GP articles from May 2010

GP archives from May 2010

Opinion: The myth of an NHS safe in Labour's hands.
May 28, 2010... You get used to anything coming though those surgery doors, but when a lemming walked in it was a bit of a surprise tinged with disappointment: 'No QOF points here,' I thought. 'I usually go to the vit'nary,' said the lemming with a...

Opinion: Jargon-busting is a fight you can never win.
May 28, 2010... Mrs Sore Knee is worried and I read the letter she thrusts at me with shaking hands, in some sympathy. 'Dear Dr PCT,' it begins charmingly, 'thank you for sending me Mrs Sore Knee. I have examined her and entered the following consultation...

Clinical: At a Glance - Ankylosing spondylitis vs Pott disease.(Disease/Disorder overview)(Brief article)
May 28, 2010... ANKYLOSING SPONDYLITIS Aetiology - Uncertain cause but associated with the HLA-B27 gene. - More common in men. Usually presents in the 20-30 years age group. - Early diagnosis is important if irreversible spinal changes are to be...

Clinical: The Basics - Recurrent vaginal candidiasis.(Disease/Disorder overview)
May 28, 2010... Recurrent vulvovaginal candidiasis is defined as four or more episodes in a year. By Dr Louise Newson. Vulvovaginal candidiasis (VVC or thrush) is a symptomatic inflammation of the vagina and/or vulva caused by a superficial fungal infection...

Clinical: Practice dilemma - A GP with an alcohol problem.
May 28, 2010... The dilemma - A patient you know well comes to see you with symptoms of lethargy and fatigue. He works nearby as a salaried GP and his wife has recently divorced him. You know he likes more than the occasional alcoholic drink and he has admitted...

Clinical: Eyes.(eye diseases)(Report)
May 28, 2010... - Subconjunctival haemorrhage This common problem always causes a degree of worry due to its dramatic appearance. This patient is on warfarin and hence developed a very impressive haemorrhage. No action was required - Ectropion This frail...

Education: Effective Consulting - Part 3 - Sharing an understanding.
May 28, 2010... In this series on consulting skills, Dr Peter Tate discusses common scenarios you can watch online. This week's scenario concerns a common outcome of the cervical screening programme. Most women enter the programme because they perceive...

Education: Book Review - Notes for the MRCGP - A guide but not a revision tool.
May 28, 2010... Notes for the MRCGP is a curriculum-based guide to the applied knowledge test (AKT), clinical skills assessment (CSA), and workplace-based assessment (WPBA). It is both unique and broad enough to attract the attention of many GP trainees, as...

Education: A registrar survival guide ... Dealing with the aggressive patient.
May 28, 2010... - Understanding aggression: the patient's perspective Aggression in a patient tends to be a manifestation of underlying emotion. These emotions may include fear, confusion and stress. Aggression can be verbal, non-verbal and physical. It...

Medeconomics: Medico-Legal - Complaints system one year on.
May 28, 2010... Some practices have yet to adopt the new process, say Terri Bonnici, Sue Taylor and Sara Williams. April 2009 saw the introduction of a reformed NHS complaints system in England but, nearly 14 months later, there are still practices that have...

Medeconomics: Finding the right GP job for you.
May 28, 2010... When Dr Mona Kular finished her vocational training, she weighed up her career options carefully. Searching for a job can be both exciting and daunting, whether you are a newly qualified GP or a more experienced hand looking for a change. ...

Medeconomics: Personal Finance - Benefits and risks of venture capital trusts.
May 28, 2010... Investing in VCTs is high risk but you could make a large and untaxed capital gain, says Liz Willis. Venture capital trusts (VCTs) are tax-efficient and are increasingly popular investment vehicles. They are not a suitable home for money you...

Medeconomics: Ask the experts - Pensions and service charges.
May 28, 2010... Q: SUPERANNUATION I will be taking my NHS pension at age 60. My partners know I will be working no more than 16 hours per week for a month, and then returning to my usual hours. Is it right that around 20 per cent of my income will no...

