URGENT MESSAGE
It never rains but it pours. I returned from Europe today to learn that I have been summoned to an Interim Orders Procedure at teh General Medical Council at 9.30am on Wednesday 22nd February 2012 at the GMC Offices at St james's Buildings, 79 Oxford Street, Manchester, M1 6 FQ.
This IOP has arisen following five complaints to the GMC from Family Practitioners in the recent past. This would not be the place to debate these complaints but suffice to say that I do not believe that I have placed any patient in harm from my ministrations.
I have formally requested that the Hearing on Wednesday be open to the public and that adequate facility will be available; I realise that you must be extremely worried at this latest turn of events particularly perhaps those of you for whom I provide prescription for thyroid medication. I am working closely with the Medical Protection Society to try to finally put these allegations of shortfall in patient care to rest.
Aye yours,
Gordon R B Skinner MD, DSc, FRCOG, FRCPath
Fitness to Practice
I thought it would be reasonable to advise that the conditions of registration which were imposed by the General Medical Council on my practice on November 2007 for 3 years ended November 2010. These conditions were of an administrative nature and the General Medical Council did not seek to influence the conductance of my medical practice, which I hope has continued to provide a useful service towards the diagnosis and management for patients with hypothyroidism.
The General Medical Council have convened a Hearing for the 28th and 29th July (probably Manchester). This Hearing will examine if I have successfully fulfilled my conditions of registration which were set for 3 years from November 2007 to November 2010. I have requested that this Hearing be public.
June 29th 2011
I have now been advised that the Hearing is to continue for 5 days in Manchester at the GMC premises as before and beginning on 28th July.
This would not be the place to delve into the details of this Hearing. Suffice to say, that the conditions between November 2007 and 2010 asked that I transmit to the GMC the referral letter from the referring practioner, my clinical notes and my return letter to the referring practioner. I have fulfilled these conditions with dilligence and no significant problems have been drawn to my attention at 6 monthly review during these three years; addtionally, there are no cases under review by the GMC or any further allegations vis-a-vis my medical Practice. The focus of the investigation during five days of expensive court proceedings is therefore something of a mystery.
These proceedings are public and you are welcome to attend any part of these proceedings. I would of course appreciate any support and encouragement during these proceedings.
July 4th 2011
The Medical Protection Society would welcome the support from any of the patients that have seen Dr. Skinner and if you wish to send a note to Dr. Stewart, Medical Protection Society, 33 Cavendish Square, London, W1G 0PS; it is very important to send a copy to Louise Lorne Clinic, 22 Alcester Road, Moseley, Birmingham, B13 8BE. Thank you.
October 14th 2011
I will be attending a further GMC hearing on 14-11-2011 to 19-11-2011 Manchester at the GMC premises. This hearing will examine my compliance with my conditions of registration which were set in November 2007. I have failthfully conformed to these conditions and I am now very hopeful that I will be reinstated to my full medical registration.
November 25th 2011
I am delighted to inform you that at the recent GMC hearing the panel decided to lift my conditions of registration and I am free to practice without restriction. As a gesture of good faith I will to continue to see new patients who have been referred from a medical practitioner registered within Europe.
I very much hope that the termination of my conditions will encourage a more flexible strategy among Endocrinologists and Family Practitioners on the diagnosis of hypothyroidism. As you know I have been trying for some 15 years to establish a formal clinical trial to investigate the pivotality of thyroid chemistry in the diagnosis and manangement of this condition; and secondly a formal trial to compare the relevant efficacy of the synthetic hormone preparations and the dessicated extract preparation.
This is more critical than ever as a number of Practitioners continue to adhere to a proposition advanced by the Assocation of Clinical Biochemists and two Royal Colleges that hypothyroidism should not be diagnosed unless the TSH value is more than 10 miu/L. I believe that this is a seriously flawed position; it is statistically wayward given the average TSH value and the standard error of this average and thus a TSH value of 10 miu/L will be an unacceptably high number of standard errors from the average value; secondly it is hardly commensurate with clinical experience culled over many years of clinical practice where few Practitioners will not have encountered unequivocally hypothyroid patients who had a TSH level of, say 7 miu/L, who have returned to optimal health on thyroid replacement therapy.
We will continue to press for these important clinical trials and would of course welcome any suggestions towards possible funding sources to conduct these trials.
January 25th 2012
As the dust settles - or fails to settle as it so seems - I thought it worth advising that a new issue has arisen with respect to complaints from Family Practitioners on my work. I would add that none of the Practitioners have made contact with me prior to firing off a complaint to the General Medical Council.
This would not be the place to discuss the nature of these complaints save to advise that the patients who are involved have not made any complaint(s) and, as far as I can judge and indeed as reported by two of the four GP complainants they have returned to good health. I am sure that you are anxiously awaiting publication of my new book “Essential Statistics” and there is an interesting practical application of Poissonian theory to this matter.
Poissonian distribution describes the frequency of independent events for example goals at football matches, number of letters arriving per day to a house, accidents in a given day in a city. Poisson teaches a remarkable linkup between mathematics and biology; if we know the average number of goals in a football match we can predict the probability of no goals or five goals or eleven goals. Thus it may be with the frequency of complaints about a given medical practitioner.
Anybody still listening ?
The average number of complaints from Family Practitioners over a decade has been 1.5 per year. Thus if complaints are random events, then the probability of receiving four complaints at two weekly intervals is P <0.0001 or in other words less than one in 10,000 chance if complaints were randomly distributed which is the point. This suggests that some other factor has motivated this plague of complaints. The only event which might have distorted the randomness would be my recent FTP but this would be contrary as the General Medical Council exonerated my position and removed restrictive conditions which were of only an administrative nature and were never intended to influence the strategy of management of patients with hypothyroidism.
The recent and inexplicable frequency of these complaints is certainly a worry in that while the complaints contain no specific allegation of shortfall in my care, the accumulative effect of a number of silly solicitations masquerading as complaints may encourage the erroneous concept that there cannot be smoke without fire etc.
In these circumstances it is my intension to seek a meeting with the General Medical Council and the Medical Protection Society.
