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A faulty production line

Nick Taylor

  • Health secretary to impose new contract on junior doctors

    Nick Taylor's comment 11 Feb 2016 5:23pm

    Hang on a minute. You all work 1 in 4 Saturdays, at least I did at the bare minimum, so does the Saturday hours change really make much difference? Those Saturdays last twelve hours. Usually 9 til 9 or such like. And then a 13.5% increase in basic. So you have only taken the hit on perhaps three to four hours on a Saturday night and by maybe 20-30% on those days. That three to four hours is less than 13.5% of your total hours.

    40 or so % of people were in for the strikes because 40 or so % of people already work the hours he is talking about. No one is going to rota any more as we already provide the necessary care.

    It is all a deconstruction and I understand the complete loss of trust from everyone and the desire to leave. And I completely understand he is a total Hunt. But we have the public support which I think is important. Despite how much they have disregarded it with this imposition.

    But it seems to me that including the safeguards this not a bad result. We didn't "win" but who was ever going to get a 100% result. But we did gain some ground and outed his disrespect to the media and public who took our side.

    I would be keen to see how the pay calculators we this for current rotas.

    I can't stand the man and I hate what his long term plan is. But to look at this pragmatically surely this was a better than expected result? What could we have possibly hoped for in addition other than a complete step down which was just impossible?

  • GPs should be given individual reports on their antibiotic prescribing, recommends NICE

    Nick Taylor's comment 18 Feb 2015 1:57pm

    12:36 I am not sure what you are advocating? Clinical, evidence-based decision-making based on well documented facts at the time? Or blanket antibiotic prescribing and defensive medicine?

    Surely you do not mean we should prescribe antibiotics for every ear infection in case of a future mastoiditis? And if you saw someone with ear pain and documented - no effusion, no mastoid tenderness, no headache and apyrexial and a clear safety-net how could you be blamed if it progressed? I am not sure the MDU expects you to see the future....

    Missing sepsis is very different to prescribing antibiotics for a benign self-limiting illness.

    I would rather take the chance personally than be bullied by litigation into prescribing defensively against my findings... Surely that is what this article is attempting to highlight?

  • GPs should be given individual reports on their antibiotic prescribing, recommends NICE

    Nick Taylor's comment 18 Feb 2015 11:05am

    I am a locum so am exposed to a huge array of antibiotic prescribing. On the most part it is terrible!!! I whole-heartedly agree with some personal accountability - I would happily take that on myself and currently audit my own prescribing as it annoys me so much!

    The expectations of patients and the general health beliefs of the population are severely damaged by Drs giving out antibiotics for ear infections, sinusitis, viruses and bronchitis that are entirely not indicated and is just lack of assertiveness, poor communication of the lack of need or just laziness which then leaves you in a difficult position of "well, last time I got them" which then undermines you when you justifiably refuse, resulting in repeat consultations with GPs or secondary care based on incorrect health expectations.

    If you document your history and examination correctly and make a decision based on this and then a further bacterial infection develops then how are you accountable in response to 10:20? Every decision cannot be made with the benefit of hindsight.

    And if you excluded everyone coded for rescue antibiotics surely that would remove the issue of CF/COPD/bronchiectasis?

    I am worried there is going to be a crisis in resistance well within my career.

  • GPs to face 8% rise in GMC fees from April

    Nick Taylor's comment 11 Dec 2014 10:46am

    And thats before tax.

  • GPs to face 8% rise in GMC fees from April

    Nick Taylor's comment 11 Dec 2014 10:45am

    Bit of perspective here guys....
    Inflation is say 3% ish. Five years of inflation equates to a 15.9% increase roughly.
    A 7.69% increase is less than half of inflation - so in essence a drop in fees.
    And it is £30 a year. <10p a day. Or a round of drinks.
    I know morale is bad but I think we can cover
    it....

  • BMA warns over proposal to remove pharmacy checks on naproxen use

    Nick Taylor's comment 16 Apr 2014 1:44pm

    But you have Beecham's on the same shelf as generic paracetamol. And aspirin on the same shelf as ibuprofen....

  • Gabapentin 'could help treat alcohol dependence'

    Nick Taylor's comment 19 Nov 2013 9:58am

    I completely agree on the concern re: abuse. It would create a whole new gabapentin market within communities of people already proven to have a substance misuse problem. It may work on a an individual basis but would be terrible for the health of the community and produce a huge burden on GPs as I expect a large proportion of the alcohol abusing community would demand to be put on it with no way of measuring response or outcome reliably. Please, please, please don't make this a recommendation. I spend long enough in prison arguing about gabapentin/pregabalin - I don't want it to take over my days on the outside too!