Surgical Regs everywhere:

“look, can you just give some more ABx rather than calling me for fu-”

I treated a complex patient with a (genuine) UTI.

The urine - I kid you not - smelt like fish and shit.

Proteus on prev growths.

Is this a thing? I’m mindful of the “my urine smells bad” crowd always being shot down with The Evidence.

(No I don’t think they had a fistula)

I know we’re not allowed to blame people. But I don’t care.

Who’s responsible for the Placeholder doctor scandal? What did they/didn’t they do?

Was it a case of getting sums wrong? Too many lines on an Excel sheet?

Red Sally 💙 Oldbury 😷 💉💉💉💉 Dean Yep, but also, we are not commissioned to do it.

Imagine how ED would feel if they saw someone with a barn door ED presentation but were also expected to do a QOF asthma review and read code smoking status and bring them back to do a cervical smear.

Worrying lack of opportunity for woefully inadequate number of GPs we have in the NHS.

Choices are poor:

Partner - unlimited liability/workload, inadequate investment/unviable contracts

Salaried - unsustainable/unsafe workloads, 33% pay erosion

Locum - risk of unemployment

#blessed

'Signing Med 3s is not so much a fragment of general practice as it is actually a massive piece of perianal shrapnel.'

Dr Copperfield urges GPs to see the bright side of the proposed fit note reform

buff.ly/3UtuP2H

If you’re ordering a D-Dimer “urgently tomorrow”, you shouldn’t be ordering a D-Dimer.

Or seeing patients, probably.

I don’t want to do Med3 “sick notes”. I’ve no interest. It’s not a mark of being in a trusted position; it’s a total pain in the arse that complicates patients’ relationships with me and adds to my workload.

“Take them away” from me? Pfft.
You’re welcome to them.

Welcome to my day off processing work that secondary care can't be arsed to do for no apparent reason.

Enjoy my thread...

Trends in workload in UK general practice. (My PhD student’s paper)

bjgp.org/content/early/…

😑

free access, bmj
why the fuss about PAs?
bmj.com/content/385/bm…

GPs/Urologists:

Has anyone come up with a definitive way of managing non-significant haematuria (1+ or trace bld w <10RBC under a microscope) that doesn’t involve just repeating it ad infinitum?

Assume young, low risk patient w normal renal function.

Gavish Munbauhal Mike Henley 🤨

Dr Goblin Doug McKechnie Ah yes, the challenge of VSED.... and the tendency of clinicians who are usually champions of patient autonomy to get the wibbles! Some info in bmj.com/content/379/bm… and a 2023 article on VSED clinical guidelines: jpsmjournal.com/article/S0885-…