Clin Med
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The New Zealand Health Service had to start adapting to significant restrictions in junior medical staff's hours of work in the mid-1980s. Some consequences of this presage those that will occur in the UK and Europe with the implementation of the European Working Time Directive (EWTD). These naturally include continuity of patient care, changing responsibility and hours of senior medical and administrative staff, some aspects of medical professionalism and training issues. Life does, however, go on.
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The optimal management of acute ventilatory failure lies in a multidisciplinary approach focusing on doing simple things correctly, close liaison between healthcare professionals and adequate communication with patients and carers. The use of NIV support is increasing in a variety of conditions, both inside and outside the ICU.
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Whilst patients and doctors each bring a collection of rights and responsibilities with them into the consulting room, these parties must not be seen in isolation. The government of the day and its representatives have an absolute right to influence the future direction of the health service but they also have very grave responsibilities.
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The aim of revalidation is to reassure the public that doctors are up to date and fit to practise. The Royal College of Physicians has developed various programmes of work, both ongoing and under development, in support of revalidation. ⋯ These methods include ways of assessing both professional standards and clinical competence. Although the conclusions of the Chief Medical Officer in terms of the absolute requirements for revalidation are still unknown, the College is committed to supporting its Members and Fellows to prepare for revalidation through setting educational, professional and clinical standards in medicine.