In the current COVID-19 pandemic, many (including world ‘leaders’) have been tempted to abandon the ideas of evidence based medicine of needing clinical trials to justify the use of treatments. This is a mistake.
The effect of being stopped and searched by the police can be psychologically traumatic and leave one feeling scared, powerless and humiliated. I thought about my patients. A lot of patients I look after are black and I wondered about how negative
COVID-19 has all but ensured that primary care will never quite be the same. This includes the way in which we care for our nursing and care homes. It is important that we take the positives from the virtual ward round that
The terrible direct and indirect impact of the COVID-19 pandemic on our elders living in care homes demands our attention and clinical scrutiny. We must continue to scrutinise the effectiveness of virtual assessment of our older patients with thorough clinical governance processes.
Professor Michael Kidd is a GP and Deputy Chief Medical Officer, Australia. He talks through five principles for dealing with the COVID-19 crisis and pandemic preparedness.
New research published in the BJGP from Professor Roger Gadsby and his team at the University of Warwick has highlighted how 'morning sickness' is not an appropriate term for nausea and vomiting in pregnancy. Professor Gadsby suggests we need to "dump this
COVID-19 has forced enormous numbers of workers into working from home and students into remote learning worldwide. The infrared radiation emitted from laptops can cause erythema ab igne. Increasing awareness now may prevent case occurrence or save time and stress later.
The Appointments in General Practice data available on the NHS Digital website collects data on the activity recorded within appointment systems. We cannot rely on the experimental data that has been collected over the last two months, but now that we are
Dr Chanpreet Arhi tells us about research in over 7000 patients that shows delays in referral, including for red flag symptoms, resulted in an increase in all-cause mortality.
Two GPs reflect on the impact poetry has had on their practice and how it fits into their lives.
“Look sorry, right, no offence but we need a white doctor.” Dad looked at the wall as he spoke. It was almost as if something was compelling him. I really didn’t know what to say. I felt myself flushing, the prickle in
Health experts and politicians have warned for over 170 years that health inequality is killing those in the most deprived parts of society. We now witness the poorest in society disproportionately dying of COVID-19, suggesting that the social murder observed by Engels
New research published in the BJGP from Dr Ben Goldacre's team in Oxford found that 23% of GPs still prescribed different strength methotrexate tablets (10mg and 2.5mg) to the same person in the past year — against the safety advice. The clear
In the UK, people living in the most deprived areas have twice the mortality rate from COVID-19 as those in the least deprived areas. The pandemic offers a 'compassion window' of societal, political and professional awareness and willingness to act, and general
Simon Morgan offers up a second dose of his handy primer on virology to get you up to speed with some of the lesser known facts about viruses and their mitocycles.
As primary care physicians we are likely to have an important part to play in determining who is tested and when. Impressively high sensitivity and specificity numbers, therefore, have to be interpreted with caution. As GPs we need to be aware of
We talk to Dr Zudin Puthucheary, an ITU specialist, and Dr Eve Corner, a physiotherapist about the challenges faced by patients who get discharged from ITU.
Contextual safeguarding is a relatively new concept, which is primarily intended for adolescents. Recognising that young people are often exploited and abused outside their family environment, contextual safeguarding focuses on influencing and shaping those areas.
Prof Bill Phillips discusses the two crises in USA, COVID-19 and racism, and the role of family doctors. In Seattle, around 7000 doctors and nurses demonstrated peacefully as part of the White Coats for Black Lives movement.
The new GP contract in England now recognises the necessity for clinical pharmacists to ensure the optimal use of medicines for patients within all primary care networks. What about the benefits to the wider healthcare team within general practice?
Everyone of us in the health service has overheard unacceptable rudeness, sly put-downs, exclusion or smiling say-the-opposite-of what-you-mean British insincerity. We need to acknowledge that it is happening. There is no mysterious genetic or melanin fault causing excess deaths among health workers
Professor Felicity Goodyear-Smith outlines how New Zealand have done so well. They are a small isolated island nation and didn't leave it another week. A lot of testing seems to be key. Like everywhere, there were challenges in general practice with dramatic
Additional COVID-19 pressures of increased demand and reduced workforce has meant novel solutions have been necessary. We employed medical students, someone from NHS England, and a retail manager. It has been heartening to see others step forward to support general practice.
We must recognise that as clinicians we are involved in creating a new disease. We must be conscious that the way that we communicate symptoms and risk with each other and our patients has wider implications beyond the immediate clinical situation. Our
How much does it take for us to genuinely express sorrow and compassion for the terrible trials our patients endure? We have pride in the NHS but we have prejudice too. Perhaps it is the NHS clinician that is Icarus, flying too
An individual working as a GP runs the risk of becoming an automaton. Evidence-based medicine and professional standardisation contribute to uniformity and by definition a reduction in diversity. Camus says that “if the world were clear, art would not exist” and I
Back in 1987, Roger Neighbour wrote his seminal textbook The Inner Consultation. Neighbour theorised that the general practice consultation was "a journey, not a destination", and proposed five ‘checkpoints’ along the way. Simon Morgan explores them for the COVID-19 world of remote
Perhaps there is one silver lining to this disaster. Perhaps restriction has stimulated an appetite for change, a desire to be more active and healthy. It seems as though restriction has triggered change, a desire to be more active and healthy.
The coronavirus epidemic has forced GPs to implement remote consultations, minimise face-to-face contacts, keep our distance and put an end to shaking hands. This mandatory distance between doctors and patients, has shown us the importance of touch in our healthcare system.
Hassan Awan is a GP in Manchester and talks about how we can better manage South Asian people with long term conditions and mental health problems. COVID has laid bare inequalities and he talks more about the importance of cultural competencies with
The publication of this new anthology of poems by NHS staff could not have come at a more apposite time. The coronavirus pandemic has highlighted the vital role of the NHS and the dedication of its staff in both community and hospital
Dr Brendan Crosbie talks about his real time data workload survey in Ireland. He found that GPs worked 9.9 hours per day on average and one-third of that time is on non-clinical work. One in 10 GPs work until after 10pm in
Some reflections on retirement... Ours is a great community. I look back with thanks, but forward with both compassion for the world and belief in our ability to be better than this. And in a deeper parallel, just as we as individuals
Decision fatigue is something we have all experienced. We each have a finite amount of mental energy that we can expend on decision making before our brain starts to look for a shortcut. Decision fatigue is also a well recognised reason behind
Catherine Himsworth discusses the findings of her research in people who are homeless. The trimorbidity of homelessness – chronic disease, mental health problems, and substance misuse –increased fourfold the risk of unplanned hospital admissions.
As a 20-something millennial GP trainee, the sudden talk about the future of primary care is exciting. I once heard a futurologist say, “Don’t ask ‘what will it look like down line?’ ask ‘what do you want it to look like?’” I
Dr Mike Tomson tells us about a community-based contact tracing initiative he helped set up in Sheffield. Numbers were small in this pilot but their experience with index cases and their contacts highlights the challenges and barriers in contact tracing.
Cummings is the third senior figure involved in dealing with the pandemic to have broken the rules, and the fallout has added to the litany of incoherent messaging, opaque decision making and fumbling management that has characterised the handling of the crisis.
Professor Donald Li, President of WONCA and a GP in Hong Kong, talks about the current situation in Hong Kong and the challenges ahead. There have been almost no new cases, excluding imported disease, in recent weeks but 14 day quarantine on
A day does not go by where I do not speak to patients suffering from anxiety in one form or the other. The untold harm being done to their mental health does not make the daily evening government briefings. Other health phenomena