GP articles from January 2012

GP archives from January 2012

Opinion: When words fail you, get the 'buck' out of there.
January 25, 2012... Ireland used to be the land of saints and scholars, but when you English came along you stole our land, despoiled our relics, cut down all our ancient trees, opened branches of Marks & Spencer, introduced grey squirrels, drank our whiskey,...

Opinion - Generally speaking, it is wise not to generalise.
January 25, 2012... It's important not to generalise, but sometimes you can't help it. We were driving through rural northern California, where the deer and the antelope play. We'd passed nobody for miles and phone reception had long-since disappeared. Giant...

Clinical: The basics - Managing psychosexual problems.
January 25, 2012... Diagnosing a psychosexual problem is possible in general practice, says Dr Margaret Denman. 1. Presentation Presentation of sexual problems in general practice is often not direct A patient may prefer to see a locum or registrar, feeling...

Clinical: Haemolytic disease of the newborn.
January 25, 2012... The most important cause of this alloimmune disease is formation of antibodies to the rhesus D antigen. Haemolytic disease of the newborn (HDN), or haemolytic disease of the fetus and newborn (HDFN) used to be a major cause of fetal loss and...

Education: Medico-Legal - Duty to notify specified diseases.
January 25, 2012... The MDU's Dr Mike Devlin provides updated advice on how to deal with notifiable diseases. GPs in England have a duty to disclose information about patients with notifiable diseases, such as measles, to the local authority. The Health...

MedEconomics: GPs' call-backs solve DNA problems.
January 25, 2012... A Leicester practice achieved zero missed patient appointments one week last year. The 'did not attend' (DNA) problem has vexed general practice for years. Why are there so many DNAs and what can be done about them? Now there is a simple...

MedEconomics: Make a will and keep it up to date.
January 25, 2012... Ian Taunt explains the perils of not making a will and advises GPs on minimising inheritance tax bills. Failure to make a will and to review it from time to time could prevent your heirs from benefiting fully from your estate and result in...

Commissioning: CCg management - How to become authorised.(Clinical commissioning groups)
January 25, 2012... In the first of a series on key issues for CCGs, Ross Clark explains the authorisation process. Clinical commissioning groups (CCGs) looking for guidance on how to become authorised have three main sources: the Health Bill, the Towards...

Clinical: Journals Watch - Cellulitis and prostate biopsies.
January 25, 2012... Not had time to read the journals? Let Dr Louise Newson bring you up to date on the latest research. Prophylactic antibiotics for recurrent cellulitis Br J Dermatol 2012; 166: 169-78 Cellulitis of the leg is common, and repeat episodes...

Clinical Review: Heart failure.
January 25, 2012... Dr Rajiv Sankaranarayanan, a cardiology specialty registrar in electrophysiology, North West Deanery, and British Heart Foundation Clinical Research Fellow. Section 1: Epidemiology and aetiology Heart failure (HF) occurs when abnormal...

MedEconomics: Ask the Experts - Practising under supervision.(Column)
January 25, 2012... Q: PRACTISING UNDER SUPERVISION One of my GP partners is practising under the supervision of another partner under 'contingent removal' from our primary care organisation's performers list. Should this partner still receive a parity profit...

MedEconomics: Book Review - The business of general practice.
January 25, 2012... Dr Jeremy Phipps appraises a book on staying in control of practice finances. The authors of How to manage your GP practice are medical specialist accountant Laurence Slavin and former GP Dr Farine Clarke. Priced at pounds 27.99 and...

Plain Tales from the Surgery.(Column)
January 25, 2012... Chin up, it's not so bad I received a letter from our out-of-hours centre asking us to follow up a patient with a facial skin infection caused by the herpes simplex virus. The diagnosis read: 'Patient has coleslaw which has spread to...

