Category: Clinical

The onesie: a red flag sign for GPs

Adam Staten is a GP trainee in Surrey and is on Twitter @adamstaten. Cold reading is the art of obtaining information about a person by making a rapid assessment of their body language, manner, age, dress and behaviour. It is commonly used by psychics, mediums and illusionists. General practitioners do it too, whether it’s noticing the subtle nail changes in an undiagnosed psoriatic, or clocking the smell of stale alcohol on the problem drinker. We find clues about patients all over them and all around them. In exams the signs are usually obvious, it may be the inhaler and...

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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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URTI, menopause, universal health coverage, and chocolate cravings

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. Childhood upper respiratory tract infection (URTI). Childhood URTI is one of the commonest reasons for parents to consult in primary care. One would think that this makes it an easy type of consultation for doctors to tackle. However, the age-old antibiotic debate still rears its ugly head and has the potential to lead to much miscommunication and misunderstanding. With antimicrobial resistance high on the public health agenda, these interactions have received particular attention recently. In a study published in Patient Education and Counselling, researchers in Bristol interviewed 30 such parents from a variety of socioeconomic areas.1 They found that parents’ perceptions about the credibility of diagnosis and treatment recommendations were highly influenced by clinician communication. They suggest clinicians should focus on symptoms of particular concern to parents and give more precise safety net advice. Interestingly, they found the term ‘viral’ often trivialised the condition and contradicted the parents’ perception of severity. Although an important part of the antibiotic discussion, this explanation needs to be used sensitively with parents. [bctt tweet=”BJGP Blog – parents found the term ‘viral’ often trivialised URTIs and needs...

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Quality indicators for child health in the UK

Peter Gill is a paediatric resident at The Hospital for Sick Children in Toronto, Ontario and an Honorary Fellow at the Centre for Evidence-Based Medicine at the University of Oxford. Follow Peter on Twitter @peterjgill In the December 2014 issue of the British Journal of General Practice, several colleagues and I published a set of paediatric quality indicators for UK primary care.[1] The paper represents the main findings from my doctoral thesis completed under the supervision of Prof David Mant and Anthony Harnden at Oxford University. It is exciting to see the paper in print (it provided a morale ‘boost’ after working a stretch of nights) accompanied by a thoughtful editorial.[2] But having returned to the ‘coal face’, I am reminded of the integral role of quality indicators in clinical practice. Why develop indicators? Caring for children is an important part of UK general practice yet several studies have demonstrated that care quality can be improved. However, only 3% of Quality Outcomes Framework (QOF) markers relate to children and there is no set of child-relevant indicators for UK primary care. For years, the call to develop and integrate child health indicators into QOF has fallen on deaf ears despite evidence that leaving out indicators probably has negatives consequences for care quality. Therefore, we sought to develop a set of quality indicators for children and adolescents which cover a range of paediatric care...

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