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Gold, incentives and meh

Anonymous GP

  • Stricter rules will deter GPs from working in Australia, say recruitment agencies

    Anonymous GP's comment 02 Aug 2019 3:56am

    Example from English speaking world !!

    3 years ago similar situation - choose a country which is easy to get in and start work with no supervision and no exams to grant registration, but some restrictions on work location vs 6 months of paperwork - they call as source verification and 2 or 3 exams and supervision until you get full registration but no restrictions of work location.
    Aus Vs Canada.
    I chose Canada. I realized Aus is going to be full soon. It happened as expected. Canada is still open for MRCGP holders who are willing to do 2 exams in Canada - QE1 (AKT lite) and QE2(CSA lite) exams. If you do these 2 exams before starting work - there is no need for any supervision. You are given full registration in Ontario (Includes Toronto (capital of ontario) and Ottawa (capital of whole Canada!!)). No geographical restriction. No limit on patients seen in a day (unlike Aus). Bill for everything you do. Urine dip, ear syringing, tetanus shot, suture removal, vaccines, PAP, - Its called fee for service. Private billing for any insurance paperwork, forms, sick notes and even online/fax prescription renewal. Much less work than UK but more in compensation. No home visits ever!! You can fire any patient who broke your trust and didn't follow rules set by you. You can even open your own clinic. You can get PR in Canada from UK without even stepping foot in Canada. It does take 1 to 2 years in Canada to get above average UK pay.

  • Sorry but the drugs do work

    Anonymous GP's comment 17 Jun 2018 3:48am

    Cure for streptococcus is antibiotic. Natural methods and antibiotic aversion is going lead to few deaths and then there will be articles in newspapers about how terrible strep is and then we will start prescribing antibiotics properly for acute bacterial infections. My point is all this nonsense of superbug and antibiotic resistance and decreasing antibiotic prescriptions is causing more harm. If any government seriously wants to reduce resistance - ban antibiotics in farming and cattle and Improve infection control in underfunded hospitals by providing appropriate funding without penalising them.

  • 'Indemnity fees are killing our profession' - sign this letter to Jeremy Hunt

    Anonymous GP's comment 14 Sep 2017 4:57am

    Somanathan Damodaran

    I left UK practice and left the country due to the ever rising indemnity cost without ever calling them for several years. Full stop.

    It didn't make any sense to work harder and harder for some corporation and our beloved tax office to make more money and my post tax/ post overhead income dwindling and struggling to make ends meet.

  • RCGP reviewing whether MRCGP exam is ‘fit for purpose’

    Anonymous GP's comment 04 Aug 2017 4:42am

    Everyone knows its just a money grab from BME, especially BME international graduates by all Colleges. That simple. Nothing more nothing less. This has been going on for decades with every college!! How else would the college get funded with ever dwindling membership? Many leaving country and many leaving the membership inside UK.
    I still remember a quote from a Female hospital colleague, " He was my reg, when I was SHO. He knows a lot more than anybody I knew in this whole hospital. But he failed and I passed. I know they make it difficult for you guys to pass."

    Make few rules - reduce the exam fees, none of the fees from exams goes to Colleges for any expenses other than trainees, reduce the pay, no luxury biscuits, no natural mineral water - (just tap water is enough), no five star treatment or accommodation paid for for GP examiners, stop hiring Royal stage actors for exam - everyone would pass first time. Stop the exams being a business opportunity and profit based exercise for colleges.

    If you want to test communication skills and English language ask candidates to take IELTS - standard English test all over the world.

    CSA exam has no real world bearing either for communication skills or medical knowledge. CSA is biased exam. So is AKT. Asking non-english native speakers to do a english reading game with complicated sentence structure and asking them to differentiate between false negatives and untrue non-positives and shorter time limit. Not actually a test for clinical knowledge in true sense.

    Just a game.

    P.S - I took exams with 3 different royal colleges. Above info is from real world personal experience.
    Thanks Una for remaining in touch with this wretched world.