Medeconomics: The experts - Email questions or phone our experts.
May 28, 2010... NHS Rules - Dr Tim Kimber is a Littlehampton GP and deputy chairman of West Sussex LMC. Email: tim.kimber@nhs.net Investment planning - Liz Willis is a financial adviser and partner at the medical division, St James's Place Partnership....

Good Practice: Primary care - Bringing down A&E attendances.
May 28, 2010... Community minor emergency services work, say Drs Shyamal Mukherjee, Abhi Mantgani and Shanila Roohi. Improvements in community-based urgent care services in Wirral, including an innovative pilot at two GP practices in Birkenhead, have helped...

Plain Tales from the Surgery.
May 28, 2010... - Heartless treatment I received a letter from the cardiology department about one of my patients: '... this sounds like possible angina. He will have a myocardial perfusion scan. If this is abnormal, we will arrange for him to have a...

GPs to take on commissioning by 2011.
May 28, 2010... NHS Reform - Coalition report promises a contract rethink and freeze on NHS reforms. The GP contract is to be renegotiated and all local service reforms halted until they have the support of local GPs, the government said last week. The...

DoH confirms GMS pay rise of 0.8% will be upheld.
May 28, 2010... The government has backed Labour's decision to overrule the Doctors' and Dentists' Review Body (DDRB) and award a 0.8 per cent pay rise. The outgoing Labour government overturned the DDRB's recommended rise of 1.34 per cent, which aimed to...

Skin cancer GPs to be monitored.
May 28, 2010... An RCGP database will allow minor surgery GPs to compare performance nationally, as NICE rolls out its updated skin cancer guidelines. Updated NICE skin cancer advice this week will allow skin surgery GPSIs to treat an expanded list of...

Reason for rise in GMC claims against GPs remains unclear.
May 28, 2010... There were more fitness to practise enquiries about GPs in 2009 than any other group of doctors, but most cases were dismissed without progressing to a full hearing. Around 45 per cent of fitness to practise enquiries received by the GMC last...

Concern at drug pricing plans.
May 28, 2010... Prices of branded drugs will be tackled so their cost matches the value they offer to patients, the government has said. The coalition's 'programme for government' pledges to 'reform NICE and move to a system of value-based pricing, so that...

Real budgets offer GPs share of savings.
May 28, 2010... Commissioning NHS Cambridgeshire plans to offer real commissioning budgets to GPs. Cambridgeshire GPs will be handed real commissioning budgets in a model that could become a prototype for the government's plans to overhaul GP commissioning....

Exclusive: PMS practices 'better off moving to GMS'.
May 28, 2010... PMS reviews and less reliance on MPIG is pushing practices back to GMS. Around one in 10 PMS practices could return to a GMS contract without incurring a financial loss, medical accountants have estimated. The analysis comes as a GP...

Violence worse in primary care.
May 28, 2010... Doctors in primary care are more likely than doctors in secondary care to report that abuse from patients is a problem, a BMA report reveals. A BMA Northern Ireland survey found 56 per cent of primary care doctors said violence and abuse from...

GP Diary.
May 28, 2010... RECORD BREAKER - A Taiwanese orthopaedist who was found to take an average of 84 seconds to diagnose each patient has been reprimanded by his health ministry, which demands that he spend more time on future patients. Dr Wu Ming-Feng, who works...

Exclusive: Clinic to help sick doctors back to work faces closure.
May 28, 2010... Cash crisis could end key revalidation support system. An 'enormously successful' clinic set up to return sick doctors to health and work could close due to a lack of funding. Cash support for the Practitioner Health Programme (PHP) runs...

BMA and GMC debate revalidation roll-out.(General Medical Council)(British Medical Association)(Conference news)(Brief article)
May 28, 2010... The BMA and GMC are in disagreement about where revalidation should start, the GMC chairman has said. Professor Peter Rubin said a draft BMA response to the GMC consultation on revalidation argued that the process should begin in areas 'where...

