Doctor articles from December 2003

Doctor archives from December 2003

Visits.
December 4, 2003... Once upon a time home visits were the main activity of GPs - the doctor was called in, and went. Enshrined in book, film and folk memory are some wonderful Hovis tales of GPs travelling their patch. Even when I started, my practice had a...

Options for the treatment of eczema.
December 4, 2003... This series condenses must-read research for everyday practice and the MRCGP. This week, Dr Rupal Shah looks at therapeutic options in eczema Atopic eczema or dermatitis affects about two to three per cent of the adult population in the UK...

From hot air to 600 bph via the RCGP.(Royal College of General Practice)
December 4, 2003... Our registrar columnist gets to grips with the joys and frustrations of general practice Some say that your time as a GP registrar is a bit like learning to drive. You do everything in slow motion, very deliberately, and you do it so...

Contract countdown.
December 4, 2003... Each week, we ask GPs how they are preparing for the new contract. This week, we talk to Dr Dean Marshall, Lothian LMC medical secretary and Scottish GPC member Dr Dean Marshall: 'Every pratice in Lothian is planning to opt out of...

What to do if arthritis patients cannot stomach NSAIDs.
December 4, 2003... Anti-inflammatory drugs such as NSAIDs can help arthritis, but increase the risk of gastrointestinal bleeding. Prof David L Scott discusses how to limit this side-effect If pain dominates arthritis, why not just use simple analgesics?...

Use of multiple therapies urged ; in patients with hypertension.(Brief Article)
December 4, 2003... GPs SHOULD be using multiple therapies to lower bloodpressure, warn UK researchers. They say BP targets are being met in less than 15 per cent of newly diagnosed hypertensives in general practice. They looked at data on 21,024 patients over...

IBD diagnosis 'often delayed'.(inflammatory bowel disease)(Brief Article)
December 4, 2003... Many children with inflammatory bowel disease in the UK and Ireland are diagnosed after prolonged delays, say researchers. A team from Bristol surveyed 3,247 hospital doctors and asked them to report all new childhood IBD diagnoses over a...

Call to use 'mystery patients' to assess GPs.
December 4, 2003... Rachel Solotti Using 'mystery patients' to evaluate GPs can be valuable but doctors should be told why they are being assessed and have to give written consent beforehand, says new research. A study by Dr Jill Thistle- thwaite, a senior...

GPs urged to tie down PCOs over services.(Brief Article)
December 4, 2003... Robin Stride GPs ARE being told to meet with their PCOs urgently to thrash out which services they will provide under the new contract. GPC negotiator Dr Andrew Dearden and medical accountant Val Martin have both urged practices to have the...

Action against TB fails to cut cases in London.
December 4, 2003... Efforts to tackle the rise of TB in London have failed to reduce cases, according to a report. A six-month investigation by the London Assembly Health Committee has concluded current activity in London is just holding TB back rather than...

GPs say no to authorising nursing home OTC lists.(Brief Article)
December 4, 2003... GPs have rejected guidance from the Royal Pharmaceutical Society that asks GPs to authorise lists of 'homely remedies' for nursing home patients. The GPC says patients living in the community do not need authorisation for over-the-counter...

Leaders accept secrecy flak but defend contract results.(Brief Article)
December 4, 2003... Judy Sands GPC NEGOTIATORS have accepted the criticism that they failed to tell the profession enough during contract talks, but say they nevertheless ach-ieved 'unprecedented' results. GPC joint-deputy chairman Dr Hamish Meldrum said the...

How to achieve maximum points for hypertension.
December 4, 2003... THIS four-part series on the clinical domain of the quality framework looks at how you can maximise your income, and guides you up the quality ladder. In this third part, Dr sabby kant looks At reaCHING the top rung for hypertension Of a...

The easy way to offer more services.
December 4, 2003... Increasing your sources of income simply involves some lateral thinking, says Dr simon cartwright Earnings diversity has given practices a number of advantages as well as boosting profits. These have included: Flexibility to increase or...

Make the most of all your new earning opportunities.
December 4, 2003... Diversity has always helped the top GP earners keep ahead. Now the new contract offers additional opportunities. Dr Simon Cartwright suggests what to consider Choosing to take on extra work might seem bonkers to GPs who feel under...

Time to set the wheels in motion.
December 4, 2003... If your PCO has not contacted you, get in touch with them THINGS SEEM to be settling down a bit in new contract land. Most of us, if not all, should have received the preparation payments by now and the first bit of the Review Body uplift....

GMC top guns offer to meet the victims' families.(General Medical Council to meet with the families of Harold Shipman's victims)(Brief Article)
December 4, 2003... The two top guns at the GMC have offered to meet the families of Harold Shipman's victims face to face. GMC president Prof Sir Graeme Catto and chief executive Finley Scott have offered to meet the families' representatives before they give...

