Elementary my dear doctor

My main pastimes —reading and on-demand television — have no doubt influenced my practice through the so-called “halo effect”. Paul Kalanithi’s book “When Breath becomes Air” forced me to re-evaluate my work-life balance, while the Netflix series “House of Cards” led me to imagine that I was the victim of an intricate work-based conspiracy involving…
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Podcast | The sessional Magazine October 2018

Dr Richard Fieldhouse and Dr Sara Chambers review the latest edition of The Sessional GP Magazine. In our 103rd edition, Richard finishes off his series on learning from mistakes in healthcare; Judith has been to Edinburgh Fringe; Louise reviews dementia management; Rachel gives the lowdown and death certification; Nigel on the worth of the NHS…
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A view from RCGP Council

With the help of votes from NASGP members, I was voted on to council in 2017. This was my 4th council meeting. The good news is that there are now a few GPs on council with portfolio careers, most of whom are involved with out-of-hours services. This is the first in a series of blogs…
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Is laughter the 
best medicine?

The use of humour is believed to have several positive psychological and physiological effects on health. Many doctors and patients believe it has a place in the consultation. Dr Rachel Birch, medicolegal adviser at Medical Protection, addresses this issue in more detail and presents a case where humour had unintended consequences. In recent years it…
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Five financial tips 
for GP locums

Being a locum has many advantages: greater flexibility, autonomy and variety. But there are some disadvantages too: peaks and troughs in income, difficulties with getting a mortgage and uncertainty about your financial situation if you fall ill or die, to name just a few. Modern life can compound matters too. A recent report has found…
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Bladder Pain Syndrome (Interstitial Cystitis)

This is a new guideline from RCOG on Bladder Pain Syndrome, which used to be called Interstitial Cystitis, among other things. As this is a new guideline and it is a common problem (affecting up to 6% of people), I will summarise the bits relevant to us. Definition This is a chronic pain syndrome and…
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Bisphosphonates, raloxifene and teriparatide for treating osteoporosis

This summary is based on 3 recent NICE guidelines: Bisphosphonates in people for primary or secondary prevention. Raloxifene for primary prevention. Basically it isn't advised. Raloxifene and teriparatide for secondary prevention. The advice hasn't changed. Previous guidance was rather complicated in that different bisphosphonates could be used at different levels of risk. This has all…
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Hearing loss and ear wax

This is a new guideline from NICE on managing hearing loss and ear wax, published in June 2018. Exciting? Well, there are a couple of good bits in here, especially given how common a problem this is. Some top tips that were new for me: Consider an urgent referral to ENT for someone of Chinese…
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