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Practice corner
  1. Carl Heneghan, BM, BCH, BA(HONS) OXON
  1. Dept of Primary Health Care, University of Oxford, Mill Stream Surgery, Benson

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    The doctor’s advice and sleepless nights: what can you find in 5 minutes?

    They have no physicians, but when a man is ill they lay him in the public square, and the passersby come up to him, and if they have ever had his disease themselves or have known anyone who has suffered from it, they give him advice, recommending to do whatever they found good in their own cases, or in the case known to them. And no-one is allowed to pass the sick man in silence without asking him what his ailment is.Herodotus 484–424 BC (Greek Historian)

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    While teaching medical undergraduates EBM one day, we digressed to discuss the advice they give and how this is perceived the nearer they are to becoming a doctor. Family members and friends were already seeking their counsel, and this led me to question my own advice. Next day in my general practice clinic, I start to offer advice to the mother of a 16 month old child bent on wrecking her mother’s marriage by refusing to sleep at night. It appeared the child was taking too much milk (7–8 bottles a day including 2 at night), was difficult to settle, and then woke within 2 hours of going to bed. Both parents worked shifts and were inconsistent in their approach. I told the mother that I would like to see the whole family together, and, meanwhile, the plan was to decrease the amount of milk feeds. The health visitor was on holiday so I left myself a note to search for an answer.


    My usual approach to …

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