GP articles from May 2008

GP archives from May 2008

No link between metabolic syndrome and CVD risk.
May 30, 2008... Identifying patients with metabolic syndrome fails to predict risk of cardiovascular disease (CVD), a UK study has shown. But the syndrome is a strong marker for predicting diabetes in the elderly. Researchers analysed data from two...

Gum disease linked to 14% higher cancer risk in men.
May 30, 2008... Having gum disease could increase a man's risk of developing cancer by 14 per cent, UK research suggests. A group of 48,375 men, aged 40-75, completed health questionnaires at baseline and every two years thereafter for a total follow-up...

Research briefs.
May 30, 2008... - ADHD adults work a month less Workers with attention deficit hyperactivity disorder (ADHD) do 22 days less work a year than people without the disorder, according to a UK study of 7,000 workers aged 18-44, screened for ADHD and asked...

Defence bodies fear unfair rulings under civil standard.(General Medical Council)(Brief article)
May 30, 2008... GMC to base decisions on civil standard of proof from next week. Medical defence experts are bracing themselves for an upsurge in appeals and legal challenges following civil standard of proof introduction in GMC fitness-to-practise...

38,000 records lost in transit.
May 30, 2008... Staff at the Sandown Health Centre on the Isle of Wight are temporarily withholding all data transfers after a routine check revealed that courier firm City Link had lost 38,650 patient records. Isle of Wight NHS PCT is now looking at...

Chlamydia tests need to be 'destigmatised'.
May 30, 2008... Quizzing women about their sexual history discourages attendance for chlamydia screening. GPs should offer chlamydia screening to patients based on age rather than sexual history to help boost screening uptake, according to Australian...

UK GPs to inspect German clinic.
May 30, 2008... A group of GPs has visited Germany to investigate poly-clinics at first hand. Nine GPs from the Family Doctor's Association (FDA) spent a weekend in Berlin, where they toured Polikum Friedenau, Germany's largest health centre. Until...

NICE advice on TIA referrals may be too tough.
May 30, 2008... ABCD2 criteria for suspected TIA referral to rapid-access clinic will only pick up those patients at highest risk. GPs may miss cases of TIA if they follow NICE draft guidelines on stroke, UK research findings suggest. Draft...

Primary care czar attacks BMA's 'hysterical attitude'.
May 30, 2008... DoH primary care czar Dr David Colin-Thome has accused the BMA of 'trade union spin' and questioned the profession's 'hysterical' attitude. Speaking to GPs at the Primary Care 2008 conference in Birmingham last week, Dr Colin-Thome said...

GPs urged to do more for hep B risk.
May 30, 2008... GPs can do more to help protect patients against hepatitis B, claims the British Liver Trust. A survey of 200 UK practices found only half followed Green Book guidelines for vaccinating at-risk patients. At-risk patients include...

Behind the Headlines: Have the HRT scares been overblown?(hormone replacement therapy)
May 30, 2008... Health scares surrounding the use of HRT have been greatly exaggerated and should not put women off using the therapy, according to media reports. An international panel of 40 menopause experts concluded that HRT is safe for women aged...

Your Say Online: Your Say on the Valuing General Practice campaign.
May 30, 2008... - On average, a full-time GP has 2,000 patients and carries out 10,000 consultations. The average income of a GP is pounds 80,000 (or pounds 100,000 if you include employer's pension contribution). So on average each consultation -...

Opinion: Sensitive handling uncovers the plane truth.(Personal account)
May 30, 2008... 'I'm very depressed,' she said. She was usually just averagely depressed, so her wording implied more than the usual menu of trivial discomfitures exaggerated out of all proportion. 'Isn't that too bad,' I said, my sarcasm as subtle as...

Opinion: Hairy moment? Blame it on the hormones.
May 30, 2008... School holidays, and I am alone at the computer, submerged by a mountain of dog hair in a house now so hormonally synchronised that the postman won't even come up the path on day 26. Mrs Flush, who currently stalks my bookable...

