Pulse articles from February 2002

Pulse archives from February 2002

Blair steps in to tackle GP morale crisis.(Tony Blair)(general practice physicians)(Brief Article)
February 4, 2002... Prime Minister Tony Blair has intervened personally in the debate on flagging GP morale as new figures show a significant deterioration of the workforce crisis. Mr Blair told a meeting of leading GPs and hospital doctors that the working...

MMR catch-up after mumps rise.(measles-mumps-rubella vaccine)(Brief Article)
February 4, 2002... The seven GPs at Dr Fiona Peckham's practice have given 39 secondary school children MMR after mumps hit their school and the health authority advised parents to get their children immunised. Dr Peckham has seen one child with mumps since...

Pulse still tops GP readership survey.(general practice physicians)(Brief Article)
February 4, 2002... Pulse has once again topped the independent GP readership survey, confirming it as the best-read medical publication. Latest JICMARS* research shows that 72 per cent of GPs read Pulse, eight percentage points more than our nearest rival....

GP premises cash is raided for prescribing overspends.(general practice physicians)(Brief Article)
February 4, 2002... Cash-strapped primary care organisations are raiding budgets for GP premises improvements in an effort to make good prescribing overspends. Cost-rent schemes and improvement grants are the main victims of attempts to offset deficits...

GPs advised to immunise young teenagers with MMR.(general practice physicians)(measles-mumps-rubella vaccine)(Brief Article)
February 4, 2002... GPs are being urged by the Public Health Laboratory Service to immunise secondary school-age children with MMR after warnings that outbreaks of mumps will sweep the nation over the next year. Following a spate of mumps outbreaks in the...

GP backs practice staff pay campaign.(general practice physicians)(Brief Article)
February 4, 2002... Dr Sheena Milne is supporting a campaign for improved pay for practice staff. West Lothian Practice Managers Group is demanding the same pay for GP receptionists as for consultants' secretaries, who were recently upgraded to grade four on the...

GPC charm offensive over contract talks.(general practice physicians)(Brief Article)
February 4, 2002... The GPC has embarked on a series of meetings with grassroots GPs to head off rumblings of discontent over the official silence surrounding the GP contract negotiations. The charm offensive kicked off last week at a closed meeting in...

GPs to comment on failing colleagues.(general practice physicians)(Brief Article)
February 4, 2002... GPs will be asked to comment on the performance of failing colleagues, Dr Rosemary Field, director of primary care development at the newly established National Clinical Assessment Authority, has revealed. The authority, which is due to...

GPs told to tell patients at risk of vCJD.(general practice physicians)(Creutzfeldt-Jakob disease)(Brief Article)
February 4, 2002... A leading expert on CJD has condemned a Government plan for GPs to inform patients at risk of developing vCJD through exposure to contaminated blood supplies or surgical instruments. Department of Health statistics show 22 people are known...

91 GPs in fraud investigations.(Brief Article)
February 4, 2002... The NHS counter-fraud directorate has revealed that 91 GPs are currently under investigation for fraud. Cases include fraudulent dispensing and improvement grant claims and pension contribution anomalies. Derby GP Dr Farouk Ibrahim was...

400 GPs apply for golden hellos.(general practice physicians)(Brief Article)
February 4, 2002... The Department of Health has received just under 400 applications from GPs for `golden hello' payments since the scheme was launched in early November. New GPs can apply for golden hellos of up to #10,000 for taking up a post in either GMS...

GPs set for double burden of HIV.(general practice physicians face doubled HIV caseload)(Brief Article)(Statistical Data Included)
February 4, 2002... GPs will have a daunting task caring for patients with HIV as the number of diagnosed cases in England and Wales is set to double by 2005. The tally for new diagnoses for 2001 is expected to reach 4,000, according to the Public Health...

Patients find errors in records.(Brief Article)
February 4, 2002... Dr Cecilia Pyper said her patients welcomed a scheme giving them access to electronic notes - despite inaccuracies found in them. Dr Pyper and colleagues at the Bury Knowle Health Centre in Oxford allowed 100 randomly selected patients to...

