GP articles from February 2010

GP archives from February 2010

Opinion: When there are no words, look to John Wayne.
February 26, 2010... General practice is a broad church and a multi-coloured tapestry. Its manifestations are legion, and we can't be prepared for all of them; its vagaries can leave us scrambling for the right words, as the skill of extemporaneous dissembling, like...

Opinion: It's a dog's life - but it can help obese patients.
February 26, 2010... There is much talk about tackling obesity, while at home the incontinent Chihuahua is teaching us all about formative feedback. The world's smallest wolf revealed her true nature when first she saw a piece of raw chicken. It was like seeing...

Clinical: Journals Watch - Knee injuries, GAD and opioids.(Report)
February 26, 2010... Don't have the time to catch up with the latest journals? Dr Alison Glenesk brings you up to date. Outcome of knee injuries in general practice - Br J Gen Pract 2010; 60: e56-e63 We see quite a number of knee injuries in our daily work,...

Clinical: Injuries.(Case study)
February 26, 2010... - Fractured olecranon This man fell off his mountain bike and was very lucky to sustain only a relatively minor injury. He had a fracture of the tip of the olecranon. In spite of this, he had minimal problems and was back on his bike soon...

Clinical: Clinical Review - Bronchiolitis in children.(Disease/Disorder overview)
February 26, 2010... By Dr Prasad Nagakumar, paediatric respiratory registrar, Royal Brompton Hospital and Professor Andrew Bush, paediatric respirology professor, Imperial College and Royal Brompton, London. Section 1: Aetiology and classification Acute...

Clinical: At a Glance - Molluscum contagiosum vs HSV.(Disease/Disorder overview)
February 26, 2010... MOLLUSCUM CONTAGIOSUM Presentation - Caused by a DNA pox virus. - Transmitted by skin contact. Incubation two to seven weeks. - Most common in children and young adults - often sexually transmitted in adults. - Presents with small,...

Clinical: The basics - Dyspepsia.(Disease/Disorder overview)
February 26, 2010... Treatment can be simple, but dyspepsia is so common it is costing the NHS, says Dr Anna Cumisky. Most people experience a degree of dyspepsia at some time in their lives, and for some it may be a lifelong, relapsing and remitting problem. It...

Clinical: Substance misuse - Managing amphetamine use.(Drug overview)
February 26, 2010... GPs should be aware of illegal stimulants and the best ways to help users, says Dr Gordon Morse. Humans have exploited chemicals to counteract negative feelings for centuries and developed the ability to make psychoactive drugs de novo. ...

Clinical: Headache fact file - Classification of the headache.
February 26, 2010... In the first of a new series of monthly headache fact files in association with the RCGP, headache lead Dr David Kernick explains how headaches can be classified as primary and secondary. Headache is formally classified by the International...

Clinical: Red flag symptoms - Tinnitus.(Disease/Disorder overview)
February 26, 2010... Provide reassurance but watch out for serious underlying causes. Tinnitus (from the Latin for ringing) is a common ear complaint which can affect people of all ages. At least 15 per cent of the UK population experience it at some stage,...

Education: Medico-legal - Alterations to medical records.
February 26, 2010... Patients have rights regarding their medical records, but there are exceptions. GPs come into contact with medical records on a daily basis. Now that there is an increasing emphasis on cross-team working, information in records has become...

Education: Book Review - Test questions for the AKT exam.(nMRCGP Practice Papers: Applied Knowledge Test )(Book review)
February 26, 2010... The book is split into 19 chapters for targeted studying and is accompanied by online extras to compete with exam revision websites Review by Dr Ankit Kant. This book from the popular PasTest series aims to be a complete revision aid for...

Education: A registrar survival guide - How to gain recognition in the workplace.
February 26, 2010... Knowledge Keep up to date with your knowledge. After a course, summarise key points and share them with colleagues. Do some teaching. - Skills Develop your skills such as coil fitting or minor surgery. Can your IT, language or...

MedEconomics: Employment Law - Creating the right staff contracts.(Law overview)
February 26, 2010... Practices must ensure that staff employment contracts meet legal requirements. As a GP partner or practice manager, you may have been recruiting staff for years without ever being quite sure of your obligations in relation to documenting the...

MedEconomics: Helping hospices develop care.
February 26, 2010... Hospices need the help of GPs to dispel some myths and to create new models of care. The hospice movement has gathered pace in recent years, so it is no surprise that the role of hospices and specialist palliative care services is not fully...

MedEconomics: Ask the experts - Surgery closure and recruitment.
February 26, 2010... Q: Business interruption cover I have taken over responsibility for our insurance arrangements from a retiring partner. As a surgery insurance novice, I am not clear what business interruption cover is, or if we need it. Can you clarify? ...

MedEconomics: Focus on youth at GP-led centre.
February 26, 2010... A new health centre in Oldham is targeting young people's health Dr Shelley Grumbridge explains. I am one of five GPs at Lindley House Health Centre, a new GP-led facility in Oldham that has a special focus on improving services for young...

MedEconomics: Revalidation - The essential guide to gaining CPD credits.(Royal College of General Practitioners)(continuing professional development )
February 26, 2010... Accumulating credits is not difficult if you plan ahead and stay positive, says Professor Ruth Chambers. 1. Be prepared and don't panic about what you have to do. 2. Keep abreast of the RCGP revisions to the requirements for GPs of 50 CPD...

MedEconomics: Dispensing - Welcoming the RCGP Rural Forum.(Royal College of General Practitioners)(Conference news)
February 26, 2010... If you care about the future of rural practice, join the Rural Forum, writes Dr Malcolm Ward. Last February, the RCGP UK Council voted overwhelmingly in favour of the creation of the Rural Forum which will run as a two-year pilot. The...

Plain Tales from the Surgery.
February 26, 2010... - Fit for a president A patient proudly told me that he had been diagnosed with an 'inaugural hernia'. I presume it was so impressive that when the examination curtains were drawn back in the outpatient department, he received a round of...

Enhanced services funds diverted.(local health boards)(David Bailey from British Medical Association. General Practitioners Committee)(Local Medical Committee)(Conference news)
February 26, 2010... Welsh LMCs Conference Practices denied funding - Half-day closing warning - Call for GP swine flu jabs. Local health boards diverted more than half of a pounds 6.5 million uplift for enhanced services in Wales in 2008/9 to other services, GPC...

GPs 'should have the swine flu jab'.
February 26, 2010... GPs should vaccinate themselves against swine flu to convince patients to have the jab, Welsh LMCs believe. LMC representatives voted unanimously in favour of a motion calling for all health professionals to have the jab to set an example for...

GPC wants end to half days.
February 26, 2010... GPC Wales has urged practices to examine their availability to patients and said practices that close for half a day should consider staying open. Dr David Bailey, GPC Wales chairman, said that since the GMS contract came into operation in...

Tough HbA1c targets 'will cut QOF diabetes scores'.
February 26, 2010... Diabetes - Decline in patients hitting the lowest HbA1c target. QOF payments for diabetes are likely to fall this year as GPs push fewer patients to achieve the lowest HbA1c target, experts have warned. But government officials warned GPs...

Bowel disease link to VTE risk.
February 26, 2010... Patients who have flare-ups of inflammatory bowel disease (IBD) and are not admitted to hospital are at high risk of venous thromboembolism (VTE), researchers have found. A team from the University of Nottingham studied anonymised records of...

GP diary.
February 26, 2010... Mine's a large one Smart marketing of condoms could reduce the spread of STIs, according to a study in the BMJ. It points out that men would rather purchase ill-fitting prophylactics (more likely to break) than admit that their condom size is...

