Speed, prostitution and the media – a dangerous triad!

It was Easter 1993 and I was feeling pretty pleased with myself. I had just secured a prestigious MRC Senior Clinical Fellowship and with it my Consultant contract. Life was looking good! You can probably see the smile on my face as we head south on the M5, kids in the back of the car, for a well deserved Easter break in Cornwall. It was 6.10am when we slowed to negotiate the start of a 10 mile stretch of road works with the inner lane coned off.

No one was in sight and the only other car on the road turned out to be an unmarked Police car sitting in the inner lane. I saw a policeman point something at me through his windscreen and was met with an official letter on my return from holiday a week later informing me that I had been doing 74 mph in a 50mph coned limit. The bad news was that I was to be the victim of a means tested process and was required to complete a form giving full details of my salary and personal circumstances. The recent change in contract had seen an increase in my salary and, to cut to the chase, I was faced with a maximum £580 fine. My smile had vanished, but to make matters worse, that same week a High Court Judge (John Prosser if I recall correctly) had admonished a 15 year old boy found guilty of committing rape with a £500 fine that he suggested be given to his victim towards a “good holiday”. I was incensed not only because I believed I had been driving responsibly in the first place, but also at receiving a punishment, which in eyes of some, equated to a charge of rape. I took great pleasure in arguing my cause at Stroud Crown court several weeks later; it made no difference – a sympathetic Judge but “his hands were tied” and the £580 fine became £700 with added court costs.  But my day was to get worse. Clearly not much happened in Court that day because I was greeted by a journalist after my hearing who claimed he was writing a piece on means tested fines and wanted to hear my story (incidentally means testing was abolished shortly afterwards). Nothing could have been further from the truth – the following day I was front page of the Birmingham Post “New Consultant in reckless driving offence” followed by entire section as to how I had potentially put my own patient’s lives at risk by driving at excessive speed. Anonymous hate mail followed from the public at large to my University/hospital address. It was an unpleasant experience to say the least. I did learn several lessons however; firstly, watch your speed and secondly, beware of the media. Having had a few run-ins since on professional rather than personal matters, I rushed off to be “media trained” and am hopefully now better equipped to use media positively and to spot where trouble may lie.

Almost 20 years later and Andrew Lansley, Secretary of State for Health is visiting Birmingham to announce a £12.8 million award from the government to support our pioneering Wellcome Trust Clinical Research Facility embedded within the Queen Elizabeth and Birmingham Children’s Hospitals. It is great news for us – officially recognising Birmingham as having the biggest and best such facility across the UK. The Media pack is alerted but sadly both BBC and ITN seem hell bent on picking holes in his plans for NHS reforms rather than celebrating the good news surrounding more research funding. Very clearly Lansley has been media trained as well!!

With Lansley en route back home, I have an urgent message to call Ben Hill in the University Press office. At last, I think, perhaps a sensible reporter wanting an in depth interview on the great innovations and discoveries across the Medical School that will impact on Human life! Alas, I am told to expect an uneasy few days as a story breaks on Medical Students and Prostitution ….. and Birmingham Medical School is the source!

And that is how I met Jodi Dixon – one of our very talented final year medical students. After discussion Jodi agreed to help me write this blog and this is her unedited contribution.

Last week I somehow managed  to make the world think that 1 in 10 medical students were sidelining in prostitution. To those who felt their reputation was called into disrepute or felt offended by what they read in the newspapers I am truly sorry this was never my intention. For those of you who found it funny, I’m glad someone got a laugh out of it and for those of you who have not got a clue what I am talking about here’s the truth about what happened- maybe you can learn from my mistakes!On the 14th December 2011 the BBC published an article with the headline ‘NUS: Students turning to prostitution to fund studies.’ This article reported the result of a 2010 study that showed   the number of students who knew a student who worked in the sex industry had increased. The Student BMJ then asked me to write an article looking into how acceptable it would be for medical students to work as prostitutes. Having always found medical ethics interesting I wrote the article, getting my information from studies already widely available through a Google search and a few e-mails to relevant people. I produced what I thought was a balanced article, it neither sought to condemn or encourage prostitution, merely spark debate by looking at what would happen in the hypothetical situation that a medical student was a prostitute.And so I was totally shocked when I realised this story had made headlines around the world, I had phone calls from across the globe, even radio stations and TV channels showed an interest in running features based on my article.

But what many seemed to report was not true. Obviously, 1 in 10 medical students are not prostitutes, in fact, apart from one medical student the Student BMJ interviewed anonymously, there is not a scrap of evidence that any medical student is a prostitute, I don’t know about anyone reading this but I certainly don’t know anyone. My article used data from a study that showed that 1 in 10 students in general knew a student who had worked as a prostitute (the same study the papers had already reported data from in December). And so the press took one paragraph of my article and sensationalised it into craziness!

Having written this article I have had my professional behaviour called into question. I never intended for the world to think that myself and my colleagues were prostitutes but in my naivety I did just that.

As I hopefully soon embark on my career as a doctor, I feel it an appropriate opportunity to think about what professional behaviour as a doctor entails and how we as the future of the medical profession must behave in a manner that meets the expectations placed on us.

So what exactly does professional behaviour mean?  Some aspects of professional behaviour are obvious. Obviously medical students cannot behave in a way that may harm patients, not attend university or placement, or cheat in exams and coursework; it is easy to see why such behaviour is unprofessional.  But, Medical students: professional values and fitness to practice published by the GMC states: ‘Students must be aware that their behaviour outside the clinical environment, including in their personal lives, may have an impact on their fitness to practice. Their behaviour at all times must justify the trust the public places in the medical profession.’ It is this point where what you do in your personal life may impact up on your professional life where what is right and what is wrong become shades of grey. The public expect certain behaviour by doctors. A 2002 article in the BMJ stated that: ‘in the United Kingdom doctors top the polls as the most trustworthy and hardworking of all professionals.’

The BMA conducted a poll in 2011 and found that 88% of adults trusted doctors. Since the poll began in 1983 doctors have topped the list of most trusted professionals every year. So I guess the problems arise when what you do in your private life conflict with what is expected of your profession in the eyes of the public. We can’t all be perfect, very few of us do nothing wrong so finally I’d just like to draw your attention to another point from the GMC guidance: ‘Reflect, learn and teach others.’
I have reflected on last week’s events, I have definitely learned from them and I hope I can teach you all to think about how what you do outside of your clinical practice might effect how others view you and your profession.”

Jodi Dixon

What Jodi doesn’t tell you is that she intercalated in Medical Journalism and has also written several other articles – notably an extremely incisive piece on Student participation in Clinical Research. Following this incident I have taken up the matter with Fiona Godlee, Editor in Chief of the BMJ who also raised surprise at the press interest in this story and has promised to do more to help authors faced with similar situations in the future. Thanks to lobbying from some upset parents of local students, the Birmingham papers have apologised for printing an incorrect interpretation of Jodi’s article.

We all make errors of judgement and will continue to do so. At times external forces – in this case the media – exaggerate the significance of these errors, but this must not make us fearful of new ventures. The secret is that we learn from these life events and thereby enhance our Professional standing.

Paul M Stewart

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