade and need to be replaced.

In recent months the ADA has been stepping up warnings about the risks of veneer procedures done by unlicensed individuals.

“Quality control is lost without the involvement of a licensed dentist,” said Dr. Ada Cooper, a New York-based dentist and ADA spokesperson. “We undergo years of education and training and need to be licensed by various regulatory bodies before we can practice.”

What are the risks of getting veneers from someone who isn’t licensed?

Improper veneer procedures can cause a range of health problems, including severe pain, nerve damage and tooth loss.

Patients need to be anesthetized before the enamel is removed from their teeth.

“It could be incredibly painful if they’re not anesthetized correctly,” said Dr. Zach Truman, who runs an orthodontics practice in Las Vegas. “You can also go too deep into the tooth and penetrate what’s called the pulp chamber, which contains blood vessels and nerves.”

One of the biggest problems Truman sees with unregulated veneer work is that customers aren’t getting screened for existing dental problems, such as gum disease and cavities.

“If you put a veneer on a tooth that has an active cavity, you’re just going to seal it in there and eventually it’s going to progress to tooth loss,” Truman said.

Dental veneers aren’t the only option for improving the appearance of teeth. Over-the-counter whitening kits can help with minor stains and discoloration. And dentists can sometimes use composite materials to reshape chipped or uneven teeth. But Truman says those fillings are prone to crack and won’t last as long as veneers.

How can I spot bogus veneer providers online?

One clue: Many individuals performing unlicensed dental work promote themselves on social media as “veneer technicians.”

Instead of working out of a dental office they often perform treatments at beauty salons, hotel rooms or private homes. Some advertise multi-city tours and encourage clients to message them to book an appointment in advance.

Much of the appeal of the services is in their pricing, with some offering a full set of veneers for a flat fee of $4,000 or $5,000. That’s less than half of what patients can generally expect to pay at a dental office.

Performing dental work without an appropriate license is illegal, the ADA notes.

Dentists and hygienists are licensed by state governments, who also define the work dental assistants can perform. But in all cases, veneers and other dental procedures must be supervised by a licensed dentist.

Earlier this year, Illinois law enforcement officials arrested a woman running a business called the Veneer Experts after she posted videos of herself fitting braces, veneers and other dental products without a license. She was previously arrested in Nevada on similar allegations of practicing dentistry without a license.

What are the best ways to find legitimate dental providers?

The ADA maintains a website detailing the training and licensing requirements for dentists across the U.S. Most states also maintain websites where you can lookup and verify licensure information and find any past disciplinary actions for dentists and other health professionals.

“It’s really critical to understand that dentistry is a regulated health care profession that requires formal educations and licensure,” Cooper said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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