Amlodipine 'outperforms' diuretic in CKD prevention.
February 26, 2010... Hypertension - Lower CKD incidence found with calcium blocker. Calcium-channel blocker amlodipine is more effective than the diuretic hydrochlorothiazide at preventing renal complications in hypertension patients, US research suggests. Dr...

Vitamin D recommended for severe COPD.
February 26, 2010... Patients with severe COPD should take vitamin D supplements, Belgian researchers have suggested. Wim Janssens and colleagues from Leuven University measured serum vitamin D levels in a group of 414 people aged over 50 years. Among the 262...

Flu outbreaks.
February 26, 2010... Low atmospheric humidity in cold weather may explain why flu outbreaks occur in winter, US scientists say. Including humidity data in a computer model of flu reproduced an outbreak pattern seen over a 31-year period (PLoS Biology Online 2010)....

Overweight.
February 26, 2010... Being overweight can help the elderly live longer. For people aged 70, the risk of death is lowest for those with a BMI classified as overweight, researchers say (Journal of the American Geriatrics Society Online 2010). --------------------...

DoH sets out swine flu jab timetable and thanks GPs.
February 26, 2010... Swine Flu - Jabs for healthy children will end next month. Vaccination of healthy children against swine flu will stop at the end of March, but vaccination of other groups can continue until the autumn, the DoH has said. In a letter to...

Flu director steps down as pandemic fears ease off.
February 26, 2010... England's director of flu resil-ience is to step down from his role, as swine flu cases remain at their lowest level since the disease appeared in the UK. Ian Dalton returned to his role as chief executive of NHS North East earlier this...

Details of 'fit note' form are revealed.
February 26, 2010... Fit Notes - The government's revised Med 3 form 'hands responsibility to employers'. The new Med 3 form has been published by the government, revealing the full details of what will be expected from GPs. From 6 April, the so-called 'fit...

GPs set for cash windfall after floating IT system firm.
February 26, 2010... The EMIS Web programme is to be rolled out nationally, after the owners of EMIS reinvest the millions they are set to make when the company is floated on the stock exchange next month. Peter Sowerby and David Stables, former GPs and owners of...

GMC to consult on revalidation.(Brief article)
February 26, 2010... A consultation on the current plans for revalidation will be launched next month, the GMC has revealed. The GMC is asking GPs, patients 'and all those involved or affected by revalidation' to help shape the process. The consultation will be...

Women head the race to lead RCGP.(election between women physicians Clare Gerada v. Maureen Baker)
February 26, 2010... RCGP Election - RCGP to choose first female chairman for 50 years after hustings this week. A hustings event this week will allow the two contenders to replace RCGP chairman Professor Steve Field to make their case for election. Both are...

Test 'failing to boost diversity'.(Brief article)
February 26, 2010... An aptitude test aimed at increasing diversity in medical school entrants still shows an 'inherent gender and socioeconomic bias', a BMJ report says. The UK Clinical Aptitude Test (UKCAT) was found to have a 'favourable bias to male...

Community-based COPD therapy 'is effective'.
February 26, 2010... COPD - NHS research shows pulmonary rehabilitation in primary care is as effective as hospital-based therapy. Pulmonary rehabilitation for COPD patients can be carried out as effectively in community settings as it can in hospital, NHS...

Flu virus triggers anti-inflammatory response.
February 26, 2010... Influenza infection leads to systemic immunosuppression by stimulating the release of anti-inflammatory compounds, researchers have found. Dr Ruslan Medzhitov of Yale University School of Medicine and his team identified that...

Revalidation pilots to test affiliate role.
February 26, 2010... Two GMC affiliates pilots are to be launched within the DoH's 10 revalidation pathfinder pilot areas. The two pilots will be carried out for six months on a regional basis in the West Midlands and in Yorkshire and Humber, to test the...

Behind the Headlines: Will taking statins increase risk of diabetes?
February 26, 2010... Taking statins increases the risk of developing diabetes, according to media reports. Dr Naveed Sattar and colleagues at the University of Glasgow investigated 13 statin trials in a meta-analysis published in The Lancet. The study covered...

