This focus on cardiovascular risk is understandable, but it is not clear why the requirement to maintain a register of people with SMI has been removed, other than possibly to free up financial resources.
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
There has been significant debate recently around how best to name the newest healthcare profession to seek regulation under the umbrella of the Professional Standards Authority (PSA). Cathal Gallagher reflects on the legality of the title 'Doctor'.
The Lancet recently published a series on the menopause. GPs are consulting with large numbers of women around this time of life and will no doubt welcome a major medical journal addressing an area of rising need. Ellen Fellows argues that there
I have recently read ‘Too Many Pills - How too much medicine is endangering our health and what we can do about it’ by James Le Fanu... So, this is my new purpose in life - to create opportunities to have open,
My husband and I visited my ancestral village home in the state of Bihar. I was visiting my village after 25 years and could see the obvious changes – both the progress and ongoing challenges.
It used to be just in the context of type 1 diabetes, but the little white circles on people’s upper arms seem to be more ubiquitous, and it’s clear that the use of continuous glucose monitoring (CGM) is shifting from a medical
With the weight loss effects of semaglutide and other GLP-1 agonists so widely reported in the press and social media, it’s not just people with obesity and weight-related comorbidities that are asking about it. But ask they will, so what we can
"Confidence in the future of NHS primary care is thin right now. My resilience suddenly really matters. Are the two linked?" asks Saul Miller.
I first read his 2014 book Superintelligence: Paths, Dangers, Strategies five years ago, which convinced me that the risks which would be posed to humanity by a highly capable AI system (a ‘superintelligence’) ought to be taken very seriously before such a
GPs feel they are increasingly managing increasingly risky mental health patients, with rising frustration that their referrals are being rejected. Just as in general practice, CMHT teams are facing their own challenges in not having the workforce or capacity to meet those
‘Wherefore’, meaning ‘For what reason’, is one of the most fundamental questions we must ask in medicine. Tasneem Khan applies this idea to trauma-informed care.
Is there 'One Big Thing' that GPs do? Or does it emerge out of all the things that GPs do?
Nurse Bernadette Millwood, in the final year of her career, is interviewed by her daughter Dr Sinead Millwood, a newly qualified GP in the first year of hers. What can we learn about primary healthcare going forward into the future?
"Healthcare professionals are being increasingly asked to consider referral for genetic testing. While for the majority with an abnormal finding, curative treatment is not currently possible, having a disease with a name can provide relief and allow for more targeted supportive measures.
Is general practice the platypus of medical specialities?
Medicine: Right Idea, wrong science? Should critical realism be the new science of medical practice?
Alistair Appleby introduces critical realism as a philosophical foundation for medical science and primary healthcare
Do the ARRS roles lead to GP clinics filled with increasing complexity, and what are the other contributory factors? Nada Khan looks at the evidence.
"We wish to share the story of an innovative digital intervention that has helped to overcome existing divisions by creating a vibrant interdisciplinary network of learning and health activism. We describe how a few family physicians created a virtual community on WhatsApp
Pattern recognition by AI is already overtaking humans in many diagnostic fields such as radiology and cytology. Large language models are doing the same in communication, dialogue and processing human-generated text. Here we present their potential within primary care using four broad
Richard Armitage visits the wild frontier of LLM-powered commercial health apps and reflects on three examples: ElliQ, MMGuardian and WHOOP Coach
Throughout medical history, there has been a tension between systems that locate health within the patient and those that have it outside. Ben Hoban finds the determinants of health and illness by looking in and by looking out.
Nada Khan argues that it’s worth just reflecting back on what was on offer and why, whether this retention scheme was working, and what future plans NHS England may have to keep GPs in practice.
This issue’s life and times articles describe the failure of society and policymakers to value general practice. To value is to understand and appreciate both the beauty and appropriate uses of a thing. It also has a sense of quantitate weighing -
Drawing inspiration from Brazil, Cornelia Junghans, Matthew Harris, and Azeem Majeed suggest building a community infrastructure of trained and paid Community Health and Wellbeing Workers (CHWWs) who work with GPs, community services and local authority.
Ahmed Rashid muses about surgical site infection, opioid dependence, racial diversity, and 'Meals on Wheels'
Richard Armitage predicts how AI can transform clinician-patient consultation.
Employing lower skilled healthcarers at the ‘diagnostic front door’ of general practice will not save money, resources, professional time or efficiently – it produces the opposite. David Zigmond invites debate.
Even as a GP trainee in the mid-90s, I genuinely don’t recall learning about the concept or practice of clinical reasoning. It’s not as if we weren’t guided on data synthesis or critical thinking, or the importance of these aspects of the
Hannah Milton reflects on domestic abuse statistics in relation to men and women