General practice has been surviving because of the personal touch with 'Own GP', with large conglomerate, health care provision would become an impersonal commodity. Change is good, but Change for the sake of change not good. Patients become numbers rather than Mr X/Y and doctors become computer algorithms. UK GP practise has sustained for so long only because of the personal human touch unaffected by isolated Financial considerations when dealing with patients. But working in big companies is good for GP work life balance. I certainly did not become a doctor to just work with indifference a 9-5 job.
Dr Hinkley, You should take up writing books, you are amazing in the way you write. I am sure you are a good doctor too. But your writing skills are great. dont stop writing.
even if this is the most awful sounding news, it must be a part of a bigger plan, we still havent arrived at the A-HA moment, If anything the BAPIO challenge has achieved, it is awareness that for Overseas trained doctors GP training is not the best option, hence the difficulties in recruitment. Local Graduates too are shying away from the GP training due to changes post GP training. The Ploy currently is Confuse the masses and please the classes.
...and all GPs should check all their patients record daily, do ward rounds twice weekly in residential home, nursing homes and hostels. and there should be a system to have an on call 24x7 GP from each surgery...but do we have so much time to do all this, do we have the numbers to do all this. some residential home staff writes something on the notes, whose responsibility is it to act on it, what are the legal implications, what happens when consent cannot be obtained?.. where does this stop
Commercial companies convince/confuse/corrupt government officials saying they are sitting on a gold mine of data, that they can broker to international private companies for millions of pounds -> policy is made to obtain data and then sell it for profit. Any issues that get created will easily be forgotten and forgiven, after all it wouldnt be the first time data has. Been lost by government, all they have to do is throw a meaningless apology. Makes sense?
last nail in the coffin, before privatisation takes over. make way for the politicians agenda of privatising NHS in a roundabout way, using such absurd logic.
'Dramatic' changes to GP contract by next April as Hunt spells out detail of general practice reform
one wrong is being 'righted' ( Les/des qof) but ?with another wrong ( 24/7 responsibility) which under current infrastructure and resources is impossible. Solution is to provide the infrastructure and resources first. No point in putting the roof on a house for rains without any pillars to support the house.
its rabbit out of a magicians hat act. well done
it works well when you have a good trainee who makes good decisions. In know a lot of trainees who needed their trainers to look at every consultation and ensure patient safety during and after each surgery, one cannot generalize on trainee or trainers but having a trainee gp can be both a boon or a bane, dependent entirely on the particular person in question.
without going to extremes o examples, i can remember 2 very intelligent girls who worked at HCA's at the practices i worked or. One HCA would make notes relating to patients concerns and emotional state, this would greatly help all of us treat the patient holistically, especially knowing that they have seen the HCA for longer duration both over the years and on each appointment. The other i came accross was so inclusive in her practice, was ready to pick up where other doctors and nurses have left and deal with issues correctly. I think intelligence and compassion is not determined by the position you hold in health care system.
RCGP needs to practice what it preaches, Reflect first, understand what question is being asked and then analyse. No exam can say it is absolutely fair. All exams are biased against failing candidates. Are the qualities you are looking for 'English' rather than 'good GP'. If so then you will find a big Gap. I am reminded by one of my course organisers saying, if my wife who is not a doctor sat the exam, she will pass the exam easily. Of course his context for the statement was very different as he was trying to drive another point home, but when you reflect on this, you would realise how true it is. we are not blaming RCGP for being wrong. We want the RCGP to improve, All IMGs are with you in your efforts to improve RCGP, please donot fight us, fight with us. Coming up with meaningless research with no clear definition of what bias means, or any critical analysis of the study would mean nothing. If the function of the research is to sway the opinion of the gullible public then perhaps it suits the purpose, but remember, the gp trainees are medical doctors at different levels who have themselves written several papers and are aware of flaws in any research study, all you have to do is release the research article in the BMJ for us to analyse it. 'at the end of the day', donot deprive the public of good doctors, doctors who are holding forts as Middle grade in AE and only senior doctor available in the middle of the night when the helicopter brings in severely injured trauma patient. If they can manage that then they certainly can manage general practice.