Category: Clinical

Arclight: a new ophthalmoscope and otoscope

John Porter recently completed his GP training and is enjoying living in Bath and working as a salaried GP in Bristol. There are items of equipment without which a GP in clinic cannot function. Top of this list comes a stethoscope. Closely followed by an ophthalmoscope or otoscope. As I neared the end of GP specialist training the time was nearing to hand back the practice supplied equipment and to put a hand in my pocket and buy an ophthalmoscope/otoscope of my own. A few hundred pounds, this tends to be the most expensive item needed to get started...

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Child & Adolescent Mental Health Problems – Twitter Journal Club

Carrie Ladd is a part time NHS GP, a spare time RCGP Clinical Fellow in Perinatal Mental Health and a full time mum… doing overtime! You can find her on Twitter @LaddCar and she has a website. On Sunday 28th November, Dr Lucy Pocock and I co-hosted a session of the Twitter based journal club #gpjc to discuss one of the emerging priority areas of General Practice – Child and Young People’s Mental Health. The BJGP paper we discussed was a systematic review of primary care practitioner’s perceptions to barriers in managing these problems. All contributors seemed to agree that...

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Medicine in an Age of Empires

I recently attended a talk at the hospital post-graduate centre where the speaker introduced herself as the hospital’s new ‘heart failure consultant’ rather than the new cardiologist. This set me thinking, as many things do, about the strange nature of secondary care medicine. Single organ specialisation is now a thing of the past, apparently our hospital based colleagues are best employed dealing with single problems of single organs. Many of the same thoughts occurred to me when I listened to a lipid specialist describe the difficult and technical differentiation of familial hypercholesterolaemia from poly-genic hypercholesterolaemia in patients with a...

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You’re the Doctor

When a patient says ‘you’re the doctor’ it can mean several things. Sometimes it means ‘I trust you and the advice you’ve given me’, sometimes it means ‘I don’t like what you’re saying but I don’t feel like I’m in a position to argue’, and sometimes it means ‘just get on with it and do what you’ve got to do’. Whatever it means when a patient says this, it always feels like a kick in the teeth to me. Since my first day at medical school, the day on which I underwent my Balint lobotomy, I’ve been told to...

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Why have an operation if you can avoid one?

George Ampat is a consultant orthopaedic surgeon hoping to help patients find non-surgical solutions. Why have an operation if you can avoid one? It’s a simple question with an obvious answer but increasingly surgery is being used where it may not be necessary. There is a general consensus amongst the general public that surgery is a “fix all” solution; but, by and large, this is not the case. Unfortunately the onus of explaining the risks of surgical interventions and the potential lack of benefit following surgical intervention solely rests on the surgeon. The Medical Director of NHS England, Sir...

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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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