Keith M Laycock
I had a similar experience:- A British National, Edinburgh Graduate working in Canada but doing locums in UK from 2008 - on Sussex & Weald Performers List - recommended Appraisals and Revalidated until 2018 - but kicked off the Performers List because of not having worked in the region for 12 months. When challenged, reason given was 'administrative reasons' - I could 'always re-apply'. Right.
Prior to that I had a 4 yr battle, ending with the NHS Litigation Authority, to obtain a Certificate to Practice. Despite being a Principal in UK General Practice for 5 years before leaving for Canada, followed by 35 yrs as a fully certified Canadian GP, I was deemed ineligible to practice and would have to go back into training for 6 months. Right.
If I had been trained elsewhere in the EU, the Certificate would have been granted automatically (and at that time without any need to show English language ability).
My 40 yrs of total GP experience was deemed not 'Equivalent' to the 2 year GP vocational training program - which did not exist when I qualified.
Anyway, the NHS Litigation Authority ruled in my favour and instructed the various GMC Committees to (get a life and) issue the Certificate.
I'm now retired!!!!!
All correct except advising a 'dummy' - the sucking on which results in aerophagy, resulting in gastric distention, resulting in bloating, discomfort, burping et al .......?colic & GERD.
And a quick wipe on the sleeve after the repeated drops to the floor (the dummy, not the baby) is not very antibacterial.
Unless toxic level doses are taken there is no harm in Vit D supplementation - other benefits of supplementation are recorded.
No need to test and waste money, simply add RDA Vit D to the COPD regimen.
p.s. include all Scots with or without COPD!!
The RCGP should stick to GP & in-the-field medical issues - and try to get those right - they have no mandate to don a mantle of political direction purporting to be representative of its membership.
There's so much wrong with this decision, difficult to know where to start. Except within the confines of their particular practice, 'specialists' overall know less about medicine in general and less about other 'specialists' practice than do general practioners.
Ask the dermatologist about medications or current protocols for heart failure or the cardiologist for targeted therapy with biologic agents.
The old maxim that specialists know more and more about less and less until they know all about nothing has validity.
They certainly have no insight, nor wish to have, into the actual lifes of patients.
Still, since there is little known about the real, rather than anecdotal, therapeutic benefits of cannabis, maybe that 'nothing' will fit well with their practices.
Whether cannabis should be prescribed at all, whether it should be decriminalised or legalised (as per Canada Oct. 2018) is the fundamental question.
However that question is answered it should be on based on the BIo-Psycho-Social Model. If it is to be prescribable, it is the GP who works within that framework, not any of the anatomically / system based specialists.
Until cannabis has been vetted in clinical trials as any other pharmaceutical / 'drug' and has been determined to efficacious and safe, it should not be a prescribable medication, by anyone.
Finally, maybe there is something in the distorted thinking that only a 'specialist doctor' can prescribe unlicensed medicines, this on the base that they will not know anything about it anyway.
Nothing could be clearer about the GMC's lowly view of General Practice as a 'decision must made only by a secialist doctor - not a GP'. Apparently supported by the BMA GP Committee's endorsement.
If the 'Specialists' had any sense they would refuse to accept this politicised responsibility.
At age 70, the CV risk based on age alone is 10% and the risk is stated to double every 7- 8yrs.
Medical marijuana has been prescribable for years in Canada, and it soon be fully legalised - nontheless the deaths from opiate overdoses continue to rise. British Columbia has the highest rate where it's about 4 per day, though March was high at 162 and July 134.
So that's one argument out the window.
Agree with David Banner's commentary.
Marijuana will be fully legalised in Canada this year after being available as 'medical marijuana' for a number of years. it is an entirley political decision unrelated to factual, data based evidence for efficacy in any but a very small cohort of medical disorders, e.g. reduction of seizures in Dravet's syndrome.
It's political philosophy/stance is to 'protect our youth and to get the criminals off the streets', verbatim from the Provinical and Federal Ministers responsible.
This is rhetoric and nonsense, if only because of the same intention relating to the succes of keeping alcohol and cigarettes out of the hands of the underaged. What a joke. Current study estimates that around 43% of 15-19yr old use, or have used, marujuana, and this while has been illegal.
There are currently 111 licensed commercial growers in Canada and the estimate of their combined production is over 400 tons annually of dried marijuanaamte. The 'average' joint is stated to contain about 0.5 grams. You work it out
Additionally, every household will be legally entitled to grow 4 plants for their 'own' use.
This is sheer madness and a long term social distaster in the making.
Canada will become the new Panama-Columbia. The largest Canadian grower, Canopy Growth, which has 1,000,000 sq ft of greenhouse space, already exports to Germany.
The only benefit for physicans will be that the 'needy' requests for 'medical' marijuana will be more easily refused.
Regarding prescribing marijuana, it is akin to precribing a bunch of foxgloves t.i.d. for heart failure.
Clear conflict of interest. As well as been a shameful proposal, it yet again illustrates the completely different and divergent mindsets of the bureaucrats 'managing' the NHS to those of physicians. A general misunderstanding of how the practice of medicine functions.
Based on her undoubtedly vast field experience in the actual provision of General Practice primary care, ask her how many patients per hour and how many work hours per week she would deem necessary for GPs to be recognised as 'delivering enough'.
Poor things: 'a busy work and family life'. Manage to fit in the hairdresser, massage, spa, gym, dentist, that necessary bit of shopping etc, etc, etc.
A Machiavellian route to the demise of the G.P., a.k.a. extinction.
They don't like you: they don't want you: and just because you're a bit paranoid, it doesn't mean that they're not out to get you.
Likely get more support and understanding as a primate on the endangered list.
Dr. Wilcox is correct and there is extensive evidence based medical literature and studies to confirm this view.
Other than diagnosing medical disorders which are absolutes preventing driving, there is nothing a GP can perform in a standard medical office which correlates to 'fitness (or safety) to drive'.
There is also case law whereby physicians have been held part responsible for MVAs caused by patients subsequently found to be 'unfit to drive'.
Pts will certainly not get 'the most appropriate medication for their needs', they will get the most appropriate, read cheapest, medication available to meet the budgetary needs.
Why not be really pro-active and go the night before. Another sheer madness scheme.
Apparently, GPs already spend 6 hours per day dealing with the EMR so how this decision will reduce work load is beyond me. Stoke up the fire and increase the burnout.
If the practices can't cope, they can't cope. How does offering an extra 48 pounds per patient help them to not cope?
If there are no doctors to fill the 16 full-time shortage, there are no doctors.
What is it the CCG's don't understand?
Symptom medicine rather than diagnostic medicine is alive and well in Canada with polypharmacy the norm.