In the long run unless you have a medical degree you wont be the one carrying the can when things go wrong.The ultimate responsibility is always the doctors.
This comment has been removed by the moderator
Great stuff ,Shaba -we as GPs are all too eager to "please"-to accede to every whim presented to us by our patients.
Can we hear your views on gender selected abortions next!!
I can remember a GP of old who became so disillusioned with his patients that he left a basket of drug rep samples with a notice saying "Help Yourself" in the waiting room and just pushed off! I must admit this is tempting but professionally suicidal.
The unnecessary garbage from NHS111 sent through to GP surgeries is actually dangerous to safe follow up by the GP because busy GPs are simply not going to bother reading it and could miss something of clinical importance as a result of the OOHs contact.
Yes agree absolutely-secure a longterm locum and top up with OOH. This is exactly what Ive done in the last 2 years since retiring as a GP principal.You get much more involved with a practice that way and even start to build up a bit of a clientele. Ive done it with three practices in succession. Another tip is if you dont see any suitable locum posts but see a suitable salaried post offer your services as a longterm locum in case the salaried post is not filled.
The RCGP has always had an exclusive , old boys club feel about it . If you dont speak the impenetrable correct lingo ,nor look like "one of us" they're not interested in you joining the club. I failed the MRCGP orals twice 35 years ago because I looked like a hippy but am still practising successfully at 64 .Being a non-member hasnt in anyway impeded my career . I feel sorry for those who today cant jump through the necessary hoops and are excluded.
Congratulations to Dr Gibson for having the resolve to fight the unjust treatment from NHS England and the GMC ,both of whom have in recent years become very heavy-handed particularly with foreign doctors.
I think we are talking about the wrong type of GP -it is salaried doctors who are paid too much -regular income often with incentives for extended hours work, average of 7 weeks paid holidays and training , sick pay and often other financial benefits , all without any real responsibility for practice management. Locums by comparison get a very raw deal but are sometimes the backbone of unpopular practices that fail to attract partners.
Unhelpful,cynical ,partisan prejudiced attitudes like the last contributor do nothing to enlighten the debate .Get real -the City is the jewel in the crown of the British economy and we would all suffer if we dont nurture it. Your lot(the Labour Party ) had 13 years to p--- all the money away.
The whole concept of non-medical persons triaging medical symptoms using a computer pathway is hopelessly flawed. NHS Direct never worked effectively so why Mark 11 should be any better I have no idea. There is no substitute for doctor or experienced nurse practitioners as frontline triagers.
Here's a recent e-mail from Harmoni to its clinical staff ie GPs and Nurse Practitioners who end up with face to face consultations as a result of triage by 111:-
"If a call is passed for visit or for PCC following an NHS 111 Pathways consultation,we are not allowed to retriage the calls .If you feel the NHS pathways has produced an incorrect disposition (visit/PCC) or incorrect urgency level, please complete one of our clinician feedback forms which can be found on Connect......"
No doubt these forms will be comprehensively ignored. This reduces clinicians to mere unthinking labourers. I anticipate Harmoni will be inundated by these forms.
I usually deal with patients anxieties when they present with a histiocytoma by rolling up my trouser leg and showing them the one on my calf I have had for 25 years!
Sorry Bronwen but you are deluded if you think the Labour Party has anything to offer to this debate.It was partly because of their financial mismanagement of the NHS that the Coalition introduced such a radical overhaul .Dont forget the legacy of debt due to PFI that Labour left us. Lets face it, the Health and Social Care Act is a great leap in the dark ,a massive economic experiment and we have no way of knowing whether it will work or not. Whoever is in power in 2015 would be unwise to tamper with a new system still in its bedding in phase.
I think leave it to fertility specialists to select suitable groups of patients with the highest "take home baby rate".Fertility treatment is not a human right ,its a lifestyle choice and it would be crazy to enforce these sort of decisions on CCGs by legal action given the current financial strictures within the NHS.
Well done Shaba -you have really stirred up a hornet's nest with this article. But how to confront the entrenched attitudes of college examiners who want clone like trainees all spouting the same sort of college drivel ! I can remember one of my trainees an excellent and experienced Malaysian doctor who fell foul of the dreaded video consultation exam because some prat from the college didnt like his style. You can probably guess Im not a college member! Your old retired partner.
Whilst I broadly agree with switching to lower doses of simvastatin or switching to atorvastatin I would point out that cases of myopathy and rhabdomyolysis occurred with very high simvastatin doses rather than a moderate dose of 40mg. Amlodipine is not exactly a clean drug as swollen ankles nasal congestion and facial flushing are common side effects. An alternative plan would be to change to a sartan (which I did when I suffered from these side effects).
It saddens me to hear the fear of litigation amongst some commentators.Take a chill pill guys! If you have a good relationship with your patient and adequate safety-netting within consultations you leave the door open for the patient to return if your course of action doesnt work out for him or her. Dont forget that intrapractice referrals are a good way of accessing expertise eg parners with a special interest in dermatology,cardiology gynaecology or musculoskeletal medicine and reducing referrals to secondary care.