This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

Gold, incentives and meh

Kids2old2migrate2young2retire

  • RCGP launches GP training on low carb diet for diabetes patients

    Kids2old2migrate2young2retire's comment 18 Jul 2018 8:23pm

    The low carb case was made decades ago. Does remind us of the H.Pylori and Semmelweis germ theory fights. The obesity pandemic is a public health emergency that needs more than a RCGP module and a belated sugar tax. The RCGP and NHS are paying belated lip service to a problem that needs better and braver leadership. Dr Unwin has done excellent work but he stands on the shoulders of unacknowledged others who researched and campaigned before him, sometimes against politicians and sometimes against political medics. Kudos to great work but sometimes the grestest innovation is timing. Hopefully this won't be buried or be used as a smokescreen. Asking a gp to advise a diabetic on better management of carbs is necessary but not sufficient to address the 50%+ predisbeyic obese population. Reinstating public health budgets and changing the dietetics advice of the general population would be a start. It took 3 decades after good advice to begrudgingly hand a award to a good GP. Hopefully we address the real problem at its root and are not satisfied by a sticky plaster.

  • GP at Hand practice adds another 2,500 patients

    Kids2old2migrate2young2retire's comment 17 May 2018 11:36am

    Facinating and infuriating... see the article on the Soho GPs. The contrast is striking. The playing field is not close to level. A small long standing struggling practice does not get support, but gets a CQC inspection. Babylon select 20,000 healthy subjects from 40,000 'applicants' and is seen as innovative. For the same cherry picking behavior, a private politically backed Babylon wins praise. The next step for the small Soho practice surely must be to stop the recruitment of a GP and to hire a lobbyist and a PR consultant to sell this as giving patients choice.

  • Soho GP practice targeted by CQC after losing all Chinese-speaking GPs

    Kids2old2migrate2young2retire's comment 17 May 2018 11:24am

    So many issues. Agree with Vinci Ho and all others. Strikes me that the playing field is not close to level. A small long standing struggling practice does not get support, but gets a CQC inspection. Babylon select 20,000 healthy subjects from 40,000 'applicants' and is seen as innovative. For the same behavior a private politically backed Babylon wins praise. The next step for the small practice surely must be to stop the recruitment of a GP and to hire a lobbyist and a PR consultant to sell this as giving patients choice.

  • The white elephant in the room

    Kids2old2migrate2young2retire's comment 07 May 2018 1:28am

    Hi Merlin
    I probably would agree with your opinion if the evidence supported it. Could you provide that evidence? I think it's important that our strongly held opinions on such important issues are robustly evidenced.

  • The white elephant in the room

    Kids2old2migrate2young2retire's comment 05 May 2018 10:18am

    @just a gp
    Sorry for snappy response. Just trying to start an evidenced solution based conversation to an obvious problem. Just get exasperated when the commentary from fellow well qualified GPs, seems just as tribal, emotive and pointless as trump/twitter. Was hoping to have my faith in humanity's ability to cite evidence, to reason, to solve problems and to care for other human beings restored on this platform...

  • The white elephant in the room

    Kids2old2migrate2young2retire's comment 05 May 2018 9:29am

    Evidence?

  • The white elephant in the room

    Kids2old2migrate2young2retire's comment 05 May 2018 8:16am

    The comments to this article has highlighted part of the problem.
    We as GPs do need to do better. We need to keep ourselves to a higher standard of informed conversation. We need to keep the discourse considered, caring, reflective and solutions orientated to support colleagues when there is an obvious multi level evidenced problem.
    @Bob - the sentiment is very well put. The direction of travel is encouraging but we have a long road to travel and we all should continue helping the arc of human civilisation improve. The only thing shocking about the St. Georges case is that they were stupid enough to formalise it and leave an audit trail. As you allude to and looking at the stats they were not the worst offenders, just the dumbest. South Africa was equally dumb by keeping laws on the books to engineer prejudice that could be easily attacked by other more 'civilised' countries. Multiple other countries eg.USA, etc etc had worse stats but are able to project a better 'brand' of supposed inclusion. Your practice seems a wonderful place/example.
    @watchdoc - please don't take this the wrong way but helping one marginalised community does not exclude helping others. Its not zero sum. In fact social science evidence suggests that caring for other human beings has positive effects on the whole of society. A rising tide... The tribalism reasoning does not travel well. A BME woman from a working class state school with a dodgy northern accent will do much much worse than you did. Our success in life as GPs, is always a combination of our stunning genetic brilliance which is outweighed by an order of magnitude by environmental factors.
    @Harvey Steinwein - not sure how to advance the conversation/respond. Probably disappointment? Again smart caring people should try to help. Again please don't take this the wrong way but 'taking offence easily' is not what Carolyn Wickware's report in this edition of Pulse, points to. I am hoping that having considered the Dr Bawa case and read the references in Carolyn Wickware's report that you could change your heart (just a little) about the gravity and reality of the problem. I do hope
    @Another Titled Buffon - ..... Odd that Shaba's personal heartfelt and vulnerable article generates a twitter-esque #AllLivesMatter response. I feel disappointed and wonder if Shaba feels even worse, probably even hurt. Carolyn Wickware's piece was presented as hard evidence and I suspect the editor thought that the balance with a more personal piece would help smart, caring, empathic professionals understand the true impact of institutional as well as personal racism. So as not to fuel a tit for tat I don't think it would be helpful for us to challenge the extrapolation of hiring "close family members" reasoning. Adding this to a debate of preferentially hiring, promoting, passing, advancing not prosecuting or imprisoning doctors/people(strangers) other doctors of your own race?.. Following the family/race logic seems to travel down a worrying rabbit hole that I am sure you did not intend.
    @Vinci Ho - could not have put it better myself! Beautifully researched and written.