  • RCGP fails to stop BME trainees falling behind in exam results

    Anonymous GP's comment 04 Aug 2017 4:13am

    What world do you guys live in? Above 3 comments. I don't know if you ever sat CSA. This has nothing to do with statistics, entry standards or career decisions.

    Everyone knows its just a money grab from BME, especially BME international graduates. By all Colleges. That simple. Nothing more nothing less. This has been going on for decades with every college!! How else would the college get funded with ever dwindling membership? Many leaving country and many leaving the membership inside UK.
    I still remember a quote from a Female hospital colleague, " He was my reg, when I was SHO. He knows a lot more than anybody I knew in this whole hospital. But he failed and I passed. I know they make it difficult for you guys to pass."

    Make few rules - reduce the exam fees, none of the fees from exams goes to Colleges for any expenses other than trainees, reduce the pay, no luxury biscuits, no natural mineral water - (just tap water is enough), no five star treatment or accommodation paid for for GP examiners, stop hiring Royal stage actors for exam - everyone would pass first time. Stop the exams being a business opportunity and profit based exercise for colleges.

    If you want to test communication skills and English language ask candidates to take IELTS - standard English test all over the world.

    CSA exam has no real world bearing either for communication skills or medical knowledge.
    Just a game.

    P.S - I took exams with 3 different royal colleges. Above info is from real world personal experience.

  • NHS recruits first wave of doctors from Indian hospital

    Anonymous GP's comment 29 Jan 2017 7:54am

    Similar scheme in Birmingham recently. Most of the doctors who came for 2 to 3 years wanted to return within few weeks. The general consensus at that time was that salary and working conditions are much better in India now compared to UK. Bonded labour with no option for a career or a formal training post. These poor souls were holding the fort for the real trainees to get to their training. How can a doctor working in corporate Apollo hospital which is entirely based on ideology (mostly american) of investigating for everything if patient can afford, work in social medicine in a&e. Its impossible for them to adopt to GP land without working in NHS for few years and then GP training in UK.

  • LMCs draw up explosive 'plan B' to take GP practices outside the NHS

    Anonymous GP's comment 29 Oct 2016 4:55am

    Correction.

    I know from the DWP letter you are on long term disability without any illnesses.

  • LMCs draw up explosive 'plan B' to take GP practices outside the NHS

    Anonymous GP's comment 29 Oct 2016 4:53am

    Anonymous | Other healthcare professional28 Oct 2016 5:41pm

    I think you don't understand the misuse of NHS by patients. I have had so many requests for OTC meds from patients for themselves and their kids. If there is a small misuse, then yeah, it can be sustainable. Now its not misuse anymore - its entitlement. one guy told me,"I f...g pay your wages" for refusing to prescribe paracetamol - 15p for a box in shops. I kept quite. I didn't want to lose my job/risk another complaint. I was so close to saying, '' No, U don't f....g pay my wages. But my taxes pay your benefits. I know because I did your sick notes and I know from the DWP letter you are on long term disability.

    Anonymous Health care professional - U have no clue whats going on and how serious this is. Just don't comment on this website please.

  • GPs face new drive to cut inappropriate antibiotic use for urinary tract infections

    Anonymous GP's comment 29 Oct 2016 3:48am

    Does any one think about unintended consequences of antibiotic restriction to dangerous levels?

    Rheumatic fever, Rheumatic Valvular disease and joint diseases are uncommon so far due to the advent of abx. Do we need these diseases to return?

    Even in this case, what happens if one patient develops pyelonephritis and requires a&e visit and hosp admission for a week?? What happens to the cost overall? what about GMC complaint after that and investigation? Is it worth it for the NHS and for the GP to even consider this premium. False economy all around.

    Trimethoprim works well if used for 5 to 7 days. Repeated contradicting EDICTS - 3 day courses only for several years and now this - all nonsense.

