One problem is hospital doctors prescribe common drugs with no idea of the cost. An example is liquid nitrofurantoin in paeds. When the cost was pointed out the consultant happily agreed to change with an expression of shock at the cost compared to capsules. They need the say computer system we have....
We can always decline expensive meds and ask they do it themselves from their budget.
You can also complain about him through IPSA at email@example.com
The more the better.
We we think we are not data controllers in principle anymore the profession needs to make that clear to the ICO. Perhaps we stop all computerised notes and go back to Lloyd George notes until it is sorted. A thought... we could have a practice based code for all patient contact details so the SystmOne contact details are only readable with the code which we keep control of. The Home Office would have to beat the code word and codebook out of you.
Interestingly it has always been a principle that we will not give over this sort of information to the police unless there was a significant danger to the patient or public. Breaking this principle would put us on the wrong side of the ICO and GMC no matter what MoU the police had with the anybody. The case for the Home Office having access is much weaker and so would also put us in serious jeopardy with the ICO and the GMC.
They do this as they know the majority of people register with a doctor and so they will pick up people who are here illegally this way. So the only way to do this ethically is to make sure all people are aware their personal contact details will be made available to the police and immigration service if they register with a doctor. Unfortunately this will then deter people from registering.
The only other way is to be deceitful and not inform people that we do this.
Either way it puts us in a very difficult position. The fundamental principle of confidentiality should prevail and we cannot allow the state access to this information. As data controllers the GP can formally complain to the ICO that the Home Office is in breach of the law, regardless of any MoU, and taking data from a data controller without consent.
The difficulty is when the inexperienced practitioner gives amoxicillin for a PE.
People not normally resident in the UK are not entitled to full NHS services. Only primary care which includes GP and A&E. People here on a visa for over 6 months pay £200 a year for access to the NHS. Which isn’t too bad. I lived in the states for a year and paid 20 dollars a month for health insurance. Admittedly it was 1988. Of course our system and the most of the developed world is far cheaper to run then the US system.
Virtual is the opposite of real.
Copperfield acted completely rationally. However I got fed up of the stress with sick notes. So I say it as it is. I write the the Patient tells me they have stress at work. Then tick maybe fit for work. Then write “ I am not able to assess please arrange anOH assessment. This is not an NHS service.” This way I act rationally and they get a slip of paper.
I suspect they closed as they couldn’t turn a profit. These organisations are not in it to provide a service to their community but to turn a profit so will shut it down without a second thought.
Retiring in a month aged 58. Then year in Australia working 30 hours a week for more money to top things up and travel. I used to be all for the NHS, as a patient I still am, but as a worker you do what is best for you. There is never any loyalty between employer and employee or contractor and contractee when the pressure is on. Either can walk away at any time.
We can drive down gun use by saying no to everyone. As anyone wanting a gun must be mad.
Did you see the Home office had to pay 50k compensation to a man it had been detained illegally for three months and separated from his child who was put into care. That is their level of incompetence. Incompetence that damages lives.
AI is more suited to hospital medicine than primary care medicine. In Primary care there is often no definitive diagnosis because the patient presents early in the history with undifferentiated symptoms. Then of course the patient really comes with a hidden agenda. They are not really their for their cough or their rash that was just an excuse to get through the door. It maybe helpful as a tool for inexperienced doctors or rare diseases. The irony is they are rolling it out for hard primary care problems when it would work better in secondary were the problems are easier. But I guess there is no market in secondary care.
There are ENT consultants and surgical consultants and respiratory consultants and GP consultants. Consultant just describes what you do... offer consultations to patients. The specialism is in the first bit. The same is true for the term doctor. People think it is a title but it just describes what you do.. same as Nurse Jones or Postman Pat or Constable Smith.
You can always get to speak to a doctor and if necessary see one in the UK as long as it is urgent. Everything else can wait a little while.
Any good references for this evidence base for ADHD treatment? I am skeptical but willing to check the papers for their results and the quality of their research.
Cassandra was right and Troy fell. I have nothing against econsults or telephone consults etc but there has to be a cost to the patient or demand will be driven up. I like the sit and waits as at least there is an opportunity cost of an hours wait. Telephone has no cost at all and so patient will ring for the most trivial query simply because they can and and it is too easy. You could put a phone in a room at the surgery and they had to come and queue outside it. That would introduce a cost.
Will just drive up demand another notch. There was a time when there were only f2f contacts and things worked well. But the more access you provide the more demand you will generate without an economic feedback of money or opportunity cost.
I wouldn’t be surprised if GPs get blamed for not achieving the 5000 target. Somehow it will be our fault for leaving the profession or not committing.