James Gooding

@bluesauce @BenObeseJecty @colinmcfarlane It’s actually not that reliable. Can only feel a small portion of the prostate and a lot of prostate cancers grow in different portions of the prostate

@BenObeseJecty @colinmcfarlane I agree with your general point, but PSA tests are much too unreliable: both false positives and false negatives. If at all concerned, make an appointment with your GP for the old “finger up the bum”test. Mildly embarrassing, mildly unpleasant, but very reliable.

“If you’re over-45 and you’re black. If you’re over-50 and you’re white. Get a PSA blood test and you’ll catch it early.” Sage advice from @colinmcfarlane about the importance of getting yourself tested for prostate cancer. I have a test annually. I’ve been criticised by GPs for encouraging men to get themselves tested and for calling for a screening programme. It doesn’t look like we’re getting a screening programme so I’ll keep encouraging men to get tested. We need to break the stigma of asking.

@BMA_GP @amyismall If you signed a contact back in June to start as salaried but don’t start the new post until 1st October would it still apply or not?

We've informed sessional GP members in England about the details of the DDRB pay uplifts for 25/26. Watch @amyismall on what it means for you as a sessional GP 👇 And read FAQs here: i.emlfiles4.com/cmpdoc/2/5/8/0…

@Dr__Sarmy But there are probably more practices not running it like this and actually doing a good job.

Another day, another DM received highlighting BSol partnerships abusing the ARRS scheme as a convenient excuse not to employ GPs - this from an F2 Dr on IG. I’m sorry but I cannot stay quiet - our profession needs to come clean & own up. Zero regard for patient care/safety:

@Neuro_Matt Would start at 0700 or earlier if i could, first patient at 0800 now but in before to try and make the mountain of paperwork more manageable

How do surgeons get in before 8 every day? I would literally die.

@JonnyBlackwell @t0uchgrasss @GMCharlatan @Cray_tweets1 @pandamonidad @Shamz_141 @IBDUKTEAM @ShomronH Anything specific you would ask/ look for in the history or examination to help not miss these kind of patients?

@t0uchgrasss @GMCharlatan @Cray_tweets1 @pandamonidad @Shamz_141 @IBDUKTEAM @ShomronH The other group where FCP can give false negatives is pts with a very short segment of proctitis (typically only involving <4cm of mucosa from the anus). Due to urgency the stool simply doesn’t have time to pick up calpro from that very short segment before it is in a pot 7/n

I’d be interested in knowing what it is in the 2yr PA curriculum which has made them silver bullet diagnosticians from day 1 after qualifying. Like what do they include that even MBBS 4+5 is missing. All I’ve seen from his matrix is less breadth and depth and less time learning…

@andy_murray Indoor use the GC quad, I don’t find the trackman picks up the spin and if not aimed up right gives slightly off readings indoors

Question for the golf nerds out there 😁 what is a better launch monitor out of the foresight gc quad or trackman4? ⛳️

@fhussain73 @iDrSunny @DrRichardPile Exactly apply to post graduate medicine if you want to study medicine. I don’t see your logic in comparing 10+ years of training to 2 years in seeing undifferentiated patients?

@iDrSunny @DrRichardPile Only a 100 years ago, doctors didn’t allow women in medical school as they believed women would faint and it would be harmful for patients. For all the allied health professionals out there, I apologise for the arrogance coming from the medical profession tonight. Sleep well all

I have cancelled my BMA membership, the primary care team today is much wider than only GPs. This is where we are. PA training may need to be reviewed and made longer and they should be regulated but this tribalism does not represent my views as a GP @DrRichardPile

@theveindoc @RRS73122257 Which is why we don’t employ them. I don’t think they have a role in primary care. In hospitals potentially as an assistant role but even you can agree 2 year degree, 1-2 years of routine 9-5 work and then going onto a reg role doesn’t seem particularly safe?

@gooding89 @RRS73122257 Well if you think that don’t employ any. Other doctors may feel they do help them.

I would encourage all doctors and others with an interest in this issue to have a listen preferably with an open mind The bizarre campaign against Physician Associates open.spotify.com/episode/74vQLJ…

@theveindoc @RRS73122257 Their current role creates more work than relieve pressure

@RRS73122257 To relieve pressure on doctors

@theveindoc @toast36742904 I’m sure there are some good ones, but still don’t think they have enough training and they shouldn’t be in 1ry care. You can only say what is a “simple “ case in hindsight

@toast36742904 I’d believe one willing to be named over a hundred anonymous cowardly bullies any day sunshine

Just listened to Dr David Lloyd a GP on Jeremy Vine show. Thank God there are some sensible people willing to put their heads above parapet and state how the PAs they work with are brilliant. And another one on just now whose name I didn’t catch. Twitter is just full of fanatics!