GPs consider patient input in judging efficacy.
February 26, 2010... GPs tend to think drugs are less effective than clinical trials suggest because they consider how likely patients are to stick to treatments, as well as efficacy, UK research suggests. Assessments of treatment adherence are ignored in...

Should GPs oversee public health?
February 26, 2010... The Marmot review has called for GPs to play a greater role in improving public health. Stephen Robinson reports. GPs' contracts should prioritise tackling health inequalities, according to the government review published this month by Sir...

A round-up of the best from GP's website this week.
February 26, 2010... GPC video interview Want to know what happened at the last GPC meeting in London on 18 February? Watch our exclusive video interview with GPC chairman Dr Laurence Buckman at healthcare republic.com/video RCGP curriculum updates To...

Letter: Don't lose your memory - vote Tory at your peril.
February 26, 2010... So Dr Cornel Fleming thinks that I am suffering from short-term memory loss does he? (GP, 12 February). I think perhaps we should start by testing Dr. Fleming's memory with a few questions. First: 'Which government gave GPs a 30 per cent pay...

Letter: Medical football team needs new players.
February 26, 2010... For more than 20 years, Stockport FC has usually been the sole English team in the World Medical and Health Games. We have enjoyed success and while other English teams have come and gone, we have endured - but we have inevitably aged too and...

Letter: The Royal Society of Medicine offers the lot.
February 26, 2010... Thank you for the overview of GP clubs I might consider joining (GP, 5 February). Dr Phipps' article on which GP clubs it was beneficial to join was very interesting. However I've actually found that membership of the Royal Society of...

Letter: Interviewees wanted for new BBC documentary.
February 26, 2010... We are researching a documentary series for BBC TV and would like to speak to GPs and doctors about how they manage their finances. The series will examine whether people from different backgrounds and professions actually have the amounts of...

Letter: Ballot box.
February 26, 2010... 55% of GPs think fit notes should replace sick notes. Source: Healthcare Republic. -------------------- Did you find this article useful? Why not subscribe to the magazine? Please call 08451 55 73 55 for more information or visit...

Letter: Your say online... www.healthcarerepublic.com/forums.
February 26, 2010... Fit notes replace sick notes in April... - Good idea, but what do I do with the regular requests from patients for sick notes who have been to sign on and told to see me because the Jobcentre staff feel they should be signed off? Once a...

GPs denied five-figure sums on rent.
February 26, 2010... Exclusive - Three quarters of practices may be underpaid on notional rent, surveyors warn. Up to three quarters of UK practices may be receiving too little notional rent, with some losing out on five-figure sums each year, GP can reveal. ...

PCT plans 'will vaporise services'.
February 26, 2010... Community Services - GPC warns reforms will cut services and 'flout Darzi principles'. Plans to reorganise community services this year will damage patient care and restrict GPs' access to district nurses and health visitors, the GPC says. ...

Swine flu added to seasonal jab.
February 26, 2010... Swine flu will be included in the 2010/11 seasonal flu vaccine, the WHO has announced. The decision follows a four-day meeting examining the influenza strains circulating globally. The organisation announced that the next trivalent vaccine...

NHS should not fund homeopathy.
February 26, 2010... Homeopathy should not be funded by the NHS, according to a House of Commons select committee. MPs on the science and technology select committee analysed scientific literature on homeopathic treatment and found no evidence of efficacy. ...

PMS reviews may force GPs back to GMS.
February 26, 2010... PMS practices could lose tens of thousands of pounds a year as PCTs force them to switch to GMS contracts in an effort to make efficiency savings. National Association of Primary Care president Dr James Kingsland said most PCTs are carrying...

Editorial: Why rent underpayments may be good news.(Editorial)
February 26, 2010... This week, GP reveals that a substantial number of practices in England may be being underpaid notional rent for their premises - some by as much as five figures. Amidst all the doom and gloom about funding cuts, this could be a bit of good news...

