Nasgp | The Art Of Gp Locuming

https://youtu.be/gsLTy0Wr2gA In our 113th edition, Claire has painted another beautiful cover picture, Isobel has been looking at locums as GP tutors; Judith doesn't want us going backwards, and Louise has an update on AAA; Nigel has an update both on DIS and some childcare help; Liz has an SEISS update and Rachel has some good advice for when we're in a rush. Scroll down to hear the podcast. Click to view the magazine

Richard Fieldhouse reviews the latest edition of the Sessional GP magazine. In our 112th edition, Liz has summarised the government's advice about financial support for locums; Rachel from MPS has advice on how to practise in these times; Judith's been keeping a diary; Louise has reviewed the latest guidance on leg ulcer management and Nigel's looking after your financial health.   Scroll down to hear the podcast. Click to view the magazine

In our 111th edition, Louise provides a roundup of Nice's clinical guideline on management of thyroid disease, Liz gives some more advice on returning to work after maternity leave, Rachel goes through some scenarios when locums give feedback to practi...

Richard Fieldhouse reviews the latest edition of The Sessional GP magazine. In our 110th edition, Rachel has some seasonal advice, Tina loves LocumDeck, Claire has some warming paintings for us, Judith unmasks a ruthless dictator, Louise gives a comprehensive rundown of hypertension in pregnancy and Liz has some great tips if you're in the process of making babies. Scroll down to hear the podcast. Click to view the magazine

A partner in a North London practice was feeling burned out. The crushing target-chasing workload was no longer offset by the reward of helping patients. The BNF had no remedy for the distresses of modern life which patients were bringing into her consulting room. She, like her patients, was ground down. Casting about for a way of reviving the sense of hope and enthusiasm that had led her into medicine, she contacted the local Transition Group. Three years later a bleak courtyard next to the practice has transformed into The Listening Space – a therapeutic garden where patients and staff get together. They have pitched in to create a beautiful and productive green space. People who no longer have gardens of their own share their expertise, patients help with planting and harvesting, and they cook for seasonal parties. Immigrants are delighted to share their traditional dishes. Patients and staff demonstrate their music talents, and everyone chats. The ‘Crafternoons’ in the waiting room were slow to take off,

In our 109th edition, Alacoque describes a legal case where a locum's tax status was different to their legal status, Rachel's being a Good Samaritan, Judith's been looking at therapeutic spaces, Louise has summarised the Nice hypertension guidelines for us, plus much more. Scroll down to hear the podcast. Click to view the magazine

The Royal Opera House orchestra was rehearsing Die Walküre. For more than three hours violist Chris Goldscheider sat in front of twenty brass players belting out Wagner at 90dB. His hearing was permanently damaged. The Opera House argued that artistic standards took precedence over the risk of acoustic shock, but the courts thought otherwise and awarded Goldscheider substantial damages. A musician’s job is to create sound. Rock musicians ramp up the amplifiers and often lose their hearing temporarily after a particularly loud concert. Many don’t acknowledge the warning. Over time, even violinists can lose 6dB of hearing in their left ear. Many publicans and restaurateurs foster sound. They rip out partitions, strip out soft furnishings and turn up the music. Chatter turns to shouting and then to screaming, and by the time the sound level is 90dB – that’s the same as a pneumatic drill – they have created the vibe they think their clientele enjoy. At least that’s what many of them told Action on Hearing Loss. I

In our 108th edition, Judith makes a noise about being quiet, Liz summarises everything a newly qualified GP needs to know about getting their tax in order, Nigel helps us plan for when our offspring go off to university, Louise has been making sense of LFTs and Rachel has something to teach us about learning. Scroll down to hear the podcast. Click to view the magazine

