Since nursing homes were 'hived off' from the NHS and given to the private sector, the standards have gone from underfunded dodgyness, through criminal, and are currently passing mindless inhumanity.
These two 'nurses' are a fucking disgrace.
What has happened to 'care'?
Oh, of course. The private sector got it's hands on it.
We gave patients the money to choose where to go.
No-One and DK are fucking morons to believe in the 'private' sector can do anything other than find better ways to kill people for money.
Friday, May 23, 2008
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87 comments:
My pet x2 theories are:
[1] A % of weirdo's will gravitate toward jobs (either consciously, or subconsciously) where they can give vent to their unappatising predilections, such as those who seek to gain proximity to children.
[2] The everyday environment becomes so dehumanised (and removed from public scrutiny) that staff become hopelessly burnt out, and free from any sort of moral leadership ?
I suspect that standards in many care homes are inadequate - but it's a stone not enough people want to lift up, outrage is expressed (periodicly) but little substantial improvement is ever made (see Tom Reynolds frequent post).
p.s. apologies to those running a decent service.
p.s.s why were the sentences suspended ?
Anon in the past the care homes were run by the NHS.
Now they are "free market" institutions...not really working is it?
As far as i can tell care home costs have shot up since they became private and care standards have failed to improve.
I'm not a GP.
However it does apply in that costs have shot up (the Gov had no clue how much work the GP's did ona fixed price contract).
So GP's working for the gov on a fixed price NHS negotiated contract= cost effective care. GP's negotiating a new contract using "the market" = increased costs for the same job.
So yes it applies.
Basically the gov can't put the NHS into "the market" as it dosn't work and the real worth of health care is more than can be afforded (on a national basis).
Summary, "market" good for buying veg or buying a new computer..bad for healthcare.
Gah, the day before you posted this I'd just blogged about how care homes in my patch were actucally doing a rather splendid job!
Agreed that private homes can be ghastly, I really really think that it's the NHS input into the care homes by a specialist team with a medic that makes the difference.
Not to worry, shrink. Some private nursing homes are indeed very good and when I chose my mother's, very detailed inspection reports were available on the web (and were reasonably accurate!), and I was able to visit, and the two best places told me not to make an appointment to do that, but to call in without notice. I did have to pay more than the Social Services minimum, indeed, rather a lot over it, admittedly.
My mother was, as the consultant who decreed she must enter a nursing home had said, better off there than in hospital.
-- I see I'm largely agreeing with no one in this instance! So I'll add that I learned later that there were two very good council run nursing homes in the neighbourhood but they were 'invisible' to most people... Also there were private nursing homes that charged the Social Services fees; but their reports were poor.
(There are some very good people nursing homes who can't get NHS jobs -- they took time out from their nursing jobs, they now want to work part time; or they need to work there till they can apply for a hospital post -- and so on. There are also some very caring ones. A number of them are not British and will work for the minimum wage and work well. Also the good homes offer NVQ training.)
still believe giving the end consumer the real money to take where they want pays dividends,
no one, it certainly works in the case of some nursing homes (the money going with the patient, that is) and I agree it would be good if people could shop around for hospitals in the same way; but we would need far more hospitals. Also it works in the case of the good nursing homes; there are also the ones whose reports showed, e.g., that the wiring was unsafe; that there were defective bells in some rooms; and so on. Those were, of course, the cheap private nursing homes, the ones all of whose patients are paid for by Social Services. Also it works when relatives check the homes out, and are prepared to move their relative to a new nursing home.
Sending the money with the patient works really well.
So well in fact that the best nursing homes can charge well over a grand a week. Now you get some paid by the state but the rest of it has to be paid for.
So in essesence you end up with a two tier nursing home service...one for those who can't pay and another for those with extra money.
This is a case study of what would happen if the NHS were to "give the patient a cheque" and let the market forces work. The crap ones don't get closed down they just force up the price of the good homes and take in the state funded places with little regard.
Funny Pseudonym, no no no no no!
