Is blood glucose self-monitoring worthwhile in type 2 diabetes?
...practising in Tony Blair's backyard
Dr Dinah Roy, a singlehanded GP and PEC chair at Sedgefield PCT, struggles to arrange funding for a chemical castration and avoids a pharmacist who treats her like a second Shipman
treats her like a second Shipman
Week ending April 17
Home visits: 9
Lunchtime meetings: 4
06:30 Wake children 13-year-old daughter excited, as French exchange partner arriving tonight. She goes to a girls' school so how come she's the only child with a boy coming to stay? Panic with limited space and builders due to start extension today, how will French boy survive?
08:30 Late start to surgery. Builders didn't turn up and haven't returned calls. Plus I've developed a skin infection.
Forget this as complexities of 'out-of-contract' referral arrangements absorb me. A patient who is concerned he may pose a risk for incest and whose psychiatrist agrees wants chemical castration as he's worried his children may be taken away from him. Castration might mean he's pronounced 'safe to be a father'. PCT has no contract for castration can I get funding? He's moved from another area. Don't have his notes yet but after several phone calls/faxes/application forms to lawyers/psychiatry/PCT/ previous GP, begin to think I may be getting somewhere.
13:00 PCT meetings all afternoon.
17:45 At airport with daughter to collect exchange students. Subjected to Scissor Sisters in car. French boy impressed but I get temperature and headache, so stop at supermarket pharmacy for antibiotics, with signed order. Leave 40 minutes later with small supply of fluclox, but only after public humiliation by pharmacist because I don't have GMC number and ID (he blames Shipman). Anyone would think this was a controlled drug after that carry-on. Running late so make do with glaring as ferociously as possible. Note: ask prescribing adviser how to spot bogus pharmacists.
08:30 Builder still unobtainable.
11:00 Interview for re-appointment as PEC member (three years already!). Four GP candidates for three places. Unsure how I'll fare after argument with PCT chair last week over late board paper. I suggest remit of PEC should change as practice-based commissioning requires a different role: supporting practices in service development and business planning, then approving changes.
11:20 Sneak out for quick coffee with colleague.
12:30 Phone call I am re-appointed, just in time for board meeting this afternoon. Gulp coffee too quickly, ectopics and high temperature result.
20:00 Detour to different supermarket for pizza in case I bump into pharmacist. Foolishly agree children can have party tomorrow night if they promise to keep music down.
08:30 Practice meeting with salaried GPs; one already works as gynaecology GPwSI at community hospital. Will start practice-based commissioning ball rolling with
in-house gynae and expand from there. 'Scrap outpatients' to be my modus operandi.
10:00 Arrive late at unscheduled care workshop, just in time for coffee break. Speculate on how practice-based commissioning might affect out-of-hours, ambulance and other 'unscheduled' services.
10:30 Builder phones he'll start next week. At least he's coming I've only waited nine months.
12:30 Afternoon surgery quiet funding for castration sorted.
18:30 Au revoir to childminder, bonsoir to children. Turn music down, cook pizza, open wine.