Working in partnership with patients and their families
Neena Modi, president of the Royal College of Paediatrics and Child Health, offers her views on why #paedsrocks
Neena Modi is professor of neonatal medicine at Imperial College London and president of the Royal College of Paediatrics and Child Health (RCPCH). She qualified from the University of Edinburgh and trained in neonatal medicine at University College London and Liverpool Women’s Hospital. She was president of the Neonatal Society (2012-15) and president of the Academic Paediatrics Association of Great Britain and Ireland (2014-15). She served as chair of the BMJ Ethics Committee between 2010 and 2015.
The RCPCH recently launched #paedsrocks on Twitter listing 40 reasons why students should pick paediatrics. What are your top three reasons?
There’s nothing quite so rewarding as seeing a sick child get better—it’s the most fantastic thing to see and the joy it brings never wears off.
In paediatrics we treat patients in a holistic way and don’t see patients as a bundle of individual widgets. To achieve this, we work as part of large multidisciplinary teams to deliver the best care for patients, which means there is a great sense of teamwork.
Paediatrics is also the last bastion of general medicine. All paediatricians train as generalists first, which gives you a greater appreciation of patients’ needs as a whole and benefits you whether you remain a generalist or subspecialise.
How should paediatric and child health services be delivered in the future?
Children need to stay out of hospital as far as possible and receive good care at home, so preventive health is tremendously important. To achieve this we need to break down the artificial barriers between preventive, primary, and secondary care. The NHS needs to take this seriously; it requires doctors to be able to work in multiple locations in ways that suit patients.
In terms of how we train doctors to be ready for this, every doctor should be better acquainted with paediatrics before they move on to practise in adult medicine. Undergraduate medical education should start with the beginning of life from preconception, intrauterine life, paediatrics, and then move on to adult medicine. This would give doctors a better understanding of the effects of early life determinants on adult health.
What lessons can we learn from the Charlie Gard case, where the medical team and parents disagreed about whether experimental treatment was in the best interests of the child?
The fundamental problem that arose was that trust broke down between the parents and the healthcare team. In paediatrics we always do things in partnership with a child’s parents and family, so the breakdown of trust was painful because it is so rare.
Also, the public and press were confused about where responsibility and duties lie for paediatricians. The duty of care for every paediatrician is towards the child, not the parents or wider family, and the court rulings reflected and upheld this moral and legal duty.
What are the essential aptitudes required to practise as a paediatrician?
You can’t have an ego because children will destroy it. You need to be comfortable sitting on the floor with kids and having sloppy stuff all over you. You also need to be able to communicate well with children and their parents. We do a lot of work at the RCPCH asking children and young people how they want to be talked to, and it can make a huge difference to their experience of care when doctors get it right.
What do you think are the essential qualities of leadership?
I wouldn’t call myself a leader at all, but I’ve always had a vision for what I wanted to do and I followed it. My vision today could be defined in two parts.
One is to safeguard the NHS for the whole UK population, but particularly for children, given that they stand to lose the most if it weakens. Secondly, I want children and parents to have more of a say in how they want to be involved in research. The RCPCH has just launched a Children’s Research Charter to guide researchers on how to achieve this.
What has been the highlight of your career?
On a professional level, being appointed president of the RCPCH was a fantastic honour.
I am also proud of how, as paediatricians, we deliver holistic care and work in partnership with patients and their families. When we appointed a new board of trustees at the RCPCH, each candidate was first interviewed by a young people’s panel. I thought this was a great example of how the involvement of children and young people is core to what we do. We can learn a lot from young people and must continue to listen to them and shape our services and delivery around them.Matthew Billingsley, editor, Student BMJ
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.