Doc Em🕷🇪🇺

@LostDazes @Megsenmumdr @rheumipainmask Indeed. But easier just to ask us to find out & let them know - even though I don’t know the exact ins & outs of the procedure. How anyone can think that’s OK is beyond me.

@Megsenmumdr @DocEmUK @rheumipainmask Capacity is time & decision specific. If it's consenting or declining a procedure then the person doing the procedure should really be doing the assessment.

The sheer volume of work we get means that I have to log on most evenings & weekends. Not that uncommon in the professional world I guess, except that most people don’t have the public chastising them for being lazy part-timers. I’m physically in practice two days a week. I work at least five. Just logged off today and I’m utterly exasperated by the dumps on me by other organisations who seem to think everything is my job because it’s easier or they don’t know what to do. Requests for specialist referrals for a patient that has been with them for a couple of weeks with minimal information on why. The team they want referral to is in the same hospital. Asks for us to do capacity assessments on patients & let the specialist know that the patient declining the treatment they recommend is making an ‘unwise decision’ rather than a capacity issue. Arrange a MASH for a patient I know nothing about. Urgently prescribe medication for a patient a NP has literally just consulted with in clinic. Does secondary care think that we’re sitting around waiting for work? Holding spare capacity to do their job? Believe that all things administrative are the role of the GP? This is what will drive me out of general practice. Not the govt (close second). Not the media. Not the patients. It’s the incessant dumping on us. The total lack of respect for our time. The complete ignorance as to what we do. The treating of us as if we are community juniors. The unreasonable expectations they set for patients from us. Once upon a time we were on the same team. Now, they seem hell-bent on breaking us. The consultants are least responsible for this. It’s the lower-skilled, narrow-trained, don’t-know-what-else-to-do doctor subs that are the worst. I am sending all the tasks back, because that’s the only way to educate & change practice, but it’s exhausting. It’s not good for patients either, but they should never have done it & it needs to change for the benefit of population health.

Bring back proper medicine, alliance between hospital & primary care doctors, and a doctor-first service. Quality will improve and care will be coherent. The alternative is a two-tier health service, and I don’t think I even mind any more. That’s very sad.

@Shrink_at_Large Found it. It’s Amarox Ltd. If you have meds by anyone else, it’s not an issue (there will be a logo on the box, eg Dr Reddy, Teva etc (not sure who does make it, these are just pharma company examples) ).

@Shrink_at_Large It would be helpful if they stated the manufacturer in the first instance as that’s a really easy way to know know you’re not affected - better than searching for small numbers.

There has been a recall of SERTRALINE 100mg tablets batch number V2500425. The regulator said 81,872 packs are included in the recall. Please check if you are on Sertraline. Thank you.

@nemorolo @AndyStoneSheila @SteelerGoalie94 @wesstreeting Perhaps they do a lot of work outside of consulting. Seeing patients FTF is only a fraction of the job. I ‘only work 2 days’ but do more than FT hours.

@DocEmUK @AndyStoneSheila @SteelerGoalie94 @wesstreeting I don't know their schedules inside out. Why would I? I just know, in our surgery. Some are in 5 days. Some 3 and some 2. They could have any number of non-work things going on too. I doubt they work 37.5 hours over 2 days though.

Tried to get a GP appointment. Told to go to A&E. Go to A&E. They say go to walk in GP centre at Northern. Go to walk in GP centre and see….. My GP. The system is utterly broken. #NHS #HealthService #GP

@Shrink_at_Large @AgnesAyton In any services it’s bad, but mental health it’s worst.

I resent the normalisation of discontinuity of care in NHS mental health services.

‘Bully the GP’. Have you ever thought why they may feel that referring you isn’t right? Self-limiting condition? Unfunded NHS service? Resource demand management? Local/national pathway restrictions? I tell you what, I only ever don’t refer if it’s because it’s not needed, not available or I’m not allowed. Personally, it matters to me not a jot. I have no ulterior motive and neither do any of the other NHS GPs in the country.

My health insurance costs £150 a month for the family and I get seen immediately. Both wife and I each pay £300 a month in NI, our employers pay another £600 each on our behalf. £1800 a month and I have bully the GP to even refer me, then wait 4 months for a scan.

@Kriskirb Acceptable? Not in society. Standard? Absolutely. Why? Lack of resource & overwhelming demand. Cause? Tory austerity & subsequent money in the wrong place.

