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  • Matt Hancock announces bid for PM

    IDGAF's comment 25 May 2019 1:26pm

    Ask yourself- What kind of disingenuous individual would seek this job when it is clearly a poisoned chalice, which will require the blatant and overt expression of promises which will not be fulfilled to a populace who insist upon the right to "stick to their guns" when such a path could well be a disaster?

    The answer? The 5 who have so far declared their candidacy.

    And Matt Hancock, the dyslexic, can only be the best man for the job in a world turned upside down.

  • 5% of doctors are alcohol dependent, research says

    IDGAF's comment 16 May 2019 7:22pm

    Looks like the staff of Pulse have been on the bottle; paragraph 6 and 10 are identical with the latter adding nothing new to the article.

  • NHS England instructs GPs to do more hep C testing after blood scandal

    IDGAF's comment 03 May 2019 6:15pm

    Its important to remember that perhaps 1/3 of patients can have chronic Hep C but normal LFTs including the ALT.My policy is to check Hep B+C status in any persistently elevated ALT even if trivial, along with a ferritin and HbA1c/lipids as a minimum (fatty liver etc/hemochromatosis) and test those with clear risk factors for these infections if risk factors are identified, with or without vague constitutional symptoms. Bear in mind that sharing a cigarette/spliff/toothbrush are risk factors which may not be recalled (or admitted to).

  • RCGP received 'significant' donation from Sultan of Brunei in 2013

    IDGAF's comment 09 Apr 2019 10:49am

    I heard (don't ask me where) that the Sultan of Brunei is interested in evaluating geological trauma on the human body, in the name of science of course. Its a field that few other nations have taken an active investigative approach to./s.

    Sick jokes aside, the reality is that many establishment outfits regularly engage in morally questionable activities through cynical self-interest and short-termism.

    Heres a corker for you-the role of the BBC World Service in facilitating the coup of the leader of Iran Mossadegh in 1953. The blowback from that glorious moment seems to be falling on the shoulders of Nazanin Zardari-Radcliffe, a lady who has worked for the BBC and rots in prison in Tehran. What she has done may not be troubling to us in the UK but the attitude of Iran makes more sense when this piece of history is pondered upon.

  • 'Today is a red letter day in the history of English general practice'

    IDGAF's comment 01 Apr 2019 5:24pm

    If the author continues to pat himself on the back with such abandon then I am fearful for his rotator cuff.

  • 'General practice made Richie ill'

    IDGAF's comment 22 Mar 2019 4:20am

    "One death is a tragedy, a million is a statistic".

    The sad truth is that a nation which allows its military veterans to suffer their PTSD incurred in wars of questionable "validity" on the streets without support, and has no capacity to deal with youngsters who are not quite suicidal enough by mental health services has no real regard for doctor suicides. The "Fat Cat" notion is part of it, as is the belief that we are "taught" to handle the brain-damage which the work imparts, and suicide simply implies that the deceased was just not up to it.

    But having said that I am oh so reassured that as I am part of the bedrock of the NHS, Tw~t Canhock(sic) has got my back......

  • Digital GP consultations make spotting signs of sepsis 'a challenge', says PHE

    IDGAF's comment 11 Mar 2019 7:26pm

    Pfff…… We GPs just love a challenge, and so do the ambulance-chasing lawyers. This should be used to attract Australian GPs to the NHS.

  • Our SMS templates helped save 40 follow-up appointments per week

    IDGAF's comment 26 Feb 2019 8:27am

    How big is the patient list?

    Twenty-five MRI scans per week? I guess the answer to my question above is needed to put this into some kind of perspective.

    Has the follow-up pathway for abnormal results been reviewed by any group other than the CCG? Unless the history taking (and often, the examination) are very robust at the time the test is deemed needed, the result could have multiple and varying implications. The ferritin springs to mind here.

    On the face of it the scheme has some merits but also runs the risk of institutionalising poor practice, devoid of individualised patient-centred thought.

  • We've lost momentum in our fight against cervical cancer

    IDGAF's comment 20 Feb 2019 6:30pm

    Ah yes,"after that QOF tick...I don't often THINK what happens next.".

    Add it to the list of things which are also done badly (apart from the keyboard flourish which applies the tick in way that Picasso would applaud) but are less emotive than "Cancer".

  • Class dismissed

    IDGAF's comment 20 Feb 2019 6:15pm

    Calm yersen, lad.

    Without reading the notes, the term "dismissed" may or may not be warranted, but from the journalists perspective he has achieved his/her aim, namely to grab YOUR attention and evoke a response, and indirectly promote their work by drawing attention to it as far and wide as Pulse reaches.

    He/she can now make a case for a payrise.

  • Social media as a force for anti-racist good

    IDGAF's comment 20 Feb 2019 5:48pm

    Several points on this piece.And let me declare that I, as MP Angela Smith would say, have a "funny tinge" to my skin.

