Pale Male and Stale
Scary? How about this. Many years ago, single handed I did minor surgery at the end of surgery. I'd seen a lady with an 'obvious' lipoma and agreed to excise it for her. However when she arrived it seemed bigger than I had remembered and after some humming and haring I decided to refer - UNHAPPY patient! - The surgeons saw her agreed with my diagnosis and arranged day case surgery - you guessed it - spigalean hernia - I had actually seen and heard about these in medical school! Glad it wasn't me cutting through a loop of bowel!
Have faith - Haven't the government delivered on Brexit, Universal Credit and pulling out of Afghanistan and Iraq?
Some may say "Your part time flexibility is my early mornings, late evenings and working through the holidays"
I'd say "I'm off, been there done that and never got the thanks!"
Do we really want to be managed from above? Well the answer at the coal face is "No - I'll work when and where I want as a locum" - Until those taking the risk and ultimately the responsibility for premises, staff contracts, GMS Contracts etc. are rewarded MUCH better than locum or salaried jobs then the temptation will be to take the money and the flexibility.
At the end of the day we can't all have ultimate flexibility and remain 'equal' - Some are indeed more equal than others. Big Brother will take over the farm and GPs will be offered take it or leave it contracts....unless SOME GPs take back control and are rewarded for doing so, not just money.....maybe they too would like some flexibility!!
...to those who have, shall be given.
Adulting begins at sixty - twenty years a kid, 20 years pretending to be an adult, another 20 years preparing and then you’re there - Adult - only to find it’s actually like the first 20 years - fewer responsibilities and certainly less fear of mucking things up! Goodbye imposter syndrome, I’ve been there done that and if that’s not good enough for you - TOUGH !! You know you’ve arrived when you can truly laugh at yourself when the others are falling off their chair having fallen off yours and not caring you don’t know all the answers and openly use Dr Google for advice!
It's a sorry state of affairs but the best and cheapest solution is probably to do nothing. All practices MUST do GP2GP and somewhere along the way notes will be summarised (hopefully) - In time whatever is left in the Lloyd George will become less and less relevant. The alternative IS to scan everything and upload onto clinical system - not ideal but less likely to be lost than LG - The time taken to review notes and clear out 'junk' is too great - if scanned and separate pages created this exercise can again in time be edited and irrelevant guff culled.
Does anyone one think that making the job attractive might help?
Is this recurrent funding or another trial?
We are having our out of hours payments halved - you know the scenario - Same work, half the money. (This was extra money for extra work - is the expectation that we provide the same number of appointments in contracted hours if we decline?) My guess is that once set up this project will find that the funding is slashed and the expectation will be that the OOH cover remains. It will be tied in to other income streams - Out of Hospital services contracts only available to those who offer 7/7 8/8 etc!
Looks good now - just watch out in future.
GMC needs tree trunk let alone root and branch radical pruning - Unfortunately not just dead wood but alive and rotten to the core. Fell the whole damn thing and plant new saplings with vigour, promise and integrity.
Now who has the balls to sue the GMC for damages? Hopefully some money left in the pot!
If one says one thing and believes another and likely promotes something altogether different elsewhere then getting ones ‘come upance’ is the outcome. I am sure Dr M will now use his energies to fight for larger practices including his own Hurley Group. Those that have expressed their desire to save small and medium practices now need to step up and DO something. It’s likely Dr M was expressing NHSE opinion as of course he was working for THEM not us. He’ll be replaced by someone of like mind so the battle continues!
Nice one! Feel I’ve been better off for standing up for myself over the years - literally and on occasion nose to nose shouting back. It helps I’m 6ft 3in and it’s not for everyone, however the shock and horror on the faces of the abusers can be something to behild - “...No YOU F**** off!!” Often followed by “...errr you can’t talk to me like that - you’re a doctor?!?!?!” - Well I can and I do.
It’s often a surprise to the abusing patient that I/we push back and aren’t just a vessel for there vileness - in fact on reflection, not pushing back seems to make matters worse as nobreaction or an apologetic one is like a red rag to a bull.
I do hope however that the perpetrators of the physical abuse metred out to the 2 GPs feel the full weight of the law and we can use these as examples so as to help prevent any further attacks. (...would this be a deterrent?!)
I may have been in a Brexit/World Cup/Thai cave bubble but why didn’t I hear of these attacks - surely this is ‘news’ ??
So a partnership model to share profits but take no risk, presume partners would like the profits but not the losses?! I think this seems like getting a job and being employed - premises issues work both ways - I actually like working in a place decorated and fitted out as I like but accept I have to pay for it, others think differently. I do find that ‘proper’ partners are more inclined to make savings and refer/prescribe if it affects them directly!
As mentioned above charging for DNAs will only ensure they turn up however wasteful for both GP and patient. However the 'while I'm here Dr' banal questions will increase. In terms of increasing efficiency I think the DNAs are already factored in for most of us - still don't get a coffee break and these allow for the inevitable overruns. So charge to make an appointment, return fee if they turn up or cancel more than 24 hours before. Otherwise keep the £s! Not as ludicrous as it sounds as it would put the ball very much more in the patients court.
...why the element of surprise? We are the lowest of the low priority from central to local government and beyond!
Go girl!! - you have our hopes and wishes - your fight is our fight too! Best of luck from an old boy!
111 use a very short algorithm.
Do you feel ill - No - see GP
Do you feel ill - Yes - see your GP
Do you feel you need to see your GP - see your GP within 12 hours
Do you NOT want to see your GP - see your GP!
I've had NUMEROUS patients who wanted simple advice but were TOLD MUST see GP
As GPs we manage risk well - 111 doesn't manage risk at all - see GP. So we see the 'dross' at the expense of those who might actually benefit - NOT ME - I'm off!!
I’ll not be rushing out on a mad spending spree then!
Thanks to the BMA for helping push forward my retirement plans!
Would be grateful if ‘snowy white peaks’ could be clarified. I’m Pale Male and Stale - I believe through no fault of my own - so I’m a minority in GP as there are more females 51:49%! I take on the ‘what is black’ argument and can’t help bring up the ‘tar brush’ / what makes the greatest president of our generation a ‘black man’ - it can only be that it suits some arguments - he’s a middle class child of a white mother is he not?
Let’s get away from BME / Pale Male & Stale / Tinted Female & Fresh.
To me young enthusiastic GPs (especially those with a portfolio and ability to communicate well) are the future - gender, accent and heritage or sexuality matter little to me but putting in at least as much as you get out and recognising the team is key - (please don’t confuse portfolio career with working term time only and finishing at 4pm for the School run.)
You identify yourself as Asian and British Indian do shy get upset when others do also ‘coloured’ is old fashioned and may have been prefixed or suffixed by lady : pretty : young etc Get over yourself and if it matters enough define yourself and put out there how you wish to be described when patients can’t remember your name. (I’m the grumpy old GP in room 2 as opposed to the young Male GP, the 2 lady GPs one with long hair the other not and the New or ‘foreign’ Dr upstairs - amongst other descriptions
My daughters want one of those heritage DNA tests - the look Nordic but aspire to some rather more exotic connection - would it be a good thing or not?
If the young talented, tinted and LGBTQI or even H want change at the top then THEY need to step up - Many of us are more than willing to help but the idea that those at the top need to step aside is unrealistic and patently unfair. The power is in YOUR hands - step up and you’ll find that as we pm&s fade away there will be a space for you to step into should you want it.
GO = GP
big = bit