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Gold, incentives and meh

Midlands Doc

  • Are there too many posh doctors?

    Midlands Doc's comment 11 Dec 2019 8:17pm

    Interesting article - fascinating comments.

    Being a GP is now completely impossible. Social class / sex / ethnicity - all irrelevant. We need individuals who are bright enough to complete the training - yet daft enough to sign up for the job!

  • Highest number of appointments ever as GP numbers continue to fall

    Midlands Doc's comment 28 Nov 2019 11:34am

    Link to report is -
    https://digital.nhs.uk/data-and-information/publications/statistical/general-and-personal-medical-services/final-30-september-2019

    Interesting document - one could easily spend all the long gaps in a GP day glancing through it. Many docs will only get as far as the opening definition of a full time GP's workload!!

    "Full-Time Equivalent
    is a standardised measure of the workload of an employed person and allows for the total workforce workload to be expressed in an equivalent number of full-time staff. 1.0 FTE equates to full-time work of 37.5 hours per week, an FTE of 0.5 would equate to 18.75 hours per week."

  • GPs' working conditions are 'lonely' and 'damage' patient relationship, warns GMC

    Midlands Doc's comment 18 Nov 2019 10:17am

    "General practices are developing new roles and working in primary care teams to better support GPs, they’re designing services – with patients and communities – to ensure preventive healthcare, using technologies to manage demand, and developing healthier and more supportive environments for GPs and their staff."

    The usual twaddle hinting that it's really all GPs' fault - if only they didn't just sit on their idle asses and just got on with it and "instituted best practice".

    That's what we need - more meetings about best practice.

  • We must convince graduates that general practice is 'exciting', says Ashworth

    Midlands Doc's comment 14 Nov 2019 11:16am

    Do you remember those pod things in the movie 'Alien' which burst open and produced - well - aliens?

    This Ashworth chappie has been incubating in the pod next to the one that hatched Matt Hancock

  • GP practice warns new patients they will not routinely prescribe opiates

    Midlands Doc's comment 06 Nov 2019 7:27pm

    Well done the Springburn Health Centre. I hope that they stick to their guns.

  • Mitigating the effects of the new coroner reporting rules

    Midlands Doc's comment 04 Nov 2019 2:48pm

    Very helpful.

  • Over seven in 10 doctors face ‘superdoctor syndrome’

    Midlands Doc's comment 04 Nov 2019 12:27pm

    David Banner - rather bravely - 'describes it exactly as it is'. He is also probably right about 'how its going to be'.

    In small to medium partnerships, one doc's flexible approach is another doc's MI.

    I suspect the situation is exactly the same in most DGH consultant teams - especially if they are involved in acute admissions.

  • Genitourinary syndrome of the menopause

    Midlands Doc's comment 29 Oct 2019 6:44pm

    Useful update of current therapy and thoughts on a very common problem.

  • MDU admits 'dwindling funds' to cover GPs' future claims

    Midlands Doc's comment 23 Oct 2019 10:20am

    The medical defence organisations' (MDOs') subscriptions have historically been set towards large pooled funds to cover likely future claims against members.

    Attempts to use members premiums to 'buy policies' in the larger insurance market have failed.

    It was always the case that the 'smaller the subscription the less secure the funding for future claims'. An MDO could only really affect this fundamental truth through four methods - weeding out 'higher risk doctors', being ruthless at defending claims, attempting to 'educate their members in risk reduction' or keeping overheads down through sheer size. I suspect all three major players in the market were trying to use all four techniques as best they could.

    It has always been the case that reducing premiums (perhaps better described as members' subscriptions) increased future risk - NOT just to the MDO but to all the members of that MDO.

    I was always struck by the naivety of GPs who though that they were 'buying car insurance' and could just 'go for the lowest premium'. The size of an individual doctor's indemnity costs are always trivial compared with the effects of even a single significant claim for damages.

    I was not a member of MPS - my practice had 'always been MDU'. I felt though that MPS's higher subscriptions (higher than the final year of MDU fees and much higher than longer term MDDUS charges) suggested a possibly more sensible approach to ensuring that future risks were covered.

  • Judge finds in favour of GP practice that refused to post medical records

    Midlands Doc's comment 21 Oct 2019 10:42am

    Practices though, it seems, are still stuck with the vast workload of producing copies of records 'for free'.

    Government departments - such as HM Tribunals and Courts Service - have stopped paying anything for copies of medical records and just give appellants (your patients) a letter demanding full copies of notes.

  • CQC, take your own intelligent advice

    Midlands Doc's comment 17 Oct 2019 6:20pm

    This whole business is really really simple. No one should be allowed to comment on another clinician's work unless they have at least 20 years full-time experience in a reasonably well functioning practice.

    Loafing around an academic department or plonking your way through RCGP meetings does NOT count as full time experience at the coalface of primary care.

  • Four in 10 GPs in favour of charging patients for appointments

    Midlands Doc's comment 10 Oct 2019 11:45am

    I'm against billing the patient - but the three medical systems that lie geographically nearest to us - all charge for a primary care contact. (France, Ireland and the Channel Islands).

    Charges vary between about 18 and about 50 pounds. There are exemptions (in Ireland), refunds (in France) or a state contribution (in the Channel Islands).

    It is my impression that access to all three of the above primary care systems is generally rather better than in the UK.

    I note though that all three areas - like the UK - have recruitment problems. The situation in France - where the charge is lowest - is helped by the excellence of the hospital system.

  • Just say no to drug (shortage)s

    Midlands Doc's comment 03 Sep 2019 6:59pm

    Any chance of a patient shortage?

  • Government to end 'one-size-fits-all' NHS Health Checks

    Midlands Doc's comment 18 Aug 2019 2:27pm

    Always worth googling the 'other voices' who 'chip in' when the minister speaks.

    Have a look at Duncan Selbie's Wikipedia entry (Public Health England chief executive).

    He 'joined the NHS as a teenager'. According to Wikipedia he claims no special public health knowledge. He earns just south of £190K each year.

    The key skills required for this post?

  • The King of Complaints

    Midlands Doc's comment 01 Aug 2019 9:07pm

    Just guessing - the 100 page close typed complainer - suffers from CFS / ME?

  • What to do with lung nodules

    Midlands Doc's comment 28 Jul 2019 1:45pm

    An excellent article.

    A rather depressing reminder of the mind-numbing complexity surrounding just one single type of incidental investigation finding.

  • Revised benefits letter still 'misleading' GPs about issuing fit notes

    Midlands Doc's comment 18 Jul 2019 11:00am

    The policy of trying to persistently bamboozle everyone who comes into contact with ESA is not accidental.

  • Practices must define their own thrombocytosis threshold or risk missing cancer

    Midlands Doc's comment 18 Jul 2019 10:57am

    Excellent article- perhaps the most interesting primary care clinical piece that I have read this year.

    I suspect that there is far more mileage in evidence based data mining of our existing records than in trying to replace GPs with an AI driven interface.

  • Beware of thin notes

    Midlands Doc's comment 18 Jul 2019 10:51am

    Good luck old son.

  • The tragic legacy of our serial GP reforms

    Midlands Doc's comment 03 Jul 2019 10:40am

    Excellent article - the whole point of General Practice is building long term relationships with patients and their families. It is just utterly meaningless otherwise. One might as well work in a call centre.