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Gold, incentives and meh

Tilton Rifle

  • DH and GP leaders 'to review partnership model'

    Tilton Rifle's comment 14 Feb 2018 6:05pm

    Re: JMC’s comments - if you’re working in a practice where the Partners do as much work as the Salaried GPs, then I suggest you vote with your feet and find somewhere more appropriate.
    Either that, or demonstrate that you have the inclination and skills to involve yourself in the business and take a Partnership role, very simple!

  • GP trainees locked out of MRCGP exam could get 'sixth' attempt

    Tilton Rifle's comment 15 Aug 2017 6:36pm

    If it takes you more than five attempts to pass this pathetic exam you should probably quit medicine.

  • Are young GPs’ career choices killing off partnerships?

    Tilton Rifle's comment 15 Aug 2017 9:21am

    On the contrary, I think that Partnership will start self-selecting only the most ambitious and capable, rather than just being seen as the natural end point for all and sundry,

    The flip side is that this is all well and good, but then no can complain if the future of GP is indentured, salaried servitude; rota'd and controlled and paid for the 8 hour days you seem to desire. The Locum market is already saturated, there's no way I'll pay a newly qualified GP as much as what we earn a session, so how long before attitudes change?

    It's also a bit of a shame to hear excuses like "oh well training hasn't prepared me". Training is pathetic and barely prepares you to be a doctor, some initiative and self-directed learning is required, surely his is one of the joys of being a GP? I do despair.

  • Don’t 'sell' general practice to us – it won’t work

    Tilton Rifle's comment 07 Aug 2017 8:32am

    As an aside, it'd be helpful if someone might be kind enough to fix the link to the cited study.

  • Don’t 'sell' general practice to us – it won’t work

    Tilton Rifle's comment 07 Aug 2017 8:31am

    Sensible indeed. Yes, there are problems, but there is still much specific to GP which sets it apart from other specialities - other careers - in a positive way. We need to recognise those qualities, champion them and be prepared to defend them.

  • What should be in Jeremy Hunt's new 'package' for GPs?

    Tilton Rifle's comment 05 Apr 2016 11:50am

    Crown indemnity.
    Proper restoration of funding.
    His resignation.

    We shall instead get a heap of shit in return for yet more of our time and independence.

  • Why I absolutely think we should work weekends

    Tilton Rifle's comment 14 Jan 2016 5:57pm

    Could not agree more that extending access only increases doctor- dependence. We are making people more ill, not less.

  • Physician associate indemnity ‘costs practices upwards of £2,400’

    Tilton Rifle's comment 30 Sep 2015 10:26pm

    The PA is a partner? Do these GPs have no self respect?

  • 'We want to show what physician associates can do'

    Tilton Rifle's comment 30 Aug 2015 4:44pm

    Trained in the same way as doctors... but take less than half of the time to do it. Tell me, are they advanced learners? Twice as capable as medical students? Or intact are they nowhere near as well trained or clinically capable as an FY1, let alone the CTs that they will be paid more than for less responsibility.

    We have a responsibility as a profession to kick this far into touch. Abysmal work force planning is not our problem.

  • NHS offering £50k per year for US physician associates to practise in underdoctored areas

    Tilton Rifle's comment 28 Aug 2015 6:11pm

    Surely we just all have to say no, not a chance?

    I would sooner take on another FY2 - better qualified, proper clinical training and experience.

  • Physician associates should be subject to mandatory regulation

    Tilton Rifle's comment 21 Aug 2015 7:29pm

    A two year postgraduate course covering 90-95% of medicine!? Why does an undergraduate medical degree take five years then? Are you accelerated learners? Are medical students remedial?

    This is the sort of dangerous attitude which makes me think we shouldn't go anywhere near non-medical Assistants.

  • ‘This could set a precedent for the rest of the country’

    Tilton Rifle's comment 28 Jul 2015 12:10pm

    "I still have issues around duplicating resources. Why are we extending core hours when we already have fantastic out-of-hours services?"

    Absolutely agree - why are we indeed?

  • How can a ‘primary care workforce review’ say so little about GPs?

    Tilton Rifle's comment 23 Jul 2015 11:02am

    Your previous article was on the money - I have no idea where the sudden spate of frothing apologists arrived from - almost all GPs would agree with you, and, frankly, this is the sort of common sense we would hope for from an magazine for General Practitioners.

  • 'Seven-day access fairytale is not deliverable'

    Tilton Rifle's comment 13 Oct 2014 6:36pm

    Having worked for some of the Manchester pilots I can see both sides.

    As a locum it's great: relatively stress free work for (currently) acceptable remuneration. People who know about it like it (promotion has been fairly scarce thus far). The advantage over OOH work is that their notes are available to you. But that's about it really - we have some very good OOH services in the city which could quite ably deal with most of the complaints presenting to Extended Hours, which are still almost exclusively of the coughs/colds/sore throat variety. But people don't want to go there.

    Yes, you do get the odd routine consult, but not many; I suspect people have better things to do with their evenings than discuss their cholesterol.

    Then there are DNAs - lots of them. Again, it can't be that important if you don't want to travel ten minutes down the road.

    There are two more problems, touched on above. Firstly, like anything, it encourages doctor-shopping; "my GP wouldn't give me this, will you?" is a very common question.

    Secondly, are we really doing people a favour here by taking even more responsibility for their health? For a variety of reasons we have an increasingly dependent society. Wouldn't the money be far better spent on public education - empowering people - teaching them the basics that for whatever reason education has completely failed to instil in them? No, you do not need antibiotics for a virus; no, you do not need to see a doctor at the first sign of a cough.

    I agree with Dr. Bennett that we need to be proactive, but I'm sure there are ways to do it more likely to achieve positive permanent results.