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Gold, incentives and meh

Burnt Out

  • Stop meddling with NHS DNA

    Burnt Out's comment 05 Jan 2019 12:17pm

    There are three types of patients. Those who make appointments and keep them, those who make appointments and don't keep them, and those who don't make appointments at all. Most of the trouble comes from the first group.

  • Pulse 2018 review: Cash incentives targeted at GPs who cut referrals

    Burnt Out's comment 30 Dec 2018 6:10pm

    Within the past four years I reduced my referrals and prescribing to just a third of what they were! Also admissions by the same amount!
    I did this by cutting my weekly sessions down from six to just two. Where do I claim my reward?

  • Reaction: Dr Hadiza Bawa-Garba reinstated to the medical register

    Burnt Out's comment 16 Aug 2018 8:25pm

    Third world health service; first world expectations.
    Judged and punished as if working in ideal conditions, when the actual situation is anything but.
    When you do CPR the first question you ask is, “Am I safe?”
    When you turn up for work, you need to ask, “Are these conditions safe to work in?”
    Anyone employed by the practice should walk out if they feel at risk of being blamed and punished for the consequences of excessive workload, and inadequate support.
    As for partners, I’m afraid you put yourself at risk by continuing to hold a contract which makes you responsible for doing the impossible.

  • Locums at NHS-run practices faced with 'unacceptable workload'

    Burnt Out's comment 21 Jul 2018 12:25pm

    If they don’t make a stand, they shouldn’t be surprised if the workload gets worse and worse. Work at a safe pace. After five hours per session, the outstanding work should be handed back to their employer on the grounds that it isn’t indemnified, not to mention paid. If they feel they have to carry on, to avoid harm to patients, then charge them punitive overtime rates. Maybe something will be done about it then.

  • GPs offered up to 50% cut of savings generated by slashing their own referrals

    Burnt Out's comment 01 Mar 2018 11:25am

    Regretting being so economical with my referral rate to date, as there’s no leverage to cut it further. Tempted to avoid the same mistake with scrips and admissions, which might be coming next.

  • GMC successful in High Court bid to strike off junior doctor

    Burnt Out's comment 26 Jan 2018 8:26pm

    I wonder how much trouble she would have been in had she simply walked out, once she realised she was doing the work of three doctors, a double shift without food or a break, with a broken computer system, no adequate support and no induction? Would she have been as culpable for the events that ensued? I suspect not. A lesson for us all.

  • Revalidation paperwork equivalent to 390,000 days' worth of GP appointments

    Burnt Out's comment 05 Jan 2018 11:00am

    When appraisal first started my senior partner retired, and then my remaining partner became seriously ill, and very sadly died. This left me, previously part-time and with four children including a young baby, single-handedly looking after 4000 patients.

    It seemed the only way to escape this insane situation was either to get struck off, go to prison, or fail my appraisal. Deciding that the last option was the best one, I did no preparation for my appraisal, and had the worst attitude you can imagine. However, I still passed the bloody thing!

    After an extremely difficult six months, a new partner joined. However, since then, I refuse to worry too much about appraisals. They don’t want you to fail!

  • 10 tips on being appropriately assertive in your surgery

    Burnt Out's comment 01 Oct 2017 9:24am

    What about, “I’m sorry but I have reached the safe maximum for number of patient contacts/hours worked this session, so I am unable to help you today. I suggest you complain to your MP”?

  • It’s time to discuss how much we earn

    Burnt Out's comment 01 Sep 2017 6:42pm

    Legally a session is no more than five hours, including all admin, etc. Otherwise we’re not properly indemnified, and this is dishonest as well as foolish. After five hours, we are into another session and should be paid and indemnified accordingly (if salaried).
    If it’s impossible to cater for demand within the indemnified hours, excess patients should be turned away, with emergencies sent to A&E. Anyone who regularly works more than five hours per session is shoring up an unsustainable, unsafe system and not doing themselves, or their colleagues, any favours.

