@TerribleMaps If a ship can hold a million barrels and a truck only 250, why not put the ship on a truck and drive it over? Simple.
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Dr Stephen Ward
1.2K posts
Dr Stephen Ward
@DrStephenWard
Consultant in Pain Medicine @GSTTnhs | Chair: NICE Guidelines on Back Pain, RA & Epilepsy |
Sicily, Italy Katılım Ekim 2016
1.1K Takip Edilen806 Takipçiler
@RoshanaMN Writing a letter is just the tip of the admin iceberg associated with an appointment. We are now our own secretaries - enter diagnosis and encounter details, fill out TCI form, arrange follow up appointments, address letters to the appropriate people/departments. This adds time.
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Hm…
No other industry would expect an expert to:
Greet a client
Assess their history
Examine them
Manage their expectations & emotions
Formulate a high risk action plan
Communicate that plan to the client verbally
Write a letter to a colleague & client
In 10-20 minutes
Adam Boxer@adamboxer1
Had to leave work early for a specialist NHS appointment in town 1530: appointment 1630: still waiting I just can't bear this nonsense. It's unacceptable and no other industry would tolerate it
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@DrHuw If the starting wait is, say, 300 days, then this '3x faster fall in waiting times' (1.4% reduction vs 4.2% reduction) looks like 295 days vs 287 days. I wonder what that amounts to in £crackteam per days saved.
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I wonder who these “crack teams” of top doctors are
And why they’re not needed at their base hospitals if they’re so “top”
thetimes.com/article/eece7f…
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@Art_Li This Tweet might need a bit of tweaking, Arthur 😂
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@valhumphreys51 I triage referrals for GSTT pain clinic. 99.99% of the rejections are because of inadequate information. We have clinics for pelvic, facial, spinal, urological, vascular pain etc- where do we put the ‘please see this patient with chronic pain’?
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@camtudor If my pain intensity is lower, I will be able to do more rather than: if my level of function is better, my pain will be less. I think that’s how people think about it but maybe I’m wrong
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@camtudor I would probably contest that. Pain intensity (and not the functional impairment associated with pain) is reliably the No.1 priority for patients in just about every study that I have read. Maybe with chronicity that balance shifts a bit
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Patients don’t usually seek for care for pain itself. (Unless severe)
They come when it prevents them doing something significant; playing with their kids, tennis with friends, cycling to work.
Their priority is usually to return to activity first. Resolving pain, second.
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@parthaskar @iDrSunny @ExplosiveEnema2 This is scandalous. A clear, blatant and ocean going attempt to influence the outcome of an independent review.
This is the sort of thing that should make @BBCPanorama salivate.
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@ExplosiveEnema2 is it by any chance the RCP asked to conduct a review on their behaviour around PAs?
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The GMC wanted to redact who they were seeking support off to influence the Leng review
Unfortunately they didn't redact it all
"Potential KF support"
Now what organisation would have the resources for such a task, the appearance of independence, and have the letters KF…
🙃
Mike@Mike88881221
Another email from Charlie Massey (@gmcuk chief executive) to Prof Leng, where the GMC said they would suggest which NHS orgs the review team should visit. "...provide some suggestions on locations you might visit to see how PAs and AAs are deployed and working in practice"
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@parthaskar @lengreview @DrAsifQasim @DrSelvarajah @DrLKVaughan @ShrillaB @Rezaidi @TIME_research @sasbanerjee @COPDdoc @Zudin_P @respirologist Ps I think the ‘uniform’ bit is the killer blow
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@parthaskar @lengreview @DrAsifQasim @DrSelvarajah @DrLKVaughan @ShrillaB @Rezaidi @TIME_research @sasbanerjee @COPDdoc @Zudin_P @respirologist I met Prof Leng during my NICE guideline work - she really is an outstanding individual when you see her in action.
She would not have enjoyed this gig but to create an ‘oh, it’s kind of ok but could have been a bit better for us’ piece of work for both sides is impressive
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I have seen the views from some quarters re @lengreview
Personally?
A change in name; defining uniform; no undifferentiated patients; senior named clinician as Supervisor ; GMC having to make distinctive differentiation etc are steps forward for patient safety
Yes, there are bits (Higher PA etc) which will raise concerns - and that’s the role of BMA, Colleges to tackle.
It won’t satisfy everyone- but such reviews never will.
Where does it go next?
Blog from Nov 24 as a prediction- and it’s certainly headed that way.
nhssugardoc.blogspot.com/2024/11/crysta…
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Amazing 36km swim by my little sister - Capri to Napoli (beat nearly all of the men 😄)
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@mancunianmedic I’ve been waiting for my old girl to sprout since seeing your post. Here she is in all her glory
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My crazy idea that back pain might have a viral cause - huge thanks to the @TwinsUKres team. Hope it leads somewhere onlinelibrary.wiley.com/doi/10.1002/js…
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@DrLKVaughan Interesting that it started with the term Physician’s Assistant’ (assistant to the physician) and somewhere along the line became ‘Physician Assistant’ (a physician who assists)
That one little apostrophe - where did it go?
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The origins of the PA project have intrigued me.
The conventional narrative is that various plucky heroes went off to the USA and were impressed by what they saw there with regard to PAs, AAs, SCPs etc. Brought the model home and persuaded others that it was A Good Thing.
1/
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@cjsnowdon The review does not include international evidence for good reason: Indirectness.
Indirectness (apples and oranges) absolutely poisons a systematic review.
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One can argue that research of this kind is not perfect and could be improved, but claiming that there is no evidence at all just isn’t true, is it? And that's without looking at all the international evidence and the evidence produced before 2015.
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It's knives out for physician associates again after a study in the BMJ supposedly found no evidence that they can practise safely. Let's take a look. 🧵
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GMC to @AnaesUnited: We don't set scope for PAs/AAs.
Also GMC to @RCoANews: We hope the College can address this (scope) issue ... "ideally by including additional flexibility for all experienced AAs to extend their scope of practice beyond that defined in Phase 3".
Royal College of Anaesthetists@RCoANews
The Interim AA Scope of Practice 2024, endorsed by @Assoc_Anaes is now published. We've also published the independent report of our member consultation and explanatory notes that include details of the changes made in response to feedback. Read more: ow.ly/QAMg50UtY6R
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@DrStephenWard That's crazy, never heard of an EPR not requiring 2FA
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PA leader claims PAs at Guys and st Thomas "accidentally" used a doctors login to illegally prescribe.
They use EPIC, each staff member has a smart card with a pin code to login. This is 2 factor authentication and cannot be accidentally logged into.
There is no justification
PA Stephen Nash@pa_StephenNash
If they're doing it knowingly I completely agree with you they need referral to regulator. It's completely unacceptable. What I have seen evidence of amongst doctor colleagues was on tap and goes or computers logging into a shared space, they accidentally prescribed off each others accounts. If accounts were set up wrong this could explain how some Pas prescribed unknowingly or ordered scans.
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