"Morale in general practice has never been lower, and I can say that having been a GP for 37 years. In all this adversity and negative press, the care has carried on regardless, even allowing pockets of brilliance to shine through. We
Primary care systems can clearly be described as networks of people and things, ideas, processes, relationships and technologies. It is patently clear that we have a duty open the black boxes of our primary care systems, lest ignorance of how they work
What are the personal and human factors that most motivate and anchor our best healthcare? What best nourishes and sustains both patients and healthcarers to endure together life’s most difficult challenges? This book answers such questions with luminous and engaging clarity.
General practice can play a major role in assisting in raising awareness and supporting primary prevention, early identificationand intervention of domestic abuse, argues Vasumathy Sivarajasingam
This year marks the 75th anniversary of the foundation of the NHS, and it is timely to consider the post-1948 story of general practice, and what we can learn from the past to make the future more propitious than it appears. Edin
Fourteen years ago, I watched the drama-documentary-animation hybrid film: The Age of Stupid. This is set in a climate-ravaged 2055, and features a last-surviving human who has been entrusted to archive human records. He is reflecting on news footage demonstrating the devastation
Vasumathy Sivarajasingam showcases how GP practices in Ealing (NW London) worked towards ‘greener practice’ and sustainable healthcare.
Charlie Massey, Chief Executive of the GMC, tells us ‘there is no ready-made batch of GPs waiting to be plucked off the shelf to ease the pressures on the workforce...’ In the bookcase of doctors coming to the rescue of general practice,
Richard Armitage uses ChatGPT to interview an AI simulation of the 'Father of Western Medicine.'
In an era where difficulties in GP recruitment and retention are having significant impacts on the workforce, will knowing the ‘value’ of a GP give us any clues as to the projected cost in terms of loss to the system if that
Slight changes in phraseology can dramatically alter the central meaning of a vitally important principle. By “consenting the patient” instead of “seeking meaningful consent,” the right of our patients to be involved in choices about their treatment and care... is exchanged with
Andrew Papanikitas introduces the articles in this Month's Life and Times, and reflects on the meaning of 'Crisis' as it applies to global general practice
Rabia Aftab advocates that exercising these three Es (Expectations, explanation and empathy) in our consultations offers a path to better satisfaction for GP and patient alike.
"More validation should be given to the therapeutic benefits of listening closely and bearing witness to somebody’s suffering." – Rupal Shah and colleagues continue their hermeneutic series, focusing on the importance of relational care in general practice ...
The effects of the earthquakes on child health in Türkiye are substantial, multifaceted and, without urgent intervention, deeply enduring throughout the life course. Richard Armitage reports from the scene.
General Practice’s independent contractor model must be fought for or risks being undermined by lack of political support
The independent contractor model for general practice is one of the under-rated aspects of the NHS that rarely hits the headlines. It is particularly important for our professional autonomy and business flexibility.
Teams are the talk of the town in practice transformation circles. They are extolled as the solution for many of our deficiencies– from chronic staffing shortfalls to employee burnout. This extended essay by David Loxterkamp gives a perspective from American primary care
My assumption was of a middle class journalist parachuting in to a deprived area and reporting through his own middle class lens. How wrong I was – this is actually the extraordinarily reflective work of a man who grew up with
When we use a computer scoring chart and tell a patient they have depression and need medication or even psychological therapy we locate the problem firmly in the brain of one individual. Does this prevent the wider solutions?
Crowdfunding of direct medical costs raises some ethical issues which may legitimately concern health professionals and should concern regulators. Kathryn Millard explores the key issues.
Sharing my humanity with your humanity, in snapshots, journeying together over a lifetime. That is the essence of the general practice that I know, love and hate simultaneously. Kathleen Wenaden reflects...
If there’s latent theme hiding in this month’s life and times, it has something to do with qualities and deployment of good leadership.
In the surgery, patients still express the hopelessness of their lived reality: lives built around sitting; exercise options that are difficult to access geographically and financially; and the cheapest food options too often the ‘wrong’ choices...
In the First and Second Ages, medicine was transacted between individual patients and doctors at times of illness. The Third Age, in which we find ourselves currently, is associated with the development of a much bigger picture in which this is no
"The conflict in Ukraine has displaced over 7 million people since February 2022. The UK Government has responded by issuing 219 400 visas for Ukrainians through sponsorship schemes. One year on, we feel there is value in reflecting on the health needs
"Who has been in charge of the processes of change in the last 20 years? What ingredients must be restored now that we have a full-blown factory farm model of primary care medicine? Is it too late to save family medicine 70
Foell and colleagues argue that assembly-line approaches in manufacturing rely on accurately measuring the time it takes to perform tasks in a digitalised workplace. They juxtapose this with the concept of time as the time it takes in the mystery of General
The worsening relationship between primary and secondary care if this NHS is to be saved, argues Edin Lakasing
So, is the description of the GP as a ‘gatekeeper’ outdated? I would argue it is. GPs are not trying to block access to specialists. Rather, through their distinct expertise, they provide a safety net for patients who could risk further harm
All four countries in the UK are devising methods/models to enable healthcare professionals by way of multidisciplinary teams (MDTs) to work with GPs thereby reducing the workload & enhancing the patient experience, but such changes may not bring about these desired outcomes.
Richard Armitage highlights a selection of issues in tension with public health and respiratory communicable diseases both pre and post the outbreak of COVID-19.
"As this book progresses, its early playful, even comedic, lightness gives way to the author’s very substantial criticisms ... [that] attempts to metricise, micromanage, and proceduralise all medical consultations and services has led to the displacement and destructing of trusting relationships ...
We can use concepts and language to share ideas/help us see things we might overlook. We can use the narratives of others to extend our own experiences of the world. The dangers from being intellectually and morally passive compel us to embrace
Rational self-interest and the Inverse Care Law: considering how John Rawls and Robert Nozick might have reflected on Julian Tudor-Hart’s problem
How might American political economists Rawls and Nozick have viewed Julian Tudor Hart's inverse care law? Ayu Takayanagi explores two types of self-interest.
Piecework is advantageous for production where output volume is a reliable proxy for productivity and monitoring and incentivising output volume does not compromise quality. Lara Shemtob and colleagues argue this is inappropriate for general practice.
What are safe workload limits in general practice, and how can these limits be implemented in practice? Nada Khan investigates.
in 2022 Richard Armitage altruistically donated a kidney. He discusses what GPs need to know in order to support patients who choose to go through this process themselves.
Topical corticosteroids remain the mainstay treatment for atopic eczema in the UK. However, it is evident from literature searches, and from communicating with dermatologists, that patient or parental underuse, non-compliance, and steroid phobia have been major concerns for some time. This lay
Richard Armitage finds that general anaesthesia is in fact quite unlike sleep in its most fundamental components.
Assessing the effectiveness of each charitable project and directing financial donations to the one that ranks highest is certainly a task of gargantuan proportions. Richard Armitage explains.