@Norfolkforever @DrAnimeshSingh But I’ve heard of countless GP’s committing suicide due to stress of the job/ complaints etc which all go with it as you take ultimate responsibility

@DrAnimeshSingh And yet, in my 65 years, I have never ever heard of a single Doctor losing their house/life savings/pension pot due to poor medical care.

Yep. With unlimited personal liability. Unlike any other business owner.

@Norfolkforever @drhjefferson @DrAnimeshSingh Many are paid part time but work far more hours than paid. Also a lot don’t just do pure clinical work they do other roles outside of clinical medicine. I do 8-10 clinical sessions a week and will be reducing as it’s mentally exhausting

@Norfolkforever @drhjefferson @DrAnimeshSingh They’re wrong. We’ve read the article

Polite reminder that ‘part time’ general practice is a full time job. My wife is a 6 session ‘part time ‘ GP partner. She works beyond a 40 hour week.

@Norfolkforever @Alison6123 @DrCarolineMWF Always shows you haven’t got a clue when you just respond swearing

@Alison6123 @DrCarolineMWF Bollocks.

@SteveBarclay Quoting false numbers is pretty poor from yourself? Expecting a retraction and apology?

@grumpymunster @jabberwock951 @ShaunLintern We get to retire at 68? If I retire my late 50s I wipe off 50% off my pension? Don’t earn anywhere near £135k, don’t earn 6 figures and I work full time as a GP? For the amount of training/ debts accumulated it’s not on par with other countries/ professions

@jabberwock951 @ShaunLintern Retiring in one’s late 50s on a huge pension and having earned a basic of £135k pa for years is not poor pay. Being in the top 10% of earners in the UK is not poor pay. Doctors are quite rightly well remunerated, time to accept that they are in fact paid well. Money corrupts tho!

👀 Junior doctors leader on the pay deal and striking again for more in 12 months time:

@PPaauk @Statsjamiefact @pa_StephenNash @Adam_Skeen I don’t know how can claim this. Dentists who go on to do MaxFac do a 4 year course. They’ve already done a 5 year degree and studied physiology but still need 4 years. You can’t cover enough detail and claim to be a “generalist” in 2 years and genuinely believe this to be true

@Statsjamiefact @pa_StephenNash @Adam_Skeen Adam’s opinion is wholly ungeneralisable. Many if not most PA courses have a vast focus on physiology, anatomy, immunology etc. though content has previously been shown to vary prior to QA by GMC.

Thank you for highlighting @IncogAssociate I'm happy to address this publicly. 🧵 It is interesting to note that the tweets you have cherry picked were written a matter of weeks into the course. (1/7)

@AFCLee_ @DocDoLi I don’t know anyone earning that money as a full time partner not even close. Most consultants I know take home more from nhs and that’s before private

@gooding89 @DocDoLi We are talking about pro rata here as well as 8 sessions would be considered “full time”

I’d argue that we need to move to a salary structure as below for Doctors (funded through abolishing the PA role, removing permanent locums and getting rid of other Noctor roles) Per annum: FY1 - £50 - 55k FY2 - £60 - 65k CT1 to CT2 - 70 - 75k ST3 - ST8 - Starting at £80k and incremental increases of £5k per year (£105k pa in ST8) CCT and Consultant - minimum starting salary £150k

@AFCLee_ @DocDoLi I wouldn’t go self employed we have to pay 26% towards pension it’s a huge cut in your pay. GPs don’t earn more than consultants with the pension contributions it’s a big difference

@DocDoLi @gooding89 GPs should earn whatever their business generates but we need to restore funding and keep in line with inflation. The fact all other doctors want to be employees of the state is sad they shouldn’t force this on GPs. GPs shouldn’t be embarrassed to earn more than consultants

@anish_k_patel We should really be in a job for life. Though I think it could help as locums didn’t always provide the best care at least if salaried might actually care a bit more.

Heard an interesting perspective about GPs out of work when I raised it recently. They said it was a positive development: 1 - Make the job market more competitive 2 - Encourage GPs to work in underserved areas 3 - No one should be “entitled” to a job in life 1/2