Doctor articles from January 2004

Doctor archives from January 2004

Workload.
January 8, 2004... None of us would be human if we were not concerned with workload. As a registrar, I am sure it is really important to you. Certainly, partners think a lot about it - I wonder if X is pulling their weight?' 'Y always seems to finish before I...

'So it is off on my broomstick.
January 8, 2004... Our registrar columnist gets to grips with the joys and frustrations of general practice Okay, I admit that I have been called a witch before, usually by friends, but I have never expected patients to believe it. In fact, I think many of...

Contract countdown.
January 8, 2004... Dr Robbie Currie: 'My gravest concern is the lack of acknowledgement from the highest sources regarding the need for serious investment in out-of-hours' What has your practice done to prepare for the new contract? We have convened an...

Should andrology become a specialty in its own right?
January 8, 2004... Mr John Pryor surveys the management of health problems specific to men and asks if there is a place for andrology as its own specialty Gynaecology as a specialty has been around for decades. But andrology, the counterpart of gynaecology...

The evidence on cervical screening.
January 8, 2004... This series condenses must-read research valuable for the MRCGP and everyday practice. This week, Dr Pamela Crawford looks at recent changes to cervical screening The national cervical screening programme has recently been altered. It now...

Smart moves to help you prepare for the new contract.
January 8, 2004... With less than three months to go before the new GMS contract kicks in, Check how you are doing against Dougie PatoN'S list of key areas Over the past months, we have been working with around 25 GP practices to determine what action they...

Why blood sugar self-testing is a waste of money.
January 8, 2004... Self-blood testing by type 2 diabetes patients wastes resources Working in Tower Hamlets, a deprived area of east London, I have found that poorly educated type 2 diabetes patients from South East Asia have little understanding about when...

Make a note of important tax deadlines in the coming year.
January 8, 2004... Don't forget this year's tax deadlines. Wendy O'Connor provides a round-up of the main ones affecting GPs and gives some timely tips The tax calendar is non-negotiable. Even though GPs' minds may be diverted by the new contract, they...

Steroids high in herbal creams.
January 8, 2004... Many herbal eczema creams contain high levels of corticosteroids, warn UK researchers. The Sheffield team are calling for tighter regulation and better public education on alternative therapies. They analysed the contents of 24 herbal creams...

Baseline C-reactive protein raises risk of hypertension.
January 8, 2004... an increased risk of hypertension is modestly but independently associated with baseline inflammatory markers, say US researchers. Using data from the Women's Health Study, the investigators measured hypertension development, plasma C-reactive...

Obesity 'unlikely' asthma risk.
January 8, 2004... Obesity is unlikely to be a risk factor for asthma in children, according to Australian researchers. The team says higher body mass index is linked to a higher prevalence of symptoms attributed to asthma, but not to the condition itself. They...

Cot death publicity campaigns do not work, says expert.
January 8, 2004... Falling cot death levels are due to natural variation rather than campaigns aimed at getting parents to put children to sleep on their backs, argues an Australian expert. Dr Paul Goldwater, from Adelaide's Women and Children's Hospital, says...

New osteoporosis drug gets the green light in Scotland.
January 8, 2004... A new drug for osteoporosis has been made available on the NHS in Scotland, six months before it is likely to be made available in England and Wales. Teriparatide (Forsteo) stimul- ates bone growth by increasing osteoblast activity and has been...

Fluoxetine 'only SSRI for use in children'.
January 8, 2004... Children who are depressed should not be treated with any selective serotonin reuptake inhibitors other than fluoxetine (Prozac), GPs have been advised. The Medicines and Health- care products and Regulatory Agency says the balance of risks and...

Advice for dispensing GPs on VAT.
January 8, 2004... VAT uncertainty continues for dispensing doctors. IN THE FIRST OF TWO ARTICLES John Barnes outlines the story so far and answers GPs' questions Customs and Excise won't give in on the issue of VAT. It has been granted leave by the House of...

No national bowel cancer screening until 2008.
January 8, 2004... Michelle Roberts Do not expect a national bowel cancer screening programme until 2008, doctors were told at a London conference last month. Julietta Patnick, national co-ordinator of the NHS Cancer Screening Programmes, warned it could...

BMA is only as active as its members.
January 8, 2004... BMA members must stop whingeing and be more proactive Many of us accuse the BMA of not acting like a trade union often enough. I have much sympathy with this point of view. However, just the other day I found myself accused of acting 'as if...