"This is a case study of what would happen if the NHS were to "give the patient a cheque" and let the market forces work."
This free market already exists, it's just where the cash comes from that varies. Patients either have lots of cash, so buy in to whichever care home they wish. Or they don't and social services pays for them.
Either way, almost all care homes are private care homes, nothing to do with the NHS at all.
Because they're businesses, out to get punters paying cash every week to them, as you suggest certain standards need to be met. CSCI regulate this. In many care homes, standards are often poor but acceptable.
Profit margins are modest in care homes (a group of managers told me they run at about 3%, in large organisations with oodles of care homes, another said 4%). Capital costs can be invested in to nice curtains, new sofas, bright flowers. But care homes have a choice about care.
If you pay a bit over the minimum wage, with the extra bits employers pay on top of that, and oncosts for having extra employees, care home managers might be spending, what, £8 an hour in total for a carer. 40 hours a week, that's £320. £1386 a month. 40 hours a week might mean an extra 1 hour a week to each resident. Is a care home going to want to spend that cash on getting just an extra hour or two per person over then 168 hour week they're in care for? Will the person or their families see any difference from that? The manager will see a difference, they'll see their home's profitability drop by £1386 a month. Best just meet the minimum standards, have a swanky hotel like look to the place, and cut on the recurring staff costs every month. Who's to know, anyway?
The Shrink,
I thought that was what i was saying?
Basicaly if the NHS goes the way no-one et al want and are run in the way the care homes are (free market, either with your top up for the extra nice one or state funded for basic care) standards will drop.
As you say, who is going to see the difference from cutting a few front line posts?
I cannot see how standards will not drop or basically stay the same with decreased funding to the front line (but with a nice 3% profit for shareholders).
3-4% of the NHS as a profit. I bet that could be squeezed if the NHS went private.
Anyway 3% of £100Bn is a big enough cake to make it attractive to any profit driven company.
Anonymous said: "All you fucking GP's are private sector. Same apply to you with regards to standard of care etc etc etc?????"
Were you born stupid or did you go to a special training course?
GPs aren't "private sector" the way most care homes are.
I also feel my standard of care is actually extremely high - and very good value to the NHS.
My job would be a whole lot less stressful if brain-dead arsewipes like you just evolved some capacity for thought before spilling forth such utter shite.
Tosser.
Market forces do work in General Practice.
GP income depends on the number of patients on the practice books (both normal payments and quality points).
So the GP makes more money for more patients.
If the GP does not want you, then that is market forces at work.
You could offer more money (ie: ask to be a private patient). However, again market forces are at work and most GPs have enough income not to need private work.
You could arrange to be seen during 9-5. Presumably, the reason that you want to be seen outside these hours is that you work 9-5 yourself. You could use 'money' to buy time off (take unpaid time off) and solve the problem.
You will no doubt claim that this is not a true market, and you are right. In a true market the GP would be able to charge far more, and would be able to tell you to fuck off you winging bastard to your face.
So, the irony is that the market that you love so much would in fact give you worse care. That should be funny, but actually it's just really sad.
More to the point, why the fuck should you NOT have to write a letter to the GP?
I'm so fucking fed up of spoilt bastard patients who think that they are getting such a crap service when the GP care in the UK is so fucking amazing.
Ignorant, useless, winging, mouthy fuckers.
But mainly spoilt.
Spoilt.
Spoilt.
Spoilt bastards.
Oh dear Mr Troll is back.
Either that or No-one is off his meds again.
He has no fucking idea does he?
You think yo uhave paid in more than you will ever get out eh?
Then you must have pain in tens of thousands (and you havn't, unless you somehowm divert all your taxes to the NHS).
Your shittly little job you think is so stressful should mean you have a heart attack in the not too distant future.
A PCI, you know CCU and a bit of angio..maybe even a CABG. There you go all your payments and then some back into your care.