Government set to review epilepsy drug safety.(Brief Article)
February 4, 2002... The Government's Medicines Control Agency is to review controversial new research revealing an increased risk of birth defects in babies born to women on the epilepsy drug sodium valproate. The MCA last week acknowledged GPs were in a...

Being overtired is no defence for GPs.(general practice physicians)(Brief Article)
February 4, 2002... Defence bodies have warned GPs that sleep deprivation due to overwork would not be a complete defence in the event of a serious clinical mistake. The Medical Defence Union and Medical Protection Society said that they had received numerous...

GPs urged to restrict courses of antibiotics given to babies.(general practice physicians)(Brief Article)
February 4, 2002... Babies who receive four or more courses of antibiotics in the first year of life from their GP run double the risk of developing asthma, a large study has revealed. The results have prompted the study leaders to urge GPs to think carefully...

`Coughers who blame smoking likely to quit'.(Brief Article)(Statistical Data Included)
February 4, 2002... Dr Tim Coleman's research has found that patients who blame their respiratory problems on smoking are six times more likely to quit than smokers who do not. Dr Coleman, a GP in Nottingham, also found these patients were eight times more...

GPs told to join PMS or forfeit benefits.(general practice physicians)(practice management system)(Brief Article)
February 4, 2002... GPs are divided over controversial plans to corral practices into a PMS pilot scheme covering an entire primary care trust. GPs who fail to go along with the plan have been warned by their primary care group that their practices will `stand...

GPs ran out of time with Men C vaccine.(general practice physicians)(meningitis)(Brief Article)
February 4, 2002... GPs succeeded in immunising only a few 20- to 24-year-olds in the Government's extended meningitis C campaign before the first batch of vaccine supplies expired last week. Practices across the country had to return thousands of out-of-date...

GP talks his way out of paperwork.(general practice physicians)(Brief Article)
February 4, 2002... Dr Ian Buchanan has all but eliminated the need for secretarial support, thanks to his use of voice-activated computer technology for making consultation notes. Dr Buchanan, a GP in Carrickfergus, Northern Ireland, is one of a growing band...

NICE denies showing political bias.(National Institute for Clinical Excellence)(Brief Article)
February 4, 2002... The National Institute for Clinical Excellence has rebuffed claims from the BMA that its decisions are influenced by politics. NICE said its evidence was `more robust and transparent than anywhere else in the world'. The Department of...

Pre-school pertussis booster cuts infant morbidity by 40%.(Brief Article)
February 4, 2002... The burden of pertussis in infants remains high and the Government's new policy of a pre-school pertussis booster will prove cost-effective, research has shown. GPs in England and Wales were ordered to give four-year-olds the new acellular...

Guide cuts colorectal Ca referrals.(cancer)(Brief Article)
February 4, 2002... The national cancer referral guidelines can cut dramatically the number of urgent appointments for colorectal cancers under the Government's two-week rule with no loss in detection of cancers, research shows. The study of 206 GP referrals...

Tony Blair's flattery leaves GPs cold.(general practitioners)(Brief Article)
February 4, 2002... Practices dubbed `innovative' by the Prime Minister for GP access are unhappy with Government priorities - by Nerys Hairon GPs hailed as `innovators' by Tony Blair for fulfilling the 48-hour access target have criticised him for putting...

More backing for the benefits of alcohol.(Brief Article)
February 4, 2002... We know that light-to-moderate alcohol consumption reduces the risk of coronary heart disease and stroke and that vascular disease is associated with cognitive impairment and dementia. This study investigates the direct relationship between...

Effects of aircraft noise on children's learning reviewed.(Brief Article)
February 4, 2002... Does aircraft noise harm children's learning? This sort of question generates heated debate, as the controversy over Heathrow terminal five demonstrates. It is good to balance the heat with evidence. This paper examines the effect of...

GPs must not be passed the buck for treatment abroad.(general practitioners)(Brief Article)
February 4, 2002... The Government's latest ruse to cut waiting lists by sending patients abroad for surgery has already fulfilled predictions by roping GPs into doing pre-operative assessments, fitness to travel forms and assorted clinical investigations. Tales...

Letter: I'm incensed by slight on GP's role in obesity.
February 4, 2002... The recent parliamentary report on obesity (News, January 21) struck a nerve. Apart from being irritated by the banality of most of its conclusions, I was incensed by the suggestion that GPs are not doing enough to help patients with obesity....

