BJGP Long Read – Page 9

English Pastoral and rural primary care

"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

4 March 2023

10 mins read

3

BJGP Long Read·Opinion

It’s about time: A conundrum in General Practice

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

27 February 2023

9 mins read

BJGP Long Read·Opinion

The worsening relationship between primary and secondary care

The worsening relationship between primary and secondary care if this NHS is to be saved, argues Edin Lakasing

20 February 2023

5 mins read

BJGP Long Read·Opinion

GPs are far more than gatekeepers…

So, is the description of the GP as a ‘gatekeeper’ outdated?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

15 February 2023

5 mins read

BJGP Long Read

Obstacles to the effective introduction of mental health practitioners into the GP surgery

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.

8 February 2023

8 mins read

1

BJGP Long Read·Coronavirus·Opinion

Ethics, COVID-19, and the common cold: Three examples of duties in tension with public health

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.

30 January 2023

8 mins read

BJGP Long Read·Book review

Time to Heal. But has that time gone? The spirited disaffection of a vocational doctor

"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 ...

28 January 2023

6 mins read

BJGP Long Read·Opinion

Being philosophical when it’s complicated

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

27 January 2023

5 mins read

BJGP Long Read·Undergraduate

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.

22 January 2023

7 mins read

1

BJGP Long Read·Opinion

General practice cannot be piecework

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.

19 January 2023

5 mins read

BJGP Long Read·Opinion

Put a cap on it – safe workload levels in general practice

What are safe workload limits in general practice, and how can these limits be implemented in practice? Nada Khan investigates.

11 January 2023

4 mins read

2

BJGP Long Read·Opinion

Supporting patients who choose to donate a kidney: what GPs need to know

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.

9 January 2023

6 mins read

BJGP Long Read

Topical corticosteroids overuse and withdrawal reactions: a UK lay-person’s perspective

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

27 December 2022

14 mins read

3

BJGP Long Read·Opinion

Drifting off to sleep? The dis-analogy of sleep and general anaesthesia

Richard Armitage finds that general anaesthesia is in fact quite unlike sleep in its most fundamental components.

26 December 2022

7 mins read

BJGP Long Read·International·Opinion

The art and science of effective giving

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.

19 December 2022

7 mins read

BJGP Long Read·Book review

Moral leadership in medicine: a book that deserves reading and re-reading

Moral Leadership in Medicine provides a vital account of how the needs of patients and the aspirations of professionals are translated into actions beyond the bedside and should form part of any debate on the future of healthcare.

17 December 2022

4 mins read

BJGP Long Read·Opinion

Medicalising poverty: whose responsibility is it?

Why have poverty and fuel poverty become medicalised? We know that social determinants of health shape and drive health outcomes. Poverty and fuel poverty are increasingly positioned within a biopsychosocial model of medicine and health.

8 December 2022

4 mins read

BJGP Long Read·Bright Ideas and Innovation

Could the properties of metals and animal peptides be harnessed to reduce infection and antimicrobial resistance?

Antimicrobial resistance is developing rapidly and threatens to outstrip the rate at which new anti-infective agents are introduced. There are now, however, more than 250 antibacterial compounds isolated from natural sources. Here, Simran Patel and colleagues examine some of the leading contenders.

7 December 2022

8 mins read

BJGP Long Read·Opinion

Replacing one dichotomy with another? Suggested revisions to a definition of health

While various definitions of health have been offered over recent centuries, the search for an enduring and completely satisfying definition has proven frustratingly elusive. Richard Armitage wrestles with one of the most recent and promising definitions.

27 November 2022

8 mins read

BJGP Long Read·Bright Ideas and Innovation

Reflections of implementing social prescription community groups

Social prescribing: Fiaz A Hussain and Feryad A Hussain present the experiences of a group facilitator with extensive experience of running community groups, offering patient feedback, highlighting the challenges of implementation at the coalface, and offering a number of considerations for GPs

23 November 2022

12 mins read

BJGP Long Read·Opinion

Turning the clocks back an hour: extra time in bed or maybe something more?

The clocks going back as we descend into winter each year generates an additional hour that we generally choose to spend asleep. A poignant philosophical reflection on time.

20 November 2022

5 mins read

BJGP Long Read·Opinion

Manufacturing doctors is one thing; sustaining working communities is quite another

In an age of mass-production and commodification it is not surprising that the governmental response to our increasing losses of doctors is to recurrently and rhetorically press for greater production and wider recruitment. But in doing so are we avoiding deeper human

17 November 2022

8 mins read

BJGP Long Read·International

Turning diversity from a barrier to a facilitator of empathy in healthcare

Most developed countries have increasingly diverse populations. This context presents a challenge to empathic healthcare, as well as an opportunity. Better communication, treating diversity as an opportunity, and formal training in empathy and diversity can help transform diversity from a potential barrier

16 November 2022

7 mins read

1

BJGP Long Read·Opinion

‘The bird is freed’: the role of Twitter in today’s general practice

Twitter has undoubtedly become the world’s digital town square, and provides the soapbox upon which contemporary issues and political dialogue are played out in real time. Richard Armitage explores the Twittersphere in the wake of Elon Musk's takeover.