Latest Clinical Research: Falls risk doubles for middle-aged adults taking two drugs.
January 25, 2012... Taking two medicines at the same time doubles working-age adults' risk of falling, researchers in New Zealand have found. Although previous work has highlighted the falls risk from medicine use in the elderly, prevention also needs to tackle...

Infection tools to aid Olympic plan.
January 25, 2012... Tools that predict the global spread of infections may be crucial for planning health service needs during the 2012 Olympics, researchers say. Understanding air travel patterns before and during gatherings is critical for public health...

Research Briefs: Laboratory cheats.
January 25, 2012... Research fraud is common, according to a survey that found one in 10 researchers have witnessed data manipulation. A poll of 2,782 UK academics found that 13% had seen colleagues changing or fabricating data (BMJ 2012; 344: d8357). ...

Research Briefs: Stand up.
January 25, 2012... Office workers need to stand up more, researchers have warned Loughborough University scientists said people 'just forget' to stand up during the working day, with many sitting at desks for as long as they are in bed (British Psychological...

'Fed-up' GPs may quit commissioning.
January 25, 2012... NHS Alliance warns CCGs may fail to achieve authorisation by 2013. Many clinical commissioning groups (CCGs) may fail to achieve authorisation in 2013 as 'fed-up' GPs walk away, the NHS Alliance has warned. Dr Michael Dixon warned there...

Locums and salaried GPs are still being frozen out of CCGs.
January 25, 2012... Commissioning GPC says more must be done to include sessionals. More needs to be done to ensure locum and salaried GPs are not excluded from clinical commissioning groups (CCGs), the GPC has warned. GPC sessional GP subcommittee chairwoman...

Warning about nutrition advice.
January 25, 2012... Nutritional therapists are giving dangerous advice that could seriously damage health and urging patients to keep their GPs in the dark about it, a consumer watchdog has found. GPs must remain the first port of call for anyone who is worried...

Plan for UK-wide cervical screen age.
January 25, 2012... Scotland and Wales set to raise screening age in response to advice about harm in younger women. Scotland and Wales look set to raise the age at which women are first invited for cervical cancer screening after the UK screening body said...

Deadly flu studies must continue.
January 25, 2012... Deadly flu strains must continue to be studied and findings published so that vaccines and treatments can be developed, scientists writing in Nature have urged. A US panel has voted to restrict access to scientific papers describing the...

What Will Integration Mean for GPs?
January 25, 2012... Integration is at the heart of NHS policy. Susie Sell examines how it will work and how GPs could be affected. When the DH backed the Future Forum's proposals on NHS reform, it cemented the place of 'integration' at the heart of health...

Opinion: Ballot box.
January 25, 2012... Take part in our daily polls at GPonline.com. Results from recent polls include: Should the Health Bill be withdrawn? No 18% Yes 82% Should the GMS contract incentivise greater integration between practices? No 59% Yes 41% ...

Opinion: Your say online.
January 25, 2012... GPs face tougher scrutiny over diagnostic scans - So just to be clear, the government wants us to diagnose cancer earlier, refer more appropriately to secondary care, avoid unnecessary referrals and at the same time not over-investigate or...

Letters: Sharing records with patients has benefits.(Letter to the editor)
January 25, 2012... I write in response to Dr Chris Lancelot's article 'Allowing patients to access their medical records is risky' (GP, 11 January). I started to share records with patients in 1994. I wrote the record assuming it would be seen by the patient and...

Letters: Patients have right to see speculative comments.(Letter to the editor)
January 25, 2012... I am a GP and co-director of PAERS Ltd that makes online record access possible now for all EMIS practices. We have had about 70 practices offering record access for many years now. I have been sharing records with patients on paper and...

Letters: Assisted suicide report needs further scrutiny.(Letter to the editor)
January 25, 2012... I was puzzled by your article headlined 'GPs must assess requests to die' (GP, 11 January). It is reported as if the 'commission' were an authoritative and independent body, which had come to a reasoned position in favour of assisted suicide. ...

