The wolves in the forest that frighten human beings are now at last being accurately named: poverty, homelessness, hunger, unemployment, domestic abuse, adverse childhood experiences. Humans like sheep have a basic need to feel safe. They can’t function well until that need
Now imagine, that for the majority of cases being presented, the consultant condescendingly - and unnecessarily - adds, at the end of the majority of cases, that they had been diagnosed and managed wrongly by the 'incompetent' GP prior to coming to
...After a long day being your child’s GP, I come home. I get a few tantrums, followed by a cuddle 10 minutes later. I am a mum, just like you.
Are GP practices equipped to respond to the current mental health crisis? Here, Jonathan Coates and Nick Hartley reflect on a recent pilot of the role of GP clinical psychologists in primary care - "an experienced, senior clinician independently handling undifferentiated presentations
Inhaler prescribing alone accounts for approximately 3% of the NHS’s carbon footprint. Unsurprisingly, this has been targeted by Greener NHS as a priority area. Here, Emma Radcliffe describes a number of success stories of practices reducing their metered dose inhaler (MDI) prescribing,
The first planned strike action will take place for 72 hours in mid-March and will see junior doctors stepping away from their wards, surgical theatres, outpatient clinics, and indeed, for GP registrars, their practices. How do junior doctor strikes impact on general
They are billed as digital solutions, but they simply offer a locum GP, restricted to video. My experience over the last 3 years leading a GP federation has opened my eyes to the long-term perils of short-term solutions such as this.
My parents being immigrants, enforced into us to keep our heads down and work hard, to adopt a ‘don’t cause trouble’ attitude... Being called these occasional names I still performed well academically at school, it never placed limits. Life was good …
With the COVID-19 pandemic there has been a shift to digital technology that has necessitated both GPs and their patients to adapt rapidly. There is concern that older adults will struggle to adapt to this shift due to their low technology usage
In response to recent earthquakes, the UK Emergency Medical Team (UKEMT) is currently providing a variety of clinical services from a field hospital in a heavily-damaged town located around 50 kilometres from Gaziantep in Kahramanmaraş Province. Richard Armitage is there.
...it wasn’t until I became sick myself that I really understood what it meant to be a patient, or indeed those wider principles I tried to root my own practice in. For me, that once watertight seal between clinician and clinic was
A brief check of the notes and it is a patient you don’t know, taking eight different medications for four separate problems. You’ve probably got 10 minutes...
GPs can hide, to a degree, behind the castle walls and beyond the moat consisting of front-line administrative staff. But I ask myself two questions: does that mean we are in an ‘ivory tower’; and do we have a ‘drawbridge mentality’? Emilie
Alex Pavitt argues that we need a systematic shift from focusing on appointment quantity to consider appointment quality as we work towards embracing and combating the overall problem of ‘multimorbidity’.
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
The phrase ‘we can’t go on like this’ is frequently banded around on social media in relation to the NHS. However, it seems that the staff working within this organisation can, and are; but at what cost?
Ask any doctor, and they’ll tell you that talking to patients can be difficult. Mind you, ask any patient and they’ll tell you that talking to doctors can be really difficult too. Ben Hoban discusses how we address the problem.
What is my take on carers? They deny they need a medal for what they do. I now have the awareness and the greatest respect for these unsung heroes. For me. I will continue to care for Mavis, to do whatever I
The worsening relationship between primary and secondary care if this NHS is to be saved, argues Edin Lakasing
For the first time, a coroner in the UK declared domestic abuse as having a causal role in death by suicide. Domestic abuse is a growing public health burden, so what can primary care do to protect individuals experiencing domestic abuse? Here,
How have media depictions of general practice and GPs affected how we work, and healthcare policy in the UK? Nada Khan investigates...
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
Imagine having to relive the moment you are told that you have a life-limiting illness every time you need support; every time you feel vulnerable because of a physical or mental complaint that needs attention. Emilie Couchman argues for meaningful informational continuity.
In 'Helgoland,' Carlo Rovelli attempts to bring us up to date with the latest in the bewildering and bewitching subject of quantum physics. One of his main assertions is that the observer will always affect the observed.
Richard Armitage reviews two self-help books by controversial psychologist Jordan Peterson
Digital medicine is a priority for modern general practice and is a core theme for NHS England strategy. As a recent Topol Digital Health Fellow, Bilal Salman describes ...
The Canadian Centre on Substance Use and Addiction (CCSA), in new guidelines endorsed by Health Canada, recommend that Canadians should have no more than two alcohol-containing drinks per week. Nada Khan explores alcohol advice in primary care.
Is it because people are getting older and sicker, developing more and more chronic diseases as they age and then expecting a magic cure-all that doesn’t exist? Expectations for such, we have all likely fed into.
When someone asks you whether you’re telling them it’s all in their head, the most accurate answer is: Yes, but isn’t everything?
Finding the right partner is critical. With a generation of senior and capable partners retiring and not being replaced at the same rate, there is a huge concern of seeing this post continue to diminish. Here, Adnan Saad outlines how best to
As the latest cohort in the Oxford International Primary Care Research Leadership Programme, we present the ‘10 things we wish we had known’ for anyone considering a career in academic primary care.
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.
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
Labour seems to have its own version of a disruptor in Wes Streeting, the shadow health secretary, who declared that he wants to phase out the system of GP partners, & scrap the gatekeeping model of primary care, but how many of
It is well known that the life expectancy of people with severe mental illness (SMI) is reduced by 15–20 years compared to the general population, but what is less well known is that people with SMI also experience serious inequalities in oral
"When a patient who happens to be a barber comes to see me for a consultation, that is precisely what – and only what – he gets. When I go to see my barber for a haircut, however, not only do I
Ask yourself ‘Do I feel lucky?’ This often-misquoted line from Dirty Harry, said by Clint Eastwood in role, serves to introduce the notion of moral luck. Gratifyingly, we do not often find ourselves staring down the barrel of a violent cop wielding
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.
Apichai Wattanapisit reminds us that lifelong learning is a crucial element to maintain the standard of practices and develop the future career.
The results of a recent BMA survey, which asked junior doctors what they felt about leaving the NHS, should send a shudder to the heart of the NHS, including through general practice upon which the health system stands.
Ben Hoban suggests that GPs can keep track of more in the consultation by not worrying about keeping track of so much, but instead choosing what to focus on.
