Home visits when appropriate are in my view an important part of Primary Care. I have two so far down for today, and both totally appropriate with one for a rapidly developing ca lung and the other in a younger man who is tetraplegic due to a spinal abscess and just out of hospital. I still strive for a degree of continuity of care and handing these patients across to the ambulance service would seem unlikely to be very helpful.
To be honest, I didn't know there were 10, 30 and 40mg versions. Only ever seen 20 and 60mg capsules. I note the huge cost of the 10mg version as well.Don't think this will require much work at all for my practice at least!
Quite right - wonderful job. When you are allowed to do it and not have to sit through team building and suffer CQC visits.The seeing the patients bit is great - I still do 10 clinical sessions and cover my palliative care OOH. That is the rewarding bit. Unfortunately so much now is politics. I am however pretty Jurassic!
I think the NHS England comment about part time working is outrageous. Many salaried GPs and indeed partners make a life decision about the hours they work and implying that they should work more, which would likely lead to a mass exodus, is ridiculous.
Surely this is the Doctor First model - rather than additional phone calls. We have avoided this as it would appear to make every day and on call day. We do however run an Acute Service which involves triage by phone and seeing run by two doctors each day in a dedicated area. This makes the rest of the surgery more relaxed and the acute service is only one day - some GPs actually like doing it - I am ambivalent but it makes the rest of the week better and the patients like it.
Interestingly, the vet put my basset hound on a slightly bigger dose for his back and he too improved markedly. Again short course!
From personal experience, for sciatica, which was causing me to have to crawl to bathroom, 24 hrs gabapentin allowed me to carry on working. On for 2 weeks and then stopped as really slows the brain down, but was completely fantastic for pain. Anecdotal I know, but short courses would possibly seem the way forward.
Interestingly, we are being incentivised to move away from Emis!
But you will just get the same people. Cronyism and nepotism is alive and well in Westminster. Unlike teaching and medicine, no formal qualifications are needed so to equate with them seems bizarre. I suggested some time ago that the obvious pay scale for an MP would be directly related to the median salary of the UK, so that success in making the country richer would be rewarded. I see little to change my opinion.
Only Labour and Conservative promises actually have any hope of actually being in a position where they can be tested. The other parties can promise anything they like since they are at no risk of having to deliver them. And as the Labour party have returned to the plan of squeezing till the pips squeak, they are unlikely to get in and even if they did, they would then see that they would face a failing economy due to their policies. We need a sensible opposition party but it looks like we will be getting 5 more years of what we already have but worse. The only light at the end of the tunnel would seem to be that Mr Hunt will be no longer Health Secretary - please let it be Sarah Wollaston, though I doubt it will be.
Sympathise with you - have the same - Kneeling chair good for consulting - back actually feels better at end of surgery. You can also use bottom step to sit on when dealing with kids so you are on same level which can be useful. Not so good on knees at end of day though. Found gabapentin simply brilliant for sciatica though - stopped me being off though made me very stupid so only took for 2 weeks. The vet put our dog on it after this but is basset hound so tricky to say if it made him any more stupid.
Completely agree - if this is what they want us to do, that is fine - however it is clearly not going to happen in the lead up to an election!!
DoH - Ministry of Truth
NHSE- Ministry of Plenty
CQC/GMC- Ministry of Love
The more I read DH spokesperson comments, the more I am reminded of the Orwellian 1984. The fact they were delighted to announce the 1% pay rise in recognition of all the hard work shown by NHS staff being an admirable example - i.e. a pay cut.
Having said that, the sickness provision, which I have been informed now does cover partners, seems a bit too good to be true. £1800 a week for an 8 session partner for 26 weeks and £900 following this seems very generous and I am not sure they realise what this could result in.
Delighted to see you back - Pulse will once again be something I turn to in search of being cheered up!
Very easy to find on line - some are sold as fish antibiotics but are actually just human tablets. Ciproflaxacin and Cefalexin easy to get.
Of course you can also get benzodiazepines on line without a script as well!Diazepam, lorazepam and zopiclone and temazepam.
Certainly helps us - but we pay the salaried GPs MDU fees from the practice.
The problem is not the fee, it is that the letter is required at all. No letter, no fee. Demanding GPs provide letters for all and sundry is unreasonable and only adds to the workload with no useful purpose being served.
Agree completely - we all get things wrong and admitting this only strengthens the doctor patient relationship. I always tell patients if something was missed or I made a mistake and it has stood me in good stead for over 30 years.