Editorial: Cutting paperwork would ease workload crisis.(Editorial)
January 25, 2012... This week, GP reveals that the amount of paperwork GPs have to do is spiralling out of control. According to our survey, 23% of GPs are now spending more than half their time on paperwork. Some 91% say paperwork has increased over the past...

Opinion: Why don't we use the tools to better understand ourselves?
January 25, 2012... Are you by any chance an ENTP? Or an ISFJ? If you don't know what I'm talking about - and you may well not - these are two of the Myers-Briggs classification of personality types. Other systems are also used - the Porter's Strength Deployment...

Opinion: GP News Blog.
January 25, 2012... I know GPs are angry about the proposals for pensions. But is this anger enough to make GPs strike? Regardless of how strongly they feel about an issue, the bottom line for GPs has always been that patient safety comes first. ...

Opinion: Money Talks.
January 25, 2012... So the differential between hiring a GP partner or a salaried GP is now only pounds 705 per session. Of course there are other factors to consider, if practice income falls you can make a salaried GP redundant but not a partner. But partners...

Tales from the Black Tower.
January 25, 2012... Of course Sasha is happy to have a job but he tells me he could deliver a better quality service, with some innovation, productivity and preventive work, if he'd been allowed to get on with the job he was trained for in the place he had chosen...

Scan crisis threat to cancer diagnosis.
January 25, 2012... Pressure on tests and shortage of diagnostics undermine cancer detection. Early detection of cancer is being undermined by pressure on GPs to use fewer tests and a lack of NHS diagnostic capacity, a DH adviser has warned. Yorkshire GP Dr...

Quarter of GPs spend half their time on paperwork.(Statistical data)
January 25, 2012... GPs issue warning of 'death by data' as 91% report rise in their paperwork over the past five years. GPs face 'death by data collection', with 24% now spending more than half their time dealing with paperwork, a GP magazine survey has found....

Scrapped NICE guides 'may hit workload'.
January 25, 2012... NICE's decision to scrap 'quick reference guides' that summarise its guidance has sparked concern among GPs who fear it will increase workload and lead to fewer clinicians reading new advice. Abandoning the guides in favour of a new...

Nurses condemn the 'flawed' Bill.
January 25, 2012... The DH last week refused to rethink its plans for NHS reform after the Royal College of Nursing (RCN) joined the ranks of organisations opposing the Health Bill outright. The RCN declared its opposition to the Health Bill 'in its entirety',...

Industrial action looms over cuts to pensions.
January 25, 2012... Government rebuffs call for talks after BMA rejects pension reform in poll of 46,000 doctors. BMA members could take industrial action over pension reforms by the end of March, after health secretary Andrew Lansley ruled out fresh talks. ...

Practice concern over indemnity.(Brief article)
January 25, 2012... Medical defence organisations have seen a dramatic rise in inquiries following changes to indemnity offered by the Royal College of Nursing (RCN). From January 2012, the RCN changed its policy so that defence organisations representing GP...

CCGs 'must fight external pressure to merge'.(clinical commissioning groups)(Brief article)
January 25, 2012... DH adviser forced to defend his own CCG explains why smaller GP groups can be a success. Small clinical commissioning groups (CCGs) should fight back against claims they will fail to achieve authorisation unless they merge, according to a DH...

GP Diary.
January 25, 2012... ANTS THEORY Politicians scrapping over the future of the NHS could learn a lesson from ants, according to scientists from the UK, Ireland and Germany They studied the critters' use of resources and developed computer models they believe could...

GPs could be assessed on unregistered patients' health.
January 25, 2012... Plan for local health assessments 'unworkable'. Plans for the health of unregistered patients to count towards practices' QOF scores are unworkable, the GPC has warned. The NHS Future Forum proposed the move, as well as raising upper QOF...

Hospitals must shift work to meet targets.
January 25, 2012... Hospitals will only meet the efficiency savings required by the Nicholson challenge if they move large parts of their work into community settings, Nuffield Trust researchers say. A review by the Nuffield Trust looked at international and UK...

