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King Obama? The media are going overboard, says Mehdi Hasan

The press coverage of the US president's state visit to Britain is bordering on the ridiculous.

I blogged in the weekend about Andrew Marr's soft interview with Barack Obama in the White House ahead of his state visit to the UK. There were plenty of journalists willing to take potshots at Marr's giddiness and obvious excitement at being in the presence of "The One".

But newspaper journalists, commentators, pundits, broadcasters and bloggers alike have been fawning in their coverage of the US president since his arrival on our shores on Monday night.

It's a point that hasn't been lost on the more Obama-sceptic press corps back home in the United States. From USA Today:

President Obama traded a cozy pub for a spacious palace Tuesday, but the reception was the same: he was treated like royalty.

After basking amid one of the most affectionate audiences of his presidency Monday in Ireland, Obama arrived here to be feted by a queen and three generations of princes.

He and first lady Michelle Obama were welcomed at Buckingham Palace, where they were given a six-room suite last occupied by Prince William and his bride, Kate Middleton, on their wedding night.

They were fawned over at Westminster Abbey, greeted warmly at No 10 Downing Street and, finally, lauded at the first state dinner thrown here for a US president in eight years.

I never thought I'd find myself in agreement with the City AM editor, Allister Heath, who tweeted:

Why is the UK media treating Barack Obama's visit with such deference? Feels like being in some 1950s BBC newsreel on trip by royal family

Forget Afghanistan or Libya, climate change or Middle East peace -- the real issues have been table tennis and the Downing Street barbecue. Take the BBC, the voice of the establishment, which, on its live blog, notes:

Now the news you've all been waiting for. After the grandeur of last night's state banquet at Buckingham Palace, we are told the Downing Street barbecue is a little more down to earth. Guests are apparently tucking into British sausages, beefburgers, Kentish lamb chops, corn on the cob, Jersey Royal potatoes, with tomato, mozarella and basil salad, then summer berries and ice cream to top it off. Sounds tasty.

Doesn't the "leader of the free world", the president of the globe's only remaining superpower, the commander-in-chief of the mightiest armed forces on earth, deserve proper scrutiny? Rigorous and serious coverage? Yes, he is a great speaker and a cool dude. Yes, he isn't George W Bush. But he is a foreign president who has done some pretty dodgy things (from helping undermine Copenhagen to doubling the number of drone strikes inside Pakistan). Or are all these issues off-limits?

As I type this blog post, I'm watching Obama and Cameron on television, in shirt sleeves and ties, grilling sausages in the No 10 garden. This is what geopolitics has been reduced to; this is what the "special relationship" is all about. Gimme a break . . .

The cult of Obama, especially in the British media, is deeply dispiriting. Having said all this, I'm now off to Westminster Hall to see the US president address both Houses of Parliament on issues unrelated to ping-pong and barbecues and I'm sure I won't be able to stop myself from going all weak-at-the-knees when he starts speaking. Agh!

Mehdi Hasan is a contributing writer for the New Statesman and the co-author of Ed: The Milibands and the Making of a Labour Leader. He was the New Statesman's senior editor (politics) from 2009-12.

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Want to know how you really behave as a doctor? Watch yourself on video

There is nothing quite like watching oneself at work to spur development – and videos can help us understand patients, too.

One of the most useful tools I have as a GP trainer is my video camera. Periodically, and always with patients’ permission, I place it in the corner of my registrar’s room. We then look through their consultations together during a tutorial.

There is nothing quite like watching oneself at work to spur development. One of my trainees – a lovely guy called Nick – was appalled to find that he wheeled his chair closer and closer to the patient as he narrowed down the diagnosis with a series of questions. It was entirely unconscious, but somewhat intimidating, and he never repeated it once he’d seen the recording. Whether it’s spending half the consultation staring at the computer screen, or slipping into baffling technospeak, or parroting “OK” after every comment a patient makes, we all have unhelpful mannerisms of which we are blithely unaware.

Videos are a great way of understanding how patients communicate, too. Another registrar, Anthony, had spent several years as a rheumatologist before switching to general practice, so when consulted by Yvette he felt on familiar ground. She began by saying she thought she had carpal tunnel syndrome. Anthony confirmed the diagnosis with some clinical tests, then went on to establish the impact it was having on Yvette’s life. Her sleep was disturbed every night, and she was no longer able to pick up and carry her young children. Her desperation for a swift cure came across loud and clear.

The consultation then ran into difficulty. There are three things that can help CTS: wrist splints, steroid injections and surgery to release the nerve. Splints are usually the preferred first option because they carry no risk of complications, and are inexpensive to the NHS. We watched as Anthony tried to explain this. Yvette kept raising objections, and even though Anthony did his best to address her concerns, it was clear she remained unconvinced.

The problem for Anthony, as for many doctors, is that much medical training still reflects an era when patients relied heavily on professionals for health information. Today, most will have consulted with Dr Google before presenting to their GP. Sometimes this will have stoked unfounded fears – pretty much any symptom just might be an indication of cancer – and our task then is to put things in proper context. But frequently, as with Yvette, patients have not only worked out what is wrong, they also have firm ideas what to do about it.

We played the video through again, and I highlighted the numerous subtle cues that Yvette had offered. Like many patients, she was reticent about stating outright what she wanted, but the information was there in what she did and didn’t say, and in how she responded to Anthony’s suggestions. By the time we’d finished analysing their exchanges, Anthony could see that Yvette had already decided against splints as being too cumbersome and taking too long to work. For her, a steroid injection was the quickest and surest way to obtain relief.

Competing considerations must be weighed in any “shared” decision between a doctor and patient. Autonomy – the ability for a patient to determine their own care – is of prime importance, but it isn’t unrestricted. The balance between doing good and doing harm, of which doctors sometimes have a far clearer appreciation, has to be factored in. Then there are questions of equity and fairness: within a finite NHS budget, doctors have a duty to prioritise the most cost-effective treatments. For the NHS and for Yvette, going straight for surgery wouldn’t have been right – nor did she want it – but a steroid injection is both low-cost and low-risk, and Anthony could see he’d missed the chance to maximise her autonomy.

The lessons he learned from the video had a powerful impact on him, and from that day on he became much more adept at achieving truly shared decisions with his patients.

This article first appeared in the 01 October 2015 issue of the New Statesman, The Tory tide