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Gold, incentives and meh

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GPs set for incentives to screen for atrial fibrillation


(1) We all can agree that checking the pulse alongside BP is natural in an physical examination in any age group . Question is how often should we check on patients , especially those asymptomatic with no registered chronic illnesses. That refers to the principle of screening . Every 5 years , every 3 years? Perhaps , that really needs some statistics to support some arguments. But we also know there is something called interval incidents , just like in breast , cervical , bowel and AAA screening . A selected age group e.g. 65 makes sense. (2) The ball does not stop at the point of picking up the irregularly irregular pulse . It leads to verification of the diagnosis,subsequent oral anticoagulant and the actual counselling of which one to use(as well as options of treating AF). It should be quite a proactive , dynamic sequence of actions.One can argue a community one stop shop for GPs to refer after picking up AF is one way but it depends on waiting time . I would argue patients prefer to be followed up by the same clinician(or the colleagues in same practice, hence not for locums working short period of time here and there). Clearly , it demonstrates the essential role of general practitioners from palpating the pulse to commencing oral anticoagulants in a fashion of continuity .(Yes , yes , not the cup of tea for those arguing fast and easy GP access!) (3) Overall , we are dealing with both secondary prevention of AF and more importantly primary prevention of systemic embolisation and hence , stroke . If the health stakeholders genuinely understand this health philosophy and science , fund (including funding to train) General Practice 'properly' in a package as I am not sure several QOF points are really up to it.

Posted date

03 Aug 2016

Posted time