Opinion: The odds are stacked against GPs in this race.(General Practitioners)(Viewpoint essay)
January 18, 2012... When I was at medical school in Dublin, myself and a few buddies used to skip lectures, bundle into Mickleen Og's little Datsun and go racing. Fairyhouse, Kilbeggan, Ballinrobe, those names still bring it all back to me; carefree youth, the...

Opinion: No need to get in a state about your prostate.(Viewpoint essay)
January 18, 2012... Mr Spleen died last autumn, aged 80, the death he had predicted weekly for 30 years finally proving him right. His spirit lingers in the surgery, partly because he gave me his Barry Manilow CDs and partly because of Mr Healthy, despite the...

Clinical: Journals Watch - IUD checks, vitamin D and pneumonia.(The intrauterine device)
January 18, 2012... Not had time to read the journals? Let Dr Louise Newson bring you up to date on the latest research. Are IUD checks a waste of time? J Fam Plann Reprod Health Care 2012; 38: 15-18 Many GPs still advise women to have their IUDs checked...

Clinical: The basics - Menopause.(Report)
January 18, 2012... Diagnosis is primarily clinical, based on the menstrual pattern and symptoms, writes Dr Sarah Gray. Menopause is technically the last menstrual period and can only be identified retrospectively. Menopause transition is a more helpful concept,...

Clinical: Case Study - Identifying the cause of testicular pain.(Case study)
January 18, 2012... Post-vasectomy pain is a well recognised, poorly publicised condition, write Dr Jonathan Pinnell and Dr Lorna MacColl. A 43-year-old man attended the surgery due to a three-month history of pain in his right testicle. While it was not usually...

Education: Consultation Skills - Effective mental health consultations.(General Practitioners)(Report)
January 18, 2012... As demand continues to grow, Dr Martin Lindsay explains how to achieve more in consultations. Surgeries are reporting that 30% of all appointments are being used by patients seeking help for mental health conditions such as anxiety and...

MedEconomics: Viewpoint - Peer support in a social setting.
January 18, 2012... Need some talking therapy? An evening out with a GP pal is a great 'de-stresser'. Thursday evening at 7.40pm: one more patient to see before the surgery closes at 8pm. I feel like I am running for my life on a hamster wheel, seeing...

MedEconomics: Tax Nuggets - When course expenses tax relief is available.
January 18, 2012... Self-employed GPs can obtain relief on costs to update their skills but not to gain new expertise. Self-employed people rightly think that all expenses they incur in operating their business or helping it to grow, are allowable deductions for...

MedEconomics: Locums - How to get the best from locums.
January 18, 2012... Dr Judith Harvey says the practice may be the real culprit when a GP locum it hires underperforms. GP locums are not going to disappear. If they did, general practice would grind to a halt. But grumbling about them is almost a sport. It...

Commissioning: Leadership Coaching - How GPs can be trained as leaders.(general practitioners)
January 18, 2012... CCGs need to support their GPs, say GP Dr Elizabeth Goodburn and leadership coach Isobel Gowan. GPs are being pushed hard to take on substantial leadership roles: they are at the heart of commissioning and in the spotlight as leaders. We...

GPonline.com: A round-up of the best from GP's website this week.(general practitioners)
January 18, 2012... - Exclusive videos Watch NHS Future Forum chairman Professor Steve Field discuss the group's report which recommends incentivising integration, and Dr Vicky Weeks, chairwoman of the GPC's sessionals subcommittee, talk about her aspirations...

Latest Clinical Research: Statins link to postmenopausal diabetes risk.
January 18, 2012... Postmenopausal women taking statins may be at greater risk of developing diabetes, US research suggests. Dr Yunsheng Ma, of the University of Massachusetts Medical School, and colleagues estimate that these women may be at almost 50% greater...

