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A faulty production line

Mgt Mccartney

  • Patients age 45 should be able to request PSA test, say new guidelines

    Mgt Mccartney's comment 31 Mar 2016 7:05pm

    The RCGP did not approve this document from Prostate Cancer UK. Public Health England have issued their own guidance (pretty much unchanged) and is separate from this charity's self issued statements.
    I have asked Prostate Cancer UK to correct this.

    The UK National Screening Committee are usually where I look for evidence based updates and guidance.
    margaret mccartney

  • NICE supports call for QOF to reward offers of treatment rather than prescribing

    Mgt Mccartney's comment 14 Oct 2015 11:11pm

    the wording sent is about guidelines and how they are framed for GPs and patients/carers/families. Personally I would tear QOF down. If it persists in whatever form/or coding of whatever kind continues/ in whatever form on treatment choices - it has to be realistic and about what patients want - not what qof/expert guideline writers/politicians say.
    I think the principle is important and I'm glad that NICE seem to agree
    chair of overdiagnosis group

    if you want to get involved do email me
    mgt mccartney

  • RCGP council to launch working group on overdiagnosis and overtreatment

    Mgt Mccartney's comment 12 Aug 2014 10:49pm

    I owe the third commentator money at least
    choice is to accept the status quo
    and damn our children and relatives to a primary care service which is straining at the seams and is starting to go bust.
    start the revolution.
    the NHS cannot work without GPs. we are the risk sink,, the generalists who can take rational risks, who can manage most things given the time and resource.
    I love the NHS, and do not want it to sink ever, but not on my/our watch.
    I can't do much on my own, but lots of people calling out the current health policies as crap and the contract as harmful will eventually get listened to.
    The more people that challenge what's happening the better.
    last week I had a letter saying that it was best practice to do speculum examination on 'all women' with genital symptoms.
    this is nonsense - of course some women should be examined, but plenty of women will know they have (recurrent) BV or thrush and are safe to treat themselves and seek help if concerns.
    after lots of emails back and forward I understand this is now going to be changed. But it's such an effort and so demoralising to have to challenge this nonsense - but what if we worked together, what if the RCGP could offer advice which would start to ensure that these kinds of guidelines are written for and by generalists rather than it being done to us.
    we are being ruled by guidelines written by specialists who aren't trained in and don't work within the pressing needs of generalism.
    if you want to help the group, please email me, we will be working mainly online with position papers. Julian Treadwell, GP and I and others are also willing to come and talk to local GP groups if invited, and we plan a website with lots of resources for GPs.Lanching at the rcgp conference in Liverpool.

  • The Department of Health is responsible for out-of-hours care, not GPs

    Mgt Mccartney's comment 21 May 2013 6:00pm

    oh gosh sorry ms /mr anonymous - I do not blame patients - I do blame the QOF for as you say, needless trips for many patients - esp patients with two or three conditions. Many people get little benefit - but we are told to do it.
    But out of hours - there are many people who will only call the doctor if they think they are seriously unwell. But many others don't. With walk in centres, NHS 24, 111, the problem is that patients get moved about without continuity and end up with a worse deal. And this has gone unchallenged - rather than the government saying this isn't a good direction of travel- it has been allowed to get worse. I think it makes it even more difficult for people who are very sick out of hours as they have to get through a system where most other people are not as seriously unwell.
    I think everyone loses in the current system, basically

  • Prepare for a sea change in how we assess the risk of breast cancer screening

    Mgt Mccartney's comment 31 Oct 2012 11:01pm

    I agree - and the important bit in the review is the fact that the trials are 20 years old, do NOT look at all cause mortality, and "However, given the uncertainties around all of these estimates, the Panel state that the figures quoted give a spurious impression of accuracy, and further research will be needed to more accurately assess the benefits and harms of breast cancer screening." too right

  • Prepare for a sea change in how we assess the risk of breast cancer screening

    Mgt Mccartney's comment 31 Oct 2012 8:58pm

    Dear David
    breast LUMPS are symptoms - screening DOES NOT apply. Screening is ONLY for people with no symptoms of disease. The stats can't be mixed.
    The issue for women will be how to examine the statistics for benefit and harm and make a rational choice before having screening, or not.
    We do this for just about every other medical intervention. We can do it for screening too - but it has to be about individual choice.

  • Why every GP should consider tweeting

    Mgt Mccartney's comment 18 Oct 2012 0:02am

    Dear Mark
    I asked you to stop commenting on my blog because you made incredibly rude, nasty and potentially libellous comments. I know you've also done this elsewhere so I haven't taken it personally. You might want to know that this was a very rare thing for me to do. And that's it: I'm not going to respond to you any more.