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Santa Claus requests an urgent house call

20 Dec 2010

Whether you are religious or not, and irrespective of the faith that you may or may not hold, the Christmas holiday break followed by the arrival of the New Year gives everyone a chance to ponder on the year that has gone and the year that is yet to come...

If you’re feeling under pressure, slow down

22 Nov 2010

In the years that I've written this column, I've talked about sickness and disease, receptionists and nurses, complexity and simplicity, guile and guidelines. But I don't think I've ever quite focused on the cornerstone of so many doctors' working day. A nice hot cup of tea.

Putting your stamp on general practice

20 Oct 2010

Have you seen the latest commemorative stamps? As the royal mail said when introducing them: ‘In a little over a century, British doctors and scientists have made a series of startling breakthroughs' - and the stamps rather beautifully depict those breakthroughs - beta blockers, penicillin, the Charnley hip replacement, lens implants, the understanding of malarial transmission, and CT scanners. So where are the British GPs in all this? I'm not denying the astonishing scientific achievements that these discoveries represent. But I'm always struck that we do 90% of the work of the NHS, caring for most of the health problems of most of the population most of the time. We are becoming busier every year, and clearly offering something that the public appreciates, expects, and demands. I can't think of a single week in the three decades of my professional career when I haven't had more work to do than I could readily complete, so we must be doing something that matters to people. So, if one day the Royal Mail were to notice our frenetic backwater of the medical universe, what half dozen images might sum up most clearly just what it is we do?

Art versus science in general practice

20 Sep 2010

I keep getting the very scary sensation that absolutelyeverything that I learnt at medical school will one day be proved to be wrong. Well, maybe I'm exaggerating. It's probably unlikely that much will change in the world of gross anatomy. But, when it comes to areas such as therapeutics and management, then few drugs or theories ever survive the onslaught of new research.The last straw seemed to be the recent reasonable questioning of whether lowering the temperature of feverish children is a good thing or prolongs their illness. I may have to add that to the list of activities that took up countless hours of my time in the early years of my career and for which it now appears there is no evidence that I was doing anything other than wasting time...

GPs not working fast enough for local PCT

21 Jul 2010
'If my PCT wants me to deal with my patients any quicker, for the simple sake of some ludicrous concept of efficiency and value, the answer will be a simple one. If somewhat anatomically challenging.'

Myth of the guitar man in a pale blue jumpsuit

14 Jul 2010

Aren't reputations strange things? Frequently based much more on fantasy than fact, they are often completely out of our control, and - whether good or bad - often ludicrously undeserved. These thoughts were triggered by a patient who had just registered with us. He had a wealth of medical problems, and was going to be someone I would get to know well over the coming years. At the end of the consultation he said: ‘I hear you're a pretty ace guitarist too.'

Read Codes don't tell half the story

30 May 2010
'But when the hospital team discussed discharging him to a nursing home, his wife would have none of it. He was coming home, and she would care for him. By this stage she was in her eighties, but she set to organising the house, rearranging everything to make her husband's last months or years comfortable.'

Why is your patient worried sick?

15 Apr 2010

"That's a fair amount you've got to deal with. You must be worried sick." I waited and the penny dropped

Better safe than sorry

15 Feb 2010

'I wake in the early hours suddenly wondering if I got a particular case that day right or not'

There’s nowt as queer as folks on holiday

15 Jan 2010

‘I always go back to first principles and explore the individual’s ideas, concerns, and expectations’


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