Another good GP meet up last night, we shared fantastic curry and current dilemmas. As one of us has had to let go a partner and another has resigned from her partnership. Both had issues to do with being able to work with colleagues in practice. Tough decisions but we all agreed both had done the right thing.
Shingles vaccine and norovirus vaccine on the horizon, nursing homes and home visiting.
We covered a lot of ground!
Tuesday, 24 September 2013
Austerity and NICE
The GP group were in decidedly sombre mood, talking about austerity cuts and effects on patients. We discussed effects of diet poor mental health and effect on kids of the budget cuts. We discussed what we could do about it and how to raise awareness of the plight of our already disadvantaged patients.
There was more throwing hands in the air at current NICE guidance regarding tamoxifen for at risk women. Several of us had heard the Inside Health article about the recommendations and agreed with the GP on the show.
We also managed to share dilemmas regarding colleagues and partnerships. A productive if rather depressing couple of hours.meeting in July , accidentally not recorded until september as it hadnt saved
There was more throwing hands in the air at current NICE guidance regarding tamoxifen for at risk women. Several of us had heard the Inside Health article about the recommendations and agreed with the GP on the show.
We also managed to share dilemmas regarding colleagues and partnerships. A productive if rather depressing couple of hours.meeting in July , accidentally not recorded until september as it hadnt saved
Wednesday, 7 August 2013
Psychiatry and Anti-Psychiatry
It's the summer holidays so I think I should get double points for any intelligent thought at the moment!
Luckily there is lots in the media about psychiatry with the publishing of the latest DSM V manual, a couple of articles gave me pause for thought.
In the Guardian review there is a long piece by Will Self, asking what the point of Psychiatry is and criticising Psychiatrists for essentially being state-sponsored drug pushers.
http://www.theguardian.com/society/2013/aug/03/will-self-psychiatrist-drug-medication
It's certainly an interesting article, although not a balanced one. What is equally interesting is the huge number of shares and comments the article has generated since it was published 4 days ago.
An item that is less controversial and not quite so interesting there is an in the London Review of Books of the manual itself. It's by another non-medic Ian Hacking
http://www.lrb.co.uk/v35/n15/ian-hacking/lost-in-the-forest
It also seems to have generated alot of comment in a short time. The article expands on the idea that really this manual is not for clinicians, as it is virtually inusuable. It's role is largely in the US for bureaucrats to decide how and who to provide medical care to.
Both articles give plenty to think about. It's interesting to compare the message of Will Self's article with Ben Goldacre's Bad Pharma. Both men want clinicians to be more thoughtful in thier prescribing I think. One has the medical back ground the other is well read and educated on the subject but not a prescribing clinican themselves.
Luckily there is lots in the media about psychiatry with the publishing of the latest DSM V manual, a couple of articles gave me pause for thought.
In the Guardian review there is a long piece by Will Self, asking what the point of Psychiatry is and criticising Psychiatrists for essentially being state-sponsored drug pushers.
http://www.theguardian.com/society/2013/aug/03/will-self-psychiatrist-drug-medication
It's certainly an interesting article, although not a balanced one. What is equally interesting is the huge number of shares and comments the article has generated since it was published 4 days ago.
An item that is less controversial and not quite so interesting there is an in the London Review of Books of the manual itself. It's by another non-medic Ian Hacking
http://www.lrb.co.uk/v35/n15/ian-hacking/lost-in-the-forest
It also seems to have generated alot of comment in a short time. The article expands on the idea that really this manual is not for clinicians, as it is virtually inusuable. It's role is largely in the US for bureaucrats to decide how and who to provide medical care to.
Both articles give plenty to think about. It's interesting to compare the message of Will Self's article with Ben Goldacre's Bad Pharma. Both men want clinicians to be more thoughtful in thier prescribing I think. One has the medical back ground the other is well read and educated on the subject but not a prescribing clinican themselves.
Wednesday, 26 June 2013
Thinking fast and slow
A while since I last wrote anything on here!
A crazy few weeks have been and gone, with poetry festivals school hols and trips across the country and abroad to see family.