Immune cells may play part in development of cancer.
January 18, 2012... Immune cells in skin may contribute to the development of cancer, US researchers have reported. A study in mice found that a group of immune cells best known for detecting foreign matter in the skin also promoted tumour growth by metabolising...

Novel hepatitis C drugs proposed.
January 18, 2012... New treatments for hepatitis C could be developed in the wake of research by a US team looking at how the virus is able to enter cells. Researchers from the University of Illinois identified a new cholesterol absorption receptor for hepatitis...

Research Brief: Skin diseases.
January 18, 2012... Clinicians should consider the psychological effects of skin diseases even in cases that are not clinically regarded as severe, researchers believe. A UK team studied patients with acne, psoriasis or atopic eczema and found patients' own view...

Research Brief: Brain decline.
January 18, 2012... Human brains begin to decline at just 45 years old, according to researchers. A study of 7,390 civil servants found cognitive abilities, such as reasoning and memory, began to decline when people were just 45 to 49 years of age, 15 years earlier...

LES boosts uptake of enhanced health check.
January 18, 2012... NHS Heart of Birmingham practices achieve double national target for vascular checks. GPs who signed up to an ambitious NHS Health Check local enhanced service (LES) are on track to far exceed the national target for the programme. ...

GP hands tied on call charge.
January 18, 2012... GP leaders have warned a lack of funding and long-term contracts are preventing practices from using cheaper phone lines now available from suppliers. Campaigners have renewed calls for practices to abandon phone numbers starting with '084'...

By-laws to set local minimum alcohol price.(Brief article)
January 18, 2012... Minimum alcohol pricing could be introduced on a regional basis in England using by-laws drawn up in response to slow national progress on the issue. Local authorities and health trusts across Manchester have worked together to develop a...

Interview: Most GPs 'ready for registration', says CQC.
January 18, 2012... Professor David Haslam says the CQC will iron out problems with registration. Nick Bostock reports. Former RCGP chairman Professor David Haslam has taken on the unenviable task of persuading GPs that registration with the Care Quality...

Clinical Review: Eating disorders.
January 18, 2012... Contributed by Dr Vibhav Shetty and Dr Dasha Nicholls, child and adolescent psychiatrists, Great Ormond Street Hospital feeding and eating disorders service, London. Section 1: Epidemiology and aetiology Eating disorders are serious mental...

MedEconomics: Medico-legal - Learning from clinical claims.
January 18, 2012... Dr Peter Mackenzie throws light on why certain claims brought against GPs cannot be defended. From an analysis of claims brought against its members, the Medical Protection Society (MPS) has found that nearly half the clinical negligence...

Plain Tales from the Surgery.
January 18, 2012... Lost your glasses, son? A mother brought in her four-year-old son with earache. I printed a prescription and gave it to the little boy. He looked at it seriously 'Can you read it?' I asked, smiling. He frowned. 'Not without glasses,' he...

APMS deals could drive GPs off GMS.
January 18, 2012... Move to integrate GPs under APMS deals could lead to US-style NHS. Plans to drive GPs off GMS contracts into APMS deals that pay practices to integrate could transform the NHS into a US-style system, GP leaders fear. The plans fuel fears...

NHS reform concerns trigger GP shift to Labour.
January 18, 2012... GP poll finds mounting anger among GPs over reforms, workload and cuts to income and pensions. GP support for the government is in freefall amid widespread concern about increasing workload, NHS reform and cuts to income and pensions, a GP...

RCGP poll finds 98% oppose Health Bill.(Royal College of General Practitioners)(Survey)(Brief article)
January 18, 2012... Nearly all RCGP members think it should link up with other medical royal colleges to call for the Health Bill to be withdrawn. A total of 98% of more than 2,500 RCGP members who took part in a survey said the college should call for the Bill...