    Only solution to reduce abx resistance is to prevent abx use in farming and veterinary sector and patient education. NO MORE DOCTOR EDUCATION. Enough !!!

  • GP practices forced to tell NHS England if they pay over 'maximum rate' for locums

    Anonymous GP's comment 21 Feb 2016 1:53am

    Currently corporation tax 20% on net income after expenses. Dividends no tax up to £42,385. After that 25%.
    New Dividend tax 7.5% after first £5000 from April 16 instead of 0% currently. personal allowance around 10 K. Effectively up to 15k - 20% corporation tax. 15k to 42k 20% CT+ 7.5%. 42K onwards 20% CT + 32.5% (effectively above 50p/1£ earned.)
    Next step locum pay cut in gp land same as locum pay cut in hospitals. A&E registrar locums are being told by hospitals - can't pay more than the limit. The norm over the last 6 to 7 years was around £65 to 70/hr for any shift day or night or twilight like 5 pm till 1AM. No unsociable supplement there. Future is this.

    Registrar (SP3+) - Core Unsocial

    Max. charge from 23 Nov 2015
    £57.05 £68.94
    Max. charge from 1 Feb 2016
    £45.64 £55.15
    Max. charge from 1 Apr 2016
    £35.37 £42.74.

    This is just the agency pay. The agency have to take their cut before passing on how much ever they can give you. You can't work directly for the trust with limited company. Trust would say PAYE and full tax implications and usually lesser pay for direct work with the trust.

    Any GP trying to compare yourself to hospital consultants, it is going to be more likely close to or below registrar rates.

    Its all part of the game. GP partners and salaried trying to escape the squeeze and become locums. Squeeze locums, they will return to salaried and partner posts and then imposition of 8 to 8, 7 day contract first and then slowly 24/7 contract. If someone feels contract is unsustainable and give it back, spread the patients to neighbouring practices, stretch them and then domino effect kicks in. Then bring in the saviours private companies to save NHS and then whip the doctors and performance manage them with efficient managers - mostly kids less than 20 yrs of age who don't have any common sense and have to follow the letter of the law, "Not more than £35.37/hr for locum as per the law."

    Poor GPs who have mortgages to pay, bills to pay, stranded in this country due to family ties and righteousness and morality and indebtedness to NHS have to do some work. You see they can't even go back in to hospital locum - same rates there. Young ones can't even go back to training due to the severe contract impositions on junior doctors - Can't afford the mortgage.

    First step to do above - data collection about GP locums pay.

    CHECK MATE.

  • GP golden hello pilots fail to attract enough candidates

    Anonymous GP's comment 13 May 2015 7:21pm

    I work in Leicester as locum. I would love to be a partner or a salaried GP.
    But I can't even imagine paying 28% of my hard earned pay as partner towards my pension which has been severely eroded by recent changes, with lower overall pot and increasing pension age.
    Further my family history and south east asian decent and increasing work related stress means I won't live beyond 60 (may be 65). Pension age is currently at 67 which is bound to go up in the near future. Hardly any chance to see any pension for me.
    Only people taking salaried job in GP land now are GPs looking for a mortgage (for which you need one salary slip or 3 yrs company accounts as locum) or maternity leave. For the rest it doesn't make any financial sense to do either salaried or partner.
    Quote from MDO for 7 sessions in-hours + 2 sessions OOH as 2nd yr GP - 14,570 (slightly more than average for calling MDU for advice few times as registrar). So I start the year from - 14,570. For people who say its shouldn't be about money, I have a family to feed, roof to keep over head and pay bills. Market forces can drive up rates only so much. Money is limited. To make the best use of tax situation, being self employed, putting the MDO fees, course fees, medical instruments, laptop and other legitimate expenses incurred to work as a doctor via limited company makes sense. U can't be self employed when you are salaried. Thats the problem.

    Solution - make life easy for GPs instead of making everyday changes and fear of future. Govt thriving for more work and less pay is going to end up driving GPs away to other green pastures.