This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

Cynisus Doctorus

  • PCNs have been received 'incredibly well', says Hancock

    Cynisus Doctorus's comment 18 Nov 2019 7:24pm

    what i would really like to know is do these idiots believe what they say or are they just aware they are lying? no - id really like to know. if he believes this who is telling him this is the truth? are the high ups at NHS E telling him stuff is sorted? in which case they need shooting - if they are telling him its all rubbish and hes lying - hes lying.. can we get hold of his breifings? where does it say its better? its worse!

  • Practices facing tight deadlines to form primary care networks

    Cynisus Doctorus's comment 22 Mar 2019 7:58am

    Does anyone else think this is a complete waste of time and money. Getting every network together to discuss anything is going to take out huge chunks of clinical time and no one will do it for free. people keep telling me they will spend all the money on new staff and resources - it will all get spent on meeting and lawyers and accountants trying to run several thousand new companies - what a waste.

  • GP pilot set to test if earlier home visits reduces admissions

    Cynisus Doctorus's comment 20 Sep 2017 2:10pm

    we did this 2 winters ago. really annoys me this is presented as a new idea. we got our local practices paid to do this as part of a winter pressures scheme. there was evidence it helped - the biggest problem was although the GPs did earlier visits - the ambulance service were still taking 4-6 hours to get the pt into hospital ruining the whole point of them being seen earlier in the day!

  • GP Forward View was redundant before it even started

    Cynisus Doctorus's comment 18 Sep 2017 5:48pm

    i dont disagree but really only the first paragraph of this adds any new info. what has the bma done to help? found us cheaper insurance? helped us find more doctors? helped us in any way?? advertising in the bmj gets more and more expensive.. what does the money get spent on?

  • Er, how come we're doing out of hours again?

    Cynisus Doctorus's comment 14 Sep 2017 3:31pm

    do you have a link?

  • GP indemnity hikes could force me out of the job I love

    Cynisus Doctorus's comment 08 Sep 2017 5:01pm

    headlines... i suspect the headline is clickbate. are you really giving up GPing because of the indemnity fees or because its not the job you thought it was and its getting worse on all accounts (i dont disagree). i suspect the headline should be - person finds being a GP not to his liking so looks to retrain else where so he has a better life.

    the point im trying to make is i think its far too easy to blame one thing. if they suddenly gave us free indemnity would we all be happy campers? i dont think so. ok reducing indemnity fees might be part of the solution but its not just that..

    its all too easy to reduce complex issues around why GPing is crap to if only they paid the indemnity.

    perhaps thats how our leaders think it will be solved.. i doubt it and it gives the polictians a easy way out. they give us cheaper indemnity then say well we gave you what you wanted why are you still complaining.. or worse they give that but only against another tick box.

    rising demands, rising expectations and poor workforce planning are the problems. im not even sure right now there are any solutions.

  • GP winter indemnity scheme to be repeated in absence of long-term solution

    Cynisus Doctorus's comment 04 Sep 2017 9:21am

    lets face it pay me double or triple time and i might do a shift. our local ooh - despite sometimes being described as like working in Beirut - pays crap. they have endless meetings about why arent the local gps supporting them... well after a 10-14 hour day the last thing i want to do is take a cut in pay and do a shift. yes indemnity is an issue but just recognize its crap work and needs to pay to attract.

  • GP start-up offering £39 video consultations in pharmacies

    Cynisus Doctorus's comment 31 Aug 2017 4:53pm

    Frankly im all for this as long as they dont try and use me as the safety net like the pharmacist does for almost everything..."pharmacist said i needed to be seen straight away"

    Get rid of the dross that fills my time and let me concentrate on medicine. instant access to trained on line counselors 24/7 should be a high priorty. i had 5 pts in a row cry at me the other day.. yes GPs need to recognize low level mental health and psycho social issues but these were just people with reactive issues to life events who cant cope and who dont need a GP.

  • GPs to be asked to 'peer review' all referrals

    Cynisus Doctorus's comment 30 Aug 2017 6:53pm

    there is some evidence that if done correctly - which includes finding time and funding - this can be seen as a very positive quality exercise by the referring doctors especially if its done retrospectively in a peer supported way with careful attention paid to how the feedback is given by whom and about what. what you dont do is obsess about guidance, have non gps giving the feedback - do it in a negative critical way. of course anything nhs e implements will be done badly and for the wrong reasons... so im against it.. but there is some merit...

  • Expert review knocks plans to extend GP training to four years

    Cynisus Doctorus's comment 11 Aug 2017 4:18pm

    1. ive been very impressed with the quality and dedication of the GP registrars we have had over the last few years. despite the "old" me saying they dont work as hard as i did as a junior doc in their hospital jobs... perhaps teaching is better than on the job training! so im not convinced we need to extend GP training.
    2.newly qualified GPs and consultants arent the same. a consultant is way more experienced. the problem is a year 1 GP despite being good isnt as experienced as a good senior GP.
    not that im a member of the college or support much of what it does but the myth that MRCGP is the same as a consultant isnt true. in most hospital specialties Membership of College is a qualification you get along the way - there are exist exams and CCST assessments.
    my opinion is MRCGP should be something people do in training to partly proove to themselves they are generalists and to proove they have the basic skills to operate as a "basic" GP. there then should be a fellowship exam to be taken 3-5 years later that is considered the same as a consultant post.
    the current lets give an F to our mates on production of 3 letters from friends so they can have a nice meal and access to the college wine cellar is rubbish.
    the question is what to do with existing GPs who dont want to sit exit/exams. well a combination of appraisal and assessment on the job - that isnt hundreds of pages of documentation is probably the way to go.