Letter: Don't wait too long before referring glue ear cases.
February 4, 2002... I enjoyed Dr Adrian Freeman's article `When are grommets a must for glue ear?' (Clinical, January 14) and would like to endorse everything he said. While there is no doubt watchful waiting is the correct approach, particularly in young...

Letter: GPs mustn't settle for inadequate rewards.
February 4, 2002... I fully agree that the fee of #45 per hour for a `GP with a special interest' is ridiculous (Letter, January 7). This level of pay is suggested by the NHS, for instance for GPs to provide opiate replacement for heroin addicts. As we are...

Former registrar is being subjected to racial abuse.(Brief Article)
February 4, 2002... The problem Like many GP trainers I keep in touch with our former registrars. Recently I had a disturbing phone call from one who had been with us two years ago. In tears, she described how she was being subjected to racist abuse and...

Counting the cost of an accountant.(Brief Article)
February 4, 2002... Q Our accountancy fees for our four-partner practice were in excess of #6,000 last year. We like our accountant and get a good service, but a GP friend said we are paying far too much. Are we? You are clearly satisfied with the service you...

Father asks you to screen his teenage daughter for drugs.(Brief Article)
February 4, 2002... Simon Brown completed his VTS in 1993. He spent time as a hospital practitioner in anaesthetics and as a part-time principal. Since 1997 he has been a full time GP in Ramsey, Cambridgeshire Case history A single father comes to see you...

How do I deal with patients' apparently innocent gifts?(Brief Article)
February 4, 2002... Q I have recently joined a new practice and several patients have brought me welcoming gifts. I have been accepting them to build relationships, but am worried about the message this may be giving patients and my colleagues. A Of course...

Life as a new principal.
February 4, 2002... Dr Aran Gillespie's diary Dr Aran Gillespie is lost for words at a practice meeting, and meets two patients who warrant his close attention I often feel a bit jaded about patients demanding immediate attention for conditions they...

Keeping one step ahead of gastroenteritis hype.
February 4, 2002... GP Dr Lorna Gold interviews consultant virologist Dr Husam Osman, of the Heartlands Hospital, Birmingham, about the perceived gastroenteritis outbreak What organism is responsible for the outbreaks of gastroenteritis in hospitals and...

How GPs can sensibly tackle adult obesity.(general practitioners)
February 4, 2002... Here, GP Dr Linden Ruckert talks to metabolic physician Dr Simon Coppack about the controversial subject of obesity What's in this article * Less physical activity is main cause * No single diet works for everyone * Orlistat and...

Advising asthma patients on safe ways to exercise.
February 4, 2002... Many asthmatics see exercise as a threat to their well-being1. A typical comment is `It makes me wheezy, so I don't do it'. But as well as reaping the usual benefits to the cardiovascular system, bone health, metabolism and so on, they may also...

How GPs can best identify and treat anogenital warts.(general practitioners)
February 4, 2002... Genital warts are a vast and increasing problem - Dr Anne Edwards offers practical advice on diagnosis and current treatments Genital warts are caused by the human papilloma virus (HPV). There are more than 70 strains and HPV 6, 11, 16, 18,...

A personal logbook can help organise your year.
February 4, 2002... Pulse welcomes February entrants to the vocational training scheme Registrar Dr Helen Roberts suggests a simple way of keeping track of all the consultations, courses, tutorials, the video diary and other elements that go to make up the...

A considered approach to telling someone they are dying of cancer.(Brief Article)
February 4, 2002... Continuing our series on managing cancer, Dr Tanvir Jamil looks at ways of breaking bad news Case history Harry is 63 and has cancer of the large bowel. All curative attempts to treat his condition have been stopped. He has lost a lot...

Dealing with anxiety over unexplained weight loss.(Brief Article)
February 4, 2002... Case history 83-year-old Betty had no particular complaints when she came to the surgery accompanied by her daughter, but admitted that she had lost more than a stone in weight. Her daughter was more anxious: `There must be a reason why...

