{"id":474,"date":"2008-10-13T13:28:56","date_gmt":"2008-10-13T12:28:56","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=474"},"modified":"2008-10-13T15:53:12","modified_gmt":"2008-10-13T14:53:12","slug":"tauseef-mehrali-on-the-universal-strategy","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2008\/10\/13\/tauseef-mehrali-on-the-universal-strategy\/","title":{"rendered":"Tauseef Mehrali on the universal strategy"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.bmj.com\/columns\/icons\/tauseef_mehrali.jpg\" alt=\"Tauseef Mahrali\" width=\"139\" height=\"100\" align=\"left\" \/> With the month of fasting behind me and afternoon blood sugar levels now soaring above 3mmol\/l, I\u2019m really quite getting into the swing of general practice. It\u2019s 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.<\/p>\n<p>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 <a title=\"Darwin award\" href=\"http:\/\/www.darwinawards.com\/darwin\/darwin2002-14.html\" target=\"_blank\">Brazilian nominee for a Darwin Award in 2002<\/a> is a succinct lesson in the potential consequences of not letting go.<!--more--><\/p>\n<p>I broke from a lifetime\u2019s tradition of celebrating <a title=\"Definition of Eid\" href=\"http:\/\/en.wikipedia.org\/wiki\/Eid_ul-Fitr\" target=\"_blank\">Eid <\/a>with family and instead celebrated Eid this year with my new surrogate family, the <a title=\"Royal College of General Practitioners\" href=\"http:\/\/www.rcgp.org.uk\/\" target=\"_blank\">Royal College of General Practitioners<\/a>, at their second annual conference in Bournemouth.  I had two aims on signing up to attend: to present a <a title=\"Poster\" href=\"http:\/\/www.tauseef-mehrali.pwp.blueyonder.co.uk\/RCGP%20Fasting%20Survey%20Poster%202008%20(low-res).pdf\" target=\"_blank\">poster<\/a> and to see <a title=\"Lord Darzi\" href=\"http:\/\/www.dh.gov.uk\/en\/Aboutus\/MinistersandDepartmentLeaders\/Ministers\/Ministersbiography\/DH_076748\" target=\"_blank\">Lord Darzi<\/a> receive a mauling at the hands of the nation\u2019s GPs. Lord Darzi bottled it and did nothing to dispel the notion that his existence is now perhaps more difficult to prove than that of God. Some would say that the two have never been seen in the same room together.<\/p>\n<p>However, Fergus Walsh, the <a title=\"BBC\" href=\"http:\/\/www.bbc.co.uk\" target=\"_blank\">BBC\u2019s<\/a> medical correspondent and chair for the conference kept us entertained. One particular anecdote caught my attention. He described a crash course in questioning imparted to him by John Sergeant which I feel could form the basis of a revolutionary new 10-minute patient-led consultation model.<\/p>\n<p>Question 1: How bad is it?<br \/>\nQuestion 2: How bad is it going to get?<br \/>\nQuestion 3: What can be done about it?<\/p>\n<p>Mingling and sharing experiences with other delegates and trainees from around the country and abroad was invigorating. The fears of fellow GP registrars at the genuine prospect of unemployment were palpable though. My illustrious predecessor at the practice, Rachel Tait, captures the undercurrent of anger and dissatisfaction in her \u2018<a title=\"Recipe for success\" href=\"http:\/\/rcgp.publisher.ingentaconnect.com\/content\/rcgp\/bjgp\/2008\/00000058\/00000555\/art00021\" target=\"_blank\">Recipe for success?<\/a>\u2019.  The shambolic planning of GP workforce needs is very real. I know of too many colleagues who, having successfully completed their GP training, are now running the locum labyrinth or have sacrificed their NHS pensions to work in salaried McJobs. The government\u2019s answer? The universal strategy of course. When there\u2019s a credit crunch, flood the markets with money. Lots of money. When there\u2019s a crisis in GP employment, flood the market with GP trainees. Lots of GP trainees. 600 more in London by 2011 to be precise.<\/p>\n<p><strong>Tauseef Mehrali<\/strong> is a GP registrar<\/p>\n","protected":false},"excerpt":{"rendered":"<p>With the month of fasting behind me and afternoon blood sugar levels now soaring above 3mmol\/l, I\u2019m really quite getting into the swing of general practice. It\u2019s the Russian roulette [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2008\/10\/13\/tauseef-mehrali-on-the-universal-strategy\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[303,312,14755,274],"class_list":["post-474","post","type-post","status-publish","format-standard","hentry","category-guest-bloggers","tag-darzi","tag-general-practice","tag-nhs","tag-primary-care"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Tauseef Mehrali on the universal strategy - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2008\/10\/13\/tauseef-mehrali-on-the-universal-strategy\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Tauseef Mehrali on the universal strategy - The BMJ\" \/>\n<meta property=\"og:description\" content=\"With the month of fasting behind me and afternoon blood sugar levels now soaring above 3mmol\/l, I\u2019m really quite getting into the swing of general practice. 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