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Clinical - Page 4

BJGP Long Read/Clinical/Opinion

Should we be bothered that we are losing a QOF indicator for people with SMI?

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.

15 July 2025
9 mins read
1
Clinical

Drugs for chronic pain — we still need them

Chronic primary pain is a relatively new concept. Ensuring its definition is consistent within new guidelines is key. Here, members of the National Advisory Committee for Chronic Pain provide a number of observations on the use of drugs in chronic pain management,

2 February 2021
8 mins read
4
Clinical

Safety netting – a proposed definition

Safety netting is essentrial in primary care but there is no one accepted definition. Peter Lindsay fixes this for us!

18 November 2020
6 mins read
Clinical/Research

Are we safer cycling?

We know that cycling makes for a healthier commute for all, but GPs need evidence to help them allay patient's concerns if we are to incorporate active travel into our standard health promotion toolkit. Bethan Jones gives us the evidence.

19 October 2020
7 mins read
Clinical/Opinion

Everybody Hurts Sometimes

30 years ago we were told we were not treating pain adequately. There was a push to give people more analgesia. So, armed with our opioids and gabapentinoids we went and we medicated. But peoples' pain got worse. Katie Barnett examines what

9 October 2020
8 mins read
Clinical/Coronavirus/Research

End-of-life care during COVID-19: The central role of primary care must not be overlooked

It has been well reported that those in the community and end-of-life care have been hardest hit by the COVID-19 pandemic, but little attention has been given to GPs and district nurses working in end-of-life care and the positive stories they have

6 October 2020
6 mins read
Clinical

Lessons in Adversity

Doctors are not strangers to adversity, both in the lives of our patients and sometimes in our own. Judith Dawson examins two inspirational accounts to tell us how we can practically help.

1 October 2020
6 mins read
Bright Ideas and Innovation/Clinical

How I use drawing and creative processes within the GP consultation

Holly Quinton describes the use of metaphor and drawing in consultations to improve understanding, compliance and rapport. This can help the GP to explain medical terms to a patient, but it can also help the doctor to understand the patient's experience.

30 September 2020
5 mins read
1
Clinical

Green Fingers, Pink Puffers? A speculative view on hypersensitivity pneumonitis and domestic garden waste

Hypersensitivity pneumonitis is a form of interstitial lung disease caused by the repeated exposure and immune sensitisation to organic dusts and certain industrial agents. The circumstances of lockdown may increase the exposure of the public — and waste management workers in particular

21 July 2020
8 mins read
Clinical

Contextual safeguarding: what GPs need to know

Contextual safeguarding is a relatively new concept, which is primarily intended for adolescents. Recognising that young people are often exploited and abused outside their family environment, contextual safeguarding focuses on influencing and shaping those areas.

18 June 2020
5 mins read
Man holding hands to face
Clinical

The stressed but not ‘mentally ill’: How can we actually help?

Rosie Marshall is a GP based in Wiltshire.  General practice routinely involves supporting patients presenting with diverse manifestations of stress. This can be a challenging issue for clinicians to manage because by definition there are underlying circumstances (sometimes related to complex and

23 September 2019
14 mins read
1
flowers on gate in front of gravestone
Clinical

Audio essay: My loss

Ahmeda Ali is a GP in Ireland. Ahmeda’s essay was one of the Sheppard Memorial Prize winners at the Republic of Ireland Faculty Winter Meeting. An abridged version will be published in the BJGP and here we present the full essay with

22 July 2019
13 mins read
1
Clinical

Pain, opioids, and syringe drivers: a practical guide

Pain, Opioids and Syringe Drivers: A Practical Guide for the GP in the Wake of Gosport This article is written by Daniel Knights, Felicity Knights and Stephen Barclay and is published as a companion piece to their editorial in the October 2018 issue of the BJGP. The

1 October 2018
10 mins read
1
Clinical

Diagnosing dementia in younger people: A decision-making guide for GPs

Shona Lucitt (right) is currently studying for a Masters in Public Health at Imperial College London. She previously worked at the Alzheimer’s Society supporting a pilot project for people living with YOD. More recently she has been working for Public Health England in

26 June 2018
11 mins read
Bright Ideas and Innovation/Clinical

Paramedics in general practice: what can we expect?

The NHS enters its 70th year with the general practice workforce in crisis. Paramedics already have a track record in providing flexible and innovative ways of delivering extended clinical care.

