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A day in the life of Dr Huw Thomas

Dr Huw Thomas, a half-time GP principal in Minehead, Somerset, and deputy head of decision support for EMIS Knowledge Based Services, describes a typical day

Dr Huw Thomas, a half-time GP principal in Minehead, Somerset, and deputy head of decision support for EMIS Knowledge Based Services, describes a typical day

07:15 Roused by the alarm. Quick shower, bowl of cereal and out of the door for the drive to work.

First session this morning, before surgery, is covering the minor injury unit in Minehead from 8 am, but the journey is a very pleasant one across Exmoor… until I get irritated listening to Radio 4 on GP working hours.

08:00 Arrive at the hospital and see a couple of patients with hand and wrist injuries.

Thankfully things are quiet so I take the opportunity to review my GP inpatient beds on the ward.

The mini ward round with the nursing staff only takes a few minutes, altering a few drug charts and finalising discharge plans for Mr X recovering from a CVE.
I check the progress on two other patients with chest infections, and have time to reflect how nice it is (for both patients and GPs) to have a GP cottage hospital.

It is great to be part of a team where we can practice holistically, admitting, managing and discharging the patients whose personalities and problems we know so well.

09:15 I start work at the surgery. It is a mixture of booked patients and telephone triage, which works well for us.

I end up doing about 15 telephone calls and seeing about 10 patients with a wide range of general practice problems.

Some of the telephone triage patients need to be seen so I book some into my GP registrar's clinic, some into the nurse practitioner. The remainder I will see immediately or as extras at 11:30.

The mornings seem very full, with occasional trips to the coffee machine.

The partners all try to pause at 11:00 or we would hardly ever interact! I have a chat with Paul, the senior partner.

He tells me the pool is almost ready at his villa in Spain! I sympathise with other partners on childcare problems. My son is doing A levels, my daughter is at university.

The worries don't stop - they just change!

12:30 I finish the extras surgery and meet with Adrian our registrar to discuss the cases he has seen during the morning.

I really enjoy the stimulation of teaching, and Adrian really keeps me on my toes. I intended to discuss his PUNS and DENS coming from his surgery, but leave the discussion with several learning needs of my own.

I dash across the road for a sandwich and then do a home visit on a terminal patient, liaising with the hospice nurse who is wonderful.

14:00 I switch modes and settle down in front of a computer screen, log into the EMIS medical authoring website and load up my emails.

First step is to look at the current Mentor articles in the updating cycle and answer any queries from authors or reviewers.

Each of our 2,500 articles is in either an annual or two year review cycle so there are usually about 50-80 records being reviewed at any one time.

I will read all articles before release, so I spend the next hour getting through as many as I can, ensuring that they match national guidelines as well as my current practice.

I also check they are succinct enough for use in the consultation. All articles are written by doctors and will have been reviewed by at least one other GP. Invariably some records will need to be bounced for more amends.

I really enjoy the reviewing. It's a great way to keep up to date.

I specifically search out the articles related to my learning needs as identified at lunchtime – must remember to record both the need and its resolution in my PDP!

15:15 Coffee break and then a telephone conference with the rest of the Mentor team, discussing the day-to-day running of both the Mentor and Patient UK websites.

We discuss ways of making it easier for users to get to clinical articles, patient information leaflets and self-help group information from within the EMIS system.

We also discuss Mentor's sophisticated search engine and how we can improve the list of possible diagnoses offered when users input a list of symptoms and ask the computer for a differential diagnosis.

These conferences are quite frequent and useful, but I'm glad I'm not paying for the call.

16:00 More patient feedback has arrived in my email in tray from clinicians and patients using The Patient UK website.

One, a diabetic, doesn't like the wording of our article on blood glucose testing, and suggests we should encourage our patients to test more frequently.

I spend some time researching NICE, Diabetes UK and other websites to come up with a compromise between the varied advice available. In the end I settle on a form of words which hopefully reflects current best practice.

I edit the record, send it to two other clinicians for review and email the patient.

17:00 I spend an hour actually writing our article on IBS, updating it after a Medline search, reading the new NICE guidance, and trawling other good relevant websites.

My notes will make a good basis for an upcoming GP registrar tutorial. The article is shaping up nicely but will need more work, so I save what I've done and prepare for the drive home. I drive by the sea front and can't resist a walk on the beach.

There's nothing like brisk sea air to wash out the worries of the day. It won't be long until the long summer evenings mean I can sneak a sail on my laser dinghy or shadow catamaran.

I usually keep the sail and wetsuit in the back of the car and my record is 17 minutes from patient consultation to being on the water!

19:10 Back home (alas no sail), quick change and a brisk 5 kilometres on the rowing machine while my extremely tolerant wife sorts the food.

20:00 We settle down to eat. I catch up on what the rest of the family has been up to.

My son has banned talk of A-level revision, but all other topics are allowed, and after washing up we settle down for the evening.

I usually check my emails again and try to play the piano (poorly – but thankfully with headphones) before settling on the sofa with a cold beer to watch nothing specific on the television – like most other 40 somethings I guess.

23:00 Bed (or I'm too tired for the next day) – must be my age!

Dr Huw Thomas: I always check that articles are succinct enough to use in consultation Dr Huw Thomas CV

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