Why new; contract has; failed to lift; gloom over recruitment.
January 8, 2004... Practices are already struggling to recruit and deaneries are predicting that it will become even harder to swell the GP workforce Rachel Solotti reports Merseyside GP trainee Dr Ewen Sim is still tossing up whether to work in a GMS or PMS...

Fewer antibiotic scrips blamed for rise in pneumonia deaths.
January 8, 2004... An increase in pneumonia deaths is linked to GPs prescribing fewer antibiotics for lower respiratory tract infections in recent years, say researchers. The Scottish team says that since 1995, antibiotic prescribing for LRTIs has declined by 30...

Recruitment is; worst in towns; with poor image.
January 8, 2004... Cathy Comerford Bad PR could be making it harder to recruit new doctors to practices in stereotypically downbeat areas of the country. Practices in towns with bad names are finding local word of mouth works better than national advertising...

Chicken pox vaccination recommended in about one in ten health workers.
January 8, 2004... About ten per cent of staff in GP surgeries and hospitals should be vaccinated against chicken pox, according to updated immunisation policy. The Chief Medical Officer for England says health care workers who lack immunity to varicella and who...

Leicester approach coaxes 11 GPs out of retirement.
January 8, 2004... Trusts in Leicester are relying on a Dad's Army-style approach to combat the area's chronic doctor shortage. In the east of Leicester, there are 18 GP vacancies in an area providing health care for 180,000 people. The local PCT is now trying to...

Echinacea does not relieve; cold symptoms in children.
January 8, 2004... The herbal remedy echinacea is ineffective for upper respiratory tract infections in children, a US trial has found. Researchers looked at 707 URTIs in 407 children, aged two to 11, over a four-month period. The children received either...

. . . but there are hotspots too.
January 8, 2004... While some areas struggle to recruit doctors, for others it is a case of 'Crisis? What crisis?' Some UK hotspots have proved a stark contrast to the problems the rest of the country faces in finding GPs, with practices either flooded with...

Patients are now worth less.
January 8, 2004... Patients are becoming a bit like shares - their value may have dropped, but they could be on the way back up. Patients were worth just under [pounds sterling]53 each to the average practice, but have now dropped to [pounds sterling]49.37. This...

GPs predict new contract will mean longer working hours.
January 8, 2004... Cathy Comerford MORE THAN one third of GPs believe the new contract is going to mean even longer working hours, a Doctor survey has found. The majority of GPs thought the contract would either increase their workload or it would stay the same....

GMS pay confusion fuels mounting GP; recruitment crisis.
January 8, 2004... Rachel Solotti GPs believe uncertainty about pay and conditions under the new GMS contract is deterring doctors from joining practices and could exacerbate the recruitment crisis. It comes as a Doctor survey shows 27 per cent of GPs believe it...

Five GPs named in New Year Honours List.
January 8, 2004... RCGP HONORARY secretary Dr Maureen Baker began the new year on a high after being made a CBE last week. The Lincolnshire GP and National Patient Safety Agency primary care director was one of five GPs to receive awards. She said receiving the...

GPs protest at low prevalence pay.
January 8, 2004... Angry GPs in Wales are meeting politicians this week to hammer out problems with the new disease prevalence formula. The formula, calculated on a country-by-country basis rather than using UK-wide data, is expected to leave GPs in Wales...

GP workforce crisis deepens.
January 8, 2004... Practices fail to fill 40 per cent of vacancies Doctor reporters The workforce crisis appears to be getting worse and GPs fear the new GMS contract will exacerbate the problem rather than solve it. A Doctor survey has found that six...

Botched complaint 'shows how not to do it'.
January 8, 2004... Simon Ebbett A bungled inquiry into a complaint about a GP co-operative is to be used as a training tool in how not to investigate doctors. The Health Service Ombudsman, Ann Abraham, has told Thames Valley Strategic Health Authority that...

Delays don't help battle to recruit GPs.
January 8, 2004... In the end, 2003 finished pretty much as it had started. The Department of Health was back to playing silly beggars over the contract, delaying key documents and holding back information. After two and a half years of this nonsense, the latest...

Tiredness.
January 8, 2004... Doctor's regular guide to the presentations and pathologies commonly seen in general practicE -written this week by Dr david morris, a non-principal in shrewsbury What do you do? Louise, a 41-year-old school teacher, explains...

