Last year we shared some party games. This year I'd like to share a concept for conversation. You could share it or leave it in the background of your psyche as the news and issues of the day mingle with the miscellanies
This book is intended to fill a gap for health and social care practitioners working in prisons, and cites current evidence to back up much of the narrative and recommendations – but does it try to do too much?
Amongst the changes, you may have missed the decision to cease funding the newly qualified GP fellowship program.
Richard Armitage reminds GPs to think about medications prescribed outside the primary care setting especially when thinking about new symptoms, changes to medication or medication reviews.
People just don’t understand what General Practice, as a medical discipline, is. Meaning that people are creating solutions to our capacity issues based on a misunderstanding of what we do. Joanne Reeve channels her indignation into a rallying cry for advanced generalist
Phil Whitaker reviews 'John Berger: Ways of Learning' by Iona Heath, a "[compilation of] letters, quotations, and reminiscences from her 20-year friendship with John Berger" ...
Ben Hoban reflects on the necessity and risks of reductionism in medicine. The tension between parts and the whole is a necessary part of whole person medicine
UK GPs have to do a multi-source feedback survey (MSF) across their scope of practice every five years. Should you give feedback if asked by a colleague? Paula Wright opens the discussion
When does a GP attend a patient’s funeral? Emma Ladds writes about how it is such a privilege to be a family doctor, and about grief when losing a patient.
"If we focus on using a healthcare service to improve health outcomes we cannot be surprised when our health worsens or our staff become overwhelmed. Imagine putting the hopes of a nation winning a football match on a tired and injured goalkeeper
Is it better to think of patients as a body and a mind, or as a single entity that has both physical and conscious attributes? Alistair Appleby invites us to reflect.
Appeals to tradition represent a desire to preserve the evanescent, to build a clear narrative that tells us who we are and how we should go about things, even if its historical basis is shaky. We project our thinking onto ... general
The author tells us that 'mysterious illnesses' are complex and complicated, very individual, definitely not in the patient's head (though attention to one's psyche can be beneficial), but in her body, and, importantly, in the culture she lives in...
Primary healthcare's networked nature is manifest in the Life and Times section this issue. Andrew Papanikitas suggests that we all need the healing power of good connections.
Fraser Barratt says a lyrical farewell to hospital medicine as he moves into the community for the final phase of GP training
Can we design a healthcare system that is safer, fairer and more sustainable, without patient representation?
Newly-qualified GP John McCullough seeks wisdom from established GP and rural medicine lecturer Tim Sanders. It feels like a tough time to enter General Practice – has it always been this way?
The authors describe GPs as ‘street level bureaucrats in that we simultaneously enact the dictates of ‘tyrannical officialdom’ whilst addressing the needs of our clients. They offer a narrative account of the daily realities of British urban general practice and reflect on
"I asked ChatGPT to write me 100 words on the potential uses of AI in UK general practice, and it instantaneously churned out the above. I am simultaneously amazed and terrified!" Paul McNamara ponders the role of AI in his professional lifetime.
The inappropriate transfer of work from secondary care in particular is a well-recognised problem which seems difficult to address. Ben Hoban wonders if this reflects a broadly political change in the goals of British healthcare.
Carter Singh reflects that we need to address the underlying cause of the racism, hatred, polarisation and intolerance that is now brimming over the edges into everyday life.
In the second of two articles on NHS funding formulae, Rodney Jones looks at trends in death and the implications for cost pressures on the NHS. Why can’t government funding take into account the well-established nearness to death (NTD) methodologies, ending the
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?
Hannah Ritchie takes a clear-eyed view to understand how we got where we are, what the real problems are, and what we should be doing to build a truly sustainable world. Throughout Ritchie supports her arguments with evidence and data. Terry Kemple
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 National Confidential Enquiry into Patient Outcome and Death (NCEPOD) review has recently published a review of the quality of care provided to people diagnosed with endometriosis. What can we learn from this report, and what can GPs do differently to improve
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.
Effective public health campaigns need more than posters and TV ads about going to see your GP. We need to get key community influencers in the team if we are going to have any impact whatsoever. John Havard argues that barbers have
The intervention takes less than a minute every day - and done at scale would be safe and as cheap as chips. Imagine that existing good quality evidence showed that it is 10 times more effective than the current NHS Health Check
I don’t need to tell a GP audience this, but it’s always worth a reminder. For us GPs the relationship is everything. Outside GPs this doesn’t seem widely understood. Everyone will agree that relationships are crucial, but usually in a way that
In 'Good Reasons for Bad Feelings', Randolph M. Nesse offers a fresh perspective on anxiety and depression in modern day living – that of evolutionary medicine, specifically evolutionary psychiatry.
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
In Japan, there is a saying that deities disguise themselves as difficulties and offer trials to those who have true courage and strength. My supervisors taught me that when we are overwhelmed and troubled by complex problems, we should respond with sincerity
Not helpful but harmful: Competence expansion alone increases, rather than decreases, burnout in GPs
Competence expansion alone is not a viable solution to intolerable GP workloads in the UK or anywhere else. Richard Armitage has a simple message for policymakers on the mathematics of practitioner burnout.
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.
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: