Ever wondered what it is like to be present at an event that changes history? The Academy of Medical Sciences organised a meeting entitled “Research in General practice; bringing innovation into patient care” on Dec 12, a meeting that will, I suspect, be looked upon in future as a defining moment in UK primary care research. Orchestrated by Yvonne Carter (University of Warwick), who sadly was unable to be present, it brought invited representatives of the major funding bodies and research institutions and like many events, the unstructured and informal components were as important as the official programme. more…

The plane didn’t crash. I was pretty sure I had turned it off, but there was no mistaking the message signal and vibration in my jacket pocket as we circled Miami, close to landing. It wasn’t just one message but five in quick succession. I had to do something. I switched it off, conscious of a great imaginary finger pointing at me. I must have accidentally pressed against it during the transatlantic flight (oh yeah … I can hear you). But it made me wonder if mobile phones do have any effect. more…

I sat riveted through Kenneth Branagh’s perceptive portrayal of Ivanov in Chekhov’s eponymous play. Witnessing the desperate depression of the protagonist unfold I couldn’t help thinking how many points he would score on a Patient Health Questionnaire (PHQ-9), a common screening tool for depression in primary care and a burdensome necessity for accurate clinical coding (and payment). Would I dump a diagnosis of depression on the shoulders of this melancholy Russian on our first encounter or would I confine him to the computerised purgatory of low-mood?

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With the month of fasting behind me and afternoon blood sugar levels now soaring above 3mmol/l, I’m really quite getting into the swing of general practice. It’s the Russian roulette of the medical world. Your fate is simultaneously within and way beyond your control. After all, it was you that called that patient in during the emergency surgery.

A staggering amount of risk-management takes place in primary care. How long should you hold on to that puzzling patient who conveniently falls between NICE guidelines? The tale of the Brazilian nominee for a Darwin Award in 2002 is a succinct lesson in the potential consequences of not letting go. more…

It runs like an uneasy theme in the ethics of health care provision. How do we respond to the genuine health needs of individuals who do not have legal rights of residency and are unable to pay privately for their own health care? What obligations, if any, do we have to sick people who are here without legal status? Asylum seekers are entitled to the full panoply of NHS health care, but what of those whose claim has been refused? more…

Everyone is an expert in primary care. Newsagents, bar staff, waiters, hairdressers and little old ladies laden with shopping all have their own view. In the anonymity of a city you can tune in, unrecognised, to everyday conversations. Public opinion seems to be changing with GPs seen as overpaid, underworked, and not performing. The news is not good. more…