Christopher Ho | GP Partner/Principal26 May 2020 9:44am
Advocates free markets, gets shocked that people choose to be locums.
Advocates freedom of speech, gets shocked when someone has a different opinion.
I have neither the time nor the inclination to argue with someone so warped by ideology that their own incoherence isn't obviously apparent.
It's official; Pulse is written for older GP Partners. Any alternative view points will be condemned as nonsense by the usual suspects who despite their 80 hour work weeks seem to always be commenting on articles here.
As an ex partner I'm glad I got out of all this rubbish when I did.
Basic misunderstanding of markets by most here. Locums are simply the first to feel a lower demand ok General Practice. However if market demand remains low for General Practice then it is only a matter of time before salaried GPs and partners take a pay cut.
The current state of the market should concern all GPs.
Reality: GPs leaving/retiring early. Surgeries closing down.
Narrative: let's create "networks" (because we don't have enough staff and surgeries are closing down).
A lot of this stuff is clearly government propaganda. They are clueless about how to deal with the healthcare crisis and have simply retrofitted a narrative to make it look it's part of a grand plan instead of desperation.
Read through the lines people.
Essentially he is saying that the government thought that surgeries were badly run and below par, but the cqc proved this hypothesis incorrect.
Like qof, the cqc should now therefore be retired and general practice should receive more funding via the global sum.
As far as I'm aware askmygp is a telephone first system. So the gp rings up all patients for the day and tries to deal with the patient over the phone rather than face to face.
From what I've looked up in the past, they have mixed outcomes. Reduction in workload depends on the surgery itself and the population it's serving.
Great, at least now I understand your position which you are absolutely entitled to hold ( and you obviously don't need me to say that! :) ).
My position is that if there is a cost benefit then this should be looked into further. I don't know if there is, but it should be studied further.
My gut says that even if you treat lots of people it'll probably reduce the number of strokes/MIs/obesity related cancers etc, so will likely be cheaper than what we do now. I also feel (don't know for a fact) that this would probably be able to be done by less specialised healthcare professionals if rolled out.
Off tangent: This conversation reminds of how certain countries don't offer needle exchange programmes to prevent HIV spreading. However it does reduce costs for society. There are a lot of second order effects however, such as in San Francisco where the streets are littered with used needles. So I agree the second order effects of widespread intervention is something that should be scrutinised and analysed.
With regards to social Vs private etc. My perspective as a NHS doctor and someone who has dabbled in my fair share of business is that certain things need to have government regulation and ideally the regulations which are in place should be such that a thriving economy can be nurtured.
I'm guessing we could talk at length about our differing perspectives but this probably isn't the forum for this.
You still haven't addressed either one of the points.
1) are you saying you draw the line at diet supplements because you view this as socialized medicine?
That's fine if that's the case, but we are working in a socialised system where of course this route of treatment will garner interest.
2) are you saying that this will increase costs?
Where is the data for this claim? Isn't this why further studies / trials should be done?
What would your position be if further studies demonstrated a cost benefit?
Just as an aside- no one can force patients to do anything. No one is advocating treating patients like children. No one is saying that patients should be forced to have treatments that they don't want.
Keep up the straw man arguments people!
Instead of dealing with points such as;
1) why is a diet which is safer and more effective than drugs available the line we should draw in helping patients.
2) Why shouldn't the NHS help people who will create a greater burden on society by not helping them (again, in which case why do ANY preventative treatments).
Really makes us GPs look great as a profession when we don't learn and move forward with new data which should be looked into further...
It's rather unusual why this study is making headlines now. I first came across the findings last winter in the bmj.
Full findings here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)33102-1/fulltext
It is a preliminary study, however as I mentioned before if this was an actual drug with the main side effect being a tad bit of constipation then it would already have millions pounds worth of funding and on going trials.
Ps, no I'm not in any way affiliated with this study. I'm just a regular coal face GP partner.
Diabetic nurses can't take clinical responsibility for novel approaches, that's why doctors exist and everything isn't nurse led.
My point is that we should be fighting for resources that can help the patient.
We are under resourced at the moment but we should be fighting for more.
The cost you point out for diet replacement meals is negligible compared to the long term costs of diabetes/obesity and complications such as IHD and stroke.
In other words you're being short sighted and not thinking.
The health budget will get even worse if obesity and all of its associated health conditions aren't tackled. So your argument is already a non starter.
Also, you as a GP are already helping patients who have made poor lifestyle choices by giving them antihypertensives, providing antidiabetic agents, referring to dieticians, referring for gastric operations etc.
So WHY have you drawn the line at providing dietary supplements etc. Why have you decided that this is precisely where we should draw the line in providing care?
We're in the game of providing healthcare. If you think there's a socialist agenda or something by providing proven care to our patients then perhaps you should reconsider your profession.
@the four lunatics who have already posted above be.
What are you talking about? If ANY anti diabetic drug had as good of an outcome as meal replacements it would be mandatory to prescribe and use it.
If ANY drug had as much benefit with is few side effects then it would be touted as a wonder cure and there would be plenty of funding for it.
This is exactly the type of thing that should be supported in primary care and I'm surprised at my colleagues attitudes / responses.
It'll take the pressure off of GPs because they'll all leave the NHS and go work somewhere else! :D
Artificial intelligence? Is that something that's pretending to be intelligent? :D
Just as I have been saying.
Video over the internet is not "new technology" - it will be treated as a commodity more and more as time passes, with more and more providers in the market place.
A race to the bottom for providers but a more open market place for GPs.
Tony, then we agree.
You came across as indifferent to the current state of affairs, thus the accusation by another poster that you actually work for Babylon.
I am glad you have clarified your position; that you don't mind private providers winning contracts and skimming off profits for themselves.
Many of your colleagues do not share the same view point as you, thus the outrage.
All the best.
Tony, yes we disagree.
However, I'm guessing that you would find it odd that if your telephone provider ended up taking over your GMS contract.
Providing a way to see patients via video link is no different. Where is the flaw in my logic here?
Tony, it is not like virgin health.
Video via the internet should be treated as a commodity just like telephone lines are.
It should not be a means to gain access to gain access to GMS funding.
Tony, no one is disputing that video consultations / telephone consultations have their place.
People are concerned the way a private provider is forcing its way into the resources of a public institution.
There is not a fundamental difference between telephone consultations and video consultations in my estimation. Therefore the way Babylon is behaving seems abhorrent - it is the same as if BT positioned itself as a "medical phone provider" and started to get funded via a GMS contract by providing telephone consultations with a GP.