Non-principals body polls members over name change.(National Association of Non-Principals )(Brief Article)
December 4, 2003... The National Association of Non-Principals is canvassing its members about whether they should be called sessional GPs in future. The NANP is running a poll on its website over the next month asking whether to go ahead with the name change and...

'Twice risk of subsequent stillbirth' with caesarean.(Brief Article)
December 4, 2003... Delivering by caesarean section doubles the risk of stillbirth in subsequent pregnancies, say UK researchers. Looking at data on 120,000 births in Scotland between 1992 and 1998, the researchers found the proportion of stillbirths was greater...

Non-attendance beaten by phone reminder a week before endoscopy.(Brief Article)
December 4, 2003... Phone reminders about endoscopy appointments can reduce non-attendance rates, Irish researchers have shown. They compared non-attendance rates two months before and two months after a phone reminder project was implemented in a small district...

GP IT funding under threat as plan runs [pounds sterling]345m over budget.(Brief Article)
December 4, 2003... GP IT funding could again be in question after a leaked document shows the Govern- ment's much-vaunted IT plan is set to blow its budget. Doctor's stable mate Com-puter Weekly has published details of a leaked paper from London IT chiefs...

HIV rise prompts call for action.
December 4, 2003... Steve Ford HIV transmission is inc-reasing in the UK and urgent action is needed if health services are to cope, warn public health experts. The Health Protection Agency has revealed that the number of people infected with HIV inc-reased...

PMS GPs who customise Q&O will miss out on IT funding.(Brief Article)
December 4, 2003... Judy Sands PMS GPs who wish to use a different quality and outcomes framework to GMS GPs will have to produce their own interrogation software and pay for it. NHS Confederation lead negotiator Mike Farrar told Doctor the Government was...

'Lack of openness' in GMC process.(General Medical Counsel)
December 4, 2003... The Shipman Inquiry has turned its attention to the GMC and whether it treats doctors fairly and adequately protects patients. Simon Ebbett reports The GMC is under fire at the Shipman Inquiry for a lack of 'consistency and transparency'...

GPs face patient scrutiny.
December 4, 2003... Simon Ebbett The Shipman Inquiry has raised the prospect of patients being able to check whether a GP has been complained about before deciding to register at his or her practice. While examining how the GMC dealt with Harold Shipman and...

GMC inquiry costs approach [pounds sterling]1m.(Shipman Inquiry )(Brief Article)
December 4, 2003... The GMC says the cost of appearing at the Shipman Inquiry will eventually hit [pounds sterling]900,000. The council estimated the cost to be about [pounds sterling]650,000 but said opportunity costs would push this higher. At last week's GMC...

Contract quality goals 'will cause tunnel vision'.(Brief Article)
December 4, 2003... The new contract may create 'tunnel vision' among GPs, warn authors of a report on NHS quality. They say rewards for meeting quality targets will provide benefits for the health service, but at the expense of areas not covered in the new GMS...

Seniority pay this month.(Brief Article)
December 4, 2003... GPs should get their seniority pay this month regardless of whether PCOs have checked their service records. GPC chairman Dr John Chisholm said that guidance would be going out to PCOs, after which they should be contacting local GPs and asking...

GPC to ensure low prevalence does not penalise GPs.(Brief Article)
December 4, 2003... The GPC is considering reducing the effects of disease prevalence on GPs' pay for quality under the new contract. GPC negotiators want the raw cost of providing services to be considered when weighting the payments, so practices are not paid...

'Use aspirin in low-risk patients before statins for high-risk'.
December 4, 2003... GPs should give aspirin combined with two antihyper-tensives to patients at low risk of coronary heart disease before giving statins to high-risk patients, according to a public health researcher. Dr Tom Marshall, of Birmingham University,...

Framingham scores 'overestimate male risk'.(of coronary heart disease)
December 4, 2003... Steve Ford Framingham risk scores, which form the basis of most UK coronary heart disease guidelines, overestimate risk in men, say UK researchers. This means many patients are being treated unnecessarily with drugs that carry serious...

Accounting errors leave GPs owing ex-partners.(Brief Article)
December 4, 2003... Accounting errors mean GPs may have to pay unexpected Christmas bonuses to partners who have left their practices since March. Four-figure sums are due for doctors because some accountancy firms under-declared the profits of practices whose...

Blair offers up GPs as the route to 'complete choice'.(Tony Blair; general practitioners)
December 4, 2003... Rachel Solotti Prime Minister Tony Blair has weighed into the Government's patient choice agenda, asking whether GPs should become the gateway for patients to get 'complete choice' in the health service. Mr Blair last week launched the...

