"This book is terrifying, informative, stimulating, and educating to every member of the medical and nursing profession. It is extensively researched, has a massive bibliography, and, most importantly, it is well written and well worth reading — in spite of some truly
The General Medical Council’s requirement in its updated guidance Good Medical Practice for doctors to be kind has caused some consternation. How does being kind fit into a professional framework, and is it a luxury or a necessity? Ben Hoban reflects.
People with chronic pain need personalised care – an approach offering patients choice and control over their mental and physical health, basing care on what matters to them personally, and focusing on individual strengths and needs. It is possible.
The way we talk about mental ill health can end up creating a linguistic black box which we see but cannot see inside. How then can we know what to expect from our distressed patients, and how best to help them? Ben
This issue focusses on the heart and cardiovascular medicine. Life and Times for its part stresses the metaphysical and metaphorical heart with an eclectic smorgasbord of useful, challenging, and entertaining articles. This includes learning from tragedy, a tongue in cheek glossary, and
In Medical Generalism—Now!, Joanne Reeve extends her concept of the creative self. And she argues that the fundamental challenge for the contemporary primary care clinician is to honour the patient’s creative abilities and provide the kind of flexible, tailored care that allows
Primary care mental health is a fundamental part of general practice, delivering care to many more people than specialist mental health services, and yet there is limited documented history of its development. We sought to address this gap in the narrative by
As a GP and medical student... we wanted to see whether patients experience experiencing homelessness could also reap the benefits of nature prescriptions.
'A relational way of working, thinking and designing is one that creates possibility for change, one that creates abundance – our capacity for relationships, like love, is infinite.’ Emilie Couchman reviews a call for radical reform
Maladaptive daydreaming is a relatively new concept in the field of psychology experienced by an estimated 2.5% of the population. Sara Noden analyses this proposed mental disorder and the implications for clinicians.
Lucy Chiddick argues that promoting school attendance is a complex task, best done by those with appropriate expertise. Where GPs engage with the issue there should be appropriate time and care, recognising that there are many drivers of absenteeism and that attendance
Ilyich’s life story made me reflect on the extent to which I'm satisfied with my own life...I've often asked the question that Tolstoy confronts his readers with here: is there more to life than this? Luke Allen reviews this classic novella.
The shocking infant murders by nurse Lucy Letby represent a mercifully rare (we think) class of event. These remain extremely difficult to understand, predict or prevent, much as we must try. David Zigmond reflects on the role of commercially corporatised healthcare culture
Why hasn’t the approach of Centene and Babylon worked? And what’s the history behind corporate acquisition of GP surgeries? Nada Khan investigates.
If we look at continuity without considering the wider context of general practice, we may find ourselves being swept out to sea as we gaze longingly back at the beach. Ben Hoban helps us to reflect on the really useful elements of
Vasumathy Sivarajasingam explores domestic abuse PUNs and DENs as a relevant appraisal topic linked to mandatory safeguarding, with links to learning materials, legislation and further articles.
With the potential dismantling of the GP partnership model and the drive for a multiprofessional workforce in primary care, is this the right time to look at shared leadership as a facilitator of positive change?
"The function of a diagnosis is more than to guide treatment planning. It often provides emotional relief for patients, even if the diagnosis is dire. As Susan put it, “I keep hoping that some doctor will tell me exactly what this ‘skin
The title, ‘What is a doctor?’, neatly articulates a contemporary query. As the multidisciplinary team (MDT) becomes increasingly complex with additional moving parts, the role of the doctor becomes ever more difficult to describe. The memory of the ‘family doctor’ is fading.
In clinic last week, a patient called me by my first name – this was the first time I have experienced this in primary care, and for some reason I found it quite jarring. ...there seems to be very little evidence on
Merope Mills’ description of the death of Martha, her 13 year old daughter, is a raw and harrowing account of the mistakes doctors made that led to Martha’s deterioration and ultimately her death. Nada Khan evaluates the concept of a Martha’s rule,
As part of a Student Selected Component focussing on frailty in primary care, supervised by Paul McNamara, Scott Wylie had the chance to learn directly from GPs and attending local frailty services. As part of the project, he also carried out an
What can patients who recall their experience of death during a cardiac arrest tell us about consciousness? Armando Henrique Norman explores
I had progressed from A-Levels into becoming a GP... without pausing for breath - or allowing time for the aspect of my professional practice I enjoyed the most; teaching. But not clinical or consultation skills; instead, anatomy.
As our NHS shows increasing signs of its own sickness, many are calling for more funds, staffing, and technology. These may be necessary but are certainly not sufficient. What else of importance are we missing?
"I was very impressed by all those professionals working hard to make a difference for other people. I recognised myself in so many of the patient experiences described." – Elke Hausmann provides an overview of the 'Long COVID: what needs to happen
Why do people consult medial opinion? Alex Burrell looks at a classic paper on the the 5 triggers to seeking medical advice.
Tim Sanders views the “rewiggling” of the Swindale Beck in the Lake District as a metaphor for a need to nurture and cherish core aspects of generalism, continuity and relationship-based care within the role of the GP
So, how can GPs help their patients in facing transformative decisions? The advice, helpfully explained by Richard Armitage, is to reframe the decision-making process with which we approach them.
General Practice, then, shares the values of both the dinner date and the mobile phone, and this is reflected in the way patients consult differently depending on context, preferring ease of access for simple acute problems and continuity of care for complex
"I firstly prompted GPT-4 to “Answer the following as if you were a GP trainee in the UK.” I then asked [it] each of the 45 text-only questions ...from the RCGP AKT practice paper"
The Independent Pregnancy Loss Review, published in July 2023, offers recommendations to improve care for women and their families experiencing pregnancy loss, and includes specific advice for primary care.
So, doctors... are learning to be afraid of uncertainty, ordering ever more tests and prescribing more and more, to try – often in vain – to be sure... But where does that leave Patient Earth?
Variety is a selling point for the profession itself (challenging and interesting) and for the resources needed to do it well (GPs are ‘best’ placed to do many great things but need time and money invested). Andrew Papanikitas introduces this month's Life
"School is integral to the long-term wellbeing and aspirations of children, so it is a cause for significant concern that school absence has increased markedly since the COVID-19 pandemic ... "
All of us in the NHS want to help people, we wouldn’t be here otherwise. But, and I only use diabetes as an example, how much of our work now inadvertently keeps a proportion of our patient’s sick?
In the summer before COVID-19 it the UK, I read three works of fiction (one after another) that changed my perspective on the world and our place in it: The Wall, The World according to Anna, and The Ministry for Future
Richard Armitage argues that, in three well-defined contexts, clinical decision-making should be delegated to AI systems either today or in the very near future.
'Caring for carers is everyone’s business, though general practitioners (and we use our words wisely) are perhaps best placed to identify and support carers -more so than other health professionals.' argue Helen Walker and Clare Gerada
If we want to avoid missing significant diagnoses, and tigers, we cannot examine every symptom or blade of grass exhaustively, but we can cultivate an openness to the sort of cognitive dissonance that points to unrecognised danger. Ben Hoban explains
Introducing a temporary weight loss fix using GLP-1 agonists without consideration of the wider implications and long-term plan is quite frankly, an absurdly short-sighted idea, argues Elizabeth Dapre