I read an excellent book by the Nobel prize winner Daniel Kahnemann 'thinking fast and slow' about the mental short cuts we all make to cope with the sheer volume of information the human brain receives every second of the day.
It makes a lot of sense to me and I'm sure any GP trying to convey information regarding likelihood and risks. I'm sure it will influence my practice and I would recommend it as a good read, whatever your walk of life.
http://books.google.co.uk/books?id=oV1tXT3HigoC&printsec=frontcover&output=html_text&source=gbs_ge_summary_r&cad=0
A crazy few weeks have been and gone, with poetry festivals school hols and trips across the country and abroad to see family.
I read an excellent book by the Nobel prize winner Daniel Kahnemann 'thinking fast and slow' about the mental short cuts we all make to cope with the sheer volume of information the human brain receives every second of the day.
It makes a lot of sense to me and I'm sure any GP trying to convey information regarding likelihood and risks. I'm sure it will influence my practice and I would recommend it as a good read, whatever your walk of life.
http://books.google.co.uk/books?id=oV1tXT3HigoC&printsec=frontcover&output=html_text&source=gbs_ge_summary_r&cad=0
Sunday, 28 April 2013
Diets and Psychopaths
Firstly some listening, a helpful follow on from Inside Health as ever. Looking at the evidence for the Fast Diet 5:2 etc the opinion is there isn't enough evidence yet to support its recommendation beyond other 'move more eat less' diets, but as one helpful comment from a listener the following week pointed out, the idea of only dieting 2 days per week is both new and more achievable, so what's the harm? I'm recommending the Fast Diet which is a few quid on Amazon and written by a GP. It's top of the best sellers list bit I don't think I can take credit for that!
I've zipped through Jon Ronson's excellent Psychopath Test, lots to think about regarding diagnosis if psychiatric illness, the use of checklists to define illness and the use of medication.
I've zipped through Jon Ronson's excellent Psychopath Test, lots to think about regarding diagnosis if psychiatric illness, the use of checklists to define illness and the use of medication.
Wednesday, 20 March 2013
Francis Report & all calories are not equal
A cold snowy morning! Time to get things done that don't involve leaving the house!
So, I've been following various reports about the Francis Report before I decide what I think and how it should affect me and my practice. Yesterday I listened to the BMJ round table podcast with Mr Francis himself and various other senior figures in the health service. Only one piece of journalism in the mainstream press gave me pause for thought. It was by Roger Taylor who also has a book coming out about the NHS.
He described how a successful hospital can still have thousands of adverse events reported including serious injury and death due to medial error and still be thought of as a good hospital. So, for people working in a system and there being more than an 'acceptable' number of errors not spotted, isn't so surprising really.
He also mentioned a consultant in Mid Staffs who was running an exemplary department and managed to do so through the crisis, but unfortunately this wasn't expanded on. It strikes me he is the has something valuable to contribute to the debate.
The round table was interesting, but didn't really come up with anything above and beyond what has been extensively written about. It seems a pity to me, with so many senior figures in one place they couldn't come up with some answers.
Much more interesting was a San Franscisco Medic on another BMJ podcast, discussing how all calories are not equal and how processed foods trigger insulin release and further cravings for more calorie dense fattening foods. He went pretty fast and I found it hard to keep up so I might have to listen to that one again! The basic message was cut right down on processed foods, high fibre foods help digest sugars hence whole fruit and whole grains being preferable to anything in a packet.
This is useful to me and my family personally as I have time and resources to cook good food. Helping my patients? I guess it's a question of encouraging people to buy fruit and veg and eat more home cooked food. Although with no fresh fruit and veg shop locally and many of my patients having no cooking skills at all, I'm not sure how far I will get with my more deprived patients.
So, I've been following various reports about the Francis Report before I decide what I think and how it should affect me and my practice. Yesterday I listened to the BMJ round table podcast with Mr Francis himself and various other senior figures in the health service. Only one piece of journalism in the mainstream press gave me pause for thought. It was by Roger Taylor who also has a book coming out about the NHS.