23 February 2018
6 mins read
Clinical

Feeling blue, sad or depressed: how to manage these patients?

Peter Lucassen has been working as a GP for 35 years in a small village in the Netherlands and has just retired. He is still working as a senior researcher at Radboud University Nijmegen Medical Centre. He is interested in medically unexplained

2 February 2018
14 mins read
2
Clinical

From doctor to daughter – coping with death in the family

Claire Wastakaran is an ST2 trainee in South Yorkshire. “A 5cm lump in the pancreas. Never mind, I will fight it”. These were the words spoken by my father that made me rethink my relationship with him and all my medical training

9 November 2017
8 mins read
4
Clinical

The GP FY2 experience: Working with uncertainty

Nethmi Vithanage is a University of Edinburgh graduate from New Zealand, currently working as a FY2 in general practice and looking to get into a life of public health. Black Wednesday had arrived and along with it, a familiar feeling; like I

6 November 2017
6 mins read
2
Bright Ideas and Innovation/Clinical/Opinion

Self discovery with an ankle fracture

Kate Dawson is a full-time remote and rural ​GP on the Isle of Benbecula in the Outer Hebrides. At our staff night out, I slipped on a wet dance-floor, and in a moment, fell and became a patient. I couldn’t put any weight on my

14 March 2017
6 mins read
Bright Ideas and Innovation/Clinical

Arclight: a new ophthalmoscope and otoscope

John Porter recently completed his GP training and is enjoying living in Bath and working as a salaried GP in Bristol. There are items of equipment without which a GP in clinic cannot function. Top of this list comes a stethoscope. Closely

31 January 2017
4 mins read
1
Clinical/GP Journal Club

Child & Adolescent Mental Health Problems – Twitter Journal Club

Carrie Ladd is a part time NHS GP, a spare time RCGP Clinical Fellow in Perinatal Mental Health and a full time mum… doing overtime! You can find her on Twitter @LaddCar and she has a website. On Sunday 28th November, Dr Lucy

6 December 2016
4 mins read
Clinical

You’re the Doctor

When a patient says ‘you’re the doctor’ it can mean several things. Sometimes it means ‘I trust you and the advice you’ve given me’, sometimes it means ‘I don’t like what you’re saying but I don’t feel like I’m in a position

3 August 2016
4 mins read
Clinical/Opinion

Why have an operation if you can avoid one?

George Ampat is a consultant orthopaedic surgeon hoping to help patients find non-surgical solutions. Why have an operation if you can avoid one? It’s a simple question with an obvious answer but increasingly surgery is being used where it may not be

19 July 2016
4 mins read
1
Bright Ideas and Innovation/Clinical

Tasked based medicine and the generalist

Perhaps I have had a run of bad experiences but I sometimes feel that our secondary care colleagues are beginning to act as technicians and not physicians, directing themselves to a particular task to rule in or rule out a particular diagnosis,

10 July 2016
6 mins read
2
Clinical/GP Journal Club

Next GP Journal Club is Sunday 3rd July at 8pm: migraine and CV disease in women

The next GP Journal Club will be discussing the BMJ paper: Migraine and risk of cardiovascular disease in women: prospective cohort study by Kurth et al.  You can download it here. Migraine occurs in 15% of the UK adult population and is three times

27 June 2016
1 min read
Bright Ideas and Innovation/Clinical

Shared medical appointments: better by the dozen

A great deal of medicine is education.  The title ‘doctor’ is derived from the Latin word for teacher. Before getting that title, I spent three years working as a TEFL (Teaching English as a Foreign Language) teacher: first in Spain, and then

24 June 2016
8 mins read
Clinical/Opinion/Undergraduate

Casting down the pseudo-religion of clinical examination

The glass bounced off my back and smashed into the drinks gantry shattering a whisky bottle. All I remember is the glass, the blood and that terrible screaming. Glass fights are dangerous, especially as barman, and for $1.80 an hour I often

10 June 2016
4 mins read
1
Clinical/Opinion

Home surveys and colonoscopies: coping with risk and reassurance

[starbox id=adamstaten] Today I am writing from the most middle class circle of hell; the circle of hell where sinners are stuck in a perpetual home buying chain. Of all the costly obstacles to selling and buying houses, I have found the

1 June 2016
4 mins read
Clinical/Opinion

The Joy of Diagnosis: how to attract candidates to general practice

Diagnosis is one of the most rewarding aspects of medicine and is one of the most attractive features of general practice.  There are few areas of medicine, arguably just general practice and the Emergency Department, where you get the opportunity to encounter