My mums about to be discharged from hospital after 5 days trying to sort a rapid heart rate out. No cause identified. No care package in place. She is 93yrs old. Is this acceptable for the NHS these days ? #nhs

@RealCMc1930 @Brackens1 House call? Why??

@Brackens1 You need to get back to GP that's a dangerously low pulse. In fact I would ask for a house call saying you need to see someone today.

My medication is causing very low blood pressure. I didn’t get to see a GP. It was a Health Care Assistant who took one (normal) BP reading and pronounced me "fine". I have a pulse of 47-48 most mornings and feel awful. A HCA can do nothing but use a BP monitor. 🤷🏼‍♀️

This landed me in hospital with #1. The pressure is immense. I was hallucinating images of my baby with a dummy in his mouth like I was a monster. I felt like I deserved to die because breastfeeding was so awful I punished myself. My let-down reflex was profoundly dysphoric. It doesn’t have to be like this. Not breastfeeding won’t harm your child. Breastfeeding, if it’s a struggle, can cause untold harm to the mother. This needs to be OK to say.

Bums me out so bad seeing moms go insane or even suicidal over breastfeeding & cosleeping when it is a brutal slog for them & everyone is just like “Keep going!” I am the one who will always tell you that is crazy talk. Put the baby in a bassinet. Give that baby a bottle. You will never ever notice a difference between them & other children

@AndyStoneSheila @SteelerGoalie94 @wesstreeting Show you know nothing about how GPs work without saying you know nothing about how GPs work.

@SteelerGoalie94 Does that mean that your GP is getting paid to be at his practice (where he is not working), and also getting paid at the walk in centre (where he is working) ? If so, that’s FRAUD on the #NHS @wesstreeting

@nemorolo @AndyStoneSheila @SteelerGoalie94 @wesstreeting ‘Part time’ being 37.5h. Then additional shifts (not private) to deliver additional NHS services because they respond to the regular pleas for help to manage urgent& emergency care.

@AndyStoneSheila @SteelerGoalie94 @wesstreeting Unlikely. He'll probably work part time at the surgery (say 3 days) and then 2 days in private practice.

@Veronic57557227 @AndyStoneSheila @SteelerGoalie94 @wesstreeting You have NO idea.

@AndyStoneSheila @SteelerGoalie94 @wesstreeting They're a bunch of grifting charlatan's. They're doing exactly as they please & are getting away with it.

@DrGoblin3 @zaynhasn @SteelerGoalie94 ‘Extra shift’ = supporting urgent & acute care.

@zaynhasn @SteelerGoalie94 I reckon he went to GP with acute A&E problem, got sent there, story changed and they bounced him to GP service where he saw his GP doing an extra shift

@jeremyjhowes @SteelerGoalie94 @PokeBadgers You ‘understand’ wrong.

@SteelerGoalie94 @PokeBadgers As far as I understand, GPs attend their practice for three days a week on full salary. On the other days they can freelance, usually within the NHS, for extra money.

@sotonDSN Go to bed freezing, and if really tired end up soaked in night sweats. I think the inertia of being tied to my my desk for umpteen hours a day contributes to the coldness.

@DocEmUK I am permanently sooo cold. Have hot water bottles, heated blankets, 4 layers, heating on! Maybe it’s just NHS burnt out? 🤦🏼‍♀️

Anyone else get so tired that they can’t thermoregulate properly any more?

@DennisGodsmark @DrGoblin3 We’re in the UK. Say no more. Bro.

@DrGoblin3 Economics influences choice of modality, not whether plain imaging is needed at all. Not everyone can afford an MRI. I shouldn’t be teaching you this.

This medical student has an hx of low back pain radiating to the legs. L/S spine X-ray done but he was more worried why his lumbar vertebrae isn’t up to 5, and I told him it is. As a matter of fact that’s where our diagnosis comes in. What’s your provisional diagnosis???

@HeldinEU @babydocwhit @DrSdeG Fine. FFS don’t automatically stop them, anyone!

@babydocwhit SSRIs in pregnancy @DrSdeG ?

Anecdotally, my first pregnancy I followed every rule. My first kid is autistic (like his father.) My second kid was a Geriatric pregnancy, on SSRI's, drank coffee like a maniac, the occasional half beer, ate the sushi, ate the cured meats, ate the mercury-laced tuna, took the Tylenol...and that kid is the absolutely stone cold neurotypical one. I think everyone should maybe just stop being so overly dramatic and the kids will be better off for us not being quite so fucking neurotic