SURVIVING THE FIRST5

Whiplash - a shameful fiction

Despite the fact that I have never crashed a car or made an insurance claim in 30 years of driving, I am informed that my premium is going up again this year, by a further 20%. From an initial...
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Where have all the pension radicals gone?

What would count as a decent turnout for the BMA’s roadshows on its proposed once-in-a-generation industrial action on pensions? One hundred and fifty, maybe? Two hundred? How about 21?...
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What does it mean to be a GP?

A medical colleague has had a chat with me. He is not happy. I suppose his gripe is about how he is treated. He feels like he is expected to be the community-based run around for various people...
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No slogan. No message. No idea.

He played nervously with the indicator stalk and dipped at the accelerator. The engine threatened and then cooled, ticking with angry heat. As the lights changed he powered up the dual carriageway...
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Are observations ever more meaningful than clinical trials?

The field of alternative medicine (AM) is littered with surveys and other observational studies. 1 Typically a group of patients who have elected to use some form of AM, are asked whether they...
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How will practice boundaries change once CCGs are authorised?

At the end of April this year, the four cluster SHAs will have informed the DH about the configuration of CCGs in their regions. The Act requires all General Practices in England to be constituents...
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When everything starts to unravel

As we’re all likely to do at some point, I have just mentally unravelled. I don’t know how many neuronal threads there are in the GP brain, but the story of how it happened to me has two. ...
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Expert patients? Enough of this 'Power To The People' crap

Doctors in the main, and GPs in particular, are a bunch of patronising old gits. Everybody knows it and if anybody ever demands conclusive proof I only ever have to point them towards the letters...
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So much for my 'getting away from it all' lunch break.

Home visit done in record time, I sped off to the local bureau de change to collect foreign currency for an upcoming holiday. Money changed, and thinking I’d make the most of my (brief)...
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Voting for an option that's not an option? This ballot's got me ticked off

OK, so let’s get this straight. The BMA’s pensions ballot will ask us two questions . Whether we’d be willing to take part in industrial action short of a strike. And, er, whether we’d be willing...
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Would more patients take my advice if I had an army officer sitting in on consultations?

I met an old GP who told me the story of when he worked in A&E many years ago as an SHO. There were some army officers posted in the department getting experience; working with the paramedics...
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How can GPs get more young mums to breast-feed?

Getting young mums to breast-feed, in our neck of the woods, is challenging.  It defies the cultural norm and is only taken up by a minority of our patients. Attempts to change this behaviour...
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The college has won on training. Its next challenge? More GPs...

Everyone knows we need more GPs. To GPs, themselves, it is self-evident – in the spiralling pressures on practices, the difficulty they have finding locums for commissioning backfill and the...
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An elder, but not a better

‘I’m 98, you know!’ I have literally not got the bloody door fully open yet. It’s only about halfway ajar and already this malignant harpy is on my case. ‘I know you’re bloody 98,’ I mutter to...
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I'm too young to worry about pensions - aren't I?

I’m a GPST2, and I’m 28 years old. The idea of drawing pensions conjures up visions of a little old lady walking slowly with a Zimmer to the front of the post office queue and keeping the quietly frustrated waiting whilst she counts it out to the last penny, tucks it into her purse and hobbles off at a snail’s pace. A pension certainly doesn’t apply to me - except being another drain on my payslip along with my student loan, tax (don’t even get me started) and the hospital parking permit I haven’t yet got round to cancelling. After all, we’ll be earning a reasonable wage, we’re not going to be skint, and we’ll be OK… Right?

The news of the NHS pension reform didn’t even bother me too much, at least not enough to look into quite what this meant, until someone suggested this meant we would pay more for less. In short, a bigger slice will leave my paycheque every month with less of a payback. Well this certainly did make me sit up straight and take notice.  Suddenly pension seem much more relevant and all sense of fairness and entitlement came into play.

The new reforms (if they go ahead) change our pension contributions quite dramatically, from 7.5% to 9.9% (assuming an pre tax income of between £69,932- £110,273). This doesn’t sound too much but this will increase our gross pension contributions from £531.25 a month to £701.25, assuming a pre tax salary of £85,000.  This is an extra £2000 over the course of a year, and substantially more over a working lifetime.

And in return for these extra contributions? Well one thing’s for sure, the extra money isn’t going to the pension scheme – its headed straight to the treasury. What we will get back is to work until we’re 68, instead of 65. Don’t get me wrong, I love my job… but working until I’m close to being that little old lady hunched over my Zimmer doesn’t really appeal.

