Really really thought provoking article.
Stay safe Coppers
Jaimie - this is super helpful
Will go into my daily staff briefing. Thank you!
Lots of misconceptions about this research.
I am proud to have been one of the GPs involved with this study and I'm certain I have over estimated benefits of treatment.
This research is a forerunner to actually doing something constructive about the problem.
The problem is that there are no up to date, system-wide tools to assist clinicians with making treatment choices in partnership with patients.
Ivan - of course it is about making decisions in partnership with the patient as there are 2 types of expertise - the doctor and the patient. But as this research shows, sometimes the doctor's expertise is factually incorrect.
As for being bulldozed into treatment by NICE - this is also incorrect if you read the first few pages of every guideline, which emphasises the importance of a patient centred approach.
Shared decision making with proper documentation actually helps you with managing risk and doesn't increase it
I am left wondering:
1. Why you are blaming patients for your poor access system?
2. Why you think a nominal fee won't have the same exemptions as prescription charges?
3. Whether you are in the right job?
I am also struggling to make sense of this article.
There are valid points about the gender pay gap and it appears you are working very hard. But I'm baffled that you are blaming this on the sexist partnership model, rather than your personal domestic arrangements.
I'm not sure you appreciate the privilege and choices you have at your disposal. Being in a relationship with another GP means that you can both work as part time partners (or salaried or locums) and reap multiple benefits of retaining your personal tax allowance, a lower pension rate and possibly retention of child benefit as it's based on individual income and not household income. If you are salaried, you can also claim for a salary sacrifice scheme for childcare vouchers.
It also means you can have an equal share of childcare which makes you less burnt out.
I am entitled to none of this as I am the only earner in my household. When I was a Partner we had a fantastic Partnership relationship and we sat down and talked about our values and work life balance. This is something which is more difficult to do as a salaried GP.
I think job shares are the way forward and as so many partnerships are desperate for succession planning, they are likely to be open to negotiation.
I think it's difficult to negotiate an easier day every single day as someone still has to be on call. But if it's only once a week, you can make arrangements for cover with your husband and visa versa.
But maybe I have misunderstood the issues - I'm not sure
Please stop being tribal - Sam and Margaret are the good guys and have campaigned tirelessly against stupid non-evidenced based government gimmicks
They are trying to help!
"The other week, I had to drive a frail, elderly lady with advanced lung cancer and 02 saturations of 80% to A&E myself, because it was 8pm and the emergency ambulance I’d requested failed to turn up."
The system is broken. Not just because of the failure of the ambulance service, but mainly because we have somehow normalised a scenario of prolonging life at all cost.
It's not just about politics. It's also about rethinking what we are doing in medicine, at what cost and for whose benefit.
I'm sorry David but I think you have over simplified a very complex issue
Is there evidence that working classed doctors are more prevalent in deprived and under-resourced areas? If so, is this because they choose these areas or because it's the only place which will accept them?
And it's much easier to be a "champagne socialist" and do your bit for mankind when you have a huge safety net in the bank of mum and dad and their inheritance. So many "posh GPs" end up in challenging areas as they are doing their bit for society
I came from significant poverty. I never want to go back there so money was very important to me in partnership conversations. I wanted to work in a nice leafy suburban middle classed area but no-one would have me. So I ended up in one of the most deprived areas of the country!
I agree you don't need academic intelligence to be a good doctor but you do need emotional intelligence, good problem solving skills and resilience.
I think all universities have become overly competitive for all subjects and it's leading to an increase in mental health issues in the young
What the hell is full-time?
Difficult to interpret this report when there is no definition of full-time.
We all know that working more than 6 sessions in practice is more than full time
This is why asking people where they are from is really, really annoying
Wow - what an amazing GP and human being
I am really uncomfortable about financial incentives for screening uptake by patients.
Screening should occur only after a well informed and robust shared decision making process so the patient is acting according to their values.
Money has no place in this dialogue as it may bias the quality of balanced information given.
I've stopped asking people how they are. I ask them what they would like to discuss today.
Sorry you are going through all this and thanks for your really honest insights
Please see my post
When my son started year 6, I expressed my concerns at a parents evening, when I noticed the huge disparity between his written and verbal work. My concerns were dismissed when I was told he was lazy!(which I believed!)
It also went unnoticed when he started secondary school but I started noticing his spelling was worse than his youngest sister who was a full 4 years younger than him. Still no-one at school said a thing
His behaviour worsened as he couldn't write or keep up so in desperation I got him tested privately. I was told he was a barn door case of dyslexia with high intelligence.
My nephew was diagnosed in the 1st year of uni. It is common to miss the diagnosis in people with a high IQ who compensate for this disability.
Thanks for sharing.
Dyslexia often goes undiagnosed in above intelligence kids because they are still performing averagely or above.
I had huge problems having my concerns addressed for my son until I arranged a private assessment and he is barn door dyslexic.
It is NOT a middle classes excuse for doing badly at school. My son is now much happier using a laptop and typing instead of writing at school
Ivan - I would really like to see how many patients would accept a statin (or any other preventative drug) if a genuine shared decision making consultation had taken place, with the appropriate patient tools, time and clinician knowledge.
I suspect very few....
This is fantastic news for general practice.
Not sure I was reading the same article as everyone else but I actually thought this was a pretty balanced view
Well done Helen and Kamal
I did a retrospective audit of lung cancers in our practice (following a diagnosis in a young patient who had a normal CXR 8 months earlier)
High platelet count was one of the risk factors
I wonder if ethnicity would impact on these parameters though?