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Evening wrap up: today's late breaking business stories

Top business stories from around the web.

Deutsche Bank and Morgan Stanley resign as brokers to ENRC (FT)

Deutsche Bank and Morgan Stanley have resigned as brokers to Eurasian Natural Resources Corp, adding to the woes of the embattled FTSE 100 miner.

The two banks resigned the roles in recent weeks, two people familiar with the move said.

The banks were unlikely to act as advisers on the potential bid for ENRC that was confirmed by a trio of large shareholders last month, one of the people said.

Harbinger Capital and manager Philip Falcone to pay SEC $18m (FT)

Philip Falcone and his hedge fund Harbinger Capital Partners agreed to pay $18m to resolve civil allegations by US regulators that he misused customer funds to pay his taxes, manipulated markets and gave favourable treatment to certain clients.

Mr Falcone also agreed to a two-year bar from acting as an investment adviser, according to a regulatory filing made by Harbinger. In the filing, the firm said Mr Falcone can continue to act as chief executive and chairman of Harbinger but cannot make investment decisions. Harbinger is also prohibited from raising new funds or making capital calls from existing investors for the two-year period.

Top paid RBS banker goes in reshuffle ahead of US float (Telegraph)

Ms Alemany, chief executive of RBS Citizens Financial Group, will leave the bank in October to be replaced by Bruce Van Saun, group finance director of RBS.

Last year Ms Alemany received a package worth £4.8m - £1.6m more than the bank’s chief executive Stephen Hester.

BT unveils pricing of new sports channel (Telegraph)

Subscribers will get access to 38 Premier League games per season, as well as exclusive Premiership rugby, women's tennis and other sports.

The offer is designed to attract customers to BT's super fast fibre optic broadband service, BT Infinity, which will cost £15 per month. It will also be available for free to standard broadband subscribers, who will pay £10 per month.

Lloyds bank announces a further 850 job losses (BBC)

Lloyds Banking Group is planning a further 850 job cuts and the closure of a large office in Essex.

The bank said more than 600 jobs would go when an office in Southend shuts, with the remainder going in its commercial and insurance operations.


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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