Back answer: What atypical ways can carpal tunnel present?(Brief Article)
February 4, 2002... Q In what ways does carpal tunnel present apart from the `textbook' way? Are there any tips on making the diagnosis? Would referral to a neurologist or hand surgeon be more appropriate? A A high percentage of carpal tunnel syndrome is...

Back Answer: Is low neutrophil level just racial variation?(Brief Article)
February 4, 2002... Q I am told Afro-Caribbean patients can have racially low neutrophil counts. How can I know if this is the case and what levels would suggest this benign cause? A The normal reference range for white cell counts is lower in people of...

GPs expose NHS Direct safety flaws.(general practice physicians)(National Health Service)(Brief Article)
February 25, 2002... Exclusive By Nerys Hairon A flagship out-of-hours GP co-operative testing links with NHS Direct for the Government has launched a withering attack on the `chronically poor service' offered by the nurse-led helpline. In a stark...

GPs waste thousands of appointments chasing up referrals.(general practice physicians)(Brief Article)
February 25, 2002... Dr Haydn Mayo has taken part in a snapshot survey that suggests 9,000 GP appointments a week in Wales are `wasted' purely on expediting hospital appointments. Dr Mayo, who like fellow GPs in Bro Taf spends an average of six appointments a...

GP wins killer-mother libel case.(general practice physician)(Brief Article)
February 25, 2002... A GP has won substantial libel damages after suing a local newspaper that accused him of taking a `peremptory tone' with a mother who went on to kill her two disabled sons when she `snapped'. Dr Peter Brand, a GP on the Isle of Wight and...

Multiple vaccines `might increase risk of asthma'.(Brief Article)
February 25, 2002... US Government advisers have refused to rule out a link between multiple vaccinations in young children and the development of allergic diseases - particularly asthma. An investigation by the US Institute of Medicine immunisation review...

Government strikes deal with GPC on appraisals.(general practice physicians)(Brief Article)
February 25, 2002... The GPC has struck a deal with the Government to launch GP appraisals in April. GP negotiators agreed to support the scheme after ministers backed down on protected time and locum cover. The Department of Health has agreed to revise...

GP rejects Welsh golden handcuffs deal as futile.(general practice physicians)(Brief Article)
February 25, 2002... A golden handcuffs deal of #1,000 extra for every year spent in general practice beyond the age of 55 will not prevent Dr Joseph Skaria from retiring early. Dr Skaria, who is in his 50s, said the deal - announced by the Welsh Assembly last...

June ballot on whether GPs accept contract or quit NHS.(general practice physicians)(National Health Service)(Brief Article)
February 25, 2002... Every GP in the UK will be balloted in June on whether to accept the principles of the new GMS contract - or whether to quit the NHS. All GMS and PMS GPs will receive details in April of the contract framework hammer-ed out by GP...

GP tackles child admission rates.(general practice physicians)(Brief Article)
February 25, 2002... Dr David Sowden believes GPs need more education in paediatrics to stem the rising tide of children's admissions to hospital. Dr Sowden is RCGP representative on the expert working group for children who need acute/hospital services - the...

Government to audit GP CHD care.(general practice physicians)(coronary heart disease)(Brief Article)
February 25, 2002... The Government has asked the Commission for Health Improvement and the Audit Commission to hold GPs to account for their management of coronary heart disease. CHI and the Audit Commission have been drafted in to scrutinise practice CHD...

GPC acts over violence on GPs.(general practice physicians)(Brief Article)
February 25, 2002... Most health authorities have failed to implement measures for treating violent patients in primary care, says the GPC. A survey of 41 LMCs found only seven health authorities had taken necessary steps to protect GPs. The GPC has sent a...

GP dementia care `in crisis'.(general practice physicians)(Brief Article)(Polling Data)(Statistical Data Included)
February 25, 2002... An Audit Commission study of 8,051 GPs showed over half felt they had insufficient training to deal with dementia. A significant minority - two-fifths - were reluctant to diagnose the condition early, allowing situations to reach `crisis...

CMO rejects MMR moratorium plea.(Chief Medical Officer)(measles-mumps-rubella vaccine)(Brief Article)
February 25, 2002... The Chief Medical Officer has refused to bow to GPC demands for a moratorium on MMR target pay. Professor Liam Donaldson said that any changes to the target pay system would reduce confidence in the vaccine. GP negotiators responded by...