Maybe you will have liver failure from drinking too much to get over the stress of a GP realising your a pain in the arse and not wanting to take you on (even when throwing money at them). A liver transplant would soon settle the score eh?
Even a short stay in a mental institution should balance your books a bit (if for example your hard job led you to a breakdown).
So no you may not have had your moneys worth so far but you will...
Hmmm.
You're the 'customer' but no-one want's to take you on their list to see you at 9pm.
If you are so rich, get a private GP.
Can't get one of those either.
Tough market shit.
(Note to morons: the market works both ways - and in a capitalist system the customer is not always right: money is.)
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"Consultants regard [GPs] as medical accidents waiting to happen. "
I'm a Consultant. I have high regard for GPs. GPs in my district seem to make fewer serious errors than Consultant colleagues do. I take issue with your statement as you're putting words in to my mouth, which are wrong.
"They hold on to patients too long and don't refer to a specialist when they should because they are "generalists" and miss things due to minimal knowledge bases."
They are indeed experts at being "generalists" which is fantastic. Consultant expertise is all the poorer for subspecialiation, e.g. if someone is systemically unwell, is there a generic Consultant Physician to refer to nowadays? No, typically we have only neurologists, cardiologists, haematologists and other specialists.
GPs are becoming the only medical experts who can look at all medical problems.
GPs are medical experts who sift through all sympoms generated by patients in a consultation and generate a diagnostic formulation. Consultants invariably are referred patients with a working diagnosis, not just say a list of 11 symptoms for them to work with.
GPs are becoming the only medical experts who can offer continuity of care, since most hospital services have such pressure that patients are discharged as soon as there's a suggestion they no longer need hospital input, even if they'd benefit from it. And of course, in hospitals, they'll often no longer see a doctor at all.
Thus, rationally, I can argue that your framing of GPs is erroneous and unhelpful. I'm sure the Dr Rant team can summarise it much more succinctly in a rather more visceral and satisfying fashion.
Anonymous - your assessment of GPs is very wrong.
Shrink has alluded to the gargantuan knowledge base required to be a generalist - think of any and every medical problem (in children or adults) then task a relatively small number of doctors (less than 40,000 I believe for a population of 60million+) to sort out what is important and what's not.
We owe them a great debt because incredibly they get it right most of the time.
Now I'm going to run because Dr Rant tends to express his views far less delicately and I don't think he'll like what you have said one little bit.
Er....Fuck off, Anon?
Seriously, this is a swear blog, Dr Rant is a (fictional) old grump, and the team like to play to type, but anon's comments are so beyond all of that that I have to assume we are dealing with a troll.
What The Shrink and A&ACH said rebutted the comments excellently. Thank you.
Anonymous - it is not an either/or argument.
We need both generalist & specialists, since one group can offer advantages over the other, depending on circumstances.
The debate about threshold is an important one - I note today that mortality data is to be published by surgeons and this may affect the sort of cases some surgeons take on in the future (specialism within specialties).
I agree that ill health can be dangerous but luckily we have both GPs and specialists who can pick up the signs and make sure that something is done about it (in the vast majority of cases).
In a profession where life and death is the currency
Thanks - I'll phone theatres to let 'em know.
Anonymous - according to reports the NHS (for better or worse) is the only service in the world planning to make such data available.
Do you really see these issues in such simplistic terms ?
Any surgeon could have a high success rate - all they have to do is avoid difficult cases (such as elderly patients with a complex history, or rare or unusual clinical problems), only operate when the wards/ITU are fully staffed, and reduce the amount of work done at 2 o'clock in the morning.
Oh, and make sure that the list runs at pace that is convenient to them rather than all of the other elective or emergency cases to get onto the table.
Admittedly the private sector are now running production lines, sorry, ISTCs, but I have heard that their complication rate (for joint replacement) is hitting 20% compared to 2-3 % when the ops are done elsewhere.