Play your Christmas cards right.
January 8, 2004... This Christmas I received fewer cards and presents from patients than ever before. I am neither hugely disappointed by this, nor particularly surprised. I only work at the surgery part-time nowadays and I no longer have a personal list, so...

Stripped down to my number one pet hate.
January 8, 2004... At some time or other, each of us has reached that point in a particularly stressful surgery when the only rational course of action is to emit a blood-curdling scream, strip naked, and gyrate one's genitals in the middle of the packed waiting...

Protect your list under new contract.
January 22, 2004... The abolition of personal lists under the new contract could prejudice a doctor's negotiating power in the event of a partnership split. Daphne Robertson shows partners how to protect their position From 1 April 2004, patients at GMS...

Advice for dispensing GPs on VAT.
January 22, 2004... uncertainty over VAT continues for dispensing doctors. In the second of two articles, John Barnes answers more GPs' questions Are there any disadvantages in registering for VAT? The drawbacks for some practices include: Increased...

Tips on making switch from conventional smears to LBC.
January 22, 2004... Dr Karin Denton, consultant pathologist at Bristol's Southmead Hospital, explains the new cervical screening technique, liquid-based cytology, and provides practical advice on how to make the switch from conventional cervical smears The...

GP appraisals must pay off.
January 22, 2004... I am still awaiting my own annual GP appraisal, or a date for it, but apparently I am now a statistical exception. Most GPs around the country seem to have gone through the process, or are expecting to do so in the next couple of months. From...

Postnatal care - what should it entail?
January 22, 2004... The seventh in our series on women's health looks at what postnatal care should comprise What is the normal course of events for women in the postpartum period? With the increasingly prevalent phenomenon of early discharge after...

Dates to note.
January 22, 2004... Dozens of deadlines need to be filled in on GPs' calendars in the run-up to the new GMS contract and beyond. Doctor provides a round-up of some of the key dates By now GPs should have been offered the access and quality information...

Breast cancer risk varies by ethnic subgroup.
January 22, 2004... Breast cancer risk varies among women of South Asian origin according to their specific ethnic subgroup, say UK researchers. A team interviewed 700 first-generation South Asian women from London and the west Mid- lands, including 240 who had...

We need help to deal with heartsinks.
January 22, 2004... Government and PCOs must do their bit to support GPs I am currently away on a GP update week. Many times I have been asked what government is doing about 'it'. 'It' of course, means many different things, ranging from managing public demand...

The legacy of Shipman.
January 22, 2004... Serial killer and former GP Harold Shipman died last week in an apparent suicide. Cathy Comerford examines the lasting impact he has had on the profession In the mass of newspaper, radio, television and Internet reaction to the death of...

Only half in ethnic groups at high risk of TB get BCG jab.
January 22, 2004... Only half of children from ethnic groups at high risk of tuberculosis in the UK are receiving BCG vaccination, an audit suggests. Researchers based at Shrewsbury Hospital audited neonatal BCG vaccinations given at a Shropshire clinic over a...

Waking headache may show anxiety and depression.
January 22, 2004... Morning headaches are a good indicator of depression and insomnia disorders, according to survey results. US researchers questioned nearly 19,000 people in the UK, Germany, Italy, Portugal and Spain. Chronic morning headaches were reported by...

Bowel screening could cripple NHS.
January 22, 2004... Steve Ford The NHS would sink under the pressures of a national bowel screening programme, evidence suggests. An audit of colonoscopy services in three NHS regions has highlighted serious under-provision, and deficiencies in quality and...

Plan to allow patient forums to demand information from GPs.
January 22, 2004... Simon Meek Surgeries will find themselves at the beck and call of local patients' forums under plans to give them powers to demand information from GPs. Draft contract regulations say GPs will be required within 20 working days to produce 'any...

Don't get paranoid - get paid, says tsar.
January 22, 2004... Christina Golding The Government's primary care tsar has warned GPs against letting 'paranoia' force them into providing services for free under the new GMS contract. Dr David Colin-Thom said GPs had to exercise their right to choose to...

Heel scans can predict future fracture risk.
January 22, 2004... Ultrasound scans of the heel can rapidly predict fracture risk, UK researchers have shown. The University of Cambridge team followed the outcomes of 14,824 men and women aged 42 to 82 who had undergone ultrasound scanning of the calcaneum to...

GPs planning to ignore 'bogus' quality targets.
January 22, 2004... Simon Meek Practices are planning to forgo some of the contract's quality targets after finding the evidence backing them is 'bogus'. The GPs are also questioning the financial benefits of meeting certain targets, saying the targets pay...

