Month: July 2015

Yonder: Practice nurses, Ehlers-Danlos syndrome, fitness to drive, and Balint groups

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. Practice nurses In the UK, much like the rest of the world, a huge proportion of patients with mental health conditions are managed exclusively in primary care, with no specialist psychiatric input. Practice nurses make up a substantial part of the primary care workforce and are increasingly involved in...

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BJGP Student Writing Competition – the winner

Lydia Yarlott is in her final year at Oxford Medical School. She is the winner of the 2015 BJGP Student Writing Competition themed ‘The GP in the Digital Age’ with her original article A Digital Ache. Her tale of one GP versus the system will be horribly familiar to anyone who has done battle with the new digital bureaucracy of the NHS. It’s a rather wonderful reminder of the fundamental importance of maintaining relationships between doctors to benefit patients. The PDF version is embedded below – it needs the formatting to get the full benefit. Enjoy. [gview...

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Yonder: prostate biopsy, childhood vaccination, oral health and medical tourism

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. Prostate biopsy Prostate cancer remains one of the commonest causes of cancer death in the world and as active surveillance becomes an increasingly accepted alternative to radical treatment, the use of biopsies has extended to include monitoring as well as diagnosis. Transrectal ultrasound guided biopsy (TRUS-Bx) is therefore one...

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RATs: Quality not Quantity

Joe Anthony is a history graduate currently in his fourth year studying medicine at the University of Manchester. He was joint second in the BJGP Student Writing Competition which had the theme The GP in the Digital Age. Joe’s article took us straight into how technology has an impact on two key topics for any GP: quality and continuity. Talk to any politician and they will tell you that the problem is one of access. ‘GPs should be working 7 days a week’, ‘more appointment-slots should be available’, ‘better access equals a better service’, they yell from their soapboxes. And with a growing population, which has ever-increasing expectations of what the NHS should do for them, you might be forgiven for thinking that the problem is simply one of quantity. This attitude is evident in the government’s recent approach to improving general practice. Development of effective telehealth in the UK has been a priority, with CCGs rolling out these services thanks to heavy financial backing. Telephone consultations were once the purported solution; increasing ease of access and therefore the quantity of consultations available was the goal, however, the results were far from satisfactory as the increased access simply led to greater demand. The telephone slots were used but those same patients too often still required a traditional consultation, hence the ESTEEM trial’s conclusion that telephone consultations were not cost-effective.1 CCGs are...

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The Technophobe’s Guide to the Digital Age

Rebecca Varley trained at Lancaster Medical School and is on the brink of being an FY1 based at Manchester Royal Infirmary. She was joint second place in the BJGP Student Writing Competition which had the theme ‘The GP in the Digital Age’. We liked her warm, personal counter-perspective on how we approach technology. Douglas Adams had it right. In his Hitchhiker’s Guide to the Galaxy series he perfectly encapsulates the way I feel about technology. I am one of those poor Earthlings who “still thinks digital watches are a pretty neat idea,” and wonders why no one has noticed that technology is only making life more complicated? Adams’ infamous Nutrimatic-Drinks-Dispenser “invariably delivers a liquid that is almost, but not quite, entirely unlike tea.”1 And isn’t it true? Machines can’t even get tea right. When the best part of technology is the “sense of achievement you get from getting it to work at all,” something is wrong.2 Despite having been born slap-bang in the middle of the digital age, I am dismayed to find myself a ‘technophobe.’ But when I look around at my colleagues-to-be, I don’t believe I’m alone. On every GP placement I have heard doctors bemoaning technology day in and day out. And why not, when all the patient notes spontaneously decide to reboot mid-surgery, when the electronic prescribing program takes itself out for a few hours, or when a...

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