Any surgeon could have a high success rate - all they have to do is avoid difficult cases
Yes. And GPs could look *terribly good* and have a rather easy life by cherry-picking patients. So, I second the complaint about having to write to a GP before being accepted as a patient.
jayann
"...all they have to do is avoid difficult cases"
Don't ruin their supermarket analogies! Now, what aisle for a suspected perf, with COPD and a dodgy ticker?
(ISTCs - a total scandal, although new Spire/BUPA pimps Cinven seem to love 'em. I wonder why that is...)
Hi, Jayann - yes, I've never heard of patients writing letters to GPs to justify their inclusion on the list, at least not as a general system of registration.
To be honest I wasn't sure if it was a bit of a wind up ?
Obviously, such an approach would favour more articulate patients in the same way that MTAS favoured those who knew which buzz phrases to include on the lottery, sorry, application form.
Like you, I think such an approach (if it does indeed exist) is rather unsettling, but I can only imagine it happening in exceptional circumstances ?
"If you want to repair your plumbing you don't leave it up to the electrician."
Yes, but you need a generalist to tell you if you have a plumbing problem or an electrical problem in the first place.
Since you sound to fuckwitted to believe that, I'll give you a simple test.
1. You have shortness of breath when you walk up hill. Which specialist would you go and see?
2. You have chest pain. Which specialist would you go and see?
3. You have a painful back. Which specialist would you go and see?
4. You have a headache. Which specialist would you go and see.
As regards the letter, I had assumed from the comment that Anon was asking to join a specific practice because it had longer opening hours, and that the practice had been willing to consider this if there was a good enough reason.
I presume this was because he was technically outside their normal practice population area (which can be quite small in urban areas).
Unlike some other western health care systems (US and Canada to name but two), NHS GPs cannot refuse to take patients onto their lists if they live in their practice area and the GP's list is open.
Very few GPs have closed their lists (declared themselves unable to cope with any more patients), as this can result in severe financial/contractual penalties.
So, let me get this straight:
1. You think you should be able to join any practice you want without them having any say in it.
No private business operates in such a way ("The management reserve the right not to serve any customer").
The market functions BOTH ways. The business and the customer choose one another. If they don't want to sell something to you, there is no way to force them.
MARKET FORCES IN ACTION? Yes!
2. You think that only having limited access to GPs who are FORCED to look after you and have no say in it is a bad thing?
I thought you believed in the market?
Forcing people to take on customers sounds like communism to me.....
GPs picking which patients they want to have, patients having to 'sell' themselves because there is a shortage of GPs.
Sounds like the market is working just fine.
Personally, I think you have made my case that the market does not work for health care.
But, if it means that stupid fucks like you have a hard time, then it can't be all bad. Maybe, I've misjudged this 'medical market' thingy....
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The professional troll is being deployed against a range of blogs critical of New Labour NHS privatisation policy. Employing professional trolls to damage a blog's message is increasingly common.
The troll's modus operandi is to mimic a contrarian troll.
We suspect he may try to mutate into a bitter troll and/or a vulgar troll now that he has been identified.
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a & e charge nurse, thank you for your support -- I do find it worrying and strange. My GPs simply accepted people who asked -- till they closed their lists, recently.
No one,
re the troll warning
that's dr rant's OCD persona
the letter? I suggest implying you never ever need to see a GP, are very happy to help with QOF stuff, have absolutely no MUS... (sorry; I have no idea what you should say; if I were in that situation I'd seek out patients at that surgery and sound them out, but I realise you probably don't have time to do that)
bit hard to pretend you never need to see a GP when youre begging for a insulin script as an alternate to death
Trollonymous comments deleted.
Apologies to any extra anonoymii caught in the cross-fire.
No-One: get a google login you sad, freaky, fuck.
-Ed.
Good to see you no one. Agreed, it is a great system when you can get around it from the inside.
Rant makes a good point however. Given his list of symptoms, you could easily go to NHS Direct and through their process quickly get the right specialist. Bypass the rants of this world get better care and lose the hassle factor.
I would imagine that as a market is really created and consultants start to own diagnostic clinics and their own