In this article we out some issues for consideration for those considering the process of ‘retirement’. We aim to offer some experience to inform others’ thinking, and also to set out issues that bodies such as the RCGP still need to address.
This winter, several long-term issues are coming to a head to create a perfect storm: high fuel prices, poor housing quality, a lack of sustainable energy strategies, and families sliding into low income during a cost of living crisis. Nada Khan reviews
A British newspaper has argued that GPs were given 'record pay rises in Covid pandemic'. Richard Armitage unpicks the truth and the implications of GP earnings and productivity over the last two and half years.
Alexandre Dumas’s 19th century French novel, The Count of Monte Cristo, doesn’t usually make the list of standard medical texts but perhaps it should not be so readily dismissed. It captures the spirit of an age when medicine was undergoing a revolution...
Cassandra-like, the author warned us, and we did not listen. This is not a book about a political party or ideology however, it is about politicians and political life in the UK. Hardman’s book is divided into three sections: Why we get
While it makes no contribution to mortality statistics, the morbidity, economic cost and primary care workload generated by osteoarthritis is of sufficient proportion to render the condition a significant public health problem worthy of urgent investment of resources.
A leaked memo from the UK treasury recently suggested GPs should assess the financial health of their patients and recommend financial support to those in most need. Nada Khan considers some of the arguments and research -discussion welcome!
Doctors who find more human sense, belonging and fulfilment in their work are, almost certainly, able to provide better care. But our serial reforms have disregarded, then abandoned, a time-honoured cornerstone of practice. David Zigmond explores the tragic revival of continuity of
For today's and tomorrow's general practitioners to be able to engage with climate-related health threats in partnership with their patients, medical curricula must shape teaching and learning now. RCGP curriculum lead for planetary health Suchita Shah discusses what this mean for GP
Austin O'Carroll critiques a moralistic definition of suicide that culminates in a unjust hierarchy of worthiness for compassion and support. Seeing beyond intention to the causes of despair may be more helpful
What Rupal Shah & colleagues are proposing is not whimsical or theoretical. We need to address the broader context or practice so that connection, meaning & values can flourish. The next generation of GPs needs to be inspired & adequately resourced to
It is important that GPs are able to recognise this phenomenon, and to not dismiss the SMI lifestyle as a harmless pursuit for frivolous Gen-Z-ers. Richard Armitage unpacks the health implications.
Richard Armitage examines the 'Deborah James effect' on cancer awareness. How should we enhance the benefits and mitigate any harms of publicly shared celebrity cancer stories?
Rebecca te Water Naudé and Peter Young suggest that GPs may have duty to discuss the pros and cons of patients who contemplate crowdfunding for cancer treatment, and outline some of the issues.
Richard Armitage looks at the health needs of people who work away from home, be they itinerant telecommuters or contract-workers in haulage and construction - should general practice be evolving to meet the access needs of this group? Join the discussion!
Sharon Dixon and colleagues contend that a deeper understanding of safeguarding practices (and how these look and feel on the front-line of multi-agency encounters) is needed if future child safeguarding tragedies are to be avoided.
Healthcare professionals deploying to and practicing in conflicts and catastrophes can experience a plethora of negative emotions due to perceived or actual transgressions of their core ethical principles. In his final Ukraine report, Richard Armitage gives a powerful personal reflection.
TDR programmes consist of a low calorie (around 800 kcal/day) formula diet alongside a stepped food reintroduction as well as regular behavioural support. Yusuf Ben-Tarifite examines the evidence for TDR in Type 2 Diabetes Mellitus.
Although the GPs may well be aware that the ‘climate emergency’ is also a ‘health emergency, many of us do not make the connection with clinical practice when it comes to taking action. We often fail to realise that the majority of
Bhupinder Goraya muses on the concepts of order and randomness in relation to health and primary healthcare. We’ve worked 'bloody hard' to make a random mechanical universe work, in doing so we have ordered our leisure.
Nada Khan explores the roles of and our perceptions about primary care multidiciplinary teams, in light of the recent BBC Panorama investigation
Antimicrobial resistance (AMR) is a significant and well-recognised threat to human health in Ukraine. Richard Armitage discusses how this is further complicated by the war.
Over forty years ago, Nicholas Jewson coined the term ‘medical cosmology’ as shorthand for the prevailing theories and practices that defined the nature of medical discourse at that time. Stephen Gillam examines the changing gaze of British GPs in this final part
General practices and staff have been facing violent behaviour or aggression from members of the public -a global phenomenon now an UK issue. Vasumathy Sivarajasingam asks, what's happening, so what, and what now?
For as long as the war in Ukraine continues, the country’s existing substantial unmet need for palliative care and pain relief will increasingly intensify, and ever greater numbers of people with life-limiting conditions will experience intolerable yet preventable suffering at the most
By the 1980s, general practice was a self-confident discipline with a burgeoning research base and enviable training standards able to attract those from the highest rungs of Moran’s infamous career ladder. Yet all was not well. Stephen Gillam's biography of the profession considers
There is a tendency to assume that the National Health Service Act was the culmination of a single clear idea, realized in a glorious post-war dawn; the reality was messier. There was growing consensus in the years leading up to the Second
Many doctors in the early nineteenth century felt they were held in low regard by a public happy to employ the practitioner charging the lowest fee. Status came to rest on acquired standards of behaviour rather than superior knowledge. Part two of
The commonest misconception is that general practice, the ‘jewel in its crown’, is largely a product of the NHS. This short series of articles hopes to inform, stimulate and provoke. Stephen Gillam starts with the journey from apothecary to general practitioner.
Richard Armitage asks if the prevalence of conscientious objection among clinicians could compromise the provision of abortion services in Northern Ireland.
Roger Jones reviews 'A fortunate woman' by Polly Morland. At a very difficult time for general practice and for the medical profession as a whole, this book comes as a most welcome affirmation of the central importance of a respectful, reciprocal relationship
Ivy Mitchell and Andrew Papanikitas review Doughnut Economics - an attempt to rewire economic thinking to take account of both social deprivation and environmental sustainability.
Koki Kato reflects on the tension between patient safety and patient centered-ness with a hypothetical case that will be familiar to many. Does it have to be one or the other?
Orest Mulka and Philip Evans discuss the development of general practice in Ukraine and the role of international collaboration in the development of primary care