The rate of property takeover promised since the new contract has been glacial at best, so good luck finding the funding to buy out every GP partner in Scotland with any haste...
Enjoy your writing Anthony - keep up the tremendous work, hope you get offered writing outside of just Pride month! - I agree re: missing non verbal cues, and have experience of affirmative symbols on both sides (my doctor's bag's various pins, patient's clothing/badges) triggering positive conversations and opening in-roads that wouldn't necessarily have come about otherwise.
Not remotely embarrassed, just genuinely astounded at 2,000+ words being directed to me and your ongoing sense of entitlement that a stranger should reply to your views. But I think it’s worth noting that the frequency with which an individual states “I’m not fragile” seems to have an inverse relationship with the reality, and the gulf between is probably the distance between here and Australia coincidentally. Maybe just look at the fact you’ve blustered yourself into calling a BME female doctor’s views dangerous for daring to diverge from your opinions which is probably the most Trump move out there. I’m under no obligation to engage positively with you, and using your perception of what defines “positive engagement” to assess the validity of someone’s argument means you can immediately balm your own soul if some uppity millennial/minority/woman has the gall to say anything you disagree with.
I think a fundamental intergenerational disagreement will always be the power in logging off - you will see it as weakness/embarrassment/fragility, where I see endless bloviating as a route to saying something that undermines your whole argument and a devotion to a meaningless online debate as a means to assert dominance and translate the typical workplace hegemony into your online experience. When it comes to prioritising the adjustment of an individual’s beliefs, having to put folk I know at the top of the list over strangers unfortunately.
Wrote an equally long and tedious unemotive response but couldn’t be arsed to engage with someone who unironically ends a whitewashing rant with the obligatory “my friend is Asian” story as if this validates all of your opinions on race, and narrates the story as if it’s an achievement worthy of some kind of praise. Frankly you got to me, I’m ashamed to admit, because this just exemplifies my issue with this site at the moment, and yes, I should just log off.
Fundamentally if you live in 2020 and you can do the mental gymnastics required to be wilfully ignorant of hundreds of years of past and ongoing oppression of non white males, you’re not worth the time for me. And that’s coming from a non self loathing white male who can live in the world with no real agenda, gain or need for a wee pat on the back for being what’s likely to be seen as an “SJW” seeing as I’m anonymous. But it is endlessly depressing seeing a talented writer like Shaba endlessly have to tolerate a bunch of fragile threatened egos every time she puts pen to paper. One of these days I’m going to do an assessment of the ratio of comments between white male contributors and female or BME contributors and it’ll probably be the day I quit this site, as a bunch of likely quite smart and compassionate folk (by merit of being a GP) can’t see the irony in instantly and aggressively shouting down anyone like Shaba to try and put them back in their place.
RIP to your relative Shaba - sorry in advance that this entirely reasonable article will attract the "but what about men/white patient" brigade but unfortunately I know you probably expect that by now. In Glasgow there's a definite similar trend and an undeniable skew towards BME patients ending up needing higher levels of care. I think you've summarised the uncertainty and the potential biological and socio-economic factors very concisely and it echos what our ITU colleagues are telling us up here. Hope you're keeping well yourself.
Pre-covid, I'm already so sick of having to call patients to then ultimately just have to bring them in to examine them, it just duplicates time spent dealing with things that hinge on solid clinical skills to manage appropriately. If we allow patients to self book telephone slots, they aren't able to identify themselves what does and doesn't need seen, so I still think all remote consultations need vetted prior and access controlled by the clinican not patient (or consumer as they'll become). In addition, I think mental health phone reviews are counterintuitive as they feed into the self-isolation mentality that is unhealthily driving their anxiety/low mood. Dragging people in can be uncomfortable for them, but face to face human contact is therapeutic as every front facing GP knows and it prompts more investment in their own conditions.
Would cost about £45mill. - happy to chip in my £1.50, and I'll cover yours as well if you find it that disagreeable. You're right, I could crowdsource the whole thing and call it the Christopher Ho Benevolent Fund in your honour for giving me the bright idea. I'll set up a GoFundMe when I get a mo.
I feel like you guys deserve a contractual 3 month paid sabbatical to repay you for this - I know you're getting paid, but losing out on that gap between qualification and starting the job is a real shortcut to burnout, let alone considering the conditions you'll be working in as your starting post.
