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Gold, incentives and meh

oncehadavocation

  • GPs paid £50 to use motivational interviewing in medicine reviews

    oncehadavocation's comment 11 Apr 2018 6:29pm

    Er. Forgive my lack of enthusiasm at the underwhelming statistic that 52% of patients had a lower HBA1c

    Inpr sure that means the other 48% had a higher one (or maybe exactly the same)

    This is called natural variability. It would be just as effective (and cheaper) to read aloud the obituaries from the BMj.

    I’m sure the £27,800 that the practice pocketed from this scam was well spent though.

  • Some GPs are working over 80 hours per week, health secretary reveals

    oncehadavocation's comment 10 Apr 2018 10:40am

    So 91% of GPs work less than 50 hours a week and 61% work less than 40 hours a week. Bear in mind these figures are self-reported, and most people don't underestimate how many hours they work...

    This does not exactly represent widespread overload.The equivalent figures for hospital consultants are far higher - with 45% of consultant physicians working more than 50 hours a week.

    General practice remains a profession where it is far easier to achieve a sensible work-life balance. And yet you still moan and run nationwide campaigns about 'workload dumps'. Its hard to justify this based on these figures

  • GMC wants doctors automatically struck off if convicted for serious crime

    oncehadavocation's comment 14 Mar 2018 7:14pm

    Great timing GMC...!

    Missing the actual point here. Why not contest the gross miscarriage of justice that led to the conviction in the first place. Poor Dr Bawa-Garba and her nursing colleague were scapegoated by everyone.

  • Hospital doctors need more training in general practice

    oncehadavocation's comment 10 Nov 2017 10:46pm

    “Also many patients talk highly about their GPs. This attitude of patients can irritate many hospital doctors, since they feel undervalued and underestimated for their services. For the hospital doctor, dealing with patient lasts a few days or weeks but for GP, the commitment is lifelong until retirement or death. If two people have to ride a horse, one has to sit in the back. Naturally the horse prefers the familiar rider than the short term one”

    Ha ha ha ha ha ha ha...

    I’d be delighted to let you sit in on my consultations and listen to what patients really say about their GPs. Let’s just say quite a lot of it is completely unprintable...

  • Move hospital staff into general practice to deal with flu, RCGP says

    oncehadavocation's comment 25 Oct 2017 6:48pm

    LOL!!!!!!!!!!!!!!!!

    ...because flu has no impact on hospitals, so they'll have loads of staff with nothing to do

  • New guidance on the primary-secondary care interface

    oncehadavocation's comment 07 Jul 2017 1:06pm

    Paraphrased as 'evil hospitals must not dump any work at all on snowflake GPs (unless it involves spending money in which case they must ask for permission), and must keep the GP informed of everything immediately on no resources.

    Conversely, GPs have no responsibilities to inform hospitals of anything at all, and can pick and choose what they feel like doing. Hospitals must second guess what that will be each week

  • GPs working in new A&E 'streaming' centres to have pay capped at £80

    oncehadavocation's comment 19 Jun 2017 11:59am

    Why should you earn more per hour than the A&E consultants who will work alongside you. In an even more hard pressed and understaffed specialty.

    Do you think you're better. More deserving? Harder working? Or just a bit greedier?

  • GMC chief: ‘Revalidation can’t just be a chore for GPs’

    oncehadavocation's comment 27 Apr 2017 11:52pm

    Don't worry - when he says ' revalidation is not just a chore for GPs', he means in the spirit of fairness, it's an equal waste of time for hospital doctors too!

  • Government ‘lacks credible plan’ for improving GP access, say MPs

    oncehadavocation's comment 27 Apr 2017 7:26pm

    But they are not a 'nice to have' but a JBDI. Either you run a safe service or you call it a day. Who is this helping?

  • Government ‘lacks credible plan’ for improving GP access, say MPs

    oncehadavocation's comment 27 Apr 2017 6:35pm

    So I rang back at 2pm to discuss the serious failure of continuity of care that had prompted my call. Cheerful lady says 'Sorry no GP available. We only have locums and a practice nurse' It was not a branch surgery...

    Surely under the Trade Descriptions Act this can't be called a GP surgery. There are real people here getting appalling care

    How can we move care into the community when there is quite literally no one left. I am terrified for my patient and the thousands like her registered here

  • Government ‘lacks credible plan’ for improving GP access, say MPs

    oncehadavocation's comment 27 Apr 2017 11:54am

    just rang a GP surgery to ask for advice on a mutual patient

    The phone message says they are shut til 2pm. This is at 10 am on a Thursday morning!! Surely it is not too much to expect you could employ a receptionist.

    This is nothing to do with a GP workforce crisis, its just shoddy

  • Not a single hospital sanctioned for GP workload 'dump', finds Pulse investigation

    oncehadavocation's comment 03 Apr 2017 10:42am

    That's because there is no such thing. 'Stop the workload dump' is one of the most destructive, paranoid and unhelpful campaigns I have come ever across.

    You are targeting the one group of people who would have been on your side, as they too are drowning under an unstoppable tide of work (not 'dumped', just work).

