I agree with all contributors.
For the GI cases which will get scopes first on a 2WW basis and no clear pointers on the bloods IDGAFs thus far successful policy is to write/type on the form "needs scope(s) and if NAD, CT".
Successful here means blame deflected by thinking a step ahead. I have had more than one apology letter from a consultant when their premature dismissal of a case has resulted in cancer being missed. IDGAF has also found increased traction with subsequent referrals.And probably some unexpressed hatred.
Its all a fu##king game folks.
So you admit not reading the notes properly (or at all) before a home visit? Even when IT has not failed?
There should be a difference between unavoidable circumstances (eg IT failure) and deeming sloppiness as being equivalent.
But Shaba- are you so disparaging towards your other "critical friends"?
Those who bleat will be given a sterilised scalpel from surgical appliances along with an anatomical depiction of the popliteal fossa outlining clearly where the cuts need to be made to hamstring ones own career.
Noble sentiments, and a teeny step in the right decision but do not fool yourself that it is enough.
I am pretty familiar with the "flow state" which can be glimpsed through regular meditation practise but I personally found that despite being "in the moment", in primary care the excessive workload (more than a moments-worth) remains and might make you feel better but still lacking in the insight that you are still likely to be cutting corners.Flow states come from quality performance, not blinding oneself to the existential reality of the situation.
The writer mentions the example of being asked to sign a script when dictating.Ask yourself-honestly- does this technique mean you are just composed enough to not bark at the receptionist holding the script, or are you really going to reach the flow state of effortless but pristine performance and see whats on the script, check that the right monitoring is done and no other risky meds are being used by this patient before signing it?
A proper flow state will not exist under the current workload and time constraints.Do not confuse psychological coping with a flow state.
Platelet count of 74- what I want to know is 1. was this pre- or post-op? 2.Does she have any previous platelet counts documented including in the GP record? 3.If she does, what were they?
I would not be at all surprised if she had a niggling low-level thrombocytopenia for some time which the GP had not bothered to think about critically. I would love to be wrong but I have seen anti-phospholipid syndrome with low platelets missed/ignored until the retrospectoscope comes out when the patient has a DVT on more than one occasion.
When the risperidone supply problem was evident, and my CMHT told me to see my GP because my symptoms had returned I was horrified that my GP refused to address me as "IKEA" despite him knowing full well that I had realised the non-dual nature of reality and intuited that there was no separation between me and the chair in the consulting room.
Although it might not sit well with Dr Tarsh, sometimes laws are designed to protect people from themselves. You know what I mean- smoking crack, working for the NHS and other such injurious activities etc.
It takes a deep understanding of the complexities of the law, such as I possess, to see this.(/s).
Posh or pleb, until you address the issue of 10 minute appointments any notions of conscientiousness and having empathy and compassion (as opposed to just showing it, which the writer would deem sufficient) is just bullshit.
But the writer is spot-on in one respect- misrepresenting the virtues of GP land as it currently stands to those from less advantaged backgrounds means that once they enter it and see how crap it truly is they will not have the exit-route as well paved-out as the posh who will, by dint of a familial culture of education, better access to wealth to clear any debts and daddys connections. So it is after all a wonderful idea to boost GP numbers. But to get an engaged and happy work-force? Not so sure about that.
What amuses me (amongst lots of things) is how the BBC/ITV/Channel 4 reporters wander up and down the land seeking the considered opinions of the voting populace who offer their erudite analysis of alternative prospectuses of lies and feel that they know what they are voting to get.
The antics of the politicians reminds me of the self-aggrandizing bullshit the contestants on The Apprentice parade before Alan Sugar, with the voting public being akin to Mr Sugar bar one difference. Mr Sugars bullshit detector is actually plugged in and switched on.
I loves me a bit o' democracy.
I await the second volume which completes the story.Call it "Destruction of the Medic-The Ultimate Guide to Working in the NHS".First Edition 2022.
You owe me no royalties for the title; just mention "IDGAF" in the acknowledgements.
"..discussing this over our daily post-surgery caffeinated catharsis".
Don't let Mr Hancock know you have such spare time. He would say that your friend could have been seen as an extra whilst you instead worked on developing a DVT.
Maybe your friend just needs as much caffeine as you partake of? (/s).
I heard that Matt Hancock is working with CERN to devise a scheme which will slow down the velocity of the Earths rotation thereby making each day longer than 24 hours to help us get time to ensure we can fit in home visits.
"Hope, inclusivity, joy and kindness".
When I get short of breath with weight loss, dullness to percussion and absent breath sounds over my left lower chest, speaking personally, I would prefer a competent clinical examination and a PA Cxray.
But hey, that's just me.
I discussed this issue with Mr Ashworth- his reply was "Golly, that's exciting!"
A totally rhetorical question, did you partake of alcohol with your meal?
(Note to self- time to do the BMA Burnout Questionnaire again).
Mr Ashworth will need to establish a few gulags and Uighur-style "vocational centres" to help convince medical graduates of the errors of their beliefs about General Practise.
Plus- all GPs who are keen growers of roses will get allocated 50kg of unicorn manure per financial year as a token of appreciation for being the bedrock of the NHS.
Remember guys-prevention is better than cure.
Ergo- our practice should change such that we do our utmost to prevent old age and the corresponding co-morbidity thereby easing the pressure on the system. We should also applaud the inordinate waits for an ambulance, because preventing admission is better than getting patients in for a cure.
Personally, I await with interest to see how the UK populace, who will not be patronised as not knowing what they voted for in the EU referendum, choose to cast their votes in the election.
A wise person once said people get the leaders they deserve.
I want to know what is meant by "appropriate withdrawal program"- if the job is to put patients through a prolonged period of subacute withdrawal without any consideration for the psycho-social aspects for each individual patient (key considerations for success), then I have full confidence that the approach will be successful. I choose to deliberately not consider how this will push some patients towards using "street Valium" (eg Etizolam and other terrifying agents such as Clonazolam) and heroin to keep them functional and able to meet their responsibilities.
This is truly a complicated and nuanced issue, and I am sure that many dependent patients, with proper support, could get free of these agents. Without such support this kind of "moral policing" will just cause broader and more destructive issues.