December 23, 2013
Sessional GP and MPS medicolegal consultant Dr Rachel Birch shares a case scenario about a patient who stalked her GP
Dr L worked as a locum GP in Manchester, doing maternity and other long-term locum jobs within the city practices. Five years ago he saw a female patient, Miss X, with mental health symptoms. He spent time trying to help her to resolve some of her issues. She was referred to counselling and to psychiatry and was found to have a borderline personality disorder.
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April 25, 2013
I have not worked for two years and I am wondering whether to let my GMC registration go as money is tight. I am not working due to ill health brought on by stress at work. …..should I let it go?
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October 19, 2012
NHS appraisal is a formative process with which many GPs across the UK are already very familiar. In many ways, it’s similar to an annual car service, tuning up our performance to pretty much the best it can be. Servicing a car is generally time-consuming and expensive, and relatively subjective in that the quality of the service can vary between different garages. But there’s probably little variance in what most of us would recognise as a good service for our car. And continuing this analogy, revalidation is very similar to a yearly MOT – albeit every 5 years rather than annually. Just like an MOT, revalidation is a summative assessment – you pass or you fail – and is based on a well defined minimum set of requirements. With an MOT, each constituent criterion is also pass or fail. Broken indicator? Fail. Crack in windscreen 9mm in the A-zone? Pass. 10mm? Fail. It’s all very clear cut, and based on years and years of experience of how legislation has made for safer roads. But in that respect, NHS revalidation is very different. It’s extremely difficult, if not impossible, to quantify most of what GPs do. We are, after all, not machines, and neither are our patients. What we do, what we deal with, every day, is infinitely variable. Unlike the car – a simple machine designed 100 years ago by humans – human illness is the result of 4.5 billion years of evolution. We can’t even agree on the best management of a sore throat! A summative process based on something as subjective as the behaviour of ill people has never been done before (at least, not in any modern, democratic civilised country) and is based on criteria that in many, if not all, cases is incredibly subjective and is likely to change considerably over the course of just one revalidation cycle of 5 years.
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June 8, 2012
We’re really delighted to introduce a new option for all new and existing members – to add MPU-Unite membership to your NASGP membership, either as an ‘upgrade’ to your existing membership, or when you next renew your NASGP membership. If you’re not already a member, it just takes a few minutes to join.
The MPU – Medical Practitioners Union – has been around since before the BMA, and is now part of the much larger Unite union. Membership of MPU-Unite by no means excludes membership to the BMA, in fact the two work very closely together, with the MPU having two seats on the BMA’s GP Committee, and one of these 2 seats currently being taken up by the NASGP.
So why would you want to join a different union in addition to, or instead of, the one you belong to now?
Because this then gives you the option to be represented by a completely different, independent union if you’re involved in a dispute with an employer who is being supported by a different union.
Why would I want to join MPU-Unite.
They can give you advice and representation in matters concerning contracts and other employment problems. In addition, unlike the BMA, MPU-Unite will also represent you in any GMC ‘Fitness To Practice” hearings.
How much extra will this cost?
All NASGP members who opt in to joint membership will pay an extra £11.48 per month (by direct debit) or £137.76 per year (direct debit and card).
Why would I want to use the joint NASGP/MPU-Unite subscription?
Because it means just one payment (monthly or annually) – making it a bit easier for you – and also because, by joining as part of the NASGP, you can start receiving employment advice immediately, rather than waiting 6 months if you’d joined separately.
To upgrade your existing membership now, sign-in to the members area and follow the instructions.
May 10, 2012
Dear Career Mentor
I am attracting so many heartsink patients I feel utterly drained. It feels like my only option is to change career, but I don’t know where to start. Please advise me.
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January 24, 2011
Improper relationships with patients are in the news.
Mrs M was the patient. She might or might not have been dementing, but she seemed confused and was certainly prone to wandering. She might or might not have been in severe pain from her arthritis , but she certainly had a flail leg after failed surgery. All of which made it difficult for her to live in her isolated cottage with its steep narrow staircase. Somehow her medication had reached alarming levels and might or might not have been making things worse. She was in the cottage hospital for evaluation. Essentially this meant taking her off her psychotropics and titrating her pain relief. After several days no-one was sure what was going on. Does paracetamol take effect within half a minute? Was she skipping down the corridor when she thought no-one was watching? Was she attention-seeking? She was certainly much more peaceful when someone spent time with her.
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October 11, 2010
All GP practices should provide unique and confidential computer logins for locum doctors to ensure that they can be identified at a later date, urges the Medical Protection Society (MPS). MPS is aware of cases where an adverse event has occurred, yet there was no way of identifying who was involved, because different locums were sharing the same login. Speaking today at a conference for locum GPs, Dr Stephanie Bown, MPS Director of Policy and Communications said:
“Medical records should be attributable, the author of any entry should be clear. When making electronic records locums should not share usernames and passwords as it is important for practices to be able to identify the author of an entry and who saw the patient. When several different doctors and nurses are involved in a patient’s care, it’s important for any one of them to know who the patient has seen previously. By knowing who saw a patient, it is possible to share feedback on their performance, which leads to better care and less complaints. Whilst all practising doctors should have their own professional indemnity in place, practices could be held liable for the errors of a locum if that individual cannot be identified or traced when a claim is subsequently brought. If different people are sharing the same login, it can be impossible to trace the individual responsible.”
GMC guidance states that doctors must keep clear, accurate, legible and contemporaneous patient records, and part of this is attributing entries to an author. And see detailed information from Pallant Medical Chambers on how to advise practices.