Good enough should be good enough
In medicine, as in motherhood, the pursuit of perfect can eclipse the practice of present.
The home of general practice and family medicine
Medical societies in the 19th Century: How they influenced general practice
Many of these societies may be historical relics, but their contribution to the development of general practice in the nineteenth century should not be forgotten.
The urgent need to rebuild England’s school nursing workforce
School nurses are described as essential to promoting health, reducing inequalities, and supporting school attendance. The contrast between this expanded mandate and the reality of the workforce is stark.
Not alone, but unseen: hypothermia in an ageing home
Accidental hypothermia is rarely dramatic. It does not announce itself with urgency or spectacle. Instead, it accumulates quietly through the night, until it finally becomes visible in the early hours, when someone realises that something is wrong.
Fine. Thanks.
What if we were to let the patient into our own inner world; of battling against the clock, the relentless stacking up of admin that occurs in real time as the consultation progresses ... the lack of time in our relationships at
Episode 227: What happens in general practice before an emergency lung cancer diagnosis?
In this episode, we talk to Marta Berglund about emergency lung cancer diagnoses.
Post-Turing Clinical Relationships: how AI is reshaping patient behaviour before the consultation
Medicine is still debating whether artificial intelligence will match or exceed human diagnostic skill. But the most consequential change is already happening elsewhere. It is unfolding quietly in the relationships...
I’m a GP — do you still trust me?
Trust is not visible, but you miss it when you lose it. Trust develops from many inputs that include memories, beliefs, and emotions that help us predict how someone may act.
Primary Care Network Equity Review 2025: making equity real in everyday general practice
The Nottingham West PCN Equity Review 2025 was born out of a simple question: what would equity look like if it were treated as routine clinical business rather than a policy aspiration?
Men’s groups and initiations: A personal and professional perspective
Men’s groups also aren’t replacements for therapy, but offer something our current system often cannot: sustained relational practice where vulnerability becomes possible, where peers mirror parts of yourself you've kept hidden.
The prisoner’s dilemma, the patient’s, and the doctor’s
The Prisoner’s Dilemma is a game which in all fairness, no one plays for fun, and which hopefully none of us will ever need to play in earnest ... one of the most important decisions the patient and their doctor must make
Episode 226 – Designing neighbourhood urgent care: A general practice perspective
In this episode, we discuss an innovative set up for neighbourhood care in North Yorkshire.
The gatekeepers and the wizards revisited (Part 2): The National Kindness Service and shiny crystal balls
The Chief Wizard took a big breath before she continued, for she knew this next bit was going to be even more difficult. “So the second big thing I want to talk about now is Prevention, and I mean prevention in all
Museums of medical curiosities
"Dragon’s blood potion, a case of 100 prosthetic glass eyes, a secret subterranean alchemist’s workshop, and devices used to protect against body snatchers are a few of the medical curiosities I’ve discovered on my recent travels ..."
Patient thoughts from Oldenland
I reflect on how to present myself as a patient, and what I want from a doctor.
Who decides what counts as illness?
Patients’ apologies for “wasting time” are not personal quirks but learned responses to a system that often treats unexplained symptoms as data rather than lived experience.
Episode 225: Delayed, declined, or disengaged? Understanding childhood vaccination patterns
In this episode, we discuss childhood vaccinations rates in a borough of London and reasons for low vaccine uptake.
Let’s just do some bloods…
Anyone can implement a protocol. Anyone can order a blood test. The real skill of a primary care clinician is in navigating the complexity and finding a helpful path forward for the unique individual in front of us.
The consultation beneath the consultation
I almost missed it. My instinct was to dive into the prescription screen. But something in her silence caught me. I paused and softened my voice. “You seem like you’re carrying a lot today.”
Impostor syndrome in general practice: a cost of expert generalism
If feelings of impostor syndrome were normalised — and reframed — they might become less a source of shame and more a marker of thoughtful practice, argues Simon Tobin
Episode 224: From swabs to urine sampling: Rethinking cervical screening in general practice
In this episode, we discuss the future of cervical screening and possibilities for urine testing for HPV.