He described how a successful hospital can still have thousands of adverse events reported including serious injury and death due to medial error and still be thought of as a good hospital. So, for people working in a system and there being more than an 'acceptable' number of errors not spotted, isn't so surprising really.
He also mentioned a consultant in Mid Staffs who was running an exemplary department and managed to do so through the crisis, but unfortunately this wasn't expanded on. It strikes me he is the has something valuable to contribute to the debate.
The round table was interesting, but didn't really come up with anything above and beyond what has been extensively written about. It seems a pity to me, with so many senior figures in one place they couldn't come up with some answers.
Much more interesting was a San Franscisco Medic on another BMJ podcast, discussing how all calories are not equal and how processed foods trigger insulin release and further cravings for more calorie dense fattening foods. He went pretty fast and I found it hard to keep up so I might have to listen to that one again! The basic message was cut right down on processed foods, high fibre foods help digest sugars hence whole fruit and whole grains being preferable to anything in a packet.
This is useful to me and my family personally as I have time and resources to cook good food. Helping my patients? I guess it's a question of encouraging people to buy fruit and veg and eat more home cooked food. Although with no fresh fruit and veg shop locally and many of my patients having no cooking skills at all, I'm not sure how far I will get with my more deprived patients.
Tuesday, 19 February 2013
Cochrane collaboration podcast and Inside Health
I listened to my first Cochrane podcast and can report it was pretty good. Compared to the slick production of Inside Health it's about dry and the speaker obviously less experienced at broadcasting, but still engaging and I'll listen to some more.
The podcast I listened to was about the use of SSRIs after stroke and although not directly relevant to my daily practice, I enjoyed hearing about a novel use of a well known drug.
Inside Health continues and one good item on Parkinson's disease but I was less impressed with an article by a family planning specialist about continuing use of the combined pill in older women. The specialist highlighted all of the benefits of taking COCP but didn't mention the possible side effects once. If I was a patient I would have been left thinking there was no possible side effects and would have a very biased opinion of the class of drugs.
The podcast I listened to was about the use of SSRIs after stroke and although not directly relevant to my daily practice, I enjoyed hearing about a novel use of a well known drug.
Inside Health continues and one good item on Parkinson's disease but I was less impressed with an article by a family planning specialist about continuing use of the combined pill in older women. The specialist highlighted all of the benefits of taking COCP but didn't mention the possible side effects once. If I was a patient I would have been left thinking there was no possible side effects and would have a very biased opinion of the class of drugs.
Tuesday, 5 February 2013
Lots of listening and reading.
So, Inside Health is back on the air and as usual has lots to discuss and think about! I'm up to date with the episodes and have particularly appreciated the article on dry mouth and current cancer treatments.
I'm proud to announce I finished Bad Pharma last week, within the 3 weeks of the library book loan too! I talked about it to a friend and colleague and she asked if reading it had changed my prescribing. I think that is a really hard question to answer quickly!
The book is pretty forthright about my responsibility as a doctor regarding prescribing and Ben Goldacre really knows his stuff. He also makes good points about getting the right information to GPs to be able to make a good decision when prescribing.
He highlights the arbitrary nature of some of our decisions and how easy it would be to fix indiscrepancies by entering all patients into trials as a matter of course as opposed to the current state of affairs.
So, how will it change my prescribing? I would like to think I prescribe mainly tried and tested generics based on current best evidence already. I hope it will make me more enquiring about prescribing decisions from secondary care. I hope I will share the vagarities of some decisions with my patients where good evidence isn't available more openly.
The book is very critical of medical journals and editorial decisions and champions the Cochrane Collaboration throughout the book. I guess the CC wouldn't be my first port of call for day to day decisions, but maybe I should look at it more- i shall subscribe to their email alerts and have a listen to the podcasts they do.
I'm proud to announce I finished Bad Pharma last week, within the 3 weeks of the library book loan too! I talked about it to a friend and colleague and she asked if reading it had changed my prescribing. I think that is a really hard question to answer quickly!
