Editorial April 2005

SINGLE CASE STUDIES

These used to be valuable resources for sharing clinical experience and offering trainees food for thought. Since the advent of 'evidence-based medicine' it has become harder for busy doctors from outside research organisations to share their instructive cases. Many journals now require statistical analysis of multiple cases and controlled studies; some clinical experience thereby gets lost.

I have published three unusual cases which were encountered in medico-legal practice during the '70s & '80s. The first, about an offender who suffered from Moebius Syndrome, was welcomed and published by Medicine, Science and the Law. Thereafter my account of an ultimately succesful search for treatment for a juvenile homicide, instead of punishment, was turned down by that journal because, by its very nature, I could not provide a statistical context to make it sufficiently 'scientific' for their then editor! The three cases were collected and published eventually in the BJCSP, November 2000 under the title Happy Endings.

Doctors are generally reluctant to go public with their personal difficulties. Autobiographical studies, which can be both informative and salutory to read, may also cause unease and embarrassment.

In this month's Points of View I have made a link to a new in-depth feature article in Hospital Doctor, studying the experiences of a Kent gynaecologist. Hospital Doctor should be congratulated for affording medical journalist Melanie Newman three full pages to present it; better to read in a print copy, otherwise the text is available on HD's website. It reflects the findings of SCP's Suspensions Study Group about many examples of disciplinary over-reaction.

Readers' accounts of their interesting and illuminating cases, also of their own experiences as employees, positive or adverse, will be welcomed by SCPNET's Points of View &/or for possible publication in the BJCSP Online Edition (2004-2005). PGW

SCPNET editorials do not necessarily represent the views of the Society unless so stated.