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Opinion - Page 25

The problem of prescribing for pain

Judith Dawson reflects on the draft NICE guidelines for the management of chronic primary pain. There is widespread use of ineffective and addictive pain medication of questionable benefit. However, implementing any change will depend on a cohesive approach across primary and secondary
4 September 2020
2 mins read

Welcome to the age of #SpectacularHealthcare

Despite ‘seeing’ more patients remotely, we are becoming more isolated, living our lives in lonely clinics and solitary consultations. The art of medicine becomes abstract, doctors and patients united in their separation.
2 September 2020
3 mins read

It is time for general practice to act on racism in health care

Under the Prevent policy, NHS Trust staff are trained to spot signs of radicalisation and refer cases to the government. Within a systemically racist social system this policy succeeds only in targeting minority groups and those who are most vulnerable. The abolishment
3 August 2020
2 mins read

Retirement and managing the ‘peridoctorpause’

Ed Warren is a retired GP. He notes that a feature of getting older is that you have more opinions and are convinced that others want to hear them. He reflects on the ageing process, cognitive biases, coming to terms with his
30 July 2020
3 mins read

Is this really doctoring?

The opportunities to treat more and more patients in less and less time is the unspoken aim of the improving of technology. But as we move into this future, we must continue to courageously ask both ourselves and our employers; is this
22 July 2020
2 mins read

The fable of the dun cow: GPs are not a limitless resource

If general practice becomes unsustainable, we will lose the most effective and efficient health service we have, and it will not be easily replaced. It’s time we involved GPs in the critical analysis of the holes in the system, before our capacity
18 July 2020
4 mins read

Pandemic primary care and the lack of a picture

So why am I more exhausted from a full day in practice when I have only seen four patients face-to-face, dealt with 30 or so patients over the phone and conducted a MS Teams practice meeting? The ambience around appears calmer –
18 July 2020
2 mins read

The conundrum of self neglect

Most clinicians will encounter cases of self-neglect during their career, which will vary from mild presentations to really disturbing cases where the self-neglect becomes extreme. What drives such behaviour and how do we manage it?
17 July 2020
3 mins read

Reclaiming the physical examination for general practice

Described as the 'cornerstone of safe and effective practice', the physical examination has always been an integral part of what makes a competent GP. With recent evidence presenting a decline in GPs' physical examination skills over recent years, GP Simon Morgan reflects
16 July 2020
3 mins read

BLM, population health and policing

The effect of being stopped and searched by the police can be psychologically traumatic and leave one feeling scared, powerless and humiliated. I thought about my patients. A lot of patients I look after are black and I wondered about how negative
2 July 2020
3 mins read

Health inequality and COVID: Two centuries of social murder

Health experts and politicians have warned for over 170 years that health inequality is killing those in the most deprived parts of society. We now witness the poorest in society disproportionately dying of COVID-19, suggesting that the social murder observed by Engels
25 June 2020
3 mins read
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BAME excess deaths: chronic stress and constant hostility

Everyone of us in the health service has overheard unacceptable rudeness, sly put-downs, exclusion or smiling say-the-opposite-of what-you-mean British insincerity. We need to acknowledge that it is happening. There is no mysterious genetic or melanin fault causing excess deaths among health workers
16 June 2020
2 mins read
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Pride and prejudice in the NHS

How much does it take for us to genuinely express sorrow and compassion for the terrible trials our patients endure? We have pride in the NHS but we have prejudice too. Perhaps it is the NHS clinician that is Icarus, flying too
11 June 2020
3 mins read

The absurd general practitioner

An individual working as a GP runs the risk of becoming an automaton. Evidence-based medicine and professional standardisation contribute to uniformity and by definition a reduction in diversity. Camus says that “if the world were clear, art would not exist” and I
10 June 2020
3 mins read

Trust Me I’m a Millennial GP

As a 20-something millennial GP trainee, the sudden talk about the future of primary care is exciting. I once heard a futurologist say, “Don’t ask ‘what will it look like down line?’ ask ‘what do you want it to look like?’” I
1 June 2020
3 mins read

The Future of Medicine

The Changing Face of Medicine project is gathering momentum. As President of the BMA, Professor Pali Hungin launched a project to look into the impact of fast moving technological advances, the shifting role of the doctor, the adequacy of medical education, the
11 March 2020
7 mins read
Elizabeth Garrett Anderson at desk

Women in medicine: increasing in numbers but not regard

Throughout the last century we have witnessed major advancements for women in the UK, but gender inequalities continue to exist in the workplace. The NHS, established with the intent to treat everyone equally, is no exception. On average, female GPs — who
8 March 2020
4 mins read

My first year as a GP physician associate

When I first qualified as a physician associate (PA), I had no intention to work in general practice, at least until later in my career. I was unsure of the impact a PA could have in a GP setting prior to the
26 February 2020
2 mins read
1

On cynicism. A post-election reverie.

David Misselbrook was a South London GP for 30 years. He was involved with GP training, CPD development and medical ethics. He now teaches Family Medicine and ethics for RCSI Bahrain. According to House, “patients lie”. Well, I guess most humans lie.
13 December 2019
3 mins read

Somewhere over the rainbow

Peter Aird is a GP in Bridgwater, Somerset. Judy Garland’s was not a happy life. Last weekend I went to see Renée Zellweger in ‘Judy’. It’s a remarkable performance in a film that portrays Judy Garland towards the end of her tragically
29 October 2019
5 mins read

Inspiring healthy lives

Rachel Handscombe is a GP partner in Derbyshire. She is an activity enthusiast and is keen to share the benefits of exercise to those she meets. I wore my 100 parkrun t-shirt to work today. I was curious as to what my
25 October 2019
3 mins read
Models of Laurel and Hardy on a bench

I’ll miss this when we are gone

Peter Aird is a GP in Bridgwater, Somerset. There’s a scene in Stan and Ollie, the film about Laurel and Hardy when towards the end of the film, Hardy says to Laurel: “I’ll miss this when we’re gone”. He speaks the words,
19 August 2019
4 mins read
1
Ferris wheel and dark sky

Vanity Fair: growing wise and finding my reward

Peter Aird is a GP in Bridgwater, Somerset. General practice – the story so far: Last week many of us tried to satisfy our appraisers by proving that we had met their unilaterally determined and arbitrarily applied indicators of satisfactory professional development.
1 July 2019
2 mins read
1
Power meter face

Managing power: happy to be ‘just a GP’

Peter Aird is a GP in Bridgwater, Somerset. Not so long ago, a school uniform committee was set up at the local educational establishment frequented by my children. Predictably enough, though nobody seemed to have a problem with the previously requisite attire,
24 June 2019
3 mins read

Painful conversations: A GP perspective on chronic pain

Paul Roberts was a GP for 30 years in Rochdale then Stoke-on-Trent.  He is chair of Willow Bank CIC (a social enterprise delivering primary care) and a director of North Staffordshire GP Federation. It doesn’t happen very often, but it is recognisable
25 April 2019
4 mins read
1

Planetary health: everyone’s problem

Tim Senior is a GP in Australia and a BJGP columnist. Fans of Douglas Adams will recognise the scene.[footnote]Adams D (1982) Life, the universe and everything (Pan Books Ltd, London).[/footnote] There’s a spaceship landed at Lords cricket ground, but no one notices
22 April 2019
2 mins read
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Living in “The Citadel” in Sierra Leone

Michael Bryant is a GP who splits his time between South Wales and West Africa, where he works in paediatrics and as a medical educator. A J Cronin’s classic novel The Citadel is often credited as being partially responsible for the founding
15 March 2019
4 mins read
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