In post-war Italy TB was still rife and notices in buses commanded “No Spitting”. In Britain in 1946 the message “Coughs and sneezes spread diseases” promoted the use of handkerchiefs to catch the germ-laden droplets. Presumably a reasonably successful public health campaign, although if you are trapped like a sardine in a rush-hour tube train, you may have no alternative but to sneeze into the shoulder of the person jammed in front of you. Reducing droplet spread is a great step forward, but rhinoviruses are also transferred from noses to hands and so to any surface we touch. They survive there for several hours for the next person grabbing the handrail or turning on the tap to pick up. So do more dangerous infective agents from other sources. Hence the slogan I recall from my childhood “Now wash your hands”. So, a century after Semmelweis published his paper on reducing the spread of infection in maternity wards, his advice had reached the Department of Health. If followed today, it could cut gastrointestin

NASGP chairman Richard Fieldhouse reviews the latest edition of The Sessional GP magazine. In our 107th edition, Louise has not one but two COPD-related e-learning articles; Judith has been washing her hands, Liz has been answering your tax questions, Rachel has some advice about medical hierarchy, and Kate has been making stress her friend, all with some more beautiful paintings by Claire. Scroll down to hear the podcast. Click to view the magazine

London’s Wigmore Hall is a temple of high culture. The audience is packed with musicians. Sometimes I feel I’m the only person who couldn’t be up there performing the work. But recently I joined forty people, some able, some less able, in mind and body, for a ‘Big Sing’. Everyone seemed to feel at home. In the morning we learned to sing simple songs in four parts, and in the afternoon we went up on stage and sang them. I’m no singer but the opportunity was fun and boosted my morale. So how much more it must have done for the participants with dementia. Everyone, everywhere, responds to music. We hear it in the womb, it accompanies the important events in our lives, it modulates our emotions. Hearing is the last sense we lose as we die. People with advanced dementia who haven’t spoken for months may perk up when they hear Vera Lynn singing The White Cliffs of Dover. They may even venture into a solo, or go to the piano and play with an ability no-one knew they had. Thinking skills may have atrophied, but music

Richard reviews the latest edition of The Sessional GP magazine. In our 106th edition, Liz takes us through five taxing days, Nigel has some top tips for locums on getting a mortgage, Louise reviews the latest SIGN guidance on alcohol in pregnancy, Sara highlights the roles of locums in quality improvement, Rachel looks at the risks around burnout, Kate on mental health safety, Judith rounds off with singing in the brain, all interspersed with some beautiful paintings by Claire. Scroll down to hear the podcast. Click to view the magazine

NASGP member Eva Kalmus describes how she became co-chair of the new GeriGP group of the British Geriatrics Society (BGS), and why being a portfolio GP has never been boring. When I did my GP training, about half of the GP trainees undertook a self-made rotation of approved jobs, followed by a year in general practice to qualify. Some studied for MRCGP towards the end, and many transferred from other medical specialities. If I had stayed in hospital practice it would have been geriatrics for me. I was a geriatric SHO for an extra nine months with some wonderful, knowledgeable geriatricians and later held a clinical assistantship on long-stay wards, the NHS’s equivalent to today’s nursing homes. During my first FY1 job I had been inspired by a compassionate and wise consultant geriatrician, appreciated and admired by patients and staff alike. Years later, as a salaried GP, my practice manager forwarded me an advertisement seeking medical cover for community hospital beds; he said that the practice was not inte

Recently, in Tromsø, the Arctic capital of Norway, I came across the name Carleton Gajdusek. That name took me back many years and halfway round the globe to a village in the Fore district of Papua New Guinea. A man is standing in the doorway of his hut, clinging to the doorpost, his head nodding, before making his way unsteadily, emaciated and ataxic, to another hut. He has kuru. Dr Gajdusek was an American virologist and he spent the last years of his life in Tromsø. He won the Nobel Prize for his work on the aetiology of kuru. Traditionally, the Fore people honoured their dead by eating their flesh, the men receiving the muscles for strength, the women being left with the brain and scrag ends. The custom of eating human flesh had already died out with the missionaries, and Gajdusek hypothesized that kuru was caused by an infective agent – he called it a ‘slow virus’– with a long incubation period. He postulated that it was concentrated in the nervous system, explaining why women were more likely to develop