Editorial: Three heart tools, one guideline and no answers.(United Kingdom. National Institute for Clinical Excellence)(Editorial)
May 30, 2008... In a spectacular U-turn NICE has backtracked on its recommendations for cardiovascular risk assessment. In February, NICE's draft guideline on lipid modification plumped for the new, UK-developed QRISK tool over the established, but much...

Opinion: Desperate measurers fear a truly free market.(United Kingdom. National Health Service)(Viewpoint essay)
May 30, 2008... One of the least-recognised attributes of a truly free market is that it contains a lot of information. By contrast, a command economy contains little or none. When prices, availability and standards are all fixed centrally, they give no...

Clinical: Journals Watch - Ultrasound, HPV and childhood flu.(human papillomavirus)
May 30, 2008... Too busy to read the latest research? Let Dr Gwen Lewis keep you up to date. Ultrasound scanning in the community - J Fam Plann Reprod Health Care 2008; 34: 115-7 I was especially interested to read this audit of scanning in...

Clinical: Case study - A case of heavy legs.(Case study)
May 30, 2008... An infrequent attender presented with aching legs, explains Dr David Morris. Malcolm was a 66-year-old retired bank manager whom I had not seen before - a testament to his good health and his ability to self-manage minor illness. ...

Clinical: Competition answers.
May 30, 2008... MIMS prescribing quiz MIMS is the perfect place to refresh your prescribing knowledge and our monthly quiz helps keep you up to date, with the added incentive of a prize draw for pounds 50 of John Lewis vouchers. WINNER Thank...

Clinical: Red flag symptoms.(Brief article)
May 30, 2008... - Vomiting - Headache - Fever - Increased bowel sounds - Haematemesis - Weight loss - Dental erosion - Severe eye pain However, knowing a few key things to look out for can help distinguish between a self-limiting viral...

Clinical: At a Glance - Minor aphthous ulcer vs hand, foot and mouth.
May 30, 2008... Minor aphthous ulcer Discriminatory signs - Small and round or oval - Affects cheeks, lips or gums. - Pale centre surrounded by erythematous swollen mucosa. - Lasts seven to 10 days; resolves without scarring. - Women affected more...

Clinical: Equipment review - One-button BP monitoring.(Product/service evaluation)
May 30, 2008... This simple digital BP monitor is best suited to patient use, says Dr Nigel Stollery. In 21st century primary care, preventative medicine is an essential part of patient care, and managing hypertension is key to the process. This...

Clinical: The basics - Chronic obstructive pulmonary disease.
May 30, 2008... Effective management of COPD should preserve lung function and control exacerbations, says Dr Laurence Knott. The term COPD embraces patients formerly diagnosed with chronic bronchitis and/or emphysema. The main feature is airflow...

Clinical: Clinical Review - Rheumatoid arthritis.
May 30, 2008... Contributed by Dr Edith Villeneuve, rheumatology research fellow, and Professor Paul Emery, professor of rheumatology, at Leeds Teaching Hospitals. Section 1 Epidemiology and aetiology Rheumatoid arthritis (RA) is the most common...

Education: Professional development - The role of an educational supervisor.(Alexander Williams)(Occupation overview)
May 30, 2008... Working as an educational supervisor can be stimulating and rewarding, says Dr Alexander Williams. In 2007 I became an educational supervisor to two medical students and four doctors in specialist training for general practice. I...

MedEconomics: How to ... Pick your extended hours contract.
May 30, 2008... Jonn Elledge considers the merits of negotiating the local version of the DoH's late opening plan. The imposition of extended hours created unprecedented anger among practices. But threatened with an average pounds 18,000 funding cut,...

MedEconomics: 'Why we should be valued'.
May 30, 2008... GPs' opinions on polyclinics and what patients like about current general practice. Doctors have long topped popularity polls as the professionals the public rate the most highly. So what do patients tell their GPs they value most...