48-hour access not public priority.(medical care survey)(Brief Article)(Polling Data)(Statistical Data Included)
February 25, 2002... Access to a GP within 48 hours is not a top priority for the public, two major opinion polls showed last week. GP access within 48 hours ranked only seventh out of the options put to viewers in the BBC's Your NHS day poll, gaining only...

Paperwork hits GP COPD management.(general practice physicians)(Brief Article)
February 25, 2002... Dr Daryl Freeman has blamed lack of time and resources and the amount of paperwork GPs face for their failure to manage respiratory disease as well as they could. Speaking at a Royal Society of Medicine conference on chronic obstructive...

Helping you help smokers stop: Measuring success.(Brief Article)
February 25, 2002... How should a GP and patient measure their success when managing smoking cessation? Dr Tim Coleman offers advice. Although the vast majority of GPs recognise the harm that smoking does, many remain sceptical about the influence they can have...

Folic acid and B12 link in Alzheimer's.(Brief Article)
February 25, 2002... Dr Andrew McCaddon recommends folic acid and vitamin B12 to patients showing early signs of Alzheimer's. Dr McCaddon, a GP in Rhosllanerchrugog, North Wales, studied 88 patients with Alzheimer's-type dementia. They had elevated...

Consultants dismissive of GP career.(Brief Article)
February 25, 2002... Consultants and hospital-based teachers have contributed significantly to the GP recruitment crisis by portraying general practice as a `second-class' career, according to an influential Government-funded study. The study of 1,672 doctors...

Five-year partnership feud ends as GP quits.(Dr. Anne Rodway, Dr. Paul Landy)(Brief Article)
February 25, 2002... One of the bitterest partnership disputes in GP history has ended with the retirement of one of the feuding doctors. The five-year row between former BMA council member Dr Anne Rodway and Dr Paul Landy hit the headlines after a judge...

Muscle relaxation can ease asthma.(Brief Article)
February 25, 2002... Muscular relaxation exercises can ease asthma symptoms, a meta-analysis has concluded. Researchers at the University of Exeter reviewed 15 published trials into the effects on asthma of several relaxation therapies, including progressive...

Nurse prescribing plan `could lead to tens of thousands of deaths'.(Brief Article)
February 25, 2002... The Government's decision to extend the nurse prescribing scheme to include nine oral antibiotics carries a real risk of undermining GPs' efforts to tackle antibiotic resistance, experts have warned. Professor Hugh McGavock, a former GP...

GPs get #250 for A&E shifts.(general practice physicians)(hospital admissions and emergencies department)(Brief Article)
February 25, 2002... Dr Zahir Mughal is holding out-of-hours clinics at his local A&E department as part of a pilot scheme to reduce demand on the hospital staff. GPs can sign up for four-hour shifts at Bradford Royal Infirmary A&E department in the project...

Legal risk faced by GPs is still unclear.(general practice physicians)(Brief Article)
February 25, 2002... Medical defence experts disagree on the legal implications for GPs stemming from extended nurse prescribing. Susan Parker, nurse adviser to the Medical Defence Union, said while nurses would carry professional responsibility, employment law...

High levels of progestogen in Pill cuts cancer risk.(Brief Article)
February 25, 2002... Prescribing a combined oral contraceptive with a high rather than a low progestogen content can more than halve a woman's risk of ovarian cancer, research has suggested. The US study also showed that women not taking any oral...

`Difficult hypertensives need nurse advice'.(Brief Article)
February 25, 2002... Dr John Pittard wants nurses to play a bigger role in giving lifestyle advice to `difficult' patients with hypertension who ignore warnings to lower their blood pressure. Dr Pittard, a GP in Middlesex and a member of the CHD national...

NICE to rule on cannabis-based drugs.(National Institute for Clinical Excellence )(Brief Article)
February 25, 2002... Cannabis derivatives could be licensed in the UK by the end of next year and available on prescription within three years to relieve spasticity in multiple sclerosis. GW Pharmaceuticals and Solvay Healthcare, which are conducting trials of...