GMC to test GPs' language skills.
May 28, 2010... It is 'highly likely' that the GMC will be handed powers to test the English language ability of doctors from the European Economic Area (EEA) wanting to work in the UK, the GMC has said. Professor Peter Rubin, chairman of the GMC, said it is...

Beta-blockers 'reduce COPD exacerbations'.
May 28, 2010... Respiratory - Patients with COPD might live longer if they are given beta-blockers, a Dutch investigation suggests. COPD patients have fewer respiratory exacerbations and live longer if they are given beta-blockers, a Dutch study has shown....

Statin-treated patients 'need to be monitored'.
May 28, 2010... GPs should closely monitor the type and dose of statins prescribed as some patients will suffer adverse effects, say UK researchers. A BMJ study found some statins can increase the risk of liver dysfunction, acute renal failure, myopathy and...

Lipid signals 'cut plaque risk'.
May 28, 2010... Signals in the body that reduce cholesterol in atherosclerosis also help suppress other plaque-forming factors, researchers claim. Columbia University scientists studied a set of transporter proteins that remove cholesterol from cells. ...

Research briefs: Middle age fat.(Brief article)
May 28, 2010... Higher levels of abdominal fat in middle age may raise the risk of developing dementia, a study suggests. US researchers examined 700 middle-aged people and found an inverse association between visceral fat levels in the abdomen and total brain...

Research briefs: Bigger nose.(Brief article)
May 28, 2010... Having a bigger nose makes you less likely to catch a cold, research suggests. A University of Iowa study tested two artificial noses and found the larger nose inhaled 6.5 per cent fewer particles than the smaller one. The nose sticks out and...

RCGP sets out revalidation plan for locum GPs.
May 28, 2010... REVALIDATION - Practices warned they have a responsibility to support revalidation of locums who work for them. Practices that regularly use locums and sessional GPs have a responsibility to help them with revalidation, the RCGP has said. ...

Wales to lead on alcohol cost.
May 28, 2010... Wales is to go ahead with plans to introduce minimum alcohol pricing despite the move being omitted from a list of priorities for the UK coalition government. The UK government has committed to banning the sale of alcohol below cost price. It...

LMCs to debate salaried GP time limit.
May 28, 2010... LMCs CONFERENCE 2010 - Anger at ousted Labour government dominates the agenda. LMCs will debate plans to impose a five-year limit on salaried contracts unless partnership is offered at their 2010 conference next month. They will also...

NHS reform legal warning for GPs.
May 28, 2010... Practices have been warned to update partnership deeds and other legal paperwork to ensure their businesses are stable as the new government begins to impose NHS reforms. Lynne Abbess, partner of specialist medical law firm Hempsons, said...

Cholesterol drug widens GP options.
May 28, 2010... GPs in Scotland have access to a wider choice of treatments for cholesterol disorders, after the Scottish Medicines Consortium (SMC) approved the combination drug Tredaptive. The decision means the therapy is available for restricted use in...

GPs urged to audit their asthma prescribing.
May 28, 2010... ASTHMA - GPs warned not to deviate from best practice without careful thought and close monitoring of patients. GPs should audit their asthma prescribing to ensure that they are following best practice, Asthma UK's chief medical adviser has...

Scan of obesity better than BMI.
May 28, 2010... Dual X-ray absorptiometry (DEXA) is better than BMI at identifying whether or not a patient is obese, a US study suggests. DEXA is thought to be a more precise measure of body fat than BMI, but no large-scale studies have compared the two as...

Antibiotic research gives boost to GPs.
May 28, 2010... Research showing that people who take antibiotics develop resistance to them could help GPs dissuade patients who demand the drugs inappropriately, an expert says. Lead researcher Dr Alastair Hay, a GP in Bristol and consultant senior...

GMC urges GPs to identify advance care plan needs.
May 28, 2010... END OF LIFE - Guidance says sensitive discussion can avoid conflict. GPs should identify patients who are likely to die within 12 months to help them draw up an advance care plan, the GMC has warned. Conflict between doctors, patients and...