PCTs are blamed for CQC 'myths'.
January 18, 2012... PCTs are fuelling GPs' fears about the impact of registration with the Care Quality Commission (CQC), according to a GP adviser to the regulator. Speaking exclusively to GP, former RCGP chairman Professor David Haslam, now registration lead...

DH adviser urges primary care training focus.
January 18, 2012... DH report backs longer GP training amid calls for medical education to reflect shift to primary care. Early postgraduate medical training must shift its focus from secondary to primary care to reflect plans to move NHS work out of hospitals,...

PCTs must stop blacklisting NICE drugs.
January 18, 2012... PCTs will be forced to make NICE-approved drugs available through the introduction of an 'effective compliance regime', according to health secretary Andrew Lansley. Mr Lansley revealed the plans in response to a question in the House of...

Champion GP slimmer sheds 10 stone.
January 18, 2012... A GP from Cumbria who lost almost half of her body weight has been named Health Professional Slimmer of the Year 2012. Lady Arabella Onslow, 41, a GP at Market Street Medical Practice, Kirkby-in-Furness, (pictured before and after weight...

Use BMI for eating disorder checks.
January 18, 2012... BMI should be the preferred option when assessing weight in adolescents with eating disorders, US researchers say. Clinicians also should refer to body weight as 'expected' rather than 'ideal' to avoid unrealistic expectations, the University...

GPs to face more scrutiny over scans.
January 18, 2012... System to monitor NHS diagnostic testing must include guidance for GPs. Government plans to monitor GPs' use of diagnostic tests must set clear standards to avoid GPs being wrongly accused of inappropriate referrals, the RCGP has warned. ...

BMA plans fightback over cuts to NHS pensions.
January 18, 2012... GPs should send the government a 'strong message' about cuts, urges new BMA pensions chairman. The medical profession will only avoid further attacks on NHS pensions by sending a strong message to ministers about their opposition to cuts, the...

BMA wins legal battle over added years.(Brief article)
January 18, 2012... The BMA has won a legal battle to protect GPs' right to buy additional years for their NHS pensions. The union recently sought legal advice amid fears that the government would close the added years scheme as part of wider pension reforms. ...

Plans unveiled for flexible QOF indicator.
January 18, 2012... GPs could be set for a new kind of QOF indicator that aims to award points for meeting flexible criteria depending on a patient's health. The proposed target, for lipid control in type 2 diabetes, is the first of a new breed of indicator...

GP Diary.
January 18, 2012... ICING ON THE CAKE? When writing an official report about the future of the NHS, it is vital to ensure the findings are presented as clearly as possible. But this message seems not to have reached the authors of the recent NHS Future Forum...

How radical was the Future Forum?(General Practitioner )
January 18, 2012... Susie Sell reports on how health professionals reacted to the NHS Future Forum's proposals for healthcare reform. Right from the outset, NHS Future Forum chairman Professor Steve Field promised to come up with 'radical ideas' for his second...

Opinion: Your Say Online.
January 18, 2012... - GPs will 'reject practice boundary abolition pilots' Would somebody please stop dropping Mr Lansley on his head. Only this can explain the daft schemes he comes up with. Why is it that those who come up with these stupid plans are never the...

Opinion: Ballot box.
January 18, 2012... Take part in our daily polls at GPonline.com. Results from recent polls include: Should GPs take industrial action over the government's final pension offer? No - 19% Yes - 81% Source: GP -------------------- Did you find this...

Letters: The abolition of practice boundaries is unexciting.(Letter to the editor)
January 18, 2012... I have been thinking about the issue of abolishing practice boundaries for some time now. I know that a minority of GPs are 'excited' by it, but I am not clear why. I practise in Tower Hamlets; when people move away, it becomes in many...

Letters: Gaps in musculoskeletal medicine training exist.(Letter to the editor)
January 18, 2012... I write in response to an article regarding training gaps in musculoskeletal medicine (GP, 25 November 2011). As a fourth year medical student on my GP placement, I agree with a lot of what has been said. I cannot speak for all universities,...