The book is pretty forthright about my responsibility as a doctor regarding prescribing and Ben Goldacre really knows his stuff. He also makes good points about getting the right information to GPs to be able to make a good decision when prescribing.
He highlights the arbitrary nature of some of our decisions and how easy it would be to fix indiscrepancies by entering all patients into trials as a matter of course as opposed to the current state of affairs.
So, how will it change my prescribing? I would like to think I prescribe mainly tried and tested generics based on current best evidence already. I hope it will make me more enquiring about prescribing decisions from secondary care. I hope I will share the vagarities of some decisions with my patients where good evidence isn't available more openly.
The book is very critical of medical journals and editorial decisions and champions the Cochrane Collaboration throughout the book. I guess the CC wouldn't be my first port of call for day to day decisions, but maybe I should look at it more- i shall subscribe to their email alerts and have a listen to the podcasts they do.
Tuesday, 1 January 2013
Measles
First things first, Happy New Year! Resolution number 1, record more of my learning!
So, the spotty 20 year old I saw before Christmas had Measles confirmed on a viral swab. I've reviewed her notes and she missed her MMR, despite it being clearly recorded she was safe to have it and should do so.
The girl has epilepsy and learning difficulties so we think that's why her carers chose not to give it. She's been registered her whole life with the surgery.
A quick look at the Medscape App reminded me of all the points I had forgotten about Measles.
The girl presented with a florid rash , I was reminded of the 3 C's, which I hadn't asked about and learnt Vitamin A can reduce symptoms but I'm not sure if that's only for deficient individuals.
I also learnt that Measles directly suppresses immune response, making secondary bacterial infection a risk, not just viral sequelae.
So learning points?
Check childhood immunisations when reviewing patients with learning difficulties, consider diagnosis in unvaccinated individuals with 3 C's
My senior colleague saw 1 case in the 80s and none since so hopefully it will be a long time before I see another!
So, the spotty 20 year old I saw before Christmas had Measles confirmed on a viral swab. I've reviewed her notes and she missed her MMR, despite it being clearly recorded she was safe to have it and should do so.
The girl has epilepsy and learning difficulties so we think that's why her carers chose not to give it. She's been registered her whole life with the surgery.
A quick look at the Medscape App reminded me of all the points I had forgotten about Measles.
The girl presented with a florid rash , I was reminded of the 3 C's, which I hadn't asked about and learnt Vitamin A can reduce symptoms but I'm not sure if that's only for deficient individuals.
I also learnt that Measles directly suppresses immune response, making secondary bacterial infection a risk, not just viral sequelae.
So learning points?
Check childhood immunisations when reviewing patients with learning difficulties, consider diagnosis in unvaccinated individuals with 3 C's
My senior colleague saw 1 case in the 80s and none since so hopefully it will be a long time before I see another!
Thursday, 6 December 2012
Delicious Food and Dilemmas!
A wonderful Christmas meal atSilversmiths was my GP group treat for being so good in 2012!
We managed not to talk just about how great the food was, we also chewed over some meaty clinical dilemmas.
Ranging from pregabalin, it's use and misuse, chronic pain management in general and our frustrations with thesis services. Reorganising and managing reception/admin teams, nail biting and whether a particular little girl was in need of psychological assessment and knees!
A very pleasant and fruitful way to catch up and mull over some big issues for 3 hours!
We managed not to talk just about how great the food was, we also chewed over some meaty clinical dilemmas.
Ranging from pregabalin, it's use and misuse, chronic pain management in general and our frustrations with thesis services. Reorganising and managing reception/admin teams, nail biting and whether a particular little girl was in need of psychological assessment and knees!
A very pleasant and fruitful way to catch up and mull over some big issues for 3 hours!
Tuesday, 20 November 2012
Diagnosing patient's preference
Is it just me, or did I miss something? The editorial with the above title in BMJ this month make me chuckle, then sigh and shake my head!
http://www.bmj.com/content/345/bmj.e7745?etoc=
Surely this is what we spend our days in General Practice land doing already? I'm sure I was marked on it when I submitted videos for MRCGP nearly 10 years ago? Why are the words communication skills not used?