    Fight the cause, which is the massive gap in the NHS between funding and demand, not another group of its victims

    The Kings fund shows the massive increase in workload from the hospitals over the same period - worth a read. You are not the only ones drowning

    https://www.kingsfund.org.uk/projects/urgent-emergency-care/urgent-and-emergency-care-mythbusters

    I agree with watchdoc - if you've a specific problem, why not just write directly to the consultant? The CCG adds nothing to this process except bad feeling and inertia on both sides

  • Continuity is dead. Now what?

    oncehadavocation's comment 10 Mar 2017 10:17am

    Not deference, brothers (and sisters)in arms

    We were supposed to be on the same side, we all went to medical school together, we look after the same patients, we are all drowning under the same challenges of excess work, unreasonable expectations and underfunding.

    Why do so many of you want to punch us and call us names?

  • Continuity is dead. Now what?

    oncehadavocation's comment 09 Mar 2017 12:45pm

    Once again, this article raises some useful points about the impact of a consumer culture and over-investigation, but the message is lost by the lazy criticism of your equally over-worked and under-resourced hospital colleagues.

    You were an SHO once, why should they all be labelled snotty? Its very unkind. The ones I know are hard-working, caring and ambitious (and never allowed to come to clinic because the wards are too busy).

    You know perfectly well that all hospitals must achieve a maximum 13 week wait for new patient referrals, and that these are seen by consultants. Your consultant colleagues work extremely long hours, as you do, and we should offer each other mutual sympathy and respect for trying to prop up our failing health service together.

    Pulse is becoming as bad as the Daily Mail for vindictive criticism of doctors – just targeted at your hospital colleagues. Only last week, Copperfield wrote “And normally it’s just consultants I want to punch in the face”. This is a completely inappropriate thing to say. I would like to see the Pulse Editors take a stronger stance about this from their regular contributors.

  • GPs cannot contain the chaos much longer

    oncehadavocation's comment 09 Feb 2017 7:05am

    You should all watch this

    http://www.bbc.co.uk/news/health-38885775

    This is the reality of ED every day. Dr MSC wouldn't last five minutes if he thinks we are lazy.

    At least half of the patients could and should have been dealt with in primary care, if their own GP took a bit of responsibility and interest. We are drowning in work that you should be doing.

    Why is our on site urgent care centre rammed with 50 patients at 10 am on a Tuesday morning every week. Why can't their own practice see them in core hours, where we all agree they'd get better care. It's because you have the luxury of being able to say 'sorry, no appointments today. No local surgery is open 40 hours a week, no local GP works more than three days a week.

    My advice to all medical students is definitely pick general practice over hospital medicine if you want work life balance and proper remuneration and to wallow in the foolish notion that you are somehow more deserving martyrs than those hospital consultants.

  • GPs cannot contain the chaos much longer

    oncehadavocation's comment 07 Feb 2017 11:35pm

    At least you lot can shut up shop in the afternoon and go off home, while the hospitals deal with relentless chaos day and night.

    Why can't you raise your genuine concerns without recourse to lazy, malicious hospital-bashing. The problem is not dysfunctional hospitals, it is systemic underfunding, too few beds, too few doctors and nurses, and no social service funding.

    I've visited several GP surgeries this week, watching a single patient in the waiting room, as well as working in the hospital, and it's pretty obvious where the pressure really is.

    You guys have absolutely no idea how bad it is here.

  • My big idea? Let's replace GP training with something more useful

    oncehadavocation's comment 18 Jan 2017 7:27am

    Seriously,

    1. How will the training be funded if you don't do any work for the hospital trust. The money will have to come from somewhere as teaching is not free. Clinics need to be reduced, protected teaching time costs money

    2. Why will the consultants want to invest the time and effort in training an unknown succession of GP trainees who drift through their clinics, when they have no other investment in those individuals. Training is hard work

    The apprentice model of learning has lasted this long because it addresses these two issues.

  • My big idea? Let's replace GP training with something more useful

    oncehadavocation's comment 17 Jan 2017 8:44pm

    Nice idea for you maybe, wouldn't we all love to be supernumerary during training.

    But if the GP trainee provides absolutely no service value to the hospital or the consultants, how and indeed why should we bother to teach you?

  • More than a quarter of GPs work beyond safe hours every week

    oncehadavocation's comment 17 Jan 2017 7:40pm

    Why isn't the headline that 60% of GPs work less than 45 hours per week? Even though this is self reported and likely to over represent those who feel they work hard.

    Let's be honest, there are many who work quite a lot less than 45 hours...

    If they all worked in line with the rest of the population, the few who are carrying the can might be able to cope.

  • GPs to be paid £150 to diagnose and treat dementia

    oncehadavocation's comment 06 Jan 2017 5:43pm

    Why on earth do the GPs need to be paid to make this one diagnosis and not all the others? This feels completely unethical

    Refer and the £150 stays in the NHS to support secondary care services (not indiviual doctors), or don't refer and you get to pocket all the dosh. The cost to the CCG is identical. No cnflict of interest there then!