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Gold, incentives and meh

Dinah celebrates QOF results and gets a resistible offer


Easter hols painless with kids on adventure holiday.

Meeting with practice manager: staff social event on Thursday to celebrate QOF results. Have already blown QOF payments on flowers for all, must start saving for next year. Go over notes from patients' forum – they don't want e-mail prescriptions but they'd like a drinks machine and massage chair.

First patient, an artist, has stopped all her medication as she is allergic to everything. Go through the pills one by one. Why is it that aspirin, ACE inhibitors and atenolol are utterly intolerable whereas mebeverine, quinine and Buscopan do her the world of good? Negotiate as hard as I can, pay detailed attention to involved accounts of all her various exhibitions, then – the crunch. Can she paint me? Will

I pose for a nude photoshoot? I have done many things; graced garden parties, picked raffle winners, raided working men's clubs. But nude photoshoots are definitely not in the job description. Decline as politely as possible. She leaves just as flowers delivered so now she wants to paint all the receptionists naked with roses. How about a surgery calendar? Promise to suggest it at next staff meeting.


PCT professional executive committee has ended and new one being planned. Let's have a social event to mark the occasion. Colleagues like the idea provided I don't cook. Cheek – okay, I admit people don't come to my dinner parties for the food

and kids have been known to use the

'If accidentally ingested, may induce vomiting' notice.

Decide to go ahead anyway and design invitation.


Staff night out successful and everyone in on time this morning.

See patient for smear result following

a drawn-out process, involving various practice members, beginning with a phone call reminding her she was six years overdue. Turns out she had vulval lichen sclerosus and couldn't stand the pain (fair enough). She asks why we'd phoned at this particular time and I explain that we have an annual work cycle ending on 31 March. 'Oh,' she says, 'so you need me to reach your targets? I deserve an award. How about the Golden Speculum?' I tell her she is the first winner but am left reflecting

on whether the smear was for her benefit or ours. Suggest she joins the patient forum so we could discuss further, along with surgery calendar.

Rush to pick up kids from station. Suggest we eat out. They cheer.

Dinah Roy is a GP in Spennymoor, chair of Sedgefield PBC group and co-PEC chair of

County Durham PCT

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