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This is the first editorial of my two years in the role of secretary, and having been Dave Beaumont’s deputy for the previous two years, I have seen at first hand his indefatigable work in the role - he will be hard to match.

A modest man, Dave is what I would call a “geriatrician’s geriatrician”. He runs a very busy service in Gateshead where he is also an assistant medical director and closely involved in medical education and training. This gives him real insight into the concerns of hardworking district general hospital docs who form the bulk of our membership, and into the issues facing trainees. He has brought these insights to his editorials using an accessible and entertaining style, spiced with his dry and sometimes self-effacing sense of humour. Under his stewardship, we have more hits on our website than ever, are receiving more correspondence and interaction about controversial topics and our membership has grown steadily to an all time high of 2,500. I would like to thank Dave on behalf of the society and hope that he re-surfaces in another guise within the BGS.

Equally I’m pleased to welcome Simon Conroy to the Hon. Dep. Sec role. Simon has just been appointed as Senior Lecturer and Consultant in Leicester. He is already a rising academic star, with important grants and publications behind him, not least of which was last year’s BMJ paper about “opt in” DNR decisions in nursing homes, where he demonstrated a crucial ability to raise matters for open debate. I am also encouraged that Simon has already been checking whether it is permissible to be frank and outspoken about issues affecting older people’s care. If we are to become more proactive in media relations and campaigning (of which more anon) this will be a useful trait.

Behind the shop window..or what do I get for my membership fee?
I make no apologies for doing a little gentle evangelism on behalf of the society. Our current membership stands at 2,500 (including 589 trainees, 1,200 consultants, 310 overseas and 150 allied professionals). I realise of course that “you pays your money and you takes your choice”. Already snowed-under professionals are certainly under no obligation to engage more fully with the Society and I can well understand some people thinking “what are you actually doing for us?” rather than “what can I do for you?.” However, at more than one event recently, I have been door-stepped by doctors saying that they have “lost confidence” or aren’t getting “value for money” or at regional meetings, heading for the door the minute the BGS business meeting commences. There may therefore, be a feeling among some that we are ineffectual or irrelevant, though it is hard to say how representative these opinions are. Maybe the malcontents are more inclined to speak out. Anyway, to counter this, I have to say that as Hon Dep Sec, I have been astounded by the range of activities in which we are involved behind the scenes.

The “shop windows” may be the scientific meetings, Age and Ageing and our website. The former still managed to attract 500 and 600 delegates respectively, to the last autumn and spring meetings and is still a major vehicle for CPD and for doctors to showcase emerging research. November’s Harrogate meeting was very lively, despite being up against the NOS and BASP conferences in successive weeks. Meanwhile, Age and Ageing went from strength to strength under Prof Wilcock’s editorship - my main yardstick being how many articles I find useful in my own practice and teaching (plenty). The journal received 580 submissions last year alone - all of which requires a great deal of input from the editorial team and assistant editors. We wish the new editor, Roger Francis, good luck in taking this success forward. The website has also become a well-used resource and is regularly accessed by non members researching issues around the care of older people. It receives on average, 15,000 hits per month.

“Behind the shop window” there is so much else that the Society does though. The special interest groups and sections all provide scientific programmes, policy documents and consultation/advice as entities. The Education and Training committee has put tremendous effort into influencing the training of tomorrow’s geriatricians, attempting to get more geriatrics into undergraduate curriculae and is now leading the way on CPD, CME and re-validation. I was also delighted to see a whole issue of Clinical Medicine (the journal of the RCP) devoted to geriatric medicine, with several excellent pieces by leading lights in the specialty. And the Academic and Research committee, in addition to its vital role in overseeing the scientific meetings programmes, administers research grants and has collaborated with the College on clinical guidelines and clinical effectiveness. With other bodies, it is seeking more joined up funding for ageing research. Finally, the Policy Committee and the specialist sections, in addition to developing a range of good practice resources to aid clinicians, has responded to numerous requests for consultations on health policy, ensuring that the views of specialists in the care of older people guide policy. All of this activity is dependent on the goodwill and unpaid time of a fairly small group of engaged clinicians. It is easy from the outside looking in not to see this, or to assume that much of the work is driven by advancement or recognition. In reality, several colleagues put in hours of unpaid and unrecognised time into making the Society’s range of activities effective - backed by Alex and the rest of our permanent secretariat. So my plea for members (especially some of the younger ones) is to get more involved, more engaged and avoid the accusation that the representation on committees is a case of musical chairs within a cosy club of the “usual suspects”. We want your views (including the critical ones) and we want your involvement and engagement.

