Author: BJGP Life

Essential law for GPs: discussing treatment risks

Adam Sandell is a GP in Cumbria, and a barrister at Matrix Chambers. A Supreme Court judgment last week changed the law about the discussions we need to have with patients about the risks posed by treatment. “Doctor knows best” has just suffered another stroke. The busy-doctor version: We must discuss with patients any material risks involved in proposed treatment, as well as reasonable alternative approaches. A risk is ‘material’ if the patient is likely to attach significance to it. Ask yourself whether knowing about the risk might alter the patient’s decision: if so, tell the patient about it. If you’re more interested: Remember the Bolam test? Bolam’s the case about breaching your duty of care. You’re not negligent if you act in accordance with a practice accepted as proper by a responsible body of medical opinion, so long as the practice isn’t nuts. Until now, Bolam was how the courts determined what we have to tell our patients about the risks of treatment. You didn’t have to discuss a particular risk if there were other suitably-qualified doctors who wouldn’t have done so. That’s been changed by Montgomery, a Supreme Court case last week. Mrs Montgomery was small, diabetic and pregnant with a large baby. Her obstetrician didn’t normally warn such women of the risk of shoulder dystocia because she believed the risk of serious harm to be small,...

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NHS and astrology: a morning zodiac clinic

Tim Senior trained as a GP in Sheffield, and now works in Aboriginal and Torres Strait Islander Health in Australia. He is a Scorpio, whatever that means. He can be found tweeting from @timsenior News reaches us from the UK Health Select Committee that one of their members has suggested that there’s a simple solution to the woes of the NHS in the UK: astrology. Now, I’m as sceptical as the next doctor about how stars thousands of light-years away from Earth, that, with the trick of parallax error, suggested vague shapes to ancestors entertaining themselves on dark nights...

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Muscular dystrophy: new RCGP emodule on neuromuscular disorders

Dr Sheonad Laidlaw is a qualified GP, Chair of the Scottish Council for Muscular Dystrophy UK and has a daughter with spinal muscular atrophy (SMA) type 2. Recognising and supporting patients with rare and complex neuromuscular conditions presents acute challenges for GPs.  The Royal College of General Practitioners have worked with Muscular Dystrophy UK to produce a new set of online tools to help bridge the gap between primary care and the specialised services available. More than 60 progressive neuromuscular conditions, affect 70,000 children and adults in the UK. Recognition of neuromuscular conditions is improving, but many patients still experience long delays in diagnosis as early symptoms can be non-specific. Symptoms may include: muscle weakness resulting in difficulty with climbing stairs or lifting heavy objects; muscle stiffness or cramps; or fatigue. If a neuromuscular condition is considered, prompt referral to a neurologist is necessary. After diagnosis GPs, as part of a multi-disciplinary team, are integral in the care of the patient and making prompt referrals to a broad range of local and specialised services. As GPs we will often be the first port of call for a patient and therefore should be confident in managing acute complications as the condition progresses.  Recognition of the psychosocial impact on the condition on the patients and their families is important with a focus on quality of life paramount. My daughter, who was...

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Anorexia nervosa: how I’m inspired to be a GP

Claire Morgan is a final year medical student and shares her experience in managing her anorexia nervosa. National Eating Disorders Awareness Week runs from the 22nd to 28th February 2015. I am a final year medical student and in recovery from anorexia nervosa. At a time when general practice is receiving a lot of negative press I would like to share my experience as a patient and how I have been inspired to pursue a career in general practice. My anorexia really took a firm hold when I left home and began studying medicine. Away from home my weight...

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Robodoc will see you now…

Elinor Gunning is an academic GP and UCL Clinical Teaching Fellow (@EJGun) “So, in the future, can we just replace GPs with a diagnostic robot?” Is it just me, or do other GPs hear this question a lot? Often it’s more commonly phrased ‘who needs a GP when you’ve got Google’, but the replacement of doctors with computer programs seems to be a recurring theme when discussing the technological future of medicine. [bctt tweet=”BJGP Blog: Who needs a GP when you’ve got Google?”] Most recently I heard this question posed during a Q&A session for ‘The Day Before Tomorrow’,...

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