@philosopher1 - just so I can assess the credibility of your repeated assertions, what exactly is your role, given that you self loathingly tarnish yourself with the plural pronouns that lead us to be believe you’re one of us, yet your status tells us you’re in training, and your comments and username have the content of a non GP troll, a 17 contrarian year old reddit user, or a broken bit of AI that seems stuck on the same non evidence based authoritative declarations about telephone consultations, PPE efficacy and GP pay. Just out of interest really, as it’s been a long time (since Pulse stopped registering people without a GMC number) that there’s been someone this persistently insufferable lingering on these comments. If you despise the status quo, take on shifts in an assessment centre (staffed here by GPs working exclusively face to face), or get back to the hospital that you revere - “cowards dare others to do what they themselves dare not do”.
@doctor Lou - gold standard practice for public health and hospitals seems to be three simultaneous swabs put into pcr fluid - 2x nasal and one pharyngeal. That may account for it.
@oncehadavocation: have you got a rolling rota of other professional forums you cycle through when you’ve had a crap day and want to spit some venom to make yourself feel a wee bit bigger and better, or is it just GPs you grace with your presence? Because it’s a been a three years commitment on your part, I can always point you towards the dentists or the psychiatrists who haven’t got much coronavirus related work on at the moment if you want a change of scene, you could use oncehadadentation or oncehadamentation if you want, just an idea, you can have those ones for free, though I’m sure you could work on something punnier if you can fit it in your seemingly busy day.
@1:27 It literally says in the article. It’s 20,000 deaths for covid19 as a good outcome (best case) vs 8,000 flu related deaths. Not the most difficult rationale for being concerned to comprehend.
@dr Jub - that’s the issue, it’s probably good - at the pulse conference the pro-online triage presentation was compelling, they have good case studies etc - but just can’t fathom how distasteful it is both writing, and unfortunately for pulse, publishing something like this right now. Askmygp doesn’t seem to be the most insidious threat, but it’s just emblematic of other private industry, medical and IT, using this opportunity to sneak in the back door and profit while we’re all struggling and patients are going to start dying in substantial numbers. Also see the video consulting kit that was installed in our practice this week without any real approval or consideration.
@Andrew Hills - I haven't seen a single useful bit of guidance from NHS England, Scotland, government, even local clusters/LMCs about this conundrum. Would be interested to know what on earth we're meant to do - especially care homes/nursing homes lacking in ANPs/clinical staff.
Advertorial content during a pandemic isn’t a great look as a company. This whole article seems poorly timed and completely tasteless.
Speak to anyone in GG&C, it's not pension related. They've not actually formally enquired why young jobbing GPs aren't taking shifts. It's because the pay is terrible and the conditions are unsafe. They're hiding behind the pension scheme (ie. a GP led issue for being too "high earning") when actually it's that they pay ~£50/hour net to do house visits in the some of the most deprived and dangerous parts of Scotland with no back-up. A locum session can exceed £300 in hours, so why would anyone take on OOH?
In addition they have an attitudinal issue that immediately makes any GP bristle, as they repeatedly email us telling us "our patients will thank you" for taking on OOH shifts - I don't think my patients would appreciate me turning up having worked an additional 4-12hrs the night prior to my 11 hour days.
£57/hour at some sites and for home visits during this period of crisis. Take home of
I agree that an improvement in clinical skills, recognition of pathology etc needs incorporated into the RCGP portfolio in a more rigorous manner than the completely arbitrary and useless "CEPS" system which fixates on intimate examination at the cost of a solid CVS/Resp/Neuro/Gastro/MSK assessment - but why do we have to have such a binary approach to everything - it's possible to pride oneself on having both well developed set of clinical skills and communication skills - we shouldn't write off communication skills as "soft skills" as they can be just as tricky to navigate, and I would suggest I see more repeat visits because of poor rapport/explanation/clarity of management plans than missed pathology (though I've seen several missed symptomatic cholesteatomas recently - more so I think because I've got better kit than others rather than better skills) - though that's just my anecdotal impression.
I would suggest more of my meaningful and useful 'pearls' picked up along the way are to do with clinical examination and spot diagnosis rather than new guidelines and management.
I do also worry that in having a set of assessments that means you almost never have to touch a patient, some newer GPs aren't examining people with the rigor and discipline that they should primarily because of squeamishness about human contact rather than time (though this is what is always blamed as we're very good at convincing ourselves we don't have enough time for something).
New contract does nothing to address out of hour shortages. The pay is appalling, and receiving emails weekly that blame me for not being willing to work doesn’t encourage me to do so. They had a charismatic and enthusiastic clinical lead, but even he’s now gone, so it’s just unsafe conditions and poor pay left behind. Also the trainee shifts reinforce how unsupported you’ll be post CCT, so they also need to fix the registrar experience to encourage people to stay on. Even nearby Lanarkshire has better support for trainees on OOH.
Anonymouse - that’s a different user. There’s no space between devil and advocate in his username. I’d made the same mistake and misattributed comments hence the retraction above.