  • Practices who ditch new 'voluntary' GP contract could lose all their patients

    Cynisus Doctorus's comment 09 Aug 2017 3:43pm

    agree with the comments about make sure they do a deal on your lease.. however 1. why would i sign a mcp contract?? 2. if they dont give me back the pts who are they going to give them too? we are 12 docs with 15K pts. if they dont give us the 15K pts - whose going to look after them? none of the local practices will - they are all going under. they are going to say to our pts. because your gps think the new system is crap - and its not working we;ve decided to not give you a GP?

  • Negativity in general practice 'is worst I’ve known', says RCGP chair

    Cynisus Doctorus's comment 07 Aug 2017 2:43pm

    might be the greatest job in the world as an acedemic and well paid RCGP chair.. but those of us who have just finished morning surgery at 242pm with pm surgery starting at 3pm arent so happy.. perhaps if the RCGP chair recognised that... id be keener to be a member

  • Brace yourself. Indemnity costs will get even scarier

    Cynisus Doctorus's comment 12 Jul 2017 4:50pm

    we employ a practice pharmacist under the recent scheme. she is great - but while the aim of the scheme was to get them doing clinical work. the insurance company want a fortune for her to see routine hypertensives. this is crazy. we have spoken to a new insurance comppany who are keen to get into the primary care market but everyone is scared off by the st pauls fiasco

  • New GP-exclusive indemnity organisation promises to slash fees

    Cynisus Doctorus's comment 10 Jul 2017 5:06pm

    re: unscepted... im not so sure.. a state system will be either trying to minimize state damage or cost - will it really be looking after my interests. most consultants i know have mdu/other cover too. i dont want to be hung out to dry. weve locaaly also spoken to a new company who reckon they can save us a fortune by working in a different way - small excess - lots of peer learning events - etc. id rather my cover was 100% funded that state controlled.

  • 8,000 patients losing their GP in new round of practice closures

    Cynisus Doctorus's comment 05 Jul 2017 1:09pm

    agree with policenthieves - i just don't see this as a they want to privatise the nhs thing - where is the evidence of that - most of the big players avoid primary care - or state they only want to provide back office. none of the big super practices have sold out - you would think they would be the first. the reality is GPs run a tight ship and any savings you might make on cheaper salaried docs - and I'm not convinced thats actually the case - are offset by the increased management costs. its years of incompetence - and political inability to discuss rationing. also there are a lot of pressure groups particularly pharma and in secondary care - who see it in their interests to drive demand.

  • Is academic prowess the best predictor of a future GP?

    Cynisus Doctorus's comment 29 Jun 2017 4:19pm

    Lets face it - the feminisation of medicine has been a disaster. previously boffin types would work ridiculous hours with little thought of their own family/home life and be emotionally detached from the crying patients so that they could carry on regardless. Once the "female" side came in - touchy feeling circle sitting sandal wearing - everyone goes part time or drops out - needs a day to reflect on each consultation then write it in their e-porfolio. the profession looses its status - its earning potential..

  • Plans for GPs to annually review patients prescribed opioids under discussion

    Cynisus Doctorus's comment 29 Jun 2017 3:01pm

    can anyone point to any of these crazy schemes that actually make a difference over and above just doing a annual review on pts on meds. its all tick box - fill in a form - what are the exclusion criteria lets beat GPs up because their pts are difficult. Stop doing process. locally our pain consultant has been doing a lot of talks on why not to use opiods on chronic pain patients and heart sinks - the rate of prescribing is down no silly boxes no mandatory call recall systems.

  • Sorry to disappoint, but RCGP isn't run by a cabal of government quislings

    Cynisus Doctorus's comment 28 Jun 2017 6:37pm

    MAcdonalds medicine has a great idea - instead of super practices - how about a new membership organisation that offers indemnity and training purchased at bulk.

  • Sorry to disappoint, but RCGP isn't run by a cabal of government quislings

    Cynisus Doctorus's comment 28 Jun 2017 6:35pm

    the reality is the RCGP is run by power crazed self publicity seeking individuals who have no concept of the real world - they spend to much time wining and dining at members expense in london. in my 17 years of GPing in the north of england ive yet to see any useful thing they have done or any meaningful engagement with my practice or locality. bring back the JCTGP. My view is they made general practice unattractive to a whole generation of doctors and have actively harmed the profession by not embracing things like special interests and staff grade equivalent type posts. only now when with the top 10 high impact changes are people talking about skill mix and signposting.

  • Time for GPs to say ‘No, because’ rather than ‘Yes, but’

    Cynisus Doctorus's comment 14 Jun 2017 10:22am

    Does this really help? You say no - you get a complaint that takes - 10x as long to deal with. and no one supports you - especially the two faced Medicines Management teams