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Gold, incentives and meh

Tom Caldwell

  • No wonder GPs act like parents when patients act like children

    Tom Caldwell's comment 27 Sep 2014 4:05pm

    Shurleea Harding, your view of what GPs do seems to be rather variable in your posts of 27/9 varying from tick boxing none carers to being payed a pittance for maintaining nations health.

    Indeed on the 20th you felt GPs should be left to do what they do best care for patients.in your comments.

    I guess that the your replies which seem incongruous and different between posts is a good example of customers vs patients. For us to keep everyone happy (as GPs) we are expected to treat everyone as patients ( which I whole heartedly agree with) but are judged at various times,usually dependent upon what people wish to slate us for, on entirely different forms of assessment.

    I shall continue to do the best I can for the patient in front of me. I shall do all I can to maintain natural justice and fairness. I shall do all this because that is what I should do. Place a customer in front of me and and I will do what is needed for the patient part of the customer ( because that is what I am trained to do) but what of the customer part?

  • No wonder GPs act like parents when patients act like children

    Tom Caldwell's comment 25 Sep 2014 11:01pm

    "We MUST remember who the customer is".

    Fair enough but I suggest you realise the customer is NHSE and the politicians who drive them. This belief that healthcare is a market (which by definition is driven by profit. Not necessarily but oh so often the expense of quality) is driving the NHS to the brink of extinction.

    To keep with the customer analogy, customers are often fickle; subject to passing trends and advertising which aims to guide you to attractive produce which you may or may not need...oh and make you part with money.

    The chorus of we have paid for it through our taxes will rapidly follow...again fair enough but once the NHS has gone I do not expect you will be paying any less taxes. In fact you will be paying more only instead of the safety net of the NHS you will be paying for private companies profits, you really will be a customer.

    No, I hate the description of a customer being applied to patients. It implies something very different to the doctor(health care worker) patient interaction. A customer is something that exists to transfer funds with the aim of making a profit. To provide a steady stream of income. Stack em high sell em cheap mentality, turnover, overheads, profit margins. Customer help lines shipped out to the cheapest provider no matter where they are globally.

    A patient is not a profit, is not always right, does not always need what they see or want. A patient is a person who with our help, education and perhaps even our medicines can be helped in maintaining their own health.

    Unfortunately the customer is too often seeking approval of a paternalistic society. Unfortunately customers when they have a problem just return it and expect it to be fixed or replaced. Turn our patients into customers and is it any surprise that paternalism soon follows?

  • No wonder GPs act like parents when patients act like children

    Tom Caldwell's comment 24 Sep 2014 6:16pm

    Ah but surely we should be using the secret "this medicine cures a none specific self limiting viral illness by mutating the virus into a bacteria thus rendering it sensitive to antibiotics when you present 2 days before your holiday".

    You know I think we should use it more often especially when people have had enough of feeling unwell and something must be done for 7 days of a viral illness.

    obviously we also should do this via skype, or e-mail, or home visit, or telephone consultation or any other requested route of communication as well as offering same day or pre-booked appointments for any registered or temporary patient who wishes to have an appointment for any condition or indeed query that they may or may not have, for a symptom of any duration or severity, with or without any self management prior to seeking medical advice.

    And of course we need to be far far more reasonable about providing our services and time for form filling, assessments, letters to this that and the other ,and so on and so forth for none NHS services. I mean why should we charge for work we are not paid for which we have to do in our own time.

    And of course after 12 hrs of doing this it really is an outrage that we are not then contactable 24 hrs a day for any query of any urgency that any patient (or relative, representative, carer, interested party, school....) may wish to make. I mean how can we as doctors be so up ourselves as to offer an opinion which challenges the current use of these precious interactions and the seeming value society places on them.

  • GP training figures are a complete car crash

    Tom Caldwell's comment 17 Jun 2014 6:58pm

    where GP training figures differ from a car crash is that a whole load of resource is thrown at a car crash and none at general practice. :)

  • It's hoped a nice cup of tea and a chat will save GPs from burnout

    Tom Caldwell's comment 04 Jun 2014 10:29am

    ooh a nice cup of tea :)

  • RCP elects Professor Jane Dacre as new president

    Tom Caldwell's comment 15 Apr 2014 7:01pm

    Any relation to Daily Fail Dacre? RCP, RCGP, RCPCH, RCS, RCPath, RCPsych all now led by women. Dawn of equality in medicine or a once in a lifetime happening. I hope the former.