Opinion: We are trusted, so why not trust our opinions?
February 26, 2010... As doctors consistently come top of the list of the most trusted people in the country, why do politicians and NHS managers so consistently ignore what we say? It happened over the QOF. The DoH thought it would impose 'tough targets'. Our...

Opinion: Mechanically speaking, I have not got a clue.
February 19, 2010... We doctors suffer from something described as the 'extension of incompetence'. Because of our carefully guarded knowledge in our own area, and the resultant status afforded us by society, we are also presumed to be wise in other areas, legal,...

Opinion: A legend in the making - with muddy boots.
February 19, 2010... Friday 13th and other such superstitious occasions always remind me of a day some years ago, when I was called to see the wise woman, of whom legends are told. How does one acquire such legendary status? The question ran through my head as I...

Education: MRCGP - CSA practice case - Low mood in a menopausal patient.(clinical skills assessment )
February 19, 2010... For use individually or in a study group with someone playing the doctor, patient and assessor. Dr Prashini Naidoo sets out briefs, a marking guide and a debrief for this CSA practice case. The clinical skills assessment (CSA) tests the...

MedEconomics: How to ... Put together a business plan.
February 19, 2010... Matt Green explains why GP practices need an up-to-date plan and how best to compile one. As financial and competitive pressures on practices continue to increase, it is vital that GP partners, the practice manager and staff have a clear and...

MedEconomics: Complaints on patients' behalf.
February 19, 2010... How do you respond if someone other than the patient complains? The MDU's 24-hour advice line receives regular calls from GP members who have received a complaint concerning one of their patients. Often the patient makes the complaint, but...

MedEconomics: Helping patients back to work.(United Kingdom. Department of Health)(Department for Work and Pensions )
February 19, 2010... Only one of the 10 Fit for Work Service pilots is GP-led. Dr Rob Hampton explains what it involves. Last October, the DoH and Department for Work and Pensions chose Leicestershire as a pilot site for a national Fit for Work Service (FFWS). ...

MedEconomics: In a nutshell ... setting up trusts.
February 19, 2010... GPs can help their dependants by putting investments and life cover assets into trusts, says Liz Willis. Many GPs are concerned about how to protect their possessions for the benefit of the next generations: their children and grandchildren....

MedEconomics: Ask the Experts - Partners and retirement.
February 19, 2010... Q: Becoming a Partner - One of the older partners at our practice wants to reduce his hours. To cover the hours this partner will no longer work, we would like to offer our excellent salaried GP partnership status and a profit share, for the...

Dispensing: Providing good customer care.
February 19, 2010... Dispensers need to communicate effectively and assess patients' needs, writes Annette Arthur. Not all staff working in a general practice dispensary consider themselves to have 'customers' - they think of customers as people buying goods in...

Plain Tales from the Surgery.
February 19, 2010... Fishy tale In our computer records for out-of-hours care, each case has a brief history and two summaries amused me greatly. The first read: 'Eight weeks pregnant; keeps being pregnant,' while the second said: 'Pain in bottom; past...

Swine flu comorbidities risk for women during pregnancy.
February 19, 2010... GPs urged to carry out vaccinations on this group. Swine flu infection in pregnancy may be more likely to lead to hospital admission in women who have comorbidities, research suggests. Dr May Li Lim and colleagues studied 211 women with...

GPs to check for swine flu.
February 19, 2010... GPs in England should be assessing patients for swine flu now that the pandemic flu hotline has been shut down, but antivirals must still be picked up from PCT collection points, the DoH has said. CMO for England Sir Liam Donaldson has...

Botulinum toxin jabs may benefit migraine patients.
February 19, 2010... Dermatologists' role 'could expand' to treat some cases. Botulinum toxin injections may alleviate symptoms of some types of migraine, early findings by a US research group suggest. Dr Christine Kim and colleagues from a Massachusetts...