Hutton to announce more contract IT cash.
January 22, 2004... HEALTH MINISTER John Hutton is to launch a cash rescue package to try and sort out the IT funding crisis under the new GMS contract. The money is due in the next month, following talks last week between Mr Hutton and NHS Alliance chairman Dr...

Refusal to grant OOH opt-out rights may worsen rural recruitment crisis.
January 22, 2004... Richard Fisher GPs WARN the recruitment crisis in rural areas could worsen if doctors are refused the right to quit out-of-hours. Many remote areas, especially in Scotland, have fewer out-of-hours options to replace an on-call doctor, so...

'Fast-track' Shipman reforms.
January 22, 2004... Doctor reporters PRIME MINISTER Tony Blair wants the Government to be poised to implement the Shipman Inquiry's findings as soon as they are published. Speaking in Parliament, Mr Blair said the Government had to make sure it was organised...

Northern Ireland GPs enjoy; individual help on contract.
January 22, 2004... GPs in Northern Ireland are being walked through the new GMS contract by health boards eager to help them prepare for implementation. While in England the new deal is beset with rows between practices and trusts, Northern Ireland's health...

Call to go national with chlamydia screening.
January 22, 2004... Steve Ford The Government's decision to extend its chlamydia screening pilot has left doctors asking why is it not yet being rolled-out nationally. Ministers announced 16 new chlamydia screening pilot sites, which will cover 50 PCTs. With...

[pounds sterling]76m savings on scrips; put 2004 funds at risk.
January 22, 2004... PCTs keep cash but underspend could reduce next year's budget Simon Meek GPs ARE set to achieve [pounds sterling]76m of savings on the national drug budget - but their efforts could be rewarded with a funding cut in the coming year....

GPs left to do own out-of-hours.
January 22, 2004... Almost half of a city's GPs may have to take over their own out-of-hours care again in April because their deputising service is quitting the area. Primecare is pulling out of Portsmouth on 9 April as the local PCTs - East Hampshire, Portsmouth...

Contract countdown.
January 22, 2004... Each week, we ask GPs how they are preparing for the new contract. This week, we talk to Dr John Lockley, partner in a semi-rural, two-partner practice in Ampthill, Bedfordshire What are you doing to prepare for the new contract? Making...

E-records plan isn't worth the paper it's printed on.
January 22, 2004... The e-revolution is here - but don't hold your breath Stand by for the [pounds sterling]4bn revolution. The world's biggest civil IT programme, complete with its [pounds sterling]250,000-a-year chief executive, is about to be launched. This...

Nail dystrophy.
January 22, 2004... What do you do? Marianne, aged 37, is training to run in the London Marathon. She has noticed that two toenails on one foot, and one on the other, have become thickened and white. She takes care of her feet and says she only wears...

Name game undermines our true worth.
January 22, 2004... 'How can we be "more than" people who deal with everything already?' I realise that you and I are always outlandishly busy but, believe it or not, there are some GPs out there with too much time on their hands. Who but the tragically...

We're drowning in contract documents.
January 22, 2004... Hundreds of pages of new contract documentation have been flooding into the practice, so it's not surprising our manager has been suffering information overload. She is getting regular circular and e-mail updates on contract issues from the...

Our registrar columnist gets to grips with ; the joys and frustrations of general practice.
January 29, 2004... 'the only way to prove CAUSE OF DEATH is to do a postmortem, and for one of those you need a pathologist - and they are about as common as non-bearded primary care professors' Back in the days of hospital medicine, which I miss like a...

Generation X.
January 29, 2004... In Generation X, the title of a 1990s novel, Douglas Coupland explored what he saw as the extended adolescence experienced by young American adults. Things seemed to have changed: here apparently was a new generation, no longer motivated by...

Does counselling work?
January 29, 2004... This series condenses must-read research for everyday practice and the MRCGP. In the second of a two-part feature, Dr Elizabeth England examines the evidence for the effectiveness of counselling in primary care There is some concern that...

Care home no-shows; 'wasting; GPs' time'.
January 29, 2004... Richard Fisher Unnecessary medicals for children in care are wasting hours of surgery time, and GPs are waiting months to be paid for providing the service. Somerset LMC is complaining that children being 'dumped' in the county, often far...

Government lines up 11 more walk-in centres.
January 29, 2004... Christina Golding Millions of pounds are to be spent on 11 more NHS walk-in centres this year although studies indicate that existing facilities make little difference to GPs' workloads. The Government has pledged a further [pounds...