    Let us put our emotions, and self-congratulatory delusions, aside and take a nuanced, counter-intuitive perspective on this. To believe that the spectre of racism has been slayed because the patient took the appointment card is a vacuous notion; the patient may have really needed to see a doctor and their comment, the origins of which are presumed to be racist in origin, could conceivably have stemmed from some less than satisfactory interaction with an Asian doctor before. Perhaps they are racist, or perhaps they were attended to previously and found an issue with understanding the doctors diction. Perhaps pursuing the patients ideas could have shed some light on this. And to claim this "never happens" (ergo- racism must be the explanation), most of us realists would accept, is patently false.

    Racist views often run deep, yet can exist with self-serving pragmatism.

    You claim we live in a clued-up society and yet I am not clear on what this trite phrase means. It is incorrect to assume that the readily available reams of information, when viewed through the lens of superficiality and emotion leads to necessarily being "informed", which is what I'm presuming the descriptor to mean.

    The set-up of the NHS is an active hindrance to the public really valuing it, which is apparent when the issue is evaluated by looking at peoples actions rather than their words.

    This piece stinks of one of the modern curses which is Social Justice Warriorism and misses the unpalatable truth that racism always has and will continue to exist but blaming it for everything represents another curse which is superficial emotion-driven thinking.

    And if you don't like what the world is saying, get off Social Media where the most astute opinions are submerged in an ocean of dross.

  • New refugee recruitment scheme sees 14 GPs taken on in one region

    IDGAF's comment 18 Feb 2019 8:12pm

    If they already have PTSD, they will have a good training in what to expect.

  • PHE launches campaign to ‘detect and treat millions more’ with high blood pressure

    IDGAF's comment 14 Feb 2019 8:55pm

    Sadly, checking BPs is not enough. Acting on a raised reading is whats needed.

    Consider the scenario- patient with diabetes seen in secondary care which records a raised BP but makes no comment on it. The surgerys office staff ensure this data along with eGFR,HbA1C cholesterol etc is cherry-picked and entered on the EMIS notes where it remains in plain view and is acted upon by no GP who sees the patient for something else "because the diabetes is looked after by the hospital".

    Its illuminating and yet so depressing reading the notes properly.

  • Government medicine regulator launches major opioids review to cut prescribing

    IDGAF's comment 14 Feb 2019 8:43pm

    Took Early Retirement 6.21pm.

    The use of methadone, the cure which is worse than the disease in terms of achieving abstinence, is because society has deemed that those reprobates who for many reasons choose opiates be begrudgingly given something to stop them withdrawing whilst providing no "high" or pleasure which their preferred poison offers.

    Theres some interesting work out there which suggests ultra-low dose naltrexone combined with mu agonists reduce dependence liability (physical and certain aspects of the psychological components). But as our colleague Chris Ho would state, market forces should lead the way, a position the pharma companies endorse fully.Hence the combination doesn't exist, and profits remain excellent. And our pension plans continue to reap the benefit.

  • GPs should refer more elderly depression patients for non-drug treatments

    IDGAF's comment 14 Feb 2019 8:28pm

    Maybe the low referral rate is because the undertaker takes over further management before the psychological therapy slot arrives.......

  • How long? Seemingly the hardest question to answer

    IDGAF's comment 14 Feb 2019 8:25pm

    "It started when I got back from holiday, a while ago".
    My reply-"I wasn't there with you, was I? Do me a favour, and help me out here. Give me a number, and choose from the 3 options-day,week,year…".

  • NHS stockpiling body bags in case of no-deal Brexit, health minister writes

    IDGAF's comment 14 Feb 2019 8:43am

    Is this because of the expected rioting/civil disorder?

  • Prescribing social media is the answer to GP workload woes

    IDGAF's comment 09 Feb 2019 3:16pm

    I too see the manifold benefits of Shoshull Meedyar. The only aspect I find quite trying is that conversing with the firm devotees of the medium resembles the following:" I was like, you know, like innit like you know". Which cuts into the 10 minute slot I am forced to tolerate them in.

  • Workload survey: GPs can shout about workload all we like, but we need evidence

    IDGAF's comment 09 Feb 2019 11:17am

    We have nothing to lose by collecting this data but whether or not this will lead to any concrete improvements is not clear.

    The quality of the data is also important.Not vacuous bulls#it as espoused by HSL when she states "....more than 100 patient contacts when you take into account face-to-face and telephone, and helping out colleagues in training with support and second opinions". Does this mean 101 contacts or 307? Does supporting colleagues mean saying "Well done" and then adding their whole patient list to this tally of contacts?

    In some ways bad data is worse than no data, and can be spun in myriad unhelpful ways by those whose reason for existence is nothing other than producing professional obfuscation.

  • Obsolete? Of course not, GPs are the bedrock of the NHS

    IDGAF's comment 08 Feb 2019 7:29pm

    Tim Lee @1.10pm.

    You, Sir, are a man who has the same hymn sheet as me. The death of the General Physician role has been a serious loss to the practise of clinical medicine, and for GPs to take on this role (which incidentally does make them indispensable in the fullest sense of the word) requires a major re-think in how GPs are trained so that they can perform this role in a way which demonstrates flair, ability and undisputable competence.