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
Giles Dawnay considers practitioner, patient, culture and politics in his reflections on the present and relationship between GP and patient
Narinder Bansal and colleagues argue that clinicians should be sensitive to how experiences of poor listening and relating can replicate and trigger wider experiences of marginalisation.
Stoic philosophy was based on the recognition that we cannot escape what is destined for us. An acceptance of inevitability has a number of implications for working as a GP. Austin O'Carroll wrestles with fate.
'Perhaps a psychoanalyst would coax out of me that growing my nails is an act of quiet liberation; I can decide how long I want my nails to be, I can decide what I want to next choose for myself. taking control
Martin Hewett argues that because of their understanding of their “duty of care”, doctors make micro-adjustments to their behaviours and work practices to cope with the increased work. This acceptance of the increased workload has two main effects: it sets a new
When you are with a patient and you get a sinking feeling in the pit of your stomach, accompanied by a wish that you were somewhere else, then you are probably facing an ethical problem, writes Peter Toon
Briony Hudson gives a curator's view of the RCGP 'Women at the heart of General Practice' exhibition, now open online and in person at 30 Euston Square
Vasumathy Sivarajasingam argues that we need to talk about, and manage, the menopause much better, and reminds us about key aspects that make a huge difference to women's health
Maria Victoria Bovo and John Launer give an account of a remarkable conversation they had in December 2021 during an online workshop in narrative medicine, about Long-COVID and a colleague.
In November 2021 the First Coastal Primary Care Network (FCPCN) hosted an event to understand 'Deep End' practice. This short article intends to inform readers as well as providing a record of the day’s events.
Koki Kato introduces us to phenomenology as an approach to understanding patient-centred care, using his own illness-experience as a worked example.
Helen Burn explains that because legalised physician-assisted dying would likely involve GPs, GPs should think about their views on the issue.
Felicitas Selter, Kirsten Persson, and Gerald Neitzke discuss the similarities and differences in animal and human euthanasia as a source of moral distress for the practitioner.
Andrew Papanikitas, Peter Toon, Paquita De Zulueta, David Misselbrook and John Spicer launch the Ethics of the Ordinary column and reflect on the field of primary care ethics and its relevance
Lloyd Hughes looks at plans for an integrated Scottish National Care Service and considers the strategic challenges for general practice it poses.
Austin O'Carroll argues that the label of personality disorder is inappropriate and harmful to patients who have suffered adverse social environments in childhood. By simultaneously ignoring social causation and denying the possibility of therapy the diagnosis perpetrates a systematic injustice against those
Afsana Bhuyia and colleagues give us a de-mystifying introduction to dashboards and registries, digital public health tools which they are using in their work on the management of cancer.
Being able to connect to others, to find joy and meaning in a common purpose, is not an added extra but is the very stuff of human life. But what of the effects of the Covid pandemic? Johanna Reilly discusses her concerns.
We value patient autonomy, but how free are we, how free are our patients? Will Mackintosh considers how constraints on freedom contribute to health inequalities.
Could the mistreatment of women by men be linked to how these men behaved towards other boys when they were youngsters themselves? Arthur Kaufman, a clinical psychologist, considers this hypothesis.