GPs want action over 'out of date' CHD guidelines.(coronary heart disease)
December 4, 2003... New research contradicts national service framework on Framingham and statins Steve Ford GPs are demanding updated guidelines on coronary heart disease following research saying they overestimate male risk and treat it wrongly. Two...

Practice information for patients and the benefit of a staff away day.
December 4, 2003... Sally Irvine and Hilary Haman answer problems posed by readers. This week, they deal with practice information for patients and the benefit of a staff away day How do we tell our patients about the new contract? We are all talking...

Doctors who care too much.
December 4, 2003... Doctors who try to meet too many expectations should be identified and given directed help Of all of the tragedies experienced by doctors in their day-to-day work, few can bear comparison to the loss of a colleague, taken in their prime by...

Financial Diary.
December 4, 2003... Banking on star quality... I attended a new contract update meeting last night, jointly organised by my LMC and PCO. It was nice to hear about things directly from those in the know. What was interesting was the LMC chairman's...

Hard to see the wood for the trees on CHD.(coronary heart disease)(Brief Article)
December 4, 2003... This has been the year of correction factors. First, the furore over the new contract and the Carr-Hill formula led to an MPIG correction factor being published. And now, a new paper in the British Medical Journal says the Framingham model used...

No guarantees against another Shipman.(commentary on physician charged of murder)
December 4, 2003... 'We may be able to limit the possibility of murder, but we cannot hope to eradicate it' I have been following reports of the Shipman Inquiry with increasing dismay. I cannot help feeling that there is a serious risk of everyone losing...

Dysuria.
December 4, 2003... Doctor's regular guide to the presentations and pathologies commonly seen in general practicE - written this week by Dr julian spinks, a GPin strood What do you do? Mary is a 64-year-old married woman who attends surgery complaining...

GPs praised by NHS report for role in reducing waiting lists.(Brief Article)
December 11, 2003... Judy Sands GPs HAVE helped hospitals cut waiting lists by making specialist referrals and taking on more work that used to be done in outpatients, the Government claimed last week. Presenting the annual report on the NHS, chief executive...

How to use the aspiration point calculator.
December 11, 2003... GPs are about to get software to help them calculate how many aspiration points they should claim under the new GMS contract's quality framework. Dr Gillian Braunold, who helped design the software, shows how to use it In the next week,...

HPV test favoured over smears.
December 11, 2003... Michelle Roberts HPV testing would be a better screening tool for cervical cancer than smears, according to Cancer Research UK. It showed that HPV testing can detect 97 per cent of significant cervical abnormalities, compared with 76 per...

GMC agrees to open up to more public scrutiny.(Brief Article)
December 11, 2003... Doctor reporters GMC members have agreed to be more open, after finding that they conduct more than half of their business behind closed doors. Members at the last GMC council meeting agreed to hold all future meetings in public, except...

GMC thrashes out revalidation rules.(Brief Article)
December 11, 2003... The GMC is talking to the UK's four chief medical officers about how PCT chief executives will verify GPs' appraisals for revalidation. Doctor reported last week that PCT chief executives or clinical governance leads would send 'a certificate'...

Support for limits on HRT prescribing.(hormone replacement therapy)
December 11, 2003... Michelle Roberts ADVICE THAT GPs should not use HRT first-line to prevent osteoporosis in women over 50 has been backed by several medical bodies, despite a leading expert's resignation over the decision. The updated advice is based on a...

Q&O prevalence plans under fire.(Brief Article)
December 11, 2003... GPs have questioned plans to curb the influence of prevalence on their pay under the new GMS contract's quality and outcomes framework. Harrow GP Dr Chaand Nagpaul opposed the GPC's plans, announced last week, to have a lower-end cut-off and...

GPs caught up in Plan B hoax.(Brief Article)
December 11, 2003... Two Bristol GPs have been enmeshed in an apparent hoax inciting doctors to rebel against the Government over Christmas. An unsigned letter titled 'Plan B' was posted last week to Avon MPs, Bristol GPs and Doctor. It sets out ten actions GPs...

PCOs plan to link services deals to quality points.(Brief Article)
December 11, 2003... Limiting enhanced services to practices earning 500-plus points labelled 'arbitrary' and 'risky' Judy Sands SOME PCOs plan to only award enhanced services contracts to practices which get at least 500 quality points under the new GMS...

GPs count cost of ex-partner's fraud.
December 11, 2003... Last month, Dr Rakesh Patel was jailed for defrauding his practice. His two former partners tell Simon Ebbett about their two-and-a-half year battle for justice and why they will never whistle-blow again Just to the right of the...