William Niven

@timricketts_ Anyway that’s exceeded my quota for tweets for the next 2 years. Be well and don’t stress to stress to much about doctor jobs. You were smart enough to get to where you are and more than able to make it in this brave new world…

@timricketts_ Everything is in flux - radiology didn’t exist 120 years ago then it did and now it’s massively under threat from AI. Im pretty bullish that radiologists will find a way to adapt and change. Have faith Tim

It’s very convenient for consultants that non doctors are apparently able to replace every level of doctor aside from consultants. Very convenient

@gilliar_do @adamcifu What wonderful advice. Thank you!

@adamcifu Here is my wish and only wish: (1) close eyes (2) deep breath x6 (3) open eyes (4) formulate the bestest summary in no more than 12 (1 dozen) lines (5) state patient AND physician goals (6) follow up wisely (7) tell patient exactly (1) through (6)… da capo next visit… practice?

It says something about the EMR that the hardest thing to view on "Care Everywhere" are doctor's notes.

@AcmeDR 😂😂😂

@DrChloeBeale Well done Chloe!!!!!👊🏻👊🏻👊🏻

Yes, this is a relatively small patient cohort, but our systems are not well designed to care for them. The end result is long stays in an environment that makes people worse. We can do better

@drkeithsiau @NEJM Pellagra

Patient with chronic diarrhoea presents with this rash on the neck. What’s the diagnosis?

@GPDrYvetteDoc It’s very frustrating isn’t it. We do reiterate this with our ED doctors, but the root cause is a lack of pathways for semi-urgent work that does not fall within the aegis of the two week rule. For eg ?MS, ?abnormal lesion found on trauma scan etc.

OOH-please don't tell the patient to "go & get an MRI from your GP"(documented in notes) We can't do them! OOH-please don't say "you need an urgent CT scan" while in the shiny building, then send patient away to "get this from the GP"(documented in notes) We can't do them!

@DocsDoItBetter @GPDrYvetteDoc I think it extends to most doctors that have not worked in primary care. Unfortunately there is a lot of variation between trusts that muddies the waters somewhat. For eg - Hackney had much better access to scans than say Guildford where I work now.

@GPDrYvetteDoc ^this is only in the context of hospitalists and not OOH GP/111, though.

@jprgooch CESR = self directed learning, flexible training and greater autonomy. Ironically not unlike the SpR set ups of yesteryear. Show me the evidence that the current training set up delivers better consultants…

Dr Claire B on point as ever!

Pet hate: emails that start with ‘This is a gentle reminder…’ Perfectly happy with just the reminder! 😉😂

@padsbigsis Well done Becky. Very challenging times for all of us!

Well today was a whole new level….. Over one hundred patients on the same day triage screen by 11.30am (usually it’s 60 in a full day). On a positive note, EMIS didn’t crash once 🥳 #TeamGP

Ditto👇🏻

@DogICUma @DrSimonCraig @NEJM @NEJMEvidence @JAMANetwork we as a discipline need to take a long hard look at ourselves and leverage the collective hive mind towards these other pressing issues AND give those that are trying to address them the support and platform they require.

@DogICUma @DrSimonCraig @NEJM @NEJMEvidence @JAMANetwork research circles and academic conferences. So, to be clear, these studies you have been involved in have (no doubt) moved the dial of our understanding in certain areas. We shouldn’t chuck the RCT because it doesn’t answer all big questions but…

2022 has been ridiculous. I have had 3 manuscripts in @nejm, 2 manuscripts in @NEJMEvidence, 2 manuscripts in @JAMANetwork. Ten years ago, if someone had told me that I would publish this many high profile papers in my whole career, I would not have believed them...