The chickens will come home to roost....
I have spent time in hospital medicine, but it is only in General Practice that we have the opportunity to make an initial diagnosis, refer or treat appropriately and follow up the patient long term, through the highs and lows of their lives. We see the whole range of conditions and become acquainted with the area in which we practice in a way that no other career path in medicine offers. The problem is not the job itself, but the bureaucracy that surrounds it. That is what needs sorting out in order to attract the very brightest doctors to General Practice.
There were 1,167 deaths from asthma in the UK in 2011 (18 of these were children aged 14 and under), so we aren't getting it right yet. However, these are draft guidelines, and the majority of people responsible for them were specialists (there was one GP involved, as far as I can see). The draft guidelines are still open to consultation and comment (from GPs who may disagree with the practicalities in primary care). They also carry the disclaimer," Healthcare professionals are expected to take NICE clinical guidelines fully into account when exercising their clinical judgement. However, the guidance does not override the responsibility of
healthcare professionals to make decisions appropriate to the circumstances of each patient, in
consultation with the patient and/or their guardian or carer."
John - you can control vermin with bait boxes and trapping eg Larsen and crow traps (I am also a farmer). Whilst I respect those engaged in gun sports, I have personal grave reservations about signing gun licences. Perhaps the answer is for the police to make more use of their registers, including those for domestic violence, and for more than one person to have to sign the licence.
We already see patients who are over treated, causing a significant impact on their lives, such as old ladies in church collapsing when the hymn singing begins and their intra thoracic pressure rises. BP is dynamic measurement - will just one raised reading over the target on a 24 ABPM initiate treatment? This is medicine by numbers, not holistic care. ..........but then, numbers are easy to measure and quantify, unlike genuine health and well being.
I wonder if these lady MPs consider themselves as placing a "tremendous burden" on their constituents and Parliamentary colleagues? I am sure they also make time for their families and consider themselves no less committed than their male colleagues.
The real issue is in training enough doctors, by factoring in the likelihood that women entering medicine will take a career break at some stage.
When I first became a GP, we used to try very hard to avoid polypharmacy in the elderly. We now have numerous patients on multiple medications as a result of complying with QOF and NICE guidelines. Many of our patients do not really understand what they are taking or why and many would probably decline to take them if they had the NNT properly explained to them.
Working on the front line in General practice is one of the most rewarding roles in medicine. Who wants to watch a sleeping patients or specialise in foot surgery? We have the opportunity to make lasting relationships with our patients, which facilitates early diagnosis when they are ill. Our knowledge of family dynamics and local dynamics gives us an unrivalled opportunity to help our fellow human beings.
Tick box medicine and over rigid training schemes are fads and it is up GPs to campaign for the well being of our patients and a holistic approach to those in our care.
Those who are responsible for workforce planning need to look at the increasing numbers of women entering the profession and facilitate the training of these committed and caring women and men.