If your son is smart enough to be a doctor he is smart enough to do something worthwhile. One of my boys said he wanted to be a doctor. It was like telling me he thought he had cancer. I suggested he do some aptitude tests. These clearly indicated that he would hate medicine and now he is a mathematician. He dodged the bullet. Good.
The NHS is built very much like the British Empire was, by exploitation of the workers. I remember the 145 hour weeks and the third of your wage paid for overtime. Terms and conditions are a lot better now, but the intensity and pressure are even worse. What needs to happen is a fundamental change to what the NHS delivers. It never could and cannot be all things to all people at all times. Overt rationing is needed. Instead of pursuing endless life expectancy and "improvements" in medical innovation, a realistic expectation of what a publicly funded health care system can and should deliver needs to be done. And it needs to be done now to prevent a total implosion of the system that affects the people working in it and the patients who are relying on it.
Taking on other, less difficult, less risky, more interesting work, and often better paid work, also keeps GPs in the game for longer and reduces burn out. I don't know how I would have got to 59 as a GP on its own. I suspect I would have crashed and burned long ago. Long live the portfolio career.
Are they going to give the cash back?
The idea is to keep things that are either necessary or beautiful. (Not that I do this myself). Although GP land certainly isn't beautiful, it is currently necessary to bring in the money for day to day living, especially if you are a single parent. Also, it is necessary to build up a decent pension fund for your future. I am surprised that the A and E department axed the GP jobs since they are clogged up with attendees who are neither accidents or emergencies.
At least the dog was actually ill.
Utterly pointless in testing. I tested many of my practice population, in Ayrshire, about 12 years ago. ALL were deficient. You can buy Vit D3 for £10 a year including postage from Amazon.
Having back up when the computers fail isn't such a daft idea. It's one thing to stop buying new ones and another to ban the use of perfectly useable machinery.
If our counter productive Eatwell Plate dietary advice was scrapped and replaced by a lower carb diet without pro-inflammatory fats, diabetics blood sugar and metabolic control would improve for those who stuck to the diet. This would save at least some money on medications.
You also get out a lot less, can barely walk to the bus stop, and need to buy two seats on a plane. So you are on transport a lot less.
As SIGN states: Guidelines do NOT represent the standard of care so cannot be used to determine whether a GP acted appropriately or not.
STATEMENT OF INTENT
This guideline is not intended to be construed or to serve as a standard of care. Standards of care are
determined on the basis of all clinical data available for an individual case and are subject to change
as scientific knowledge and technology advance and patterns of care evolve. Adherence to guideline
recommendations will not ensure a successful outcome in every case, nor should they be construed as
including all proper methods of care or excluding other acceptable methods of care aimed at the same results.
The ultimate judgement must be made by the appropriate healthcare professional(s) responsible for clinical
decisions regarding a particular clinical procedure or treatment plan. This judgement should only be arrived
at through a process of shared decision making with the patient, covering the diagnostic and treatment
choices available. It is advised, however, that significant departures from the national guideline or any local
guidelines derived from it should be fully documented in the patient’s medical records at the time the
relevant decision is taken.
I agree Christopher. Free at the point of delivery is a major problem with the NHS.
Good idea. There should be no incentive to become obese, an addict, or otherwise "ill" either physically or mentally. Workers should not be unfairly penalised for working. A basic minimum income for all would avoid a huge amount of wastage in the NHS.
Posters all over the place warning of the dangers of sepsis diagnosed too late don't help either.
I agree Truth Finder. If your smart enough to get into medicine you are smart enough to do something worthwhile.
Doctors often use code language to tell each other what they really think. Eg This patient has anterior knee pain syndrome and would benefit from physiotherapy, would become, this patient has a sore knee and there is nothing I can do about it.
Filling out these forms would be easier if the benefits and harms of resuscitation both in and out of hospital were actually on the forms with numbers needed to treat recorded.
Eg for a cardiac arrest in hospital for every 100 rescuscitation attempts X no of people survive neurologically intact Y no survive but sustain brain damage and Z do not survive.
Same info for out of hospital. This would put the futility of most attempts into context instead of what people see on the telly.
Well done to her legal team and the BMA and journalists who have supported her. It has been a marathon but will hopefully influence the GMC to behave more reasonably to doctors. Also it should encourage hospitals to improve their systems rather than letting them treat doctors as expendable material.
Hi Christine, Katharine Phelan here! If you would like to get in touch I'm still at the surgery in Mauchline or via my website www.diabetesdietblog.com.
I also enjoy these posts as I do wonder what working life in OZ and NZ would have been like. Some things are better and some are worse. I had no idea there was a big barefoot culture and that rheumatic fever was still a major health problem.
The benefits system has to change so that people are not paid to be alcohol and drug addicts, have mental health problems, sore backs, neuralgia, fibromyalgia and so forth. Career lifelong patient-hood is rife with a permanent get out of work ticket, loads of drugs of dubious benefit and considerably more money than unemployment benefit. You even get someone to cut your grass. I pity the many workers who sometimes toil long unsocial shifts in unpleasant jobs who are on zero hours contracts and the minimum wage. Meanwhile, because we are so complaint averse due to our ridiculously punitive GMC and litigation system, we have little choice but to accept what skivers say at face value because we can't prove otherwise. Some patients genuinely can't work but many who claim benefits can and they exploit the system ruthlessly. If they don't get signed off with one thing they come back with another symptom that needs another round of medicolegal investigations and referrals.