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Independents' Day

All this help is making me feel a bit ‘hypo’


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Yes, it was only a trivial and innocuous electronic Task, one which would normally warrant just the usual eye-roll/delete routine. Then again, I do see it as my vocation to call out nonsense, plus there’s a bigger point here.

So that’s why I responded when I received a message about a patient that one of the various paramilitary wings of the community nursing service had just visited. In the course of sorting out a non-diabetic patient’s leg ulcer, the nurse had for some reason checked his blood sugar. Despite any relevant symptoms, ‘Because it was only 3.1,’ she made him tea and biscuits, checked that his glucose had risen, patted herself on the back and messaged me about it.

To which I replied that this made no sense at all, that significant hypoglycaemia is only realistically an issue in diabetics on treatment, and that if she really had time to brew up and crack open the Hob Nobs, maybe she could pop over when we’re next signing repeat scripts?

And that’s when the chill of the bigger issue ran down my spine. While completely misunderstanding everything about hypoglycaemia is a fairly tiny demonstration of illogicality, it does demonstrate a profound misunderstanding of, well, medicine. I could give many other examples, almost always related to non-GPs doing a GP’s job, or part of it, and doing it not-quite-right, with the resulting dysfunction inevitably ending up in our lap.

Now we have so many non-doctors, all ‘helping us out’, the problem is spiralling out of control

Now that we have HCAs, nurse practitioners, pharmacists, paramedics, physician associates, nurse specialists etc etc, all ‘helping us out’, each with their own mistakes, misunderstandings, and misinterpretations, this problem is spiralling out of control.

Someone wise and articulate recently pointed out that the current funding arrangements for general practice are like trying to paint your house using multiple tiny sample pots. Spot on. I’d argue that maintenance of that house now suffers the same problem: the keys have been handed over to multiple agencies who come in, who mean well, but who leave it in a worse state than it was in the first place, with the result that we have to clear up the mess.

It’s enough to make us feel dizzy, sweaty and trembly. And we all know what that isn’t, don’t we?

Dr Tony Copperfield is a GP in Essex


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Readers' comments (22)

  • My god!
    You're humming my tune!

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  • Well said. I had an urgent call from the laboratory on a non diabetic patient that has skipped his breakfast who feels absolutely fine. The hospital and psychiatry are pushing more and more work to the GPs. Referred a patient to psychiatry and the nurse sent him back to me for medication advice as there is no psychiatrist. Makes me wonder why I bothered in the first place.

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  • Well said. Look on system 1. The notes are now a mess with " I gained verbal consent to enter the premises" type entries. Searching in vain for the 2 lines from the GP that makes sense of the situation.

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  • All contributing to severe burnout and less GPs

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  • My father is currently in a nursing home. He has multiple well documented bouts of abdo distension and discomfort caused by wind relieved by a good fart and bowel movement into his colostomy bag! Nursing home called for an emergency GP visit in hours for further similar event. Paramedic visited instead from the GP surgery- they are doing all GP visits for this surgery apparently- diagnosed ascites and insisted on an emergency ambulance to ship him off to hospital. He has no risk factors for ascities and a review of the GP records would have told the paramedic this and would have shown the well documented bouts of "wind". Fortunately I was only 10 mins away and on exam he clearly had a bloated abdo full of wind with a lovely tympanic percussion note typical of wind! I managed to stop the ambulance carting him off but the nursing home insisted on a further visit. So the GP then came out and confirmed- yes wind!! This is a typical example of a noctor not understanding how to examine someone properly and not understanding causes of diseases- ie he had absolutely no reason to develop acute ascites. GP still had to come out in the end, no time saved! Home visits are often with the most complicated, complex patients. Noctors need to learn to know what they don't know. Whilst i have every respect for paramedics- they are great at being paramedics, but not GP's to complex patients.

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  • Copperfield,
    I am astounded how, day after day, medics, and worse still GPs can be so far up their own a***s as to write something so profoundly insulting about colleagues, yes COLLEAGUES, just to justify their own sense of superiority.

    This article is nothing less than bullying on paper, with a thinly veiled attempt at anonymity of the victim. It is backbiting, it is damaging, it is unprofessional and it is just plain rude. I’d like to see how you would manage a vacuum-pump dressing in a poorly-lit room, and then see how you felt at being ripped apart in a nursing rag and ridiculed because you were reaching beyond your station. And you wonder why bullying is headline news in the medical profession- I’ll lend you a mirror as it seems yours is broken.

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  • That is a fair point.

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  • Oh Welch you truly missed the entire point of this article. Get off your high horse you entitled salaried snowflake.

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  • You’ve said it all in one sentence Janes Wallace. My job here is done. Good luck.

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  • It's not bullying. We don't pretend to be able to change vacuum pump dressings. And yes we are frequently ripped apart in nursing rags. Copperfield of often adds self effacing as he is superior.
    I just watched this instructional video and I reckon that Copperfield could change a vacuum dressing in a dim room.
    I'm just off to stick my head up my a@@e. Sorry a@@s.

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