14 November 2022

6 mins read

1

BJGP Long Read

The intelligence-wisdom gap, and the urgent need to close it

Due to the accelerating power of our technological arsenal, and the contrasting stasis of our professional wisdom, the intelligence-wisdom gap is expanding at a blistering pace. With formidable technologies on the scientific horizon – nanotechnology, CRISPR, and general-purpose AI – the necessity

7 November 2022

9 mins read

BJGP Long Read·Opinion·Stories

A tyranny of nouns

Doctors are inordinately fond of nouns. By and large, patients come to us not just with nouns, but with stories which include them but are driven along by verbs, words of action, backed up by adverbs, pronouns, and so on...

4 November 2022

4 mins read

BJGP Long Read·Opinion

Healthcare workers balloting for strike action – no easy choice

Should healthcare professionals ever strike? For some healthcare professionals, going on strike crosses a professional and moral line. Nada Khan explores the debate.

3 November 2022

5 mins read

1

BJGP Long Read·Opinion

‘Hidden’ no more – the real work of the ‘part-time’ GPs working full-time hours

How is it that 'part time' GPs are working 'full time' hours? Nada Khan investigates!

27 October 2022

5 mins read

2

BJGP Long Read·Stories

An ethical dilemma at age 95

Tom Brett had known Martha as a patient for fifteen years. Widowed for over 25 years, she had moved from the family farm to settle in the city close to her children...

26 October 2022

3 mins read

3

BJGP Long Read·Opinion

‘Agents,’ not ‘patients,’ as the beneficiaries of general practice

Richard Armitage suggests it is right for GPs to primarily regard their beneficiaries as ‘agents’ rather than ‘patients’ in the majority of general practice consultations.

24 October 2022

5 mins read

BJGP Long Read

Under the spotlight: supportive guidelines to maintain psychological wellbeing for staff involved in patient–coroner investigations

This article aims to draw attention to the experiences of staff who are involved in the coronial process following the death of a patient by suicide. In doing so, the hope is that organisations will consider the impact and implement support strategies

20 October 2022

10 mins read

1

BJGP Long Read·Opinion

What are the health impacts of cryptocurrencies?

Digital currencies, otherwise known as blockchain-enabled cryptocurrencies, have made unmissable impacts on the global economy. But what are they, how do they work and, most importantly for us, what are their effects on human health and wellbeing?

17 October 2022

7 mins read

2

AiT·BJGP Long Read·Opinion

Should we be teaching doctors to be better patients?

Increased dialogue about the unique nuances of physicians adopting the role of ‘patient’ should be supported throughout medical training, argues Isabella de Vere Hunt.

15 October 2022

4 mins read

BJGP Long Read·Opinion

E-scooters: how safe are they?

In England over the last two years, you are likely to have seen people whizzing around on brightly coloured electric scooters. While they might be a fun, practical, and relatively cheap mode of transport, just how safe are they for their users

10 October 2022

6 mins read

BJGP Long Read

‘Delicate diagnosis’: avoiding harms in difficult, disputed, and desired diagnoses

Distinguishing conditions that would benefit from diagnosis and earlier intervention from those that are temporary, self-limiting, and prone to harmful medicalisation, remains challenging. Here, Margaret McCartney and colleagues argue that a framework to consider some diagnoses as ‘delicate’ will aid in the

7 October 2022

11 mins read

4

BJGP Long Read·Opinion

Are some kinds of patient-data too sensitive to be digitally recorded?

The recent cyber-attack on NHS systems, on the background of zero-days and zero-day exploit markets, raise concern for the safety of digitised patient data – those that are often used in primary care settings – are they too sensitive to be digitally

3 October 2022

8 mins read

1

BJGP Long Read·International

Can we take the heat?

With climate change resulting in increasing temperatures all around the world, what exactly does heat do to our cells and vital organs?

1 October 2022

5 mins read

BJGP Long Read

Tackling overprescribing: a must for climate action

The NHS has committed to becoming net zero by 2040. With medicines totalling 25% of the NHS' carbon footprint, one way to reduce the carbon footprint of health care is to simply do less health care - here, Theo Bartholomew and Samuel

28 September 2022

7 mins read

1

BJGP Long Read·International·Opinion

Nuclear power plants in conflict settings: a public health concern

Richard Armitage argues that the abuse or neglect of nuclear facilities in conflict settings represents an international public health concern

26 September 2022

5 mins read

BJGP Long Read

Do you still need your licence to practice? – some reflections for British GPs

In this article we out some issues for consideration for those considering the process of ‘retirement’. We aim to offer some experience to inform others’ thinking, and also to set out issues that bodies such as the RCGP still need to address.

25 September 2022

6 mins read

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BJGP Long Read - Page 9