I particularly like the tantalising comments about the possibility of reducing costs by asking patients what they really want. I also liked the editorial comments about making the patient part of the team, making the decision together with clinicians.
I did, of course listen to the podcast and the authors seem very genuine and again, there is no mention of General Practice or any mention of communication skills training.
I guess if there is any change in secondary care as a result of these papers, that must be a good thing. I'm just amazed this is where they are at.
http://www.bmj.com/content/345/bmj.e7745?etoc=
Surely this is what we spend our days in General Practice land doing already? I'm sure I was marked on it when I submitted videos for MRCGP nearly 10 years ago? Why are the words communication skills not used?
I particularly like the tantalising comments about the possibility of reducing costs by asking patients what they really want. I also liked the editorial comments about making the patient part of the team, making the decision together with clinicians.
I did, of course listen to the podcast and the authors seem very genuine and again, there is no mention of General Practice or any mention of communication skills training.
I guess if there is any change in secondary care as a result of these papers, that must be a good thing. I'm just amazed this is where they are at.
Friday, 9 November 2012
Reading
Squeezing in some medical reading, which is harder for me than podcasts as you have to sit down!
I'm enjoying Will Self's Booker Prize short listed 'Umbrella' although there are no chapters and keeping up with the narrative requires a lot of concentration. He has a lot to say about medical care, labelling stigma and institutionalisation. I wonder how non medics find it to read. I know he wrote this when he was unwell, then found out to have Polycythaemia Rubra Vera and I've read articles by him about his experience as a patient-
http://www.guardian.co.uk/books/2011/oct/21/will-self-blood-disease
I keep reading other people's opinion of Ben Goldacre's Bad Pharma, once I've chewed through Umbrella that will be the next big read on my list!
I'm enjoying Will Self's Booker Prize short listed 'Umbrella' although there are no chapters and keeping up with the narrative requires a lot of concentration. He has a lot to say about medical care, labelling stigma and institutionalisation. I wonder how non medics find it to read. I know he wrote this when he was unwell, then found out to have Polycythaemia Rubra Vera and I've read articles by him about his experience as a patient-
http://www.guardian.co.uk/books/2011/oct/21/will-self-blood-disease
I keep reading other people's opinion of Ben Goldacre's Bad Pharma, once I've chewed through Umbrella that will be the next big read on my list!
Friday, 19 October 2012
Lots of stuff!
Yesterday I had a wonder day devoted to studying, I was on the RCGP Alcohol Management in Primary Care Course and in addition I squeezed in 2 podcasts from Inside Health! one on the bus there and one back.
So the first had one really interesting interview with a neurology profesor about who can stop their anti-epileptics and when they can do it.
The second had a good article about benign essential tremor again from specialist, but a different one. How to diagnose, features that suggest alternative diagnoses and alarming features of a tremor.
The course was excellent too! Delivered by the wonderful Jenny Keen of the Primary care substance misuse team.
A very productive day!
So the first had one really interesting interview with a neurology profesor about who can stop their anti-epileptics and when they can do it.
The second had a good article about benign essential tremor again from specialist, but a different one. How to diagnose, features that suggest alternative diagnoses and alarming features of a tremor.
The course was excellent too! Delivered by the wonderful Jenny Keen of the Primary care substance misuse team.
A very productive day!
Tuesday, 16 October 2012
BMJ podcasts
I don't know why but I've had to re-subscribe to this podcast again and have missed a lot of them. But the latest 2 are great-
12/10/12- Over treatment is discussed mainly with reference to the American system but very pertinent to the UK when changes by the coalition government are in process.
5/10/12 discussed the recent advert by the British Heart Foundation to encourage the public to try hands only resuscitation. Apparently the campaign was hugely successful and viewed by a lot of the public. Perhaps I should be encouraging my patients to look at the advert?
http://www.bhf.org.uk/heart-health/life-saving-skills/hands-only-cpr.aspx
12/10/12- Over treatment is discussed mainly with reference to the American system but very pertinent to the UK when changes by the coalition government are in process.
