Dipesh Gopal Profile picture
Doctor (GP) | @QMULBartsTheLon @SURECANstudy #researcher #cancer #survivorship #survonc #lwbc | @NCRI_partners Late Effects | @PACTGP Comms. Own views. RT≠end.
26 Jul
🧵THREAD on Hardouin et al (2020) #MedBikini article #MedTwitter


Editors' response:

Unconscious bias = implicit bias
Conscious bias = explicit, intentional

So in this is essentially misogyny and conflicts with human rights to free speech/private life. Image

Methodological concerns: unspecified definition of 'controversial'. There needs to a validated definition.

🗣️ "Controversial political and religious comments were
...directed toward...faith.

Controversial social comments...on abortion and gun control."

Moral concerns: clinicians performed searches on social media to conduct their research.

To be fair this is what patients could/would do. I'm not condoning this methodology.

I've had patients tell me that "I'm established" when I first met them from Googling me. 😳
Read 15 tweets
28 Jun

THREAD 🧵 on why #BlackLivesMatter

This week I presented to my GP practice about this topic covering:

Socio-economic/health differences
Genetics/Race science
History @DavidOlusoga
Being anti-racist/education

🔗: youtube.com/watch?v=0SQJz3…

It's designed to start conversations and be concise. You have to put the work in to work on yourselves to be anti-racist.

Please feel free to distribute.

If there are parts that are wrong, I am happy to amend/take down. @MelaninMedics @olamide_dada @KhadijaOwusu

Please circulate if it resonates @Dr_Ayan @OrthopodReg @yvonnecoghill1 @trishgreenhalgh @AmeenKam @omaromalleykhan @aftertheletters @RoshanaMN @parthaskar @JohnBoyega @SoniaAdesara @raceandhealth

Also call me out if I've got stuff wrong too/can be better.
Read 42 tweets
6 Jun

🧵 THREAD on "Black" by @Santandave1.

This song tackles overwhelming pain, history, suffering and loss of culture that inter-twines with modern injustices that black people face. #BlackLivesMatter

@MelaninMedics @thermoflynamics @OrthopodReg


I will try my best to explain the references in the song but I admit I'm no expert in black history.

Feel free to correct me anywhere.

🗣️ "Black is pain, black is joy, black is evident"

🗣️ "It's workin' twice as hard as the people you know you're better than
' Cause you need to do double what they do so you can level them."

I was told this as a child too. Despite this minorities rarely make leadership positions.

@WRES_team: england.nhs.uk/wp-content/upl…
Read 20 tweets
5 Jun
1/ THREAD summarising @PHE_uk report

More likely to die from #COVIDー19 if you are:

From certain parts, e.g. London, NW
From a deprived background
From a ethnic minority background
A low-skilled (key) worker
A migrant
Living in a care home
Have a medical condition

Data limitations

- most lab confirmed cases were from hospital deaths - most severe cases?
- the case definition/testing of COVID-19 changed through the pandemic

- ethnicity matched from 2011 census

- lack of data on vulnerable groups: migrants, sex workers, homelessness


- no discussion/action plan

- lessons learnt due to led by Equalities Minister (@KemiBadenoch) who had never heard of @MichaelMarmot's @TheMarmotReview until mentioned in Parliament yesterday:

- I’m worried very little will change
Read 40 tweets
24 May
1/13 #FOAMed #MedTwitter

Everything I've learnt about living and beyond #cancer research (#lwbc) over the last 3⃣ years in this 8⃣ minute video! #survonc #survivorship in primary care covering:

➡️ Research
➡️ Policy
➡️ Practice
➡️ Future Directions


I wrote a couple of articles in:

@BJGPjournal 🔗: bjgp.org/content/70/694…

@CHematology 🔗: sciencedirect.com/science/articl…

👆🏽 But summarised the content in the video above 👆🏽


🤔 What is "living with and beyond cancer" or #cancer #survivorship#survonc #lwbc

The definition depends on who you talk to! Is it at diagnosis, at the start of treatment or after treatment has finished?

🔗: bjgp.org/content/61/592…

🔗: cancer.net/survivorship/w…
Read 14 tweets
2 May

🗣️ "Women make up 77% of the NHS workforce, yet are under-represented in leadership roles at all levels."

What are the right skills to lead? Common to them all were:

1⃣ Collaboration and facilitation

2⃣ Developing trust and respect

3⃣ Compassionate leadership

🗣️ “you often cannot change things without it upsetting people in the process, but it is about doing what is best for the organisation...