    We should recognise that all human beings have inherent biases. We improve as people and as a society when we acknowledge them and always humbly try to improve ourselves and help others. We may be relatively powerless to change patients and the public. That should be no reason to avoid change in ourselves and our sphere of influence. We should worry about trumpesque/school debate tactics eg. exaggerating the position of your opponents point of view and worse still exaggerated and falsely attributed solutions ("increasing punishments to non-BME so as to be seen to balance the books." watchdoc). We should not absolve ourselves from the real world change we can make to our own point of view. We can and should influence our immediate working environment and our leadership where we can. We are educated and lettered professionals and should hold ourselves and our profession to a higher standard.. We all have daughters, friends, colleagues and a wider society that will benefit.

  • An unequal race: How BME GPs face tougher hurdles

    Kids2old2migrate2young2retire's comment 05 May 2018 8:11am

    Some comments to this and Shaba's article has highlighted part of the problem.
    We as GPs do need to do better. We need to keep ourselves to a higher standard of informed conversation. We need to keep the discourse considered, caring, reflective and solutions orientated to support colleagues when there is an obvious multi level, evidenced problem.
    @Bob - the sentiment is very well put. The direction of travel is encouraging but we have a long road to travel and we all should continue helping the arc of human civilisation improve. The only thing shocking about the St. Georges case is that they were stupid enough to formalise it and leave an audit trail. As you allude to and looking at the stats they were not the worst offenders, just the dumbest. South Africa was equally dumb by keeping laws on the books to engineer prejudice that could be easily attacked by other more 'civilised' countries. Multiple other countries eg.USA, etc etc had worse stats but are able to project a better 'brand' of supposed inclusion. Your practice seems a wonderful place/example.
    @watchdoc - please don't take this the wrong way but helping one marginalised community does not exclude helping others. Its not zero sum. In fact social science evidence suggests that caring for other human beings has positive effects on the whole of society. A rising tide... The tribalism reasoning does not travel well. A BME woman from a working class state school with a dodgy northern accent will do much much worse than you did. Our success in life as GPs, is always a combination of our stunning genetic brilliance which is outweighed by an order of magnitude by environmental factors.
    @Harvey Steinwein - not sure how to advance the conversation/respond. Probably disappointment? Again smart caring people should try to help. Again please don't take this the wrong way but 'taking offence easily' is not what Carolyn Wickware's report in this edition of Pulse, points to. I am hoping that having considered the Dr Bawa case and read the references in Carolyn Wickware's report that you could change your heart (just a little) about the gravity and reality of the problem. I do hope
    @Another Titled Buffon - ..... Odd that Shaba's personal heartfelt and vulnerable article generates a twitter-esque #AllLivesMatter response. I feel disappointed and wonder if Shaba feels even worse, probably even hurt. Carolyn Wickware's piece was presented as hard evidence and I suspect the editor thought that the balance with a more personal piece would help smart, caring, empathic professionals understand the true impact of institutional as well as personal racism. So as not to fuel a tit for tat I don't think it would be helpful for us to challenge the extrapolation of hiring "close family members" reasoning. Adding this to a debate of preferentially hiring, promoting, passing, advancing not prosecuting or imprisoning doctors/people(strangers) other doctors of your own race?.. Following the family/race logic seems to travel down a worrying rabbit hole that I am sure you did not intend.
    @Vinci Ho - could not have put it better myself! Beautifully researched and written.

    We should recognise that all human beings have inherent biases. We improve as people and as a society when we acknowledge them and always humbly try to improve ourselves and help others. We may be relatively powerless to change patients and the public. That should be no reason to avoid change in ourselves and our sphere of influence. We should worry about trumpesque/school debate tactics eg. exaggerating the position of your opponents point of view and worse still exaggerated and falsely attributed solutions ("increasing punishments to non-BME so as to be seen to balance the books." watchdoc). We should not absolve ourselves from the real world change we can make to our own point of view. We can and should influence our immediate working environment and our leadership where we can. We are educated and lettered professionals and should hold ourselves and our profession to a higher standard.. We all have daughters, friends, colleagues and a wider society that will benefit.

  • Spare us the heartsink celebrity endorsement

    Kids2old2migrate2young2retire's comment 16 Mar 2018 8:18pm

    After the 5th request in 2 days thought i had surfed the tsunami then walked in a 36yo drinking 7 cups of coffee a day and wanting a PR on a Friday on call!!....Took a 5 minute walk.. contemplated my life/career choices and decided that only a gmc compliant reflective entry on why i signposted him for a full, anxiety inducing, BMI health screen would make karmic sense.
    Still in my self made prison but passive aggressive on so many levels.