Thank you Jamie. So few out there in the forum, whichever side they sit, have the foresight or the will to acknowledge that everyone makes mistakes, but that some have to make so many life-changing decisions that even the few mistakes of the conscientious can have devastating effects. It’s not how many mistakes, it is the nature of them that makes the difference. And the factors that promote more mistakes to happen.
Interesting reading in the comments here. Ponder this- could some of your comments re: retention, managing the adversities of working in GP today, and even descriptions of ‘heartsink patients’ reflect your own backgrounds, where you came from, where you saw your careers and lives going when you first embarked on your paths?
You are all so fixed on the’shit hole’ that is General Practice here and now, but changing that in the long term is about a hell of a lot more than making our own beds more comfortable, it’s about engaging and encouraging the people who will be most contented and prepared to work in future GP. Addressing the issues from all sides.
Also, as Richard Vautrey is saying 'This builds on this contract and will not replace it. Nobody will have to give up their existing contract,'...I wonder if this is up for being voted on? I suspect from the wording that it is a major contract change brought in through the back door, and ground-floor GPs may not get their say on it, unless you fight. If this is not a ‘new contract’ there is no obligation to canvass the membership, only to inform...
Beware all ye English GPs... look closely at the Scottish contract, and the ‘cluster model’ being tried up here. When QOF abandoned in Scotland GP clusters were formed of supposedly similar types of practices and localities to become the driving force for ongoing Quality Assurance and Improvement. In some areas it has worked and practices have been able to co-ordinate activities. However many areas have collapsed, with no co-operation, and still more where 1 practice has become dominant in the cluster and others have either stood back to let 1 take all the pressure, or ‘power houses’ have developed. InScotland the framework is less proscribed, but I fear a more formalised or even forced structure will create definite winners and losers, and potential divisiveness in areas where very different practices are forced to combine services or organisational structures. And if ‘incentives’ or ‘penalties’ are then added, the downward spiral of power plays and manipulation are never far behind...
Excuse me Hot Felon, I’m not in the least bit bothered by titles, unless it is clearly being used to belittle someone- yet another clear example of bullying behaviour. I am a Dr, with GMC registration just like everyone else here, unless you falsified a number to get a sign on to post here. Plus a license to practice on the GP register, which I suspect some of you are not. The only one that looks like a numpty is you if you think you can get away with hiding your insulting bully tactics behind clever denigrating sarcasm.
So, Mr. ‘I don’t have the balls to put my own name to my insulting comments’ Hot Felon, do you feel big now?
You’ve said it all in one sentence Janes Wallace. My job here is done. Good luck.
I am astounded how, day after day, medics, and worse still GPs can be so far up their own a***s as to write something so profoundly insulting about colleagues, yes COLLEAGUES, just to justify their own sense of superiority.
This article is nothing less than bullying on paper, with a thinly veiled attempt at anonymity of the victim. It is backbiting, it is damaging, it is unprofessional and it is just plain rude. I’d like to see how you would manage a vacuum-pump dressing in a poorly-lit room, and then see how you felt at being ripped apart in a nursing rag and ridiculed because you were reaching beyond your station. And you wonder why bullying is headline news in the medical profession- I’ll lend you a mirror as it seems yours is broken.
Guidelines? Or Protocols? Guidelines aren’t to be followed , ther are there as a guide to options, to be consulted as a support to clinical decision-making. Here comes the danger so many have spoken of with over-reliance on ‘guidelines’ and their institutionalisation- the workers took becomes the stick with which to beat them...
Ahh, so GPs are also expected to be experts in international law as well, and of course patients have no need to assume any responsibility for anything as the GP should know it all and take all responsibility for the patient’s choices and behaviour. So is that what is meant by realistic medicine?
S’ton class of ‘98?
Don’t worry, David, you’ve not heard the last of me yet! Back to work tomorrow (slowly!), far to much life to be lived to be giving up! :-)
David Banner- I think you are right in much of what you say, and you are recognising what I fear many others are not. However, with that it is easy to believe that everything has changed. The reality is very different, as can be seen in some active Twitter thread from medics, nurses and other HCWs in Vritain and elsewhere. It’s easy to believe something doesn’t happen just because you don’t see it yourself.
Touché. Nuff said. It seems the spelling of the gender types has also changed some I was in Primary School (slightly less than 40 years ago)...
Do you realise, AlanAlmond, that you have just fallen into exactly the same trap as I mentioned in my comment yesterday. I suspect you don’t, which just highlights the hold that cultural biases have on our thinking and behaviour. And round and round the hamster wheel we run, completely oblivious to the fact that we haven’t actually moved
Correction-‘...if you are a trainer- seriously think back...’
Reading these comments, I can see a lot of cognitive dissonance creaping through, in a similar vein to my blog on non-GP partners a few weeks ago. There is a lot of emphasis put on the title, the label. Defensiveness in the form of ‘I make my own coffee’, but very little recognition amongst the male respondents of the very real disparity between the GP workforce numbers and the numbers in roles of leadership and management, the GMC, BMA, CCGs, HBs, etc. There is an unwritten, unspoken and unrecognised bias in education and training. If you are a trainee, seriously think back- male, female, BME or other differences- did they all get the same emphasis re: clinical skills, communication skills, management skills, leadership skills. We’re the differences truly down to just their individual strengths and weaknesses, or was there a subtle shift in what you expected of each of them. Cultural bias is a silent master- you will never see the chains it holds on you til you look deep
Yes, doctordog, it probably will:-( Most cultural and thought changes do. Look st the inertia re: Safety and Systems thinking, and Human Factors & Ergonomics.
And I get your point re: courts and GMC views on responsibility. But again, there is accountability for your actions and overall responsibility. Bear in mind, though, vicarious responsibility, whereby
“However, as an owner or partner in a practice you may be responsible for liability arising from other elements of the business, for example:
vicarious liability for the acts and omissions of other healthcare professionals or staff at your practice;” MPS https://www.medicalprotection.org/uk/for-members/faqs/will-MPS-assist-with-other-liability-arising-from-my-practice
No mention there of the owner/partner being medical. But that’s what everyone assumes, because we all ssume it or let it be.
This blog is ‘Food for thought’, not a ‘we should all do this’...
Shaba, I agree that the Tsunami of dumping is not GP initiated. But can you really say that the medical profession in general has been particularly enthusiastic about sharing responsibilities? Nurse practioners, non-medical prescribers (dental less so, but nurses, pharmacists), nurse endoscopists, even nurses doing the bulk of chronic disease management, etc took years to be accepted, in large part due to medical resistance to accept that anyone ‘less’ than a Doctor was capable. The ‘Dr informed ‘ cult is a direct result of nursing and AHP colleges and professional bodies trying to protect themselves from historical and public images of the Dr being the pinnacle of the healthcare hierarchy, and we do nothing about it, other than complain that nurses are going beyond their abilities (or their status?).
Now, clinical skills and responsibilities are one thing, but this blog is about managerial and leadership skills and opportunities. It is about the culture of teamwork, equity. Medics have borne the full weight of responsibilityfor so long that we can’t even see the possibilities to share that weight, especially as we get thinner on the ground and both demand and complexity sky-rocket.
Somethin’s got to give, and it’s either changing the Primary Care model, or losing it altogether
PS- autocorrect at it again- meant to say ‘Tweeking a bit...’ not ‘Tweeting...’