Yonder: emergency care access, hospital rotations in GP training, undergraduate GP placements, communicating test results
Alex Burrell discusses emergency care access, hospital rotations in GP training, undergraduate GP placements, and communicating test results.
Wonderful and Broken: The Complex Reality Of Primary Care In the United States by Troyen A. Brennan
Troyen Brennan explores the complexities of the United States’ (US's) primary care with its multiple systems of funding and its absence of universal health care cover and finds that primary care is wonderful but broken...
Persisting, in spite of everything
The stubs of skyscrapers left over from the last air-burst remind her that there’s no going back; they’re just navigational markers now. Grass pushes up through the cracks, same as always, persisting in spite of everything.
Undervalued and unsustainable: The economic reality of GP minor surgery services
When the price of a portion of fish and chips has tripled in 20 years but the tariff for a joint injection remains static, something has gone seriously wrong with how we value general practice.
A reluctant founder: innovation at the Deep End
My hope is modest. No digital tool will fix the NHS or reverse the structural pressures driving burnout. But perhaps we can reclaim small pockets of clarity.
Episode 223: Trust matters – A practice-level look at patient confidence in health professionals
In this episode, we speak to Professor Richard Baker about trust in healthcare professionals in general practice.
We need to talk about dying
"Taking dying and death out of the solely medical domain, becoming joint partners in caring for the dying patient in the broadest sense, facilitates personalised and holistic care, and creates opportunity for a more relational and compassionate interaction ..."
28 Years Later: The Bone Temple
In many respects, Kelson embodies the idealised GP of cultural consciousness: an easy-to-talk-to, principled eccentric... Set against the film’s graphic, meandering violence, Kelson’s permanence echoes reassuring familiarity.
Ode to Diagnosis
Lines written by a doctor, after an elderly man presents with a positive PSA test, trying to decide what to do next. A poem.
Action required
Tired of scanning hospital letters to try and spot if there was anything that would necessitate action, it seemed like a simple solution: hospital teams would in future put any such information into a headed section...
On becoming: Empathy at the deep end
Empathy is not a luxury. It is the ground on which healing relationships are built — and the ground on which we remain whole.
Episode 222: Belonging, autonomy and burnout: Why GPs leave
In this episode, we speak to Dr Laura Jefferson about GP turnover and reasons why GPs leave.
A note on educators’ notes: why GP training programmes in the UK needs clearer, fairer assessment governance
GP training programmes must balance two imperatives: protecting patients and supporting the development of hardworking, reflective clinicians. To achieve this, the establishment relies heavily on narrative assessment tools...
Icarus Plummeting
Zigmond mercilessly describes the ways in which our healthcare systems have made us less able to listen to the patient’s experience, less able to see their experience in the context of their life, their family and their social circumstances.
Primary care in a destroyed health system: reflections on a deployment to Gaza
Each mission has taught me something different about medicine in low-resource settings, but Gaza has presented challenges unlike anything I've encountered before. The conflict in Gaza has resulted in the near-total collapse of the healthcare system.
The gatekeepers and the wizards revisited (part 1): Seventy eight years of fairy tales
The People waited and waited for the new King and his Minister to make things better. They were not happy. And nor were the Wizards and Gatekeepers...
Episode 221: BJGP Top 10 research most read and published in 2025
In this episode, we look back at the top 10 most read research papers in the BJGP in 2025.
Leviathans and a different sort of contract
A social contract must be framed in a way that enables people to look after other people, rather than simply creating systems of ever-increasing complexity to deliver care which is mechanical and ultimately disappointing.
Book review: How Animals Heal Us
"How Animals Heal Us is a deeply heartfelt work from an author with lived experience of both devastating mental ill health and the restorative power of animal friendship. It contains uplifting and joyful anecdotes of animal companionship and ministration. It is also,