Month: February 2016

GP Journal Club – February 2016

The February GP Journal Club is now on Storify. The paper discussed was: Douglas IJ, Bhaskaran K, Batterham RL, Smeeth L. Bariatric Surgery in the United Kingdom: A Cohort Study of Weight Loss and Clinical Outcomes in Routine Clinical Care. PLoS Med. 2015 Dec 22;12(12):e1001925. The next GP Journal Club will be in March – you can follow @GPjournalclub and #gpjc. Click here for the GP Journal club blogposts. [View the story “GP Journal Club – February 2016” on...

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GP Journal Club 28th February 2016 – Bariatric surgery in the NHS

Paper: Douglas IJ, Bhaskaran K, Batterham RL, Smeeth L. Bariatric Surgery in the United Kingdom: A Cohort Study of Weight Loss and Clinical Outcomes in Routine Clinical Care. PLoS Med. 2015 Dec 22;12(12):e1001925. Link: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001925 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 and is chairing the next #gpjc. @Dr_A_Rashid Obesity is a public health issue and not a general practice one. Right? I’ve recently had the good fortune to have talked about obesity with two wise and experienced GPs who held quite differing opinions on this. Although they were both in agreement that it is a serious and growing problem, one felt it was predominantly a social problem with solutions in policy and government whilst the other thought it a more clinical problem with solutions in the consultation room and NHS more broadly. Although the social causes of obesity are unquestionable and the need for policy change is clear, the already alarming rates of obesity and related diseases mean that we probably need solutions across the spectrum. Weight loss surgery is a concept that often divides opinion amongst clinicians and patients alike. However, it has become an important aspect of obesity management in recent years and is now an established discipline across various specialist centres in the UK. Although the results...

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Qualitative research and the BJGP

Kath Checkland (@khcheck) is a GP and a Professor at the University of Manchester. She is a passionate advocate of the value of qualitative research, and is a member of the BJGP editorial board. On Saturday, the British Medical Journal published an open letter, signed by 75 senior academics (of which I was one), calling for the journal to rethink its current stance on the publication of qualitative research. The letter was prompted by the publication on Twitter of an extract from a rejection letter stating: ‘I am sorry to say that qualitative studies are an extremely low priority for The BMJ. Our research shows that they are not as widely accessed, downloaded, or cited as other research.’ This stance represents a change in policy for the BMJ. Not only has the journal published some important and influential qualitative papers (for example see Gabbay et al 2004), but it was also at the forefront of promoting the use of qualitative methods in health research, publishing a number of highly-regarded series of ‘education and debate’ papers exploring the value of qualitative methods and providing a superb introduction to a variety of methods for the novice researcher (Pope and Mays 1995, Pope et al 2000, Pope and Mays 2009). In what would seem to represent a significant change in policy, an editorial accompanying the letter argues that: ‘qualitative studies are usually...

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StarDocs: The Coffee Shop Model

Jim Pink (top) is a GP, father and songwriter with an interest in people, rather than patients. Jenny Coventry (right) is a fourth year medical student at Cardiff. In her free time she loves country walks and playing in the Cornish waves. Leo Duffy (left) is a fourth year medical student in Cardiff. He enjoys writing and rugby and is a full time Welshman. The Apprentice: an assorted collection of wannabe entrepreneurs selling their souls in front of the TV cameras for the privilege of working with the self made billionaire Lord Sugar. As we sit in front of the goggle-box, unwinding from the day before, we learn about profit margins, innovation and “up-selling”. Back in the surgery, we reflect on what The Apprentice can teach us about running a GP surgery. The economic reality that most surgeries are profit-making enterprises is lost to most patients, and indeed, some of our secondary care colleagues. There is a certain irony that whilst most GPs would resist the privatization of the NHS (to profit making organisations), those same GPs work tirelessly to maximize the profits of their own small businesses. Up-sellling in general practice can mean two things. Even since before Stott and Davies1 described “the exceptional potential of each primary care consultation”, GPs were offering tidbits of health promotion to anyone who might listen, particularly amongst those with potential to improve...

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SAPC Dangerous Idea: funding research through Kickstarter

Sarah Knowles (@dr_know) is a Research Fellow at the University of Manchester. Her interests are mental health, applied health services research and patient and public involvement and engagement. Since 2012, the Society for Academic Primary Care has run a competition at their Annual Conference called the Dangerous Idea Soapbox. The soapbox offers primary care clinicians and researchers a platform to share a dangerous idea that they think needs to be heard by the Academic Primary Care community. Submissions are judged prior to acceptance based on how challenging and cutting edge they are. Those chosen are presented through lightning pitches (2 minutes, 1 slide) in the Soapbox session, after which the audience can debate the ideas presented with the speakers before a final vote to decide that year’s most dangerous idea. In 2015, I presented my idea that “Health research should be crowd funded through Kickstarter”, inspired by conversations with patients and members of the public involved in research, to challenge the audience with the idea that publicly funded research should have public backing before we’re allowed to get our hands on the money. Kickstarter is a crowdfunding platform. You don’t have a product available which people choose and you then sell, like you would in a shop. Instead, you ask for investment up front from potential ‘backers’ and if you don’t get enough promised custom then your product does...

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