How interdisciplinary do we want to be?
Geriatric medicine and old age psychiatry are par excellence interdisciplinary specialities. I am sure that comprehensive geriatric assessment and full multidisciplinary input are concepts that all of us champion to students and doctors in training – and to reluctant patients whom we are trying to persuade to transfer to a specialist setting. I was therefore very pleased that we changed our strapline to the profession-neutral “Better Health in Old Age”. I have been to the past two meetings of the American Geriatrics Society and it has been quite a revelation how genuinely interdisciplinary these meetings are. I also know that in some of our section and SIG meetings (for instance falls and bone health), nurses and therapists outnumber medics and that there is a small but thriving nurse consultants’ section. My personal view is that it is high time we actively sought out greater participation from other professional groups so that our membership and range of activities reflect the inter-disciplinarity of our day to day work. This would be “win/win” educationally, as I have had any number of nurses and therapists say how fantastic a number of our educational meetings are compared to what is often provided for them (as well as being competitively priced when we compare them with certain private companies currently charging an arm and a leg for one day events around older people’s care). In turn these groups will contribute to the educational and research content of our meetings. Finally, a way to avoid being marginalised and to grow our influence is to avoid being seen from the outside as a self-serving interest group of secondary care doctors (even though that is a false perception). I would very much welcome views on this topic.

What's in a name?
During the session in Harrogate and at the AGM, several members raised the issue of our Society’s name. Although it has been in use for 60 years and is a recognisable “brand”, the word “geriatrics” has arguably acquired negative connotations and might hamper our external image. In the Patrick Swayze vehicle “Roadhouse” where he plays a troubleshooting bouncer, there is a running joke “I thought you’d be bigger”. Well several of our members have experienced “I thought you’d be older” comments when representing the society. But what to change to? As mentioned in our report on the campaigning debate, one suggestion was “The British Society for Health in Ageing” – it’s not too snappy though. I would love to hear from you on a) Whether you would like to see a change and b) What the new name might be?

A couple of links
Firstly, can I commend an excellent article in the New Yorker by the neurosurgeon and writer Atul Gawande. Great propaganda for the speciality. Secondly, I recommend Dr Michael O’Donnell’s excellent BBC Radio 4 series in November “The Age Old Dilemma”.

A fluffy tail?
Finally, a story I couldn’t resist. And one which shows how far we have come in appraisal and in countering sexism. During a debate at UKMC about the Tooke report and the restructuring of the Foundation Years, the outgoing Chair of the Policy committee – one Dr Jackie Morris, told us that at least MMC had prompted formal appraisal meetings. Apparently, in her medical house job, the only career advice the young Dr Morris received from her consultant was “Jackie, you really ought to have been a bunny girl”. Jackie, it’s never too late to follow your dream!

Feedback please
Signing off, I would like to thank all those who contribute to this newsletter. We get a great deal of unsolicited material which reassures me that you consider this your newsletter. I urge you to send us your thoughts either in the form of a letter or an article. We will do our best to publish the best here and the rest on the website.

At the same time, if you feel there are any issues which we should be covering, I would be very pleased to hear from you. I may be contacted via the email address at the top of this page.

David Oliver

BGS Newsletter, December 2007
Issue 14 ISSN 1748-6343 14