New GP contract requires a new; partnership deed.
January 29, 2004... When was the last time you updated your partnership agreement? IN this Doctor special, we provide a comprehensive guide to ensure you have an effective partnership deed. LAWYER Ros Parkin starts by guiding you through the key issues your...

April threatens to pile on the paperwork.
January 29, 2004... GPs and practice staff could be buried by paperwork this April as several new procedures overlap. Practices will be expected to copy referral letters to patients from April, but this clashes with the new contract's kick-off. Wessex LMC is...

Are lifestyle contracts the key to a healthier nation?
January 29, 2004... Disease prevention implies taking an active role in your own well-being. Dr Richard Stott looks at the GP's role in encouraging patients to change their ways Last year, the Government put forward the idea of a patient-doctor contract. The...

Unregistered private GPs risk prosecution.
January 29, 2004... Many GPs working privately may be inadvertently breaking the law. NHS doctors who see patients privately in separate home surgeries may be unaware that they need to register with the National Care Standards Commission (NCSC), an LMC is warning....

Call for mammography screening from age 40.
January 29, 2004... Women should have mammography screening from the age of 40 rather than from 50, cancer experts are recommending. Dr Gill Ross, clinical oncologist at London's Royal Marsden Hospital, and Prof Kefah Mokbel, consultant breast surgeon at London's...

Lack of target delays NI access cash.
January 29, 2004... Rachel Solotti Northern Ireland's GPs are in limbo over how to earn access money because they have no target to chase. While practices in the region have learned they will receive [pounds sterling]3,500 on average under the directed...

Digital device; keeps watch on eczema night ; symptoms.
January 29, 2004... A new device can help measure how often eczema patients are disturbed by itching symptoms during the night, say researchers. The limb-worn digital accelerometer is a watch-like device that measures scratching and restlessness. UK scientists...

Combined statin-aspirin use could save thousands.
January 29, 2004... More widespread, app-ropriate use of statins and aspirin in combination could prevent thousands of premature deaths among heart patients, say US researchers. They assessed data from five trials on secondary prevention of cardiovascular disease,...

Claim of further evidence of viral link to autism.
January 29, 2004... Dr Andrew Wakefield and colleagues say they have found further evidence of a chronic viral infection, which is distinct from other inflammatory bowel diseases, in autistic children with bowel complaints. However, the London researchers said...

NI GPs may refuse to do night cover as progress stalls.
January 29, 2004... Rachel Solotti GPs IN Northern Ireland could refuse to staff out-of-hours co-operatives if they are not reassured that something is being done to relieve them of the burden of providing cover, warns their leader. GPC (NI) chairman Dr Brian...

Simple ABI check works as arterial disease test.
January 29, 2004... Steve Ford GPs CAN identify peripheral arterial disease (PAD) using a simple measure of ankle- brachial blood pressure index (ABI), say researchers. ABI is usually measured using Doppler ultrasound and, despite being recognised as a...

GPs threaten to boycott work as caps put on services pay.
January 29, 2004... Christina Golding Rows over enhanced services pay are leading many GPs to consider refusing to carry out the services and flooding local hospitals instead. In west Oxfordshire, GPs have been offered a cap on minor surgery of 20 injections or...

Worcester GPs off on-call 'by October'.
January 29, 2004... GPs IN Worcestershire could be waving goodbye to on-call work by October. While many areas of Britain are struggling over out-of-hours cover, Worcestershire's three PCTs - Wyre Forest, Bromsgrove and Redditch, and South Worcestershire - this...

'Little evidence' of benefit from upping inhaled steroid dose.
January 29, 2004... There is little evidence that doubling the dose of inhaled corticosteroid improves asthma control when the condition deteriorates, according to UK researchers. For a year they studied 390 asthma patients who were at risk of exacerbation. When...

Study into women doing their own; HPV swabs.
January 29, 2004... UK researchers are testing the feasibility of a DIY swab test for human papillomavirus. Dr Anne Szarewski and colleagues from Cancer Research UK are comparing a self-test women can do in private with conventional testing by the doctor during a...

Warning over patients mixing homeopathy with cancer drugs.
January 29, 2004... Many cancer patients may be risking dangerous side-effects by mixing alternative medicine with standard treatment, warn researchers. A survey of 318 cancer patients at London's Royal Marsden Hospital found half took herbal remedies and food...