Interviewed by Dr Denise Braganza (DMB) on behalf of the BCS
Roger Boyle
DMB: Professor Roger Boyle (RB), congratulations on being one of the two 2010 Mackenzie medal winners, an award given by the BCS for outstanding services to British Cardiology. I have not seen many adverts for Cardiology health Tsars! How did your career path lead you there? Were you head-hunted or did you volunteer?
RB: I was head-hunted for the job having helped to draw up the NSF and after a chance encounter with Alan Milburn on the train!
DMB: Harry Burns in his article about health Tsars in 2004 (BMJ 2004;328:117-8) says "Tsars tend to be appointed because they are noisy and attractattention. They are usually outspoken and passionate in advocatingchange in the way their patients are managed". Do you think that describes you?
RB: Those that know me are aware that I am not noisy or attention seeking but I am passionate about advocating change. Luckily, so are the rest of the cardiac community, in primary care, secondary care, tertiary care and in the ambulance service. Every discipline has played their part and, as a result, we now have a service of which we can be proud.
DMB: If you had to write the job description for the next health Tsar, what would you put in it?
RB: There will need to be a greater focus on chronic disease management and primary prevention, so a close liaison with primary care will be vital.
DMB: What are you most proud of achieving as National Director for the Heart Disease and Stroke Vascular Programme, and are you worried that the changes you have helped to implement will be reversed by the new coalition government?
RB: I am not worried about a new administration but the financial position is a significant threat. I believe that the progress that has been made on acute care will be secure but innovation is going to be difficult.
I am most proud of the overall collective achievements that have been achieved with the NSF. Better access, higher quality, more equity and a 50% reduction in deaths from CHD. Everyone has played a part right across the NHS and beyond. A great team effort.
DMB: How far away do you live from your nearest PPCI centre? Will it be something you look at if you were to move house?
RB: I live three miles from the Hammersmith Hospital but I will ensure that the PPCI and Stroke services in Cornwall are perfect before I retire there.
DMB: And finally, what is the best cardiology joke youve heard?
RB: The best joke was made at the late Dr Stanley Taylors expense. He was a cardiologist in Leeds and known as straight line Stan as all his research was perfect. At a dinner that he and I were hosting, he asked Martin Kendall to give a speech with zero notice. Martin stood up and said how difficult this was. He only knew two jokes and one of them was Stan.
DMB: During his career, Sir James Mackenzie advanced the understanding of both cardiology and neurology. Despite outstanding success as a London Cardiologist, he spent his final years setting up an Institute for Research in General Practice. Professor Boyle, the liaisons that you have fostered between primary, secondary and tertiary care for Cardiology services emulates that spirit. Congratulations again.
Peter Mills
DMB: Dr Peter Mills (PM) congratulations on being a co-recipient of the 2010 Mackenzie Medal for outstanding services to British Cardiology. What was the route by which you have got to where you are today?
PM: Following a two year period of research at the University of North Carolina, I returned to London in 1979 as a Consultant Cardiologist and Senior Lecturer at the Royal London Hospital and subsequently London Chest Hospital. I am always grateful to Denis Krikkler who co-opted me as an Assistant Editor of the British Heart Journal in 1985 .This eventually led to the development of “Education in Heart” which I edited from 1998 to 2009. In 1995 I was the first chairman of the North East Thames training committee in Cardiology and in 1998 became a member and subsequently secretary and chairman of the Cardiology SAC. I have been the Chairman of the European Board for the Specialty of Cardiology since 2006.
DMB: Dr Mills, I know that you are passionate about cardiology training and have a vision for a web-based method of assessment which allows demonstration of competence, both for trainees, and as revalidation looms, I suspect for consultants too. How far along this pathway do you think we have come and what are the major hurdles left?
PM: There are a number of complex strands here.
Trainees or consultant cardiologists should be able to use the internet to demonstrate their level of proficiency (my 3 year old grandson can use the iPod by himself to locate and play his pre-bedtime story)
To this end, simple user-friendly IT products are needed - these products must be developed and owned by the doctors, although approved by the Regulators eg GMC
Cardiology is an ideal setting to test an electronic-based tracker system of training or revalidation
DMB: As an advocate for “reflection” in clinical practice what lessons can you impart?
PM:
Develop hypotheses, whether about individual patients or research projects…..a lesson I learnt from the late Prof Michael Davies.
Always write in the notes the first sentence of the clinical history that the patient gives you; also write down a detail about the patient’s non-medical life (eg “I take my little dog called Toto for a walk every day; we always stop twice before we collect the papers ” - this helps to document the angina). Refer back to them at follow up appointments. Patients much prefer to be treated as people rather than cases.
Never be afraid to challenge dogma. (Steve Holmberg says I am an inveterate and persistent iconoclast. I expect he is right and that is why I am both surprised and absolutely delighted the BCS have awarded me the Mackenzie medal)
DMB: What is the funniest thing you’ve heard from a trainee at their assessments?
PM: Well you wouldn’t call it funny, but the laudable efforts of trainees to persuade me that the General Medical takes at The Hammersmith Hospital were “busy”, were certainly amusing, especially when you see the size of the A and E department . As you would expect there were some articulate trainees involved in this campaign and they were most persuasive.
DMB: Finally, you are renowned for your rapid fire questions and have no doubt terrified scores of SpRs at their ARCP/RITA. Now it’s your turn ….
Intervention or education? Education – it has a longer lasting benefit.
DES or BMS? BMS -its just my personality.
Radial or femoral? Femoral - but I think radial is the future and probably the “now”.
Gardening or music? Difficult but it has to be gardening because the plants are so like trainees ……..You get strong ones and weak ones from the increasingly depersonalised selection process (garden centre).
Football or cricket? I have often said that all of Life is reflected in the emotions and interpersonal relationships in football – many lessons on what to avoid, for instance. Cricket is quite different, it emphasises the importance of team work, so star batsmen or Interventionists are only of value if the team wins or the patient is alive and well 12 months later.
Euro or sterling? Very very difficult. I really would love to say Euro, but just at the moment it is sterling.
Cameron or Clegg? Clegg .I’ve been a radical Social Democrat long before it became fashionable.
Mac or PC? PC despite efforts from Adam Timmis and others to convert me. My children regard me as an IT desert and genetic embarrassment.
Bond or Strictly (Come Dancing)? Definitely Strictly.
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