It’s the worst of times, yet the best of times

Private practice full-timer Mr Jeremy Latham told Independent Practitioner Today’s April issue of his hopes and fears for the weeks to come. Here he reflects on new work challenges he has faced and, perhaps surprisingly, some of the happiest times of his life.

Mr Jeremy Latham

They say that a month is a long time in politics. Nearly three months after the lockdown started feels like an eternity.

We all know that the UK has been one of the worst affected countries in Europe, but healthcare workers have risen to the challenge and shown true courage, stoicism and compassion. 

As the lockdown eases, there is fear of repeated outbreaks of the disease and, of course, this has caused endless political arguments. I think our leaders have done remarkably well, all things considered. 

What now for private practice? 

As I write, I’ve heard rumours that clinics are running again in London, but the reality for most of us is that nothing much is going to happen until the end of June. 

Fear of infection

Some patients will understandably be reluctant to come into hospital because of the fear of infection. There is good evidence to show that if one catches Covid-19 in the perioperative period, then the risk of dying is significantly increased. 

Anaesthetists will be wary of taking on high-risk cases, who might have to be intubated. 

Hospitals will need rigorously to screen patients before and after admission, and the turnaround time between cases will increase dramatically because of infection control measures. 

No one knows how all of this will play out, but it seems unlikely that we will ever return to the ways that we used to do things.

Enforced break

What have I been doing during this enforced break from hip surgery? The private hospital where I have my practice was designated to receive trauma patients discharged from the local NHS trust. 

They have mostly been elderly people who have had falls, broken bones and are awaiting packages of care. It has been a privilege to work with all the staff at the hospital and to do my bit to help these vulnerable patients. 

I have really enjoyed my daily ward rounds and meetings with the senior management team. It has also kept me up to date with what is happening locally and nationally, as well as providing me with some income. 

I do a weekly phone clinic and have continued to receive instructions for medical reports. No doubt, we will see a big increase in clinical negligence work in the years to come as the fallout from the pandemic continues. 

When I am speaking to other colleagues, there does not seem to be much of an appetite for video consultations and, frankly, they are not particularly helpful in my area of expertise. 

Zoom and Skype are much more useful for keeping in touch with family and friends, and for my weekly piano lesson. 

Video channel

My video channel has seen an increase in views and I have learned how to use a green screen and do live streaming. Whether or not there will be a return on the investment of time and resources remains to be seen, but I have enjoyed the challenges of learning new skills.

One of my oldest friends told me last week that he had been a consultant for 25 years. The NHS trust gave him a £75 bonus. 

This confirmed to me that one of the better decisions I made in my life was to have left the NHS and go into full-time private practice. 

I have kept closely in touch with my colleagues who work in the NHS. It does not surprise me to hear that the usual suspects continue to behave badly and manipulate the system to their own advantage. I am delighted that I do not have to work with them anymore.

On a personal note, I have relished the time spent at home with my wife and two teenage sons. It has brought us all together in ways that I would not have imagined a year ago. 

Whatever the future holds for us, the last few weeks have been some of the happiest times in my life. Onward and upward . . .

Jeremy Latham is a consultant orthopaedic surgeon, based at Nuffield Health Wessex Hospital in Chandlers Ford, Hampshire