...If something isn’t right you need to do something about it and sometimes it is hard to be nice to everyone”.
Read 8 tweets
5 Apr
I wanted to highlight the brilliant work on #Covid_19 being done by colleagues behind the scenes with little/no recognition. If missed out, sorry!

1⃣ @DustynSaint @drstephcoughlin on @PrimaryCareIT which collates guidance as and where it comes:

🔗: primarycarepathways.co.uk/covid19
2⃣ @trishgreenhalgh and the @CebmOxford team who have worked tirelessly working on crunching skips of data to give us clear answers

Roth or not - NOT
Smartphones as oximeters - NO
How to assess breathlessness remotely...

🔗: cebm.net/covid-19/
3⃣ @drgandalf52 @egplearning who provide podcasts, video and website updates:

How to do a respiratory examination remotely
Video consultation skills
Using @MicrosoftTeams for primary care
How to use @accuRx

🔗: egplearning.co.uk
Read 10 tweets
19 Mar
1/ Worrying to hear @DrRosieRiley on @doctors_kitchen's podcast talking re #modernslavery.

🧑‍🤝‍🧑 It affects 40 mil people (2017)

💵 #modernslavery generates more money cf illegal #drugs trade: $150 bn annually (2014).

GDP of:
🇳🇿 $202bn
🇵🇹 $195bn

@ilo🔗: ilo.org/wcmsp5/groups/…
2/ Regional data from @minderoo - Global Slavery Index: downloads.globalslaveryindex.org/ephemeral/GSI-…

#FOAMed ImageImageImage
3/ Regional data from @minderoo - Global Slavery Index: downloads.globalslaveryindex.org/ephemeral/GSI-…

#FOAMed ImageImage
Read 12 tweets
1 Mar
1/ As a medical student I was taught:

Less well off people die earlier than more well off people (Marmot)

Those that need our help are least able to access it. (Tudor-Hart)

I'm summarising #Marmot2020 with key graphs. Apologies if I've lost nuance here @MichaelMarmot. #FOAMed
2/ Too often in medicine we focus on 'direct' causes of disease: smoking, diet.

What drives these causes, i.e. indirect causes such as social/economic factors? #Marmot2020 #FOAMed

➡️ Spending on social protection, education, housing and environment has GONE DOWN as % GDP 📉 % of GDP on social spending has gone down over the last decade

➡️Council spending for people in the most deprived areas has been cut the most 📉
#Marmot2020 #FOAMed Council spending per person by quintile of Index of Multiple Deprivation average score, 2009/10 to 2017/18 has decreased the most for most deprived areas.
Read 34 tweets
14 Feb
1/ #RacismInMedicine is not isolated 'lived experiences' by leftie wokists

👳🏽👳🏽I have been 'mistaken' for the other brown guy on the team.

🙊 I've been called 'wog' by a patient

🇮🇳 Asked 'Where are you really from?' by patients so we can discuss 'India'. Why does it matter?
2/ It's not really about:

'microaggressions': it's about empathy...if I said this how would the person feel?

What message am I communicating by asking them where they are from? I'm asking if they belong.

Would I ask the same question to someone else?

3/ It's not really about:

'unconscious bias': it's about understanding how your mind works. Do I treat other people differently based on skin colour? It's uncomfortable to think we all are prejudiced. We are. #RacismInMedicine

@NHSEngland video:
Read 18 tweets
13 Oct 19
1/4 @babylonhealth says that it's AI scores a higher mark than trainees on RCGP exams: NOT TRUE.

AI was tested on sample website questions. We don't let computers sit @rcgp exams.

The data isn't peer reviewed: arxiv.org/abs/1806.10698

Great thread by @doctor_oxford 👇🏽
2/4 Great reading from @prof_tweet @IpsosMORI re evaluation of @GPatHand: hammersmithfulhamccg.nhs.uk/media/156123/E…

Patients that use @GPatHand are younger/more affluent/healthier but use it more than expected: is that meeting need or creating high demand?

@DrMurphy11 @WyldeLillie @AmeenKam
3/4 GPs that work for @GPatHand are younger, can work from home, have better life-work balance for 'innovative' service.

Since the NHS was created to benefit the poorest, are the employed GPs benefiting an affluent, healthier popn? @Voa1234

The inverse-care law in effect.
Read 4 tweets