12 May 2016
5 mins read
4
Clinical/Opinion

Escape to the Country: challenges of a migrant population for the rural GP

Bronwen Warner is an FY1 doctor at Oxford University Hospitals NHS Foundation Trust. She spent a month with Heilendi GP Practice in the Orkney Islands as part of her elective at Bristol Medical School. Patients stumble into the waiting room, propelled by a passing

10 May 2016
7 mins read
Clinical/Opinion

Googling symptoms: let’s do it together

The English Health Secretary, Jeremy Hunt, recently sparked anger when he suggested that parents could look online to determine the severity of their child’s rash. The medical community rightly rebuffed this firmly, highlighting the potential harm that could be caused, notably through

5 May 2016
4 mins read
Clinical

Yonder: Rosacea, youth mental health, diagnosing arthritis and telephone triage

Ahmed Rashid is an academic clinical fellow in general practice at the University of Cambridge. He writes the regular monthly column “Yonder” in the BJGP: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature. Twitter: @Dr_A_Rashid

5 April 2016
6 mins read
Clinical

Zika virus testing: practical management for primary care

Christos Mousoulis is a medical doctor specialising in Public Health. He is currently an Academic Clinical Fellow doing his health protection placement at Public Health England – West Midlands East team. His main interest is in Academic Public Health and in Clinical Trials

1 April 2016
6 mins read
Clinical/Opinion

This milk tastes sour: cows’ milk allergy and industry-sponsored disease creep

Jonny Coates is one of the First5 GPs that’s not in Australia.  He works in Newcastle upon Tyne. Hospitals are awash with Pharma freebies. CCU is littered with the logo of the latest statin, the psychiatrist’s pen bears the name of the

22 March 2016
5 mins read
5
Clinical/GP Journal Club

GP Journal Club 28th February 2016 – Bariatric surgery in the NHS

Paper: Douglas IJ, Bhaskaran K, Batterham RL, Smeeth L. Bariatric Surgery in the United Kingdom: A Cohort Study of Weight Loss and Clinical Outcomes in Routine Clinical Care. PLoS Med. 2015 Dec 22;12(12):e1001925. Link: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001925 Ahmed Rashid is an academic clinical fellow

23 February 2016
3 mins read
Clinical

Yonder: Health checks, insomnia, nursing homes and spirituality

Ahmed Rashid is an academic clinical fellow in general practice at the University of Cambridge. He writes the regular monthly column “Yonder” in the BJGP: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature. Twitter: @Dr_A_Rashid

22 January 2016
6 mins read
Clinical/Opinion

The Ten Commandments for patient-centred treatment

Richard Lehman gives some background on the BJGP article The Ten Commandments for Patient-Centred Treatment published in the October issue. The Ten Commandments for Patient-Centred Treatment had a gestation of nearly four years. And their true parent was John S Yudkin, Emeritus

20 October 2015
3 mins read
Clinical/Opinion

Review: An interoceptive moment with your neurobiological self

Alistair Dobbin is an honorary fellow at Edinburgh University medical school, an ex GP, a researcher and charity director. Book Review: How Do You Feel?: An Interoceptive Moment with Your Neurobiological Self by A.D. (Bud) Craig. Available at Princeton Press: http://press.princeton.edu/titles/10405.html Groundbreaking scientific discovery

13 October 2015
4 mins read
Clinical

Yonder: diabetes, orofacial pain, screening tests, and pharma

Ahmed Rashid is an academic clinical fellow in general practice at the University of Cambridge. He writes the regular monthly column “Yonder” in the BJGP: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature. Twitter: @Dr_A_Rashid

8 September 2015
6 mins read
Clinical

“For One Week Only” – Diagnosing high blood pressure in primary care

David Nunan is a Departmental Lecturer and Senior Researcher based in the Nuffield Department of Primary Care Health Sciences and the Centre for Evidence Based Medicine at the University of Oxford. His research interests include evidence-based medicine, cardiovascular and non-communicable disease and

19 August 2015
9 mins read
Clinical

Yonder: Practice nurses, Ehlers-Danlos syndrome, fitness to drive, and Balint groups

Ahmed Rashid is an academic clinical fellow in general practice at the University of Cambridge. He writes the regular monthly column “Yonder” in the BJGP: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature. Twitter: @Dr_A_Rashid

31 July 2015
6 mins read
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