Off duty dilemmas

As doctors, we may sometimes feel that we are never off duty. Even when we are not at work, those close to us may seek our advice on medical matters, or even request for emergency medical assistance. Dr Rachel Birch, Medicolegal Consultant at Medical Protection, addresses this issue in more detail, presenting two examples of…
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e-learning | Hypertension in adults

This is an updated guideline from NICE on managing hypertension in adults. It was published in Aug 2019. So what is new? The meat and bones of management is the same. There are a few small differences, which I'll list below. The biggest difference is that they encourage us to have much more of a…
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Locums as educators – every day is a learning day

Dr Rachel Birch, Medicolegal Consultant at Medical Protection, looks at the valuable contribution sessional GPs can make to teaching and learning within primary care. Doctors as teachers As doctors, we are encouraged to share our knowledge and expertise with others, for the benefit of good patient care. In fact, the word “doctor” is derived from…
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e-learning | Managing abnormal liver function tests

This is a guideline on managing abnormal LFT that was published in 2017 by the British Society of Gastroenterology, but as it so useful I thought it worth summarising it. Key learning points for me: We should be investigating nearly all abnormal LFTs further and shouldn't use the duration or the degree of the abnormality…
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Stroke and TIA – initial management

This is an updated guideline from NICE on the management of stroke and TIA in over 16s. It was first published in 2008 and this update is from May 19. The most important change for us in this guideline is that they recommend that all patients with a suspected TIA now be seen by a…
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Being mindful of 
medical hierarchy

Medical hierarchy may present a challenge, and at times a possible reluctance, to open discussions about patients. Dr Rachel Birch, medicolegal consultant at Medical Protection, discusses possible reasons for this and provides helpful strategies to overcome this. Most doctors would agree that a medical hierarchy exists in the hospital setting, with junior doctors and specialist…
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