  • Calls for GPs to test for and treat hepatitis C

    Tom Caldwell's comment 13 Apr 2014 6:26pm

    Hep C Dx we can help with, the monitoring and treatment of Hep C is a specialist undertaking dependent upon genotype the treatment can be in excess of 6 months. The treatment is heavy in side effects and monitoring during which time the patients may not be stable. This is not yet suitable for widespread primary care management.

  • MRCGP 'fairest' means of ensuring safe GPs, court hears

    Tom Caldwell's comment 10 Apr 2014 0:48am

    11:22 pm I suspect the breakdown of the GPs complained about would need to be assessed to support your assertion. I thought the demographic was older male GPs having higher rate of complaint which would work against your assertion of this being related to the CSA. As to the plummeting public confidence I again wonder if a hostile political agenda and press may offer a more likely explanation.

  • Leading think-tank busts myth that 2004 GP contract was ‘disastrous’ for A&E

    Tom Caldwell's comment 08 Apr 2014 9:21pm

    can we have blanket coverage on the BBC "2004 contract did not cause A&E problem" ?

  • RCGP accused of discriminating against ethnic minority candidates in MRCGP legal case

    Tom Caldwell's comment 08 Apr 2014 7:49pm

    Most importantly when do they expect the result to be made public ?

  • Proportion of GDP spent on NHS falls

    Tom Caldwell's comment 07 Apr 2014 11:58pm

    Tories.... killing the NHS blaming those who work to keep it alive.

  • Landmark judicial review to decide on future of MRCGP exam

    Tom Caldwell's comment 07 Apr 2014 11:30pm

    Will be good to have a clear answer at the end of this process. I hope the results whichever way it is decided allows those caught up to move on one way or another.

  • CCG awards £2.3m worth of enhanced services to new GP federation

    Tom Caldwell's comment 07 Apr 2014 11:26pm

    Anonymous 2:16...... precisely, have to federate because new hoops being placed to deliver same services.

  • Revalidation process is unable to adequately assess GPs, MPs find

    Tom Caldwell's comment 02 Apr 2014 12:15pm

    A politically enforced measure considered inadequate by MPs.... perhaps we should have more assessment registration and regulation of the politicians. Why should we have to wait 5 years to flag our concerns about them and have them taken seriously?

  • Analysis: Where have all the drugs gone?

    Tom Caldwell's comment 02 Apr 2014 0:37am

    This is a constant problem, pharmacies always ask for an alternative ppn to be generated. When I get the receptionists to try other pharmacies half the time it can be found. Unsurprisingly I often don't have the time to chase other pharmacies and end up trying to generate a ppn close to what is needed. The list seems to be ever growing and ever changing....... and is hugely annoying.

  • GPs to be given two weeks' notice before a CQC inspection

    Tom Caldwell's comment 10 Mar 2014 7:09pm

    Whilst the change of approach is clearly welcomed I think there is much trust to be regained in this system after the way that the initial inspections were reported. I think there was much feeling that the handling of the release of information for the initial inspections was poorly done. I hope this restores some of the trust that was clearly lost.

  • New editor to take helm at Pulse

    Tom Caldwell's comment 03 Mar 2014 9:13pm

    Good luck to you both.

  • GPs face long wait until retirement as review omits them from age-related 'risk' list

    Tom Caldwell's comment 03 Mar 2014 9:04pm

    So in short work until you drop then they don't have to give us any pension

  • Pulse's care.data survey results

    Tom Caldwell's comment 26 Feb 2014 4:44pm

    Come on anonymous think about it. If a GP does not do as they are obliged to do by government and is taken to court they will risk the loss of their career.

    The risk of breaching contract; reporting to and censure by GMC; removal from CCG provider lists and local performers list.... how brave do you want us to be?

  • RCGP members vote to maintain opposition to assisted dying

    Tom Caldwell's comment 23 Feb 2014 5:35pm

    At least the membership was given a chance to have a say in the position being taken. Those members with strong views towards changing college position have had a chance to vote as have those who agree with the current stance.