A reflection on the madness of sense and the sense of madness. Anuj Sean Chathley captures the demoralising and costly effects of healthcare funding cuts in poetry. "...these changes do not save. They spend — time, money, morale, and sense."
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?
In the summer before COVID-19 it the UK, I read three works of fiction (one after another) that changed my perspective on the world and our place in it: The Wall, The World according to Anna, and The Ministry for Future
In a podcast recorded by the Medical Republic, Jens Sondergaard outlined six main reasons it’s great to work in Danish general practice. Nada Khan weighs up the evidence for moving to Denmark.
Richard Armitage argues that, in three well-defined contexts, clinical decision-making should be delegated to AI systems either today or in the very near future.
'Caring for carers is everyone’s business, though general practitioners (and we use our words wisely) are perhaps best placed to identify and support carers -more so than other health professionals.' argue Helen Walker and Clare Gerada
If we want to avoid missing significant diagnoses, and tigers, we cannot examine every symptom or blade of grass exhaustively, but we can cultivate an openness to the sort of cognitive dissonance that points to unrecognised danger. Ben Hoban explains
'More of the same won’t fix general practice.' So, what should we be doing differently? The Lazarus project is designed to take GPs out of ‘usual care’ to a different space for professional practice ...
Introducing a temporary weight loss fix using GLP-1 agonists without consideration of the wider implications and long-term plan is quite frankly, an absurdly short-sighted idea, argues Elizabeth Dapre
What can be done? These are five low-cost steps to take forward a modern version of the family doctor.
In both primary and secondary care, we see firsthand the concerning, growing impact of mould on the health and wellbeing of our patients. These cases are a stark reminder of how significantly more needs to be done to combat the devastating impact
GPs allow patients to make harmful choices – thereby affording primacy to autonomy at the expense of beneficence – when that harm accrues only to the individual making such choices. But if your future self is a different person, does that mean
What are GP trainers' thinking? Saul Miller gives us a glimpse.
Our relationships with patients are more than just transactional, but they do not need to be based on affection or necessarily on duration. A good doctor-patient relationship is simply one that enables both parties to bridge the gap between them, and it
Hannah Milton discusses...a gradual withdrawal from social life starting in mid-teens, often with school refusal alongside an altered sleep pattern, gaming or social media addiction and a restricted and unhealthy diet with a total lack of exercise.
Most practices at some point may find themselves in a tricky situation of having to look for a new practice manager. Adnan Saad shares some starting points. Additional insights are welcome in the comments!
The Metropolitan police chief, Sir Mark Rowley, has said that his officers will not attend calls for mental health incidents from 31 August 2022 unless there’s an immediate threat to life. Nada Khan investigates the key issues in this national scheme its
So what we need is the invention of a ‘new category’ of General Practitioner. David Mummery sets out his manifesto for the future general practitioner. Discussion welcome!
Today it is for you and your colleagues to rebuild and sustain those relationships. You have a wonderful tool for doing this in your surgery’s website. Use it to tell your patients how your surgery works.
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
So, as the ‘choose well’ guide tells us, they have to judge whether a condition is ‘serious’, a fall is ‘minor’, an emergency is ‘real’, an injury ‘non life-threatening’, and care is needed ‘urgently’.
"We regularly face a level of demand that we don’t have the resources to meet. We gradually downgrade our aspiration from thriving to functioning to surviving, and our only options look like pushing through or getting out. Simply going on as we
A recent BBC Panorama ‘expose’ of private ADHD clinics suggests that some online providers are over-diagnosing ADHD following inadequate clinical assessments. Patients are increasingly turning to private providers both out of pocket and through right-to--choose arrangements, and ultimately, GPs may be asked