GP hits back at MP's criticism.(general practice physician Dr. Bill Parker)(member of parliament Barry Sheerman)(Brief Article)
February 25, 2002... Dr Bill Parker has hit back at an MP's claim that GPs `leaned on patients' to get public support for their own primary care trust. Dr Parker, a GP in Huddersfield, said Labour MP Barry Sheerman's accusations were unfounded. `People in this...

GPs escape legal action in paroxetine withdrawal.(general practice physicians)(Brief Article)
February 25, 2002... GPs have been exonerated by the lawyer heading an impending group legal action against the manufacturer of Seroxat (paroxetine). But he has warned GPs to be more alert to possible withdrawal symptoms of the drug. Mark Harvey, partner...

Liver failure alert over nefazodone.(Brief Article)
February 25, 2002... The Committee on Safety of Medicines is considering strengthening liver failure warnings associated with the antidepressant nefazodone. The move follows warnings to US doctors by the Food and Drug Administration of `rare cases of liver...

GPs prescribe wrong inhaler to one in three children.(general practitioners)(Brief Article)
February 25, 2002... More than a third of children are being prescribed the wrong type of inhaler for controlling their asthma symptoms, a large UK study has found. Researchers said GPs were not following the 1997 British Thoracic Society guidelines for asthma...

Insulin helps older type 2 diabetics.(Brief Article)
February 25, 2002... Insulin therapy improves the overall well-being of elderly patients with type 2 diabetes and poor glycaemic control, according to a new study. Treatment with insulin significantly boosted the mental, emotional and physical health and...

Reassurance on MMR safety.(measles, mumps, rubella vaccine)(Brief Article)
February 25, 2002... Epidemiological studies have to date failed to illustrate a link between MMR vaccination and autism. However, some postulate that this may be due to a `prolonged induction interval' and also the influence of environmental or genetic co-factors...

Mental illness rife in prison.(Brief Article)
February 25, 2002... This article is a real eye-opener and pertinent to GPs, as we are all likely to have contact with current or ex-prisoners. An astounding nine million people are imprisoned throughout the world, two million in the USA alone, and 70,000 in the...

Letter: Changing pension rules may get GPs to stay to 65.
February 25, 2002... Alan Milburn accepts that to fulfil the requirements of NHS modernisation he needs to induce experienced but cynical GPs over 50 to stay in post until 65. But he produced a proposal that Dr Faustus himself would have turned down: #10,000...

Government acts like it is selling double-glazing.(Brief Article)
February 25, 2002... The Government has gone to extraordinary lengths to encourage GPs to sign up for PMS. But its 11th-hour release of additional large sums of money should be treated with suspicion by GPs. There are now only a couple of months to go until the new...

Letter: Nose drops no answer in feeding.
February 25, 2002... I would like to take issue with Dr Tanvir Jamil's advice on infant nose drops (`Blocked nose inhibiting infant feeding', February 18). A recent study has shown saline nose drops to have no clinical value and anyone who has ever been...

Letter: Dr Tanvil Jamil replies.
February 25, 2002... Ephedrine can indeed cause rebound vasodilatation problems, which is why I emphasised that the drops should be used very sparingly. Unlike Dr Menage, I have come across babies who find it difficult to feed and breathe. This causes a lot of...

Letter: Still time for GP locums to get on supplementary lists.
February 25, 2002... In your article `Department to act over locum crisis' (News, Feburary 18) you stated that if a non-principal does not apply before the end of February they cannot work after April 1. This may confuse a number of doctors. The new...

Letter: Why GPs should be working in hospitals.
February 25, 2002... In order for the NHS to move forwards, it must consider a radical change of mind-set and structure, rather than merely shuffling present procedures around. I would therefore like to propose the following. A GP working a 44-week year should...

Practice partners have different views on earnings.(Brief Article)
February 25, 2002... The problem Four years ago I joined my partner who is in her mid-50s. She and her solicitor husband have no mortgage and a combined annual salary of #150,000. I am mid-30s, have a wife who stays at home to look after our three children, a...

Don't give up on your MMR target.(measles, mumps, rubella vaccine)(Brief Article)
February 25, 2002... Why it is still worth making the effort to achieve top targets, by Dr John Couch As the media and public debate about MMR rages, GPs are left stuck firmly in the middle. The controversy is not of our making but we are still expected to...