  • GP walk-in centres to close in favour of 9:30pm Sunday bookable appointments

    Burnt Out's comment 05 Mar 2017 10:24am

    6 am? For goodness sake. How can someone with a family, dogs, household to run, breakfast to prepare, children to get off to school... be at work ready to start seeing patients at that ridiculous time of the morning? Utter madness!

  • Why STPs could spell the end of general practice

    Burnt Out's comment 16 Feb 2017 11:09am

    For those who are struggling to understand what ‘Sustainability and Transformation Plans’ actually are, I have interpreted them into plain English as follows:

    Encourage working at scale
    CLOSE SMALL PRACTICES, DESPITE THE FACT THAT THEY ARE POPULAR WITH PATIENTS AND REDUCE ADMISSIONS.

    7 day opening
    STRETCH ALREADY OVERLOADED WEEKDAY SERVICES

    More care at home
    DUMP MORE HOSPITAL WORK ONTO GPS, INCLUDING VERY ILL, COMPLEX PATIENTS

    Enhanced multi-professional primary care teams
    NON-DOCTORS TO DO GP WORK, AND GENERAL PRACTITIONERS TO DO SPECIALIST WORK. NEVER MIND THE MASSIVE MEDICO-LEGAL IMPLICATIONS OF THIS

    Reconfigure acute hospital services to ensure efficient and cost effective
    CLOSE ALL BUT THE BIGGEST HOSPITALS, MAKE PATIENTS TRAVEL FURTHER, SEND PATIENTS HOME SOONER

    Encourage behaviour change eg. childhood obesity
    TRY THE SAME STRATEGIES WHICH HAVE ALREADY FAILED. FOR EXAMPLE THE ‘FIVE A DAY’ INITIATIVE HAS FAILED TO REDUCE RATES OF CANCER, AND OBESITY HAS IN FACT INCREASED SUBSTANTIALLY SINCE IT STARTED.

    Integrate mental and physical health care
    MANAGE MENTAL HEALTH PATIENTS IN PRIMARY CARE WITHOUT ADMITTING THEM, WITH THE HELP OF ‘THERAPISTS’ RATHER THAN PSYCHIATRISTS

    Integrated health and social care
    MAKE GPS RESPONSIBLE FOR SOCIAL CARE AND MAKE IT ALL COME OUT OF THE SAME INADEQUATE BUDGET

    Reduce system costs and pressure from unmitigated growth in demand
    FAIL TO MEET INCREASING DEMAND

    Efficiency saving to lead to break-even position by 2020/21
    REDUCE FUNDING

    Dedicated support for the most complex 0.5% and those near the end of their life.
    ENSURE THAT DNACPR FORMS ARE SIGNED AND LET THESE PATIENTS DIE RATHER THAN ADMITTING THEM.

  • GPs asked to come into hospital to discharge patients and take on care

    Burnt Out's comment 12 Jan 2017 11:34am

    “Many practices are reporting having to work fifteen hour days to cope with the demand and associated administration.”

    I trust these practices are also paying their defence organisation for 3 sessions to cover this time, as one session is defined as up to 5 hours of work, inclusive all admin. Any more than this isn’t indemnified, and is therefore illegal.

    We really are our own worst enemy if we are prepared to work these hours. Why are we doing this? It’s utterly ridiculous.

    A stand needs to be made. Excessive work must be turned away. If this is impossible without the risk of being sued for negligence, then it is impossible to be a partner, and the practice should be closed.

    The situation is impossible! We should stop being so bloody stupid!

  • Calibrate this, CQC: I'm not spending £7,000 on scales

    Burnt Out's comment 13 Jul 2013 10:49am

    Thank you Copperfield for cheering me up - we have just paid over £500 to have our equipment calibrated/checked, including £26. to check a couch (!!??) and £23 to calibrate a mercury sphyg (which if you think about it, is about as logical as calibrating a ruler). What a rip-off.

  • Tricky ten minutes - I can’t cope with my fibromyalgia

    Burnt Out's comment 27 Jun 2013 8:21pm

    I have personally controlled my debilitating fibromyalgia symptoms by cutting out dietary oxalate (found in tea, potatoes, many fruit/veg, etc) - as recommended for those with kidney stones. It has helped quite a few patients too. Might be worth a try.