Revalidation fatigue…there is so much in the news, post, and medical media that I had begun to switch off.  But, Niall Dickson, from the GMC, gave us a very reassuring talk on revalidation recently and it all sounded very reasonable, sensible, and non threatening. Revalidation based on appraisal seems fair and we are well used to annual appraisals in general practice. Dare I even concede that I look forward to my appraisal and find it very helpful in my own continual professional development. Discussing areas for possible clinical improvement with someone older and wiser (though not many appraisers are older now!) has always been a very positive experience. more…

Biology A level classes in the 1970s often involved frogs making the ultimate sacrifice for the benefit of their dissector’s knowledge of what lies beneath the amphibian skin. As far as I remember, it was not however common practice to test the widely-held belief that a frog in a water bath would tolerate a slowly rising temperature and die from heat exposure before attempting to escape. Dedicated scientists have proved that this is not the case. Hot frogs jump. more…

Dark, quiet, and desolate. At 7.45 am on the mornings after Christmas, the streets look sad and neglected. A few Christmas lights blink unconvincingly. No traffic, no pedestrians, no kids going to school, and no radio except the news. But, the surgery lights are on, cars parked outside, shutters open, patients waiting… more…

Chicago. A compelling show. An intriguing narrative based on real events. Posters advertising the musical, with its ever changing cast, greet me like an old friend on the escalators of London’s underground as I travel to the BMJ office. My first visit to the city recently was equally enthralling. The modern glass skyscrapers, amazing art institute, jogging along the stunning lake side foreshore. I gawped, like any tourist, at the Wrigley building, the old Chicago Tribune offices, and walked the magnificent  mile, well wrapped up against the bitter winter wind.  more…

Whilst Italy’s government was falling, general practitioners from 21 countries convened in Turin on 11 and 12 November for the autumn meeting of the European Union of General Practitioners (UEMO), which is a leading European medical organisation based in Brussels.

As well as providing clinical care to their patients, there are a number of reasons why general practice needs a strong voice at a European level and to be increasingly respected by politicians and society. more…

Wet Tuesday. October. General practice. Year 28, day 11. Radio news. Car park. Medical bag. Waiting room- half full. Hi all. Open surgery. Password. Mouse. Press. Wait. 

Headache, blood pressure, fundoscopy, acne, GCSE abdominal pain, MSSU, delayed letter, hospital letter, hypertension, change prescription, foot injury, chest infection, recent hospital in ICU, flu vac, emergency contraception, blood pressure, referral IUCD, child vomiting, abdomen normal, mother sciatica, clinical signs, dizzy spells, alcoholism, jaundice, blood pressure, blood tests, infant unwell, doctor worried, oral thrush, depression, lymphoedema, abdominal mass- urgent referral, joint pains, heart fluttering, abdominal discomfort, xray and scan results, deafness, ear drum perforation, chest infection, facial cyst, varicose veins awaiting surgery, fall knee wrist foot, husband hayfever, pityriasis versicolor, bariatric surgery delay, antidepressant update, overweight, knee pain, NSAIDs, hypertension, elderly dementia, dry skin, intertrigo, widow family, epilepsy driving, suicide counselling, asthma, house damp mould, son’s epilepsy, knee replacement, neck pain, chest infection, asthma inhalers, back pain mri. more…

It was a comment that I made in an interview for a BBC 4 File on Four programme that caught the eye of producers at Channel 4’s Dispatches programme. I had been speaking about the problems of understanding patient safety in general practice and how we knew so little about issues related to wrong diagnosis or to misdiagnosis. I also raised the issue of who would monitor the GPs in the brave new world of commissioning. Would I be willing to take part in a documentary which would open the lid on some of the issues?

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Last night we were pulled in by the police. Nothing like a flashing blue light in the rear view mirror to make you feel guilty. They asked for my driving licence and I could hear them call my name in on the radio. No problem. There had been a robbery. They got away, apparently, in a car like mine. more…

Would you take a bus through the riot areas that made the news? Would you be comfortable walking along the streets that featured in the TV footage? Would you work there? Many of our colleagues do and I wonder how they are getting on with their immunisation targets, cervical smears, and QOF scores? Are all their diabetic patients well controlled, appointment systems working well, and hypertension patients queuing up for the practice nurse? Doctors working away as usual behind the riots. You hadn’t thought of that. more…

As part of the development of our Clinical Commissioning Groups (CCGs) the seven GP CCG chairs now have a place at the NHS Lincolnshire Board meetings.  The agenda was not particularly unusual. We were required to approve the Equality and Diversity Strategy. We had a couple of papers dealing with our legacy document and the transition planning process. There were the important performance and financial monitoring reports. It is the time of year when we present the annual governance, audit committee and annual reports and summary financial statements. We had a formal letter from the Strategic Health Authority (SHA) to note and an associated action plan (completed – in case they read this!). We reviewed the Board assurance framework, the risk management annual report, and the business continuity management update. more…