5/10/12 discussed the recent advert by the British Heart Foundation to encourage the public to try hands only resuscitation. Apparently the campaign was hugely successful and viewed by a lot of the public. Perhaps I should be encouraging my patients to look at the advert?
http://www.bhf.org.uk/heart-health/life-saving-skills/hands-only-cpr.aspx
Wednesday, 3 October 2012
B12 and Vitamin D + a new resource
2 Important topics, both covered on Inside Health on 4th September, with interesting opinions and research from 2 specialists.
Firstly, a study showing taking Vitamin D can improve recovery from TB and a discussion about how Vitamin D might be modulating immune response. Apparently one of the first ever randomised controlled trials, conducted by the Brompton Hospital in the last century found patients recieving sunlight or cod liver oil were more likely to survive TB than those who didn't.
Secondly, a specialist who feels we under diagnose and under treat B12 deficiency. He feels anyone with a level under 300 mcg is deficient or at least has an indadequate level. He also believes we should treat with im hydroxycobalamin not to BNF recommended doses in every case- we should be administering more frequently in certain people and using response to treatment instead to judge the amount needed.
This is timely for me as I'm just starting an audit in measuring B12/FBC in patients taking metformin- at Wincobank that is over 400 patients. Other drugs to consider B12 deficiency include phenytoin, h2 receptor antagonists and PPis.
Finally a new resource recommended in the back of the MPS magazine- an app for the iPhone called Medscape. It's from the States, is a free resource and is an encyclopaedia of pretty much everything- Drugs, Conditions, Procedures Drug interactions & calculators. Looks pretty useful, navigated around the app quite easily and have used it to check a drug interaction. I note it also has information about herbal medicines in this category, so could be very useful. I will report back!
www.medscape.com
Firstly, a study showing taking Vitamin D can improve recovery from TB and a discussion about how Vitamin D might be modulating immune response. Apparently one of the first ever randomised controlled trials, conducted by the Brompton Hospital in the last century found patients recieving sunlight or cod liver oil were more likely to survive TB than those who didn't.
Secondly, a specialist who feels we under diagnose and under treat B12 deficiency. He feels anyone with a level under 300 mcg is deficient or at least has an indadequate level. He also believes we should treat with im hydroxycobalamin not to BNF recommended doses in every case- we should be administering more frequently in certain people and using response to treatment instead to judge the amount needed.
This is timely for me as I'm just starting an audit in measuring B12/FBC in patients taking metformin- at Wincobank that is over 400 patients. Other drugs to consider B12 deficiency include phenytoin, h2 receptor antagonists and PPis.
Finally a new resource recommended in the back of the MPS magazine- an app for the iPhone called Medscape. It's from the States, is a free resource and is an encyclopaedia of pretty much everything- Drugs, Conditions, Procedures Drug interactions & calculators. Looks pretty useful, navigated around the app quite easily and have used it to check a drug interaction. I note it also has information about herbal medicines in this category, so could be very useful. I will report back!
www.medscape.com
Wednesday, 19 September 2012
Back to Work! Back to podcasts!
So, I've been good and booked my appraisal, I've recovered from last week and appearing in coroner's court to give evidence, now back to some learning!
There is a new series of Inside Health with dr mark Porter again, which I have missed the first few episodes of iver the summer. I cracked on with this weeks episode and squeezed in last weeks whilst cooking tea!
Worth it alone for the comments by Professor Alan Morice (ex Sheffield Consultant and a lecturer I remember well!) about treating non-acid reflux and cough- apparently PPis can make it worse not better, start with metoclopramide or domperidone instead!
Also pertinently after discussions at coroner's court last week an article about gallstones, prevalence, management and when cholecystectomy is necessary.
This reminds me of a lady I saw last week who had caught me shortly after the Eat Fast Live Longer Program we had discussed alternate day fasting as a way to loose weight, after her tries of standard low fat diet hadn't been successful. She was thrilled to have lost 3 kg in a month and had got her partner to chan§ge his diet too.