MedEconomics: Ask the experts - Premises, pensions and tax queries.
May 30, 2008... Q: Valuing Premises The district valuer (DV) has reduced the valuation of the message-taker's flat in our surgery building by 15 per cent. I am not sure if there is any statutory authority for doing this but I am told the relevant...

Dispensing: Practice Finance - Forming your own company.
May 30, 2008... Dr Jeremy Phipps explains a key step for applying for a pharmacy licence. The Pharmacy White Paper has forced dispensing doctors to consider setting up limited companies to apply for pharmacy licences. However, doctors also may wish to...

Plain tales from the surgery.
May 30, 2008... - Deep cleaning A middle-aged overweight man entered the consulting room with a look of horror on his face when he realised he had booked in with a youngish female GP. After some deliberation and with a shifty gaze he mumbled...

At-risk elderly denied bone scans.
May 30, 2008... Only a quarter of eligible women over 75 receive osteoporosis medication in the UK. Osteoporosis care in the UK is falling far short of national guidelines, researchers claim. The first evaluation of nationally representative data on...

GPs to call for mass resignation at LMCs conference.(Conference news)
May 30, 2008... GPs will vote on whether to collect undated resignations at the UK LMCs conference next month. This year's meeting looks set to be controversial as GPs vent their fury at 'unprecedented' political threats. Delegates will be asked to...

Exclusive - LIFT to pay for Darzi's health centres.
May 30, 2008... Premises for DoH super-surgery plan could be owned by private investors. All the new health centres created by the Darzi review could be majority owned by private investors, GP has learned. It is understood that most new building...

Pre-op statins cut death rates.
May 30, 2008... Patients are 43 per cent less likely to die following surgery for heart disease if they have been taking statins, according to German researchers. A meta-analysis of 19 studies was conducted involving a total of 31,725 patients...

GMC pushes ahead with appraisal plans.(General Medical Council)(Brief article)
May 30, 2008... GPs will have to put together a portfolio of evidence each year for annual appraisal, according to the GMC. Doctors will have to demonstrate their competence in four domains: knowledge, skills and performance; safety and quality;...

GP named Mind Champion.(Dr Liz Miller )(Brief article)
May 30, 2008... London GP Dr Liz Miller has been named Mind Champion of the Year for 2008. Dr Miller, who has bipolar disorder, collected her award last week at a central London ceremony hosted by Melvyn Bragg. The award was voted for by visitors to...

Single cardiovascular risk tool needed for UK.
May 30, 2008... NICE guidelines on lipid modification prompt experts to call for consistency in cardiovascular risk tools. A single cardiovascular risk assessment tool is needed for the whole of the UK, experts have warned. The call comes after NICE...

GP referrals delayed due to Christmas appointments.(General Practioners)(Brief article)
May 30, 2008... Patients making Choose and Book referrals to a hospital in south west England are being giving appointments on Christmas Day. Staff at a local GP practice say that patients referred to certain departments at the Royal United Hospital in...

GMC to pilot affiliates plan announced.(General Medical Council)(Brief article)
May 30, 2008... Pilots into GMC affiliates will be rolled out in September. Under the scheme, lay and medical GMC 'affiliates'will monitor concerns about doctors locally. One medical and one lay af-filiate will be responsible for a region, where...

GPs should offer BNP level testing.
May 30, 2008... GPs should test for elevated plasma B-type natriuretic peptide (BNP) levels to identify those most at-risk of heart failure and cut mortality risk by swapping medications, UK researchers have suggested. Currently, BNP tests are performed...

News in brief.
May 30, 2008... Army GPs given pay rise GPs in the armed forces have been awarded a 3.7 per cent pay rise. It was accompanied by a 1 per cent rise in the x-factor, a basic wage that everyone in the armed forces receives. In the UK, the average wage for...

Bone scans urged for nursing home residents.
May 30, 2008... European symposium on calcified tissues DXA scans for over-70s, glitazone risks and osteonecrosis guide. Routine dual X-ray absorptiometry (DXA) scanning of patients on entry to nursing or residential homes would cut morbidity and cost of...

Glitazones raise risk of fractures.
May 30, 2008... Glitazone treatment for type-2 diabetes increases the risk of osteoporotic fracture two to three-fold, according to data presented at the symposium. The analysis of patient records included 1,020 type-2 diabetes patients, aged 50-89...

Osteonecrosis fears alleviated.
May 30, 2008... GPs can reassure patients taking bisphosphonates for osteoporosis that they will not have to stop treatment when undergoing dental surgery. Recent reports of cases of osteonecrosis of the jaw (ONJ) in patients taking bisphosphonates had...

Clinical: AAA screening.
May 30, 2008... Mr Matthew Waltham says GPs are central to detecting aortic aneurysms. Some 5-10 per cent of UK men over 65 have an abdominal aortic aneurysm (AAA) and, for men, it is the 12th most common cause of death. At present, screening is not...

Behind the headlines: Can breastfeeding prevent RA?
May 23, 2008... Women who breastfeed for more than a year can halve their risk of developing rheumatoid arthritis (RA), reports suggest. Women who breastfed for 13 months or more were 54 per cent less likely to develop the condition than women who had...

Opinion: Introducing the queen of drug reactions.
May 23, 2008... She was a new patient, which is in itself usually reason to be suspicious. The kind of patient I like is one who never comes, who doesn't know who their doctor is or even where the health centre is: these patients are low maintenance. In...

Opinion: GP's need a dose of good old camaraderie.
May 23, 2008... 'Alastair, look at me, not at the floor. What does it take to make you look? Perhaps I shall remove my shirt. One day you will finally look up and I shall be entirely naked. 'Miles, you can't possibly need the toilet again, there must be...

Clinical: Journals Watch - Bruits, vitamins and diabetes.(Cardiovascular diseases risk decreases on cessation of smoking)(Carotid bruits may indicate an increased risk of heart attack)
May 23, 2008... Too busy to catch up on the latest research? Let Dr Raj Thakkar update you on recent papers. - Stopping smoking and mortality JAMA 2008; 299: 2,037-47 There is no question that smoking increases the risk of cardiovascular...

Clinical: Psychological issues affecting the skin.
May 23, 2008... - Persistent leg ulcers We have all seen lonely, housebound, elderly patients who have leg ulcers that never seem to heal. Somehow compliance with instructions never seems to be achieved, bandages have been loosened and legs constantly...

Clinical: The basics - Sexually transmitted infections.(Disease/Disorder overview)
May 23, 2008... Dr Alison Glenesk looks at how common infections present and how to raise awareness of prevention. STIs are reaching epidemic proportions in Britain. The incidence of chlamydia presenting to GUM clinics increased by 300 per cent between...

Clinical: Viewpoint - Dispelling herbal medicine myths.
May 23, 2008... Although herbal medicines have a role, the evidence is weak for some claims, says Dr Peter Canter. The use of herbal medicines is widespread and growing. In developing countries, they often represent the main form of healthcare, and in...

Clinical: Test yourself - MIMS prescribing quiz.
May 23, 2008... MIMS is the perfect place to refresh your prescribing knowledge, and we have devised this regular quiz to help you keep up to date, with the added incentive of a prize draw for pounds 50 of John Lewis vouchers. Each monthly edition of...

Clinical: Clinical Review - Psychosis.(Disease/Disorder overview)
May 23, 2008... Section 1: Aetiology and epidemiology In psychosis there is a loss of contact with reality as a result of delusional beliefs and/or hallucinations. There are many causes of psychosis: illicit drug use, for example cocaine and...

Education: A problem shared - Patient with a chronic illness.
May 23, 2008... A patient is taking up your time with queries. What should you do? The Problem A patient of yours has been diagnosed with a rare, progressive neurological condition. As a result she attends almost weekly and calls you frequently with...

Education: MRCGP Exam Update - Smoking cessation.(Membership of the Royal College of General Practitioners )
May 23, 2008... Current situation - In the UK, the treatment of smoking-related disease has been estimated to cost the NHS up to pounds 1.5 billion a year. - People over 60-years and women are more successful at stopping smoking. - Half of...

MedEconomics: Personal finance - Devise a successful savings plan.
May 23, 2008... Despite the dismal economic climate there are investment bargains for canny GPs, says Liz Willis. For GPs whose personal finances are unaffected by - or only peripherally caught up in - the credit crunch, there are good opportunities to...

MedEconomics: Ask the experts - Seniority pay and childcare costs.
May 23, 2008... Q: SENIORITY PAY Does the annual NHS earnings threshold for seniority pay still exist and if so, what is the current earnings threshold that a GP must earn before qualifying for full seniority. A GP partner at our practice wants to work...

MedEconomics: Clinicians' circle supports GPs.
May 23, 2008... A clinician-led company is helping GPs bid for new services, says Fiona Barr. Portsmouth, the town known for its soccer and sailing, is a leading player in the fightback by GPs against the threat to traditional general practice. In...

MedEconomics: Helping patients back to work.
May 23, 2008... Local job advisers sited at practices add value to community health services. GP practices hosting on-site employment advisers could prove a valuable service for patients with long-term health problems if Burnley GP Dr Narendra Singh's...

Dispensing: Pharmacy white paper - Replacing dispensing with a new pharmacy.
May 23, 2008... Applying for a pharmacy licence is low cost and low risk and could safeguard the practice, says Dr Jeremy Phipps. The real and serious threat to dispensing practices from the Pharmacy White Paper has led practices to consider converting...

Plain tales from the surgery.
May 23, 2008... - Give us a lift The Health and Safety officer at my patient's workplace had asked him to get a fitness for work note. I was happy to help but the patient's knee injury was still causing some pain and there were stairs to be...

Extra training in paediatrics proposed for GPs.
May 23, 2008... SHA reports call for 'children's GPs', along with urgent care centres, virtual polyclinics and better technology. Doctors' leaders have warned that proposals to create a new grade of 'children's GP' in Yorkshire would undermine...

Arterial BP for pre-eclampsia.
May 23, 2008... Measuring mean arterial pressure is a better predictor for pre-eclampsia than taking systolic and diastolic BP readings, Dutch research suggests. Currently, it is unclear which measurement of BP is the most accurate at predicting...

Anti-thrombosis therapy questioned - European Stroke Conference.(Conference news)
May 23, 2008... Doubts over gold standard therapy, benefit of early mobility and birth weight. The gold standard in anti-thrombosis therapy is no more effective than second-line treatment, according to the largest study into secondary stroke prevention...

Scots 'have first stroke earlier'.
May 23, 2008... Claims that stroke rate is falling in Scotland are untrue, with figures masking a rise in first-time hospitalisation for strokes among the under-55s. Recent population-based studies have suggested that the rate of first hospitalisation...

Low birth weight linked to stroke.
May 23, 2008... Low birth weight could be a risk factor for ischaemic stroke in adulthood, Danish research findings suggest. Baby boys who weighed 2-2.75kg at birth were found to be 60 per cent more likely to have a stroke than those weighing...

Early mobility helps depressed.
May 23, 2008... Getting a patient up and moving within 24 hours of a stroke can protect against depression, argue Australian researchers. After stroke, patients typically spend at least half of the day resting in bed. Because immobility is known to...

Summary care records are delayed until 2014.
May 23, 2008... A key part of the National Programme for IT (NPfIT) is now four years behind schedule, say government auditors. In a report out last week, the National Audit Office (NAO) says that the programme has made progress and its cost remains...

Large numbers of GPs consider Virgin link up.
May 23, 2008... Around 300 practices have already made contact with Virgin Healthcare to discuss setting up Virgin-branded health centres. The company says that the enquiries, which follow its two months of road shows earlier this year, are from...

Why the RCGP is backing GP's Valuing General Practice campaign.
May 23, 2008... 'Successful change must be local and led by clinicians'. With the publication of Lord Darzi's review on the horizon, there is no doubt that the government is committed to seeing through major changes in primary care. As the linchpin...

'Encouraging' trial results for first meningitis B vaccine.
May 23, 2008... The first vaccine against meningitis B has shown 'encouraging' results in preliminary trials. Mass vaccination against meningitis C was added to the UK's childhood immunisation programme in 1999. But no vaccine has yet been developed...

Urgent care best practice sought.
May 23, 2008... The Primary Care Foundation has invited GPs to tell it about their best work. The DoH has commissioned the foundation to review best practice in urgent care. Practices are invited to submit details of innovative ways to improve access...

Editorial: Time to tailor general practice to fit diversity.(Editorial)
May 23, 2008... General practice is no longer a one-size fits all profession. It may have been the case at the founding of the NHS, when the majority of GPs were male partners and full-time in the fullest meaning of the term. Now we have a profession...

Opinion: The NHS can learn a lot from Milton Friedman.(National Health Service)
May 23, 2008... The economist Milton Friedman made a telling observation: the care with which we spend money depends upon whether it is ours or someone else's. When spending our own money on ourselves we take care to get exactly what we want, at exactly...

Exclusive - Rift fears for partners and salaried GPs.
May 23, 2008... Exclusive - Londonwide LMCs call for employed GPs to be heard in medical politics. The under-representation of salaried and sessional GPs in medical politics risks pulling the profession apart, according to a Londonwide LMCs report. ...

Darzi says one-size-fits-all polyclinics 'not the answer'.(Patent Cooperation Treaty)
May 23, 2008... Polyclinics will not be imposed on the whole of England, health minister Lord Ara Darzi has confirmed. Each PCT has been told to create a new GP-led healthcare centre by the end of the year. But Lord Darzi told GP that London-style...

LMCs seek more female members.(Local Medical Committees)(Brief article)
May 23, 2008... Women GPs are being urged to increase their profile in medical politics and stand for election to LMCs. The call follows revelations of 'gross under-representation' in LMCs and growing workplace discrimination. At the same time, LMCs...

Triathalon challenge for a GP.
May 23, 2008... Dr Rachel Ward, a senior partner at the Stourport on Severn health centre in Worcester, will be representing Great Britain at the World Triathlon Championships in Canada next month. Dr Ward, competing in the over-45 category, said the...

GP care a third of A&E costs.
May 23, 2008... A GP consultation is less than a third the price of a trip to A&E, BMA figures show. Speaking at the King's Fund last week, GPC spokesman Dr Nigel Watson said that consultations with GPs cost the NHS an average of pounds 20. In...

'Involve pharmacists in obesity battle'.
May 23, 2008... GPs are urged to work with pharmacists to develop local weight-loss programmes. GPs should work side-by-side with pharmacists to help tackle the growing obesity epidemic, according to the National Obesity Forum (NOF). NOF clinical...

Stroke delays due to 'poor hospital organisation'.
May 23, 2008... Push for early referral for stroke and TIA marred by radiology departments 'going to lunch', UK audit reveals. GPs are being urged to refer patients with TIA and stroke quickly, but poor organisation in radiology units means over half...

News in brief.
May 23, 2008... GMC tells doctors to talk more Doctors should engage patients in discussions to let them make decisions based on their individual needs, says the GMC. For the first time the GMC has advised doctors on how to approach discussions with...

AF drug could cut mortality by 24%.
May 23, 2008... A novel anti-arrhythmia drug could cut the risk of death and hospitalisation from AF by a quarter, claim German researchers. The drug, which is yet to be licensed, works by blocking calcium, potassium and sodium channels. The trial...