Research Brief: Measuring fat.
February 19, 2010... Visceral fat levels can be assessed using electrical impulses, Japanese researchers believe. The group showed that bioelectrical impedance provided a simple method for accurately estimating visceral fat area (Diabetes Care Online 2010). ...

Research Brief: Bored to death.(Report)(Brief article)
February 19, 2010... UK research suggests that boredom can kill. Individuals who reported 'high levels' of boredom were at double the risk of heart disease or stroke, a study of 7,000 civil servants showed (International Journal of Epidemiology Online 2010). ...

Superficial thrombosis linked to DVT and PE risk.
February 19, 2010... Study finds a quarter of patients with surface leg clots may have DVT or pulmonary embolism. One in four patients with surface leg clots may also have DVT or pulmonary embolism (PE), research suggests. A French study led by Dr Herve...

Athletes at increased risk of developing arrhythmia.
February 19, 2010... Competitive athletes may be at higher risk of developing AF than the general population, a Norwegian study suggests. Researchers conducted ECGs, pulmonary function tests and exercise assessments, as well as echocardiography over a period of...

Study compares UTI strategies.
February 19, 2010... Five different strategies commonly used to manage suspected UTIs achieve similar levels of symptom control, a study published in the BMJ suggests. Researchers studied women with suspected uncomplicated UTIs who were not pregnant. They...

Buckman backs GPs over out-of-hours.
February 19, 2010... GPC chairman writes to LMCs spelling out why GPs should not be blamed. GPC chairman Dr Laurence Buckman has responded to a wave of media criticism in the wake of the recent review of out-of-hours GP services. In a letter to LMCs, Dr...

Dr Buckman's letter.
February 19, 2010... GPC chairman Dr Laurence Buckman wrote to LMCs over reports blaming GPs for out-of-hours failings. Below is an edited extract: This week has seen yet another attempt to rewrite history: a disgraced German 'plastic surgeon and GP' comes over...

Charity calls for generic substitution exemptions.
February 19, 2010... Epilepsy charity voices concern over drug changes. Generic substitution plans need to include measures to allow medicines to be permanently excluded from being switched by pharmacists, the National Epilepsy Society has argued. Last month,...

Patient reviews are urged as inhaler switch looms.
February 19, 2010... Any patients still being prescribed a Beclazone inhaler will need to be reviewed and transferred to another therapy ahead of the product's discontinuation next month. Although other CFC-containing beclometasone dipropionate inhalers are no...

BMA Scotland report says QOF 'cutting inequalities'.
February 19, 2010... Backing for QOF as NICE opens debate on new indicators. The QOF is continuing to reduce inequality in health services, a report by BMA Scotland has concluded, as NICE called for suggestions for the 2012/13 framework. NICE has launched an...

PCTs ordered to focus on out-of-hours care quality.(United Kingdom. National Health Service. Primary Care Trusts)(Conference news)(Brief article)
February 19, 2010... PCTs will be required to have the quality of out-of-hours care on their board meeting agendas for each of the next six months, according to health minister Mike O'Brien. Explaining action to be taken to improve out-of-hours care during a...

Third of palliative care patients not on registers.
February 19, 2010... Report urges practices to develop action plans to boost numbers on QOF palliative care registers. QOF palliative care registers only include two-thirds of patients who should be offered end-of-life care, a report says. Practice teams...

Probation centre first to offer on-site GP services.
February 19, 2010... A probation centre in Merseyside is the first in England to provide GP-led care for offenders as part of a unique healthcare service offered by a PCT and council partnership. Research suggests that offenders typically have the health profile...

Experts want more GP checks on big drinkers.
February 19, 2010... Practices urged to screen 'almost all' patients for evidence of harmful or hazardous drinking behaviour. More patients must be assessed for hazardous drinking in primary care, an expert on alcohol-related liver disease has said. But he...