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Gold, incentives and meh

Vinci Ho

  • Labour pledges to train 5,000 new GPs a year

    Vinci Ho's comment 23 Sep 2019 9:42am

    Oh dear
    These figures , 5000, 6000 whatever , has become new political terminology for these guys to play with .
    I leave you with your crystal clear mentality to make a judgement.
    God bless general practice......

  • Start antibiotics within four hours of diagnosing community-acquired pneumonia, urges NICE

    Vinci Ho's comment 20 Sep 2019 7:39am

    ....reasonable and logical ....

  • Start antibiotics within four hours of diagnosing community-acquired pneumonia, urges NICE

    Vinci Ho's comment 20 Sep 2019 7:38am

    You see
    One has to be sensible in looking at the meaning of this guidance. It is all about what to do AFTER the diagnosis of CAP is made . And I think that is then quite reasonable abs logical.
    The problem still lies BEFORE the diagnosis was reached in primary care which could be very tricky in general practice( like many other serious , life-threatening conditions in their early clinical stage) . CURB is not completely CURB because GPs cannot get urea( and also white cell count and serum CRP) right away , for instance. That is the part of any guidance( written by academics) which seems to be disappointing in appreciating how difficult our job is in the frontline .

  • Antidepressants work 'by tackling anxiety symptoms rather than depression'

    Vinci Ho's comment 20 Sep 2019 5:51am

    On BBC Health news as well

  • Schoolgirl died from heart attack after hour wait for ambulance at GP practice

    Vinci Ho's comment 19 Sep 2019 7:03pm

    Obviously we have not had all the details of this tragedy. But reality is this kind of following the protocols, triaging , category of urgency and eventually conclusion by algorithms, is an overcompensation for a system being neglected too long by successive government(s) . The end result is painted by loss of lives . One can say we are crybabies, scaremongers etc but the reality has become too apparent to be denied by this bunch of politicians . I always believe that we , doctors, always have a duty to oversee these despicable politicians and bureaucrats from harming our patients but the truth is we have only limited power to prevent disasters from happening.....,.......

  • Statin the bleeding obvious

    Vinci Ho's comment 18 Sep 2019 9:37pm

    Aren’t you guys bored of this kind of Brexit-like polarised debates , especially on primary prevention with statin ? As I wrote before , I am more fascinated by this nocebo effect and the less one told the patient about statin side effects , the less likely they would have them . Let the pharmacists do the ‘shit job’ of hard selling high dose statins to them . The government is pushing it anyway .
    Ultimately, again , it is not about deserve , it is about what one believes.

  • Opioid prescribing in primary care on the rise in England

    Vinci Ho's comment 18 Sep 2019 9:08pm

    In 2013/2014, the median number of pregabalin prescriptions was 66 per 1,000 population. In 2017/2018, it was 119 per 1000 population.

    The number was almost doubled in only four years . Is there a trend going further up ?
    If the fundamental argument is that GPs are not well equipped to manage these patients on these drugs , am I right to infer that the currently available specialist services where GPs are supposed to seek help , are failing us, GPs , then ?

  • Opioid prescribing in primary care on the rise in England

    Vinci Ho's comment 18 Sep 2019 8:58pm

    Would like to similar study on Tramadol prescribing.

  • The real fraud

    Vinci Ho's comment 18 Sep 2019 8:43pm

    One interesting point I want to raise here is ever since the passing of the Health and Social Care Bill , there was a surge in number of APMS practice contracts won by private companies. In fact , there was no new GMS contract approved , if I am right ??
    Now , we also know how obsessed the current health secretary is for IT-smartphone-AI driven general practice . I am not insinuating anything (in case somebody sues me for defamation , ha ha ha ).
    But folks , think deeper.......

  • Local GPs block CCG merger due to 'historical debt' issues

    Vinci Ho's comment 18 Sep 2019 8:26pm

    Nine lids to cover ten cups , to start with .
    What is common sense of making this even worse by merging all into one ?
    Do the arithmetic: 9x6= 54 lids to cover 60 cups then , ha ha ha

  • The real fraud

    Vinci Ho's comment 18 Sep 2019 5:50pm

    Thanks , Jaimie

  • General practice responsible for £88m of fraudulent behaviour, claims NHS report

    Vinci Ho's comment 17 Sep 2019 11:15am

    Ok . It is probably logical to say every tree has some bad apples as far as the outsiders are concerned. But , always a but , how would one verify the evidence and classify the ‘severity’ of the problem realistically , are the bottom line questions here .
    I dare you NHSE to ‘promote’ these figures to the media (especially you know who and which) and let them spin and see what happens??
    The crisis of retention and recruitment started from the top of the hierarchy and I stand by my argument, the government and the country need GPs more than GPs need them .
    So please go ahead , spin with these figures 😑

