"The Deep End project demonstrates change can be made by practitioners working together to advocate for primary care to be at its best where it is needed most. As a professional group, we hold more power than we realise. If we do
Carter Singh argues that accusing striking doctors of causing harm is disingenuous when there are many critical harms that strikes are attempting to address.
The argument is that, for decades, ‘business friendly’ governments have been allowing private interests to extract vast fortunes from the NHS and that over time the service has been increasingly reformed to make it ready for corporate takeover. This would make our
The Life & Times section this month highlights ways in which we risk missing important aspects of life. Many of the articles also suggest how we can extend and add necessary flexibility to our gaze.
Pregnancy for deaf women, prison mental healthcare, sexual health non-attendance, and compassion
With the potential dismantling of the GP partnership model and the drive for a multiprofessional workforce in primary care, is this the right time to look at shared leadership as a facilitator of positive change?
"The function of a diagnosis is more than to guide treatment planning. It often provides emotional relief for patients, even if the diagnosis is dire. As Susan put it, “I keep hoping that some doctor will tell me exactly what this ‘skin
The title, ‘What is a doctor?’, neatly articulates a contemporary query. As the multidisciplinary team (MDT) becomes increasingly complex with additional moving parts, the role of the doctor becomes ever more difficult to describe. The memory of the ‘family doctor’ is fading.
"Reflecting with a new appreciation of how cycling infrastructure can be done, it’s clear our system needs an overhaul." - Callum Leese writes on the importance of advocating for the development of cycling infrastructure in the UK ...
In clinic last week, a patient called me by my first name – this was the first time I have experienced this in primary care, and for some reason I found it quite jarring. ...there seems to be very little evidence on
Pablo Millares Martin considers whether the problem list has become a problem (or remains a useful clinical tool).
The ever changing face of health services has been reflected in incessant change in language. Here is a (tongue in cheek) glossary for those who have not kept up (Caution: contains satire).
A number of storylines within the Star Trek franchise refer to a combat simulation in which a stranded starship, the Kobayashi Maru, must be rescued, but in which any attempt to do so inevitably results in failure. Ben Hoban can relate...
Merope Mills’ description of the death of Martha, her 13 year old daughter, is a raw and harrowing account of the mistakes doctors made that led to Martha’s deterioration and ultimately her death. Nada Khan evaluates the concept of a Martha’s rule,
As part of a Student Selected Component focussing on frailty in primary care, supervised by Paul McNamara, Scott Wylie had the chance to learn directly from GPs and attending local frailty services. As part of the project, he also carried out an
So the NHS is in crisis. Again. Saul Miller argues that there is a thread that runs through all of these. It is the thread that is labelled expediency or short-termism.
I had progressed from A-Levels into becoming a GP... without pausing for breath - or allowing time for the aspect of my professional practice I enjoyed the most; teaching. But not clinical or consultation skills; instead, anatomy.
Doctors.net.uk recently reported that some colleges, including the Royal College of Surgeons, the Royal College of Psychiatrists and the Royal College of Physicians did more than break even on exam costs. Nada Khan investigates.
Losing my father earlier this year changed me. It changed me as a person, it changed me as a mother and it changed me as a doctor.
It has been stated that the Labour party would ‘bring back the family doctor.’ Emilie Couchman discusses the issue with colleagues and invites politicians to stop playing to the gallery and start talking those who have to make those policies work.
This month’s Life and Times articles highlight general practice at the heart of the NHS ecosystem, a powerful force for social good. It is clear that we shouldn’t waste too much time partying, and that not all of the work to be done lies within health care.
Some of us will welcome this opportunity to shine a light onto the events that took place in the early stages of the pandemic. But what is the right way to look at our response to COVID, and what’s happening in other
It seems unlikely that these things can be reduced to a few simple bullet points, and yet, it’s hard to resist the allure of the headlines, with their subtext that the universe obeys a hidden code, and that if we only pay
But being on one pole of a restrictions-versus-protections continuum is a long way from swallowing undiluted anti-vax Kool-Aid, isn’t it? ... Surely, being lukewarm on masking doesn’t mean you’re going to deny the evidence on vaccines?
Richard Armitage asserts that the art of effectively deploying this knowledge with professionalism and wisdom is rooted in the discipline of philosophy. In 2022-23 he attended a masterclass in bridging these two domains for healthcare professionals.
Tim Sanders views the “rewiggling” of the Swindale Beck in the Lake District as a metaphor for a need to nurture and cherish core aspects of generalism, continuity and relationship-based care within the role of the GP
So, how can GPs help their patients in facing transformative decisions? The advice, helpfully explained by Richard Armitage, is to reframe the decision-making process with which we approach them.
General Practice, then, shares the values of both the dinner date and the mobile phone, and this is reflected in the way patients consult differently depending on context, preferring ease of access for simple acute problems and continuity of care for complex
Nigel Masters has a déjà vu experience as he looked onto the ‘White screen’ of a newly registered patient and finds empty allergy fields, problem lists, consultations and immunisation screens.
"I was startled to notice an under-confidence in my formulation of dermatological diagnoses, calling my supervisor to review patients more frequently than usual. It soon dawned on me that there was a pattern to my reticence. With my White patients, I was
Given the increasingly multidisciplinary system we work in, perhaps no one individual can be expected to take responsibility for championing continuity.
This warning is not about climate change. Skip to the last paragraph to get your warning or keep reading to understand why we ignore warnings.
"I firstly prompted GPT-4 to “Answer the following as if you were a GP trainee in the UK.” I then asked [it] each of the 45 text-only questions ...from the RCGP AKT practice paper"
Clinical codes are of course created by the machines’ human lackeys, but sometimes betray a way of thinking that is hard to relate to. Ben Hoban muses on how we record clinical consultation data.
The term 'pathway' is commonly used within the NHS to describe the sequence of steps and services involved in a patient's care. While ‘pathway’ may be familiar and well-understood among healthcare professionals, this is far from the case with the public.
So, doctors... are learning to be afraid of uncertainty, ordering ever more tests and prescribing more and more, to try – often in vain – to be sure... But where does that leave Patient Earth?
"... machines will soon become superior to doctors in all domains of health care, where the Moravec paradox will cease to apply."
Variety is a selling point for the profession itself (challenging and interesting) and for the resources needed to do it well (GPs are ‘best’ placed to do many great things but need time and money invested). Andrew Papanikitas introduces this month's Life
A recent warning from the UK Health Security Agency suggests that London is at risk of a major measles outbreak due to poor measles vaccination coverage. What does this mean for general practice?
The service I work in was set up by the local Aboriginal community, because they were being poorly served by the health services that existed at the time. Part of this was that the options offered seemed to operate on a narrow,
All of us in the NHS want to help people, we wouldn’t be here otherwise. But, and I only use diabetes as an example, how much of our work now inadvertently keeps a proportion of our patient’s sick?