Richard reviews the latest edition of The Sessional GP. In this 105th edition, Sara concludes her article on a fresh pair of eyes; Judith would rather we didn't eat each other; Rachel has some news on medical indemnity; Liz answers your Type-2 queries; Eva and Nicky have both explored specialties outside of primary care that have enhanced their enjoyment of general practice; Kate wants us to get physical, and Louise has summarised Nice's latest on ureteric and renal stones. Scroll down to hear the podcast. Click to view the magazine

As I was shepherded into a dimly-lit lift, I was expecting an exhibition designed to titillate and shock. How do you react to seeing a man standing, flayed of his skin, his internal organs on view, his muscles brick red, his blue eyes staring out at you? Or what about the trio posed round a table playing poker? You may have seen them in the film Casino Royale. James Bond stays cool. His interest is not the plastinates but how the villain manipulates their chips. There was no Daniel Craig the day I visited the exhibition, but a crowd of people, all intensely curious and fascinated. Body Worlds, the controversial exhibition of plastinated human bodies, isn’t voyeuristic. It isn’t the Chamber of Horrors. It turned out to be earnestly educational. And compelling. The only plastinate I personally found disturbing was the man holding his flayed skin in his hands, but I had recently seen much the same in Jusepe de Ribera’s painting of Apollo flaying Marsyas. Ribera painted to disturb. Plastinates are made to intrigu

Zoe Neill had begun to feel trapped as a GP partner. She describes her journey, and speaks to Richard Fieldhouse in our latest podcast. Time was when the look of disappointment from a GP colleague would have got me down. “I was a full-time partner for 9 years,” I would proffer, but they had already moved on to someone far more erudite and accomplished: someone who hadn’t failed. Oh, you’re a GP locum… But this time the disappointment has a different vibe; “Why aren’t you staying? Can’t you see me next time? You’ve really listened.” Over the last four years, my GP identity has shifted and morphed, and is very different from when I was first shoved out of the sausage machine of training, a straight arrow through hospital medicine, then a salaried post, then a partner. On January 3rd 2015, I arrived in a new practice as a newly fledged GP locum, arriving 30 minutes before my first ever locum surgery so that I could teach myself EMIS web. (I do like a steep learning curve!) Since then, through a variety of planne

Few things in Cuba are easy. Most countries faced with what Cuba has lived with for more than half a century would be failed states. Cuba keeps going, with hardship and sacrifice, but a shared vision. The reputation of Cuba’s health service – providing rich-country outcomes on a poor-country budget – attracts interest from politically aware medical students. But arranging an elective there, well, no es fácil. Fidel Castro’s Escuela Latinoamericana de Medicina provides medical training for poor students from other countries, but few people in Cuba’s health service are aware that medical training worldwide often includes an elective. Only the occasional foreign student managed to penetrate the indifference, the bureaucracy, the lack of information and the limitations of Cuba’s IT, and arrange an elective. I was fortunate to meet a Cuban doctor with the imagination to think outside the restrictive Cuban box. He had welcomed one such applicant. We discussed the practicalities of an elective programme, and in 2010

Richard and Sara run through the December edition of the Sessional GP Magazine 2017. In our 98th edition, Liz clarifies your tax schedule, Nigel has great news for locum parents; Judith's Cuban experience, Kelly's turning her experience to the benefit ...

Mrs Jones likes blue pills; they work better than those pink ones – even though they are the same drug. But she wouldn’t touch blue mashed potato. Wine buffs rate a wine higher if they believe it is expensive. Consumers are sure that a brand name product is superior to an identical generic, whether it be atenolol or cornflakes. The kids won’t eat burned sausages at home but round a campfire they taste wonderful. Turn on a red light, and your blood pressure and heart rate will increase. We know we are influenced by experience, by context, by sensory input, by our expectations, but most of us don’t realise how open to manipulation our judgments are. Take food. There is an art to creating expectations of food. And a science too. Oxford psychologist Charles Spence’s field is gastrophysics. All our senses are involved in our appreciation of food and drink – not surprising since without them we would not survive. So Spence is investigating how our experience is shaped by our sensory input. A £275 ‘ticket’ (plus dri