  • PCNs who achieve targets 'further' and 'faster' to receive extra funding

    Vinci Ho's comment 17 Sep 2019 7:46am

    Read this if you want

  • International GPs will not be required to take second language test

    Vinci Ho's comment 17 Sep 2019 6:32am

    Ha ha ha
    This government, quintessentially , is fraught with utilitarianism . Keep topping up the number of GPs will solve this crisis ?
    My gentle reminder to you , Robocop and MojoBojo (and all the subordinates) : discern the fact of the matter before applying the principles and virtues . Why are you haemorrhaging GPs way faster than you could employ ? Stop putting the cart in front of the horse , you stupid f***🥴

  • New health minister for Brexit and workforce announced

    Vinci Ho's comment 15 Sep 2019 12:35pm

    You see
    This history of Brexit will become a must-read teaching material in future university courses of history and politics . So toxic with so many ‘casualties’ , ha ha ha.
    Cannot resist the temptation to buy Lord Vader’s new book , For the Record , when it is published next week . It is obviously about pointing fingers in a game of ‘blaming each other’ . While I never forgive the passing of Health and Social Care Bill contributing to our(GP) current crisis , the only credit I would give him for this book is donating some of the book’s profits to a charity on behalf of his son who died of epilepsy and cerebral palsy .
    And for those die-hard fans of the two ‘big’ parties, politics was simply a medium which had exposed unreservedly the weakness and dark side of human beings in your ‘beloved’ party .

  • Buy your high-dose statins here for double loyalty card points

    Vinci Ho's comment 14 Sep 2019 8:09am

    There are some ideological dilemma and hence , arguments here :
    (1) Are patients actually customers in 21st century technology driven world ?
    (2) The ‘fascinating’ story about statin , especially in primary prevention, is the way side effects can happen . Remember the evidence that there is actually a nocebo effect ?
    June 27, 2017
    Nocebo Effect May Account for Statin Adverse Events
    Anita Slomski, MA
    JAMA. 2017;317(24):2476. doi:10.1001/jama.2017.7582
    (3) Hence , the patient was more likely to develop side effects if more information about adverse effects was given to them ??
    Then one found oneself in a ‘damned you do ; damned you don’t’ situation. As you guys alluded , the pharmacists would be tempted to run a different philosophy by simply treating a customer to ensure the pack of high dose statin would appear in the checkout basket . Full stop , ‘happy days’ for everyone(less likely to have side effects ??). GPs , please shut up , say less is better , ha ha ha .

  • BMA highlights NHS 'culture of fear' in new vision for reform

    Vinci Ho's comment 13 Sep 2019 2:28pm

    You see
    This feels like the chief executive officer of Hong Kong government finally withdrew , in totality, the infamous extradition law causing the mayhem in last 3 months .
    Problem is : too little , too late , Robocop .
    As I wrote before , we had been sleepwalking into this scorched earth politics which is nobody wanted to see . The inevitable damages to NHS could not be undone in short space of time .

  • NICE may have inadvertently boosted antidepressant prescriptions in under 18s

    Vinci Ho's comment 10 Sep 2019 7:13pm

    Age 16-18 with mental illnesses is the group of ‘lost child’ as far as our local CAMHs is concerned.
    Suspected ASD and teenager-to-adult ADHD in this group is virtually no man’s land. Something is not right in the ‘system’

  • One in four adults prescribed addictive medicines, says PHE review

    Vinci Ho's comment 10 Sep 2019 5:12pm

    Thank you for the insight on OST to clarify my usual ignorant rantings . 😄😇

  • One in four adults prescribed addictive medicines, says PHE review

    Vinci Ho's comment 10 Sep 2019 3:52am

    (1) The reality of these patients who are heavily dependent on opiates(Co-codamol, Dihydrocodeine , Tramadol ( I called it CDT and etc ) and lately , gabapentinoids, are no different from those on methadone blue prescriptions . Even reducing the latter from 50 mls to 45 mls a day was confronted by strong objection from patients , for instance. And GPs have 10 minutes to complete this debate with a patient! Seriously?
    (2) The recommendations from PHE are sound but was quintessentially written in a bookworm fashion , ideological and intangible. Somebody needs to get real and mobilise resources to help the frontline.
    (3) Pain clinics need to take more responsibilities in monitoring the patient being initiated and maintained on all kinds of complex pain medications, rather than throwing them back to GPs to ‘continue’ .