The second episode I listened to was from 11/9/12 and again excellent, discussing how to look at OA and how to discuss exercise/ conservative measures with patients. I had read about the new NICE guidance and read the ARC leaflet about ' wear tear and repair' but this podcast also addressed how to get the messages over to patients. Quietly political as ever, it also included a discussion with Lawrence Buckman of the GP council for the BM A about the appalling lack if funding for musculoskeletal services. Excellent all round!
There is a new series of Inside Health with dr mark Porter again, which I have missed the first few episodes of iver the summer. I cracked on with this weeks episode and squeezed in last weeks whilst cooking tea!
Worth it alone for the comments by Professor Alan Morice (ex Sheffield Consultant and a lecturer I remember well!) about treating non-acid reflux and cough- apparently PPis can make it worse not better, start with metoclopramide or domperidone instead!
Also pertinently after discussions at coroner's court last week an article about gallstones, prevalence, management and when cholecystectomy is necessary.
This reminds me of a lady I saw last week who had caught me shortly after the Eat Fast Live Longer Program we had discussed alternate day fasting as a way to loose weight, after her tries of standard low fat diet hadn't been successful. She was thrilled to have lost 3 kg in a month and had got her partner to chan§ge his diet too.
The second episode I listened to was from 11/9/12 and again excellent, discussing how to look at OA and how to discuss exercise/ conservative measures with patients. I had read about the new NICE guidance and read the ARC leaflet about ' wear tear and repair' but this podcast also addressed how to get the messages over to patients. Quietly political as ever, it also included a discussion with Lawrence Buckman of the GP council for the BM A about the appalling lack if funding for musculoskeletal services. Excellent all round!
Wednesday, 8 August 2012
Eat, Fast, Live Longer
Another good Horizon Program I saw last night on the iPlayer from Dr Michael Moseley, about eating, or not eating as it were.
Lots to think about (and digest!) about research going on in the States mainly, into fasting to improve CV risk profiles. Lots of convincing evidence from experts and personal stories, including Harmander Singh, the 101 year old Marathon runner who regularly fasts and eats child sized portions of food.
Eat Fast and Live Longer
Further support that my time would be better discussing lifestyle issues with patients instead of dishing out pills. I'm not sure how telling people to fast/how to do it will go down in Wincobank, but I'm gong to give it a go!
Lots to think about (and digest!) about research going on in the States mainly, into fasting to improve CV risk profiles. Lots of convincing evidence from experts and personal stories, including Harmander Singh, the 101 year old Marathon runner who regularly fasts and eats child sized portions of food.
Further support that my time would be better discussing lifestyle issues with patients instead of dishing out pills. I'm not sure how telling people to fast/how to do it will go down in Wincobank, but I'm gong to give it a go!
Friday, 13 July 2012
Guts: The strange and mysterious world of the human stomach
Wednesday, 11 July 2012
The sun is shining!
At last! After 2 weeks if non- medical busyness ( I helped put on a show, played oboe live on local radio as we as family stuff!) I am sitting in sunshine reading the BJGP
Several interesting and useful articles this week- cancer in children, LUTS and what to do about them and flagging up child maltreatment.
Only half way through but thought I'd stop and think about those 3 for the mo!
Several interesting and useful articles this week- cancer in children, LUTS and what to do about them and flagging up child maltreatment.
Only half way through but thought I'd stop and think about those 3 for the mo!
Thursday, 21 June 2012
GP confederations
This time last week me and the Nurse practitioner were sent to meet the other GPs in the North Sheffield proposed GP confederations.
I was a pleasant afternoon and the practices we were allocated all seemed to enjoy having a chat about what bothers us at the moment and how we could address this.
What difference will it make?? Well, who knows, but I can see advantages in working together to address problems we are having locally. whether we will manage to achieve anything, remains to be seen!
I was a pleasant afternoon and the practices we were allocated all seemed to enjoy having a chat about what bothers us at the moment and how we could address this.
What difference will it make?? Well, who knows, but I can see advantages in working together to address problems we are having locally. whether we will manage to achieve anything, remains to be seen!
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