The overwhelming response to Pulse’s Say no to 30% campaign is hardly surprising given the injustice of it and I for one haven’t wasted any time in signing my name to this. Although drawing my pension still feels (and is) years off, at least the potential (probable) reforms have made many of us registrars and recently qualified GPs sit up, take note and consider the alternatives to the NHS pension scheme. And that, surely can only be a good thing. Every cloud...

Julie Fry is a GPST2 in Cheltenham.

Meet Brian, the lab mouse

Animal models are a well established research tool and mice have been used to investigate human disease for decades. Not only do they share some of man’s basic physiology but mice can also display some quite complex behaviours. They can run mazes and press levers, solve simple problems and drive teeny tiny cars. But doctors, continually baffled by the harmful behaviours displayed by some of their patients were in need of a more robust model.

'Meet Brian,' says Professor Candid who headed up the research. 'After months of trial and error we finally found a way to splice human DNA into the mouse’s genome.'

'Not only will Brian make his way through a maze to the feeding bucket, but he’ll eat everything he can get his greasy little paws on and then say, “I don’t know why I’m so big, I hardly ever eat!”. He lies about his blood glucose and has begun to hoard his medication in a Tesco’s bag.  For some strange reason he’s even begun to speak in a Glaswegian accent and now engages in so many harmful activities that we’ve lost count. Only this morning he asked me if I could get him a tenner bag of smack. What is smack by the way? As we speak he’s lying on the sofa heckling an episode of Jeremy Kyle stuffing his little cheeks with Rolos and has ordered in a job lot of mouse-porn.'

Brian is the first mouse in the world that can accurately reproduce human behaviour under experimental conditions.

'He represents a major leap forward for scientific research,' says the professor, 'and will revolutionise the way in which future generations of doctors approach and tackle these problems.'

Sadly, funding for the project has run dry and Brian’s future looks uncertain.  Not content to sit still, he plans to marry and open up his own catering business in Malaga, which when you think about it is quite impressive for a mouse.

Even massage therapy is not without its risks

It might be best to start this article with a declaration of conflict of interest: I am quite fond of massage therapy and, many years ago, learnt the techniques of Swedish massage myself. There...
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How long do you need to train to be a GP?

I started my career in an era where you could become an independent GP just 12 months after qualifying. Full registration with the GMC and becoming a principal on the same day. I could have done...
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Palliative care's becoming an elaborate game of Cluedo

Ah, remember terminal care in the good old days? Armed only with a prior knowledge of the patient and a syringe driver of morphine, and mercifully untroubled by outside interference, you really...
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What is your super power?

My girlfriend says I have a super power. She is actually quite jealous of it and wishes she had it too. It is not a very exciting super power like the ability to fly or invisibility. In fact,...
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Silence is all we have left

The two men are alone. They stand together wearing boots covered in dry red earth and they carry picks over their shoulders. One of them rests against the grey bark of a tree. 'Where are we?' ...
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In three weeks, we'll all be dead

I’d just seen my fourth patient of the week complaining anxiously of persistent loose motions, and I smelt a rat. Or maybe it was faecal incontinence. Whatever. This fourth patient I decided to...
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We all need an off-switch

The pressure is on for the medical profession to provide a service to a culture that exists through social networking. Increasingly, doctors are turning to Skype and chat-room style...
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The all new revalidation kit

Bored with revalidation? Find yourself writing the same old things year after year after year? Stressed out at the thought of a 360 degree feedback? Then look no further. Our revalidation kit,...
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I'm sick of being told to 'F/U'

Any general practitioner (GP) from Land’s End to John O’Groats will likely read 'GP F/U' at least couple of times per day in the hope they can learn what exactly a hospital doctor has done for one...
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History shows we've become obsessed with biochemistry

Let us consider today the case of Asclepiades and the so-called Methodist school of medicine. Asclepiades, a Greek physician who lived around 90 BCE, promoted an atomist theory of physical...
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Approval for four-year training is a big achievement - but will it come with a price for general practice?

Dr Clare Gerada’s spirited opposition to the health bill won her plenty of plaudits, but also a fair few critics who wondered what it would do for the college’s wider influence and its ability to...
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Nobody really likes a bad loser.

I get very disheartened when I watch football, when the players surround the referee, and complain about decisions (which are more often right than wrong). Football managers constantly carp at...
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Homeopathy - the legal view

During recent months the critics of homeopathy have raised their voices repeatedly. Usually they come from doctors or scientists. Now the legal profession seems to join the chorus. An...
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My shopping tips for patients

My sons love it when I do the shopping. Their mother, as befits a healthy and conscientious GP who practises what she preaches, arrives back from the shops laden with fruit and veg and fresh fish...
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