Anon 4:09pm: Priceless!
I have seen more codeine than paracetamol addicts amongst my fit and (generally) healthy population of service personnel with back pain. This contradicts previous guidance on the use of MR opiates (we use tramadol) for a defined period (usually 2-3 months) with cessation if no benefit.
I didn't think there was a huge evidence base for epidural injections.
Amitriptiline can work wonders especially for breaking the chronic pain cycle with sleep disturbance. It makes one question what outcomes were being looked at.
Psychological therapies do help & are life transforming if one can access them. The problem with this guidance is it is detached from what is actually available in the real world.
I disagree with this article but I also have reservations about striking. Striking is the easy way out for the Unions. I just wonder if the BMA couldn't have figured out a more intuitive method of turning the screw. I worry the whole thing has become a politicised game of football between a stubborn government and a political BMA. The junior doctors are piggy in the middle.
I too trained in the early 90s with long hours but compared to now, the pressures are huge. I am often amazed by my GPSTs stories. It is a great sadness that the junior doctors have been led to this but I can understand it.
I used to be a GP in the Army & often on op tours we would work long hours in horrible conditions without a break. The difference being our tour ended & we had R&R for a few weeks. I can only imagine what it must be like for the juniors trying to do the same thing for 5 odd years.
I would thoroughly recommend Practice Based Small Group Learning. £120 per year. The cost is reduced by our local Educational Trust (Wessex) if you attend 5 or more a year. It goes towards funding the doctors who write the very well researched modules.
Agree with the InnovAIT endorsement. An excellent publication.
What the GMC seems to have completely overlooked is the support provided to soldiers when they aren't well. They have Welfare Officers, the Chain of Command, we can reduce the occupational workload, there is Army Welfare, a dedicated occupational health system, Personal Recovery Units etc. They also prepare for their deployments for a full 12 months and the families that are left behind are given an excellent support package. Despite this, we are still seeing a considerable number of Mental Health problems in our service personnel.
What do GPs get?
Perhaps if Lord Rothermere, owner of the DM Group, and his ilk paid a bit more tax in this country, we might have a bit more revenue to fund things properly.