Work-related cancer 'twice as likely' as estimated, says HSE.
May 28, 2010... British men are more than twice as likely to die from work-related cancer as previously thought, a UK Health and Safety Executive (HSE) study suggests. Previous estimates of occ-upational cancer mortality in Britain have been largely based on...

Earlier MMR jab could protect infants.
May 28, 2010... MEASLES - Belgian study supports earlier vaccination if efficacy is also proven, say authors. MMR jabs should be given earlier because infants are vulnerable to measles for several months before their first vaccination, researchers say. A...

Some deaneries 'could go to the wall', GPs warn.
May 28, 2010... TRAINING - Commissioner/provider split could wreck GP training system within deaneries, course organisers say. Reforms to encourage competition between deaneries could affect the quality of GP training and even mean they are forced to close,...

Spit test 'an easy measure of COPD'.
May 28, 2010... Sputum sampling could be a cheap and easy way to identify and manage patients at risk of severe COPD, research shows. Spanish researchers found nearly half of COPD patients in the study had potentially pathogenic bacteria in their airways....

Long-term use of metformin linked to decreased levels of vitamin B12.
May 28, 2010... Patients receiving long-term metformin therapy should have their vitamin B12 levels routinely assessed, Dutch researchers have said. Long-term treatment with metformin increases patients' risk of developing vitamin B12 deficiency, the group...

Behind the Headlines: Does eating red meat raise CHD risk?
May 28, 2010... Eating processed meat substantially raises the risk of CHD and diabetes, according to newspaper reports. Researchers from Harvard Medical School assessed 20 studies involving over 1.2 million people. They found the risk of CHD increased by 42...

Practices are facing PMS overhaul.(personal medical services)(United Kingdom. National Health Service. Primary Care Trusts)
May 28, 2010... Reviews of PMS contracts are sweeping across PCTs in England. Some practices have had enough, says Susie Sell. Five out of six PCTs across England plan to carry out a review of PMS contracts in this financial year or the next, a GP...

Healthcarerepublic.com: A round-up of the best from GP's website this week.
May 28, 2010... - Exclusive revalidation blog Read GP columnist Mary Selby's Road to Revalidation blog series exclusively online health carerepublic.com/blogs This week Mary writes about her 'secret obsession with revalidation webcasts'. Andrew Lansley...

Opinion: Ballot box.
May 28, 2010... 81% of GPs think patients should not be allowed to post recordings of consultations on the internet. Source: Healthcare Republic -------------------- Did you find this article useful? Why not subscribe to the magazine? Please call 08451 55...

Opinion: Your say online ... www.healthcarerepublic.com/forums.(Website overview)(Brief article)
May 28, 2010... Lansley to force GPs to take back out-of-hours - Taking back out-of-hours' responsibilities brings additional management and business responsibilities back to GPs and, as such, it is vital that they are resourced adequately. The level of...

Editorial: Risks of PBC must not outweigh the benefits.(Editorial)
May 28, 2010... What will practice-based commissioning (PBC) look like under the new Conservative-Liberal Democrat coalition government? It's an interesting question and one nowhere near answered by the 36-page programme for government published last week....

Opinion: Let's turn general practice into a liberal world.
May 28, 2010... The sight of David Cameron and Nick Clegg posing together in front of No.10 like two partners at a civil wedding will stay with us for a long time. 'A new kind of politics,' commented Mr Cameron. It certainly seems that way. The two sides...

Clinical: Journals Watch - QRISK2 and teen birth rates.
May 28, 2010... Been too busy to catch up with the journals? Dr Jonathan Holliday brings you the latest research. Validation of QRISK2 - BMJ 2010; 340: c2442 The aim of this prospective cohort study was to evaluate the performance of QRISK2 against the...

Clinical: Emergency medicine - Managing burns and scalds.(Disease/Disorder overview)
May 28, 2010... Cool the burn for 20 minutes but warm the patient as a whole, explains Dr Clare Hammell. Burn injuries are common - around 175,000 people attend UK emergency departments each year with such injuries.1 Despite this, there may be uncertainty...

Clinical: Clinical Review - Large bowel obstruction.(Disease/Disorder overview)
May 28, 2010... Contributed by Mr Samuel Adegbola, surgical trainee, Eastern Deanery and Mr Joe Dawson, specialist registrar, North East Thames. Section 1: Epidemiology and aetiology Large bowel obstruction, an int-erruption in the flow of colonic...

Clinical: Headache fact file - Part 4 - Managing cluster headache.(Disease/Disorder overview)
May 28, 2010... In the fourth part of this five-part series, Dr David Kernick discusses management of cluster headache. Cluster headache is arguably one of the most painful conditions a GP will see. Cluster headache is very distinct from migraine - it is one...

MedEconomics: Dispensing - Implementing medicines switches.(United Kingdom. National Health Service)
May 28, 2010... Protocols must be established in line with local decision-making procedures. Changing an individual pat-ient's prescribed medicine during a consultation is common practice but implementing a practice-wide change in a prescribed medicine, for...

Clinical: Journals Watch - Cystic fibrosis and coeliac disease.(Clinical report)
May 21, 2010... Missed this week's journals? Dr Raj Thakkar brings you up to date with the latest research. - Azithromycin for pulmonary function in patients with cystic fibrosis JAMA 2010; 303 (17): 1707-15 It is crucial that we manage patients with...

Clinical: Epilepsy and pregnancy - Clinical solutions.(Clinical report)
May 21, 2010... THE CASE A 30-year-old woman with epilepsy explains that she would like to start a family and asks for advice regarding managing her epilepsy. - What advice should I give? Explain that although most women with epilepsy have a normal...

Clinical: Lyme disease.(Clinical report)
May 21, 2010... This condition is becoming increasingly common. Dr Linda Miller explains the symptoms and management. 'Mother that's not a mole, its got legs'. This memorable phrase arose during a consultation with an elderly lady and her daughter in a...

Clinical: The basics - Gastroenteritis and diarrhoea.
May 21, 2010... For the majority, the symptoms are self-limiting and short-lived, explains Dr Anna Cumisky. Gastroenteritis is one of the most common gastrointestinal complaints seen in primary care and can affect all age groups and populations. For the...

Clinical: Case Study - Patient with urinary symptoms.(Clinical report)
May 21, 2010... In this case, symptoms continued after a provisional diagnosis of UTI. A 56-year-old man presented to surgery with new-onset urinary tract symptoms over the preceding week. These consisted of urgency and frequency associated with suprapubic...

Clinical Review: Microcytic anaemia.
May 21, 2010... Section 1: Aetiology and classification Anaemia is a reduction in the total circulating number of red cells. It is defined as a reduction of more than two standard deviations below the mean of either the haemoglobin concentration (Hb), the...

Clinical: Paediatric medicine - Treating psoriasis in children.
May 21, 2010... The most common presentation in children is chronic plaque psoriasis. Psoriasis is a chronic skin condition affecting 2 per cent of the population. From a GP's perspective, it is important to bear this diagnosis in mind when assessing a child...

Clinical: Phobias.
May 21, 2010... Parasitophobia Parasitophobia is the belief that there are parasites under the skin Patients present with widespread lesions, where they have scratched and tried to 'dig out' parasites. The lesions may be infected and require treatment....

Education: Pictorial case study.
May 21, 2010... The case The worried parents of a seven-week-old baby boy attended the surgery as they had noticed a red mark on his back. They were certain that this lesion had not been present previously. The baby was well and thriving. He was delivered...

Education: A registrar survival guide ... Structuring the consultation.(Brief article)
May 21, 2010... Despite advances in medical investigations, the consultation will remain the most important tool that GPs have. - Starting the consultation Introduce yourself and ask an open question, such as: 'How can I help?' Allow the patient to...

MedEconomics: How to ... Lower your practice's expenses.
May 21, 2010... Can you generate efficiency savings this year? Simon Pointon suggests ways to cut down the bills. When the DoH announced that it was cutting the Doctors' and Dentists' Review Body's recommended GP pay rise for 2010/11 to just 0.8 per cent...

MedEconomics: In a nutshell ... GP expert witness.
May 21, 2010... The MDU's Dr Sharmala Moodley says writing expert reports and testifying in court is demanding work. In a nutshell A quick guide to issues affecting GPs GPs taking on paid work as expert witnesses may be called to give evidence in civil...

MedEconomics: Ask the experts - Swine flu figures and premises shares.
May 21, 2010... Q: SWINE FLU Do swine flu vaccination refusal percentages contribute anything to reducing the thresholds for the QOF patient experience indicators PE7 and PE8? Our practice vaccinated 43.8 per cent of patients over six months old who had...

MedEconomics: Pitfalls with GP premises leases.
May 21, 2010... James Atkins offers tips on avoiding legal snags that can arise from the terms of your surgery lease. GPs may not realise it, but leasing practice premises can hide a number of significant business risks that can impact on the practice as a...

MedEconomics: Locums - Marketing yourself as a locum GP.
May 21, 2010... Be well-informed and proactive when looking for locum work, writes Dr Linda Miller. In order to obtain sufficient work as a locum GP it is important to do your research and to market yourself effectively. Begin by defining the geographical...

Good Practice: Service development - PBC ultrasound pilot success.
May 21, 2010... A Northumberland community scan project is good for patients and the NHS, writes Julie Griffiths. Each week Susan Davis, the sonographer for Blyth Valley Community Gynaecology Ultrasound Scan Service, sees around 20 patients with symptoms of...

Plain Tales from the Surgery.
May 21, 2010... Tough love I smiled on reading the notes of a 59-year-old lady whose weight had been increasing and stood at 123kg. They read: 'Dietary advice given, treat with orlistat, consider barbaric surgery.' - Dr Amina Rahman, Faversham, Kent ...

Patients trust in nurse prescribers.
May 21, 2010... People with diabetes are confident in nurse prescribers changing their medication, a UK study shows. Professor Molly Courtenay and a team from the University of Surrey spoke to 41 diabetes patients of nurse prescribers. The researchers...

Women GPs' 'unreasonable' demands.
May 21, 2010... Female partners' maternity pay should match hospital rate, says MWF boss. Women GP partners should not do better out of maternity arrangements than hospital doctors, the incoming president of the Medical Women's Federation (MWF) says. ...

Risk of cancer in Barrett's oesophagus overestimated.
May 21, 2010... Warning over misdiagnosis of low-grade dysplasia. Cancer risk in many patients with Barrett's oesophagus is overestimated by around 18 times, research suggests. Researchers found that patients with Barrett's oesophagus are too often...

GP wins civic award.
May 21, 2010... Dr Raja Sinha, a GP in Southwark, has received a letter of commendation for community healthcare from the Southwark Civic Association. Dr Sinha, who has practised in the south London borough for 28 years, was commended on his 'dedication to...

Behind the Headlines: Can eating more nuts lower cholesterol levels?
May 21, 2010... Eating a handful of nuts a day improves blood cholesterol levels, according to news reports. US researchers found that people who ate an average of 67g of nuts each day reduced their total blood cholesterol concentration by 5.1 per cent...

A round-up of the best from GP's website this week.
May 21, 2010... Andrew Lansley profile Do you want to know new health secretary Andrew Lansley's views on key issues? Read a profile of him healthcare republic.com/gp Online video exclusive Part two of our new consulting skills series is on page 54,...

Opinion: Ballot box.
May 21, 2010... 79% of GPs think that all PCTs' swine flu costs should be met by central government. Source: Healthcare Republic. -------------------- Did you find this article useful? Why not subscribe to the magazine? Please call 08451 55 73 55 for more...

Opinion: Your say online ..
May 21, 2010... GPs warned on patients recording consultations and posting on internet. - I don't have a problem being filmed for a patient's benefit at all. I do have a problem in it being posted online without my consent. It would never happen the other...