Month: April 2015

Yonder: Choosing a GP, breast cancer, patient safety, and online dating

Ahmed Rashid is an academic clinical fellow in general practice at the University of Cambridge. He writes the regular monthly column “Yonder” in the BJGP: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature. Twitter: @Dr_A_Rashid You can download the PDF here at BJGP.org. Choosing a GP. The NHS constitution gives patients the right to choose the GP surgery they want to register at and to express a preference to see a particular doctor within that surgery. In a recent Australian study, researchers studied the factors that are taken into consideration when choosing...

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BJGP Book Review: Out of Chaos Comes a Dancing Star

Out of Chaos Comes a Dancing Star: Notes on Professional Burnout by Chris Ellis. OpenBooks Press, 2014, PB, 95pp, £18, http://www.lastoutpost.info This book review was written by Ami Sweetman and was in the April 2015 issue of the BJGP. The author of this book has a fellowship and doctorate in family medicine, and from 2005 to 209 was an associate professor of family medicine at the University of the United Arab Emirates. He is now back home, semi-retired, and doing family practice in Pietermaritzburg, South Africa. The opening quote from the philosopher Friedrich Nietzsche sets the tone, ‘Out of chaos comes a dancing star’, which in its fuller context reads: ‘One must have chaos in oneself to give birth to a dancing star.’ The text derives from his collection of notes taken from experience, workshops, and courses on the management of stress and burnout in medical doctors, and those involved in the healing professions, although he says it applies to all professionals whether in law, business, or driving the school bus. Stress is a common theme risking progression to burnout. His work shows that understanding another person’s trials and tribulations can be a source of inspiration. Although the text has a serious undertone it sparkles with wit throughout. Insights into some of the struggles experienced by healthcare professionals are revealed, creating an awareness of the similarity of concepts and conditions encountered by all doctors....

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The BJGP Student Writing Competition

A huge thanks to everyone that submitted entries to this year’s competition themed ‘The GP in the Digital Age’. We have received many wonderful entries and we are just in the final stages of judging. The people on the shortlist have now been notified by email and we will be announcing the winners next...

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Paracetamol, ethnic health inequalities, cerebral palsy, and pornography

Ahmed Rashid is an academic clinical fellow in general practice at the University of Cambridge. He writes the regular monthly column “Yonder” in the BJGP: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature. Twitter: @Dr_A_Rashid You can download the PDF here at BJGP.org. Paracetamol A recent study from South Africa, published in Patient Education & Counselling, is titled ‘But it’s just paracetamol’ — a phrase and sentiment that most GPs will be more than familiar with. The study sought to determine whether caregivers could make informed decisions about administering over-the-counter analgesia to children.1 In...

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Essential law for GPs: if CPR would be futile what do I tell my patient?

Adam Sandell is a GP in Cumbria, and a barrister at Matrix Chambers. If CPR would be futile, do I have to tell my patient about a decision not to attempt it? The busy-doctor answer: Normally, yes. In more detail: Mr Bloggs has end-stage COPD. He knows he’s unwell. But he’s an anxious man with an anxious family. He hasn’t asked you about prognosis. And he’s deteriorating. Forward planning seems wise: indeed, the General Medical Council says that, when patients become clinically unstable and there’s a foreseeable risk of arrest, a judgment about the likely benefits, burdens and risks of CPR should be made as early as possible. You reckon CPR would be futile, so a decision not to attempt cardiopulmonary resuscitation (‘DNACPR’) looks right. Were Mr Bloggs to arrest, pummelling his chest in the back of an ambulance to nowhere will do no-one any good. So surely there’s no need to cause him further distress by discussing this with him? It’s futile, so isn’t it as relevant as discussing whether you’re going to certify him fit to climb Kilimanjaro? Not so, said the Court of Appeal last year in a case called Tracey. Mrs Tracey had lung cancer and was on a ventilator following a road accident. An intensivist completed a DNACPR form without discussing it with Mrs Tracey (who was apparently conscious and communicating at the time)...

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The British Journal of General Practice and BJGP Open are bringing research to clinical practice. This is where we add the debate and opinion to help ensure everyone benefits from that research.

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