"In this article, we explore what happens when our automatic ways of being in relationships are no longer serving us well. Moreover, if we can observe what we are doing, is this enough to change things?"
Peter Toon and colleagues call on the new UK government to re-evaluate the market-driven ethos in which the NHS has been managed. Is a new GP Charter overdue?
Here, Rodney Jones looks at the allocation formulae that distribute money and resources to England’s Integrated Care Boards. He examines the hidden assumptions behind the formulae and asks why nearness to death has never been incorporated into the calculations.
The whole of modern general practice in the UK rests on both the electronic healthcare record and networked services for requests and results. Brendan Delaney reflects on the Crowdstrike outage of July 19th 2024
Paul McNamara and Yoosuf Ibrahim argue that is imperative for GPs to highlight the increased risk of overdose associated with street valium use, given its unpredictable composition, to individuals struggling with drug dependency. Additionally, efforts should be made on disseminating knowledge about
If all we have to offer are platitudes and cures, we will be stuck forever trying to eat the elephant in the room, a possibility in theory, but rarely in practice. If we can understand and engage with our patient’s point of
How has increasing workload impacted on GPs, and our sense of providing safe care to our patients? Nada Khan finds that research into workload and safety suggests an association between wellbeing, burnout and patient safety.
"Health is whatever helps me to travel hopefully within and between my story-strands." Paul Thomas describes this as Community-Oriented Integrated Practice (COIP) – a way of thinking & acting that facilitates local collaboration for health and care.
"In the dynamic landscape of healthcare delivery, South Asia stands at the forefront of transformative change, particularly in the realm of family medicine. This article explores and elucidates the diverse models of family practice emerging across the region ... "
Plans to include PAs in general practice have been recently challenged with a recent Royal College of General Practitioners’ (RCGP) call to halt additional recruitment and deployment of physician associates. The RCGP position is based on results from a recent survey of
As AI tools become increasingly sophisticated and accessible, it is important for GPs to engage with this technology, argues Marcus Lewis
Stories entertain us, but on a deeper level, they also help us make sense of our experience; they are cultural vectors, transmitting the values and wisdom of one generation to the next. The proper use of power is a common theme in
The recruitment and retention ‘crisis’ in general practice is far from being resolved, and it risks being seriously exacerbated by a lack of jobs in general practice.
"People living with long COVID symptoms should be encouraged to seek support from primary care, and primary care clinicians must be responsive to patient need." - Carolyn A Chew-Graham and colleagues provide a summary and analysis of long COVID patient care, presenting
Misselbrook masterfully uses the tools of philosophy to explain to us how we think the way we do, how we can think more clearly. In a political climate dominated by polarising and often poisonous rhetoric, bullshit-detection skills are the least of what
Critical realism offers a theoretical framework that reflects what wise clinicians instinctively know: medical disorders do not always arise as single events at molecular or cellular level but can be generated at one, or multiple levels, of complexity through numerous contributory factors:
David Kernick explores two models that offer insights into the concept of healing, here taken as a facilitation of the body's intrinsic ability to restore optimum functioning: allostatic control and complex adaptive systems.
Most jobs now involve a screen and being online. "What does this new reality do our minds and brains?" is a question yet to have enough evidence to answer. However it is fast becoming clear that we are no happier or healthier
A 'potteres-que' educational experience? Elke Hausmann reviews a long running Saturday course in the history of medicine run by one of the UK’s historical medical institutions.
Reducing medicine wastage requires a concerted effort from all stakeholders, and yields returns in terms of finance, well-being and the environment. Vasumathy Sivarajasingam explains.
David Law offers a positive experience of physician associate deployment at his practice, including how the practice accommodated the need for supervision.
...the very same addictive nature of gaming that keeps people sedentary can be harnessed to promote health through the concept of gamification. Gamification is defined as “...the use of game design elements in non-game contexts...” and is used to enhance engagement, motivation,
To be fit for work, a person must be capable of more than simply carrying out in isolation the tasks required by their role: they must be able to do so repeatedly, to a consistent standard, and in a way that represents
GPs are in the firing line of efforts to reduce sickness certification. The UK government suggest that the responsibility for issuing fit notes could be moved from GPs to specialist occupational health professionals. Nada Khan unpacks the issues.
Elke Hausmann recommends Lynn Payer's book to anyone who wants to understand the history of many of the underlying assumptions shaping medicine and our practice of it -the inevitable result of medical progress but of choices, conscious or not, that arise from
Establishing general practice first as an independent subject or specialism, and then as a university discipline has been a major challenge over many decades. Where we are at present doesn’t appear to be working. Howie, Freeman, and heath reflect on what we
...an apparent paradox makes science possible. At least two conditions are necessary, and they appear deeply contradictory. The first is that the universe must be governed by consistent physical laws, the second is that humans in general, and scientists in particular, must
Thomas Oswald questions the speed with which physician assistants have been rolled out in primary care as a GP-alternative, and wonders why the high profile debates chiefly involve the RCP rather than the RCGP.
Richard Armitage's reading about Chalmers’ proposal of two distinct Problems (the capital is deliberate) of consciousness sparked an analogy in the domain of human health...
Will using a PPI increase my patient’s risk of dementia? I wouldn’t honestly know the answer offhand if a patient came to me asking this question clutching their newspaper. What are the tensions between the media and scientists, and the implications for
General Practice or Primary Care. What is the difference? Howie, Freeman and Heath discuss the development of primary care research and education and the the rise of SAPC in 2000.
'In medical education; those with less support needs have better training environments, while those who are most in need of support end up training in the most challenging, deprived areas.' Frances Wedgwood reflects on a plausible narrative.
As we embrace digitalisation and adapt to changing legislative frameworks, healthcare professionals must redouble their commitment to safeguarding and supporting survivors of DA. Only by aligning with the new legal framework and embracing advancements in practice can we truly meet the needs
Rather than taking an approach to a patient that they are either telling the truth or lying, we suggest it can be helpful to consider a middle way: the patient may be faithfully describing a problem, but doing so in a coded
...At last GPs could receive direct reimbursement from the NHS for time taken for teaching, allowing accelerating expansion of clinical placements in General Practice. At the same time there was NHS support for additional clinical academic staff in the Departments allowing research
...illness is something normal, to be borne while the pendulum swings that way in expectation that it will soon swing back again. Most of the time, it does, and it is easy for us to claim credit as doctors, even though we
John Howie, George Freeman and Heather Heath introduce an archive that traces the development of General Practice as a university-based academic discipline in the UK
Paul was diagnosed with locally advanced cancer in 2019. Paul was under no illusion about his prognosis and from an early point he openly discussed what his future was likely to hold .He set out very clearly what was most important to
We know ambulance trusts in the UK are increasingly employing GPs, and whilst the theory is there, we wanted to explore the evidence. What follows is a summary of our discussions exploring key similarities and differences in approaches to out-of-hours (OOH) care,
Biological causality for T4 monotherapy not working for some is now established. We can’t now attribute the 10%–15% of people with hypothyroidism not feeling better on T4 as wimps, laggards, or requiring psychological attention. Sarah Cathcart Evans reflects from personal experience of
The Eisenhower matrix is an eponymous task management tool attributed to the late US President which helps to organise and prioritise tasks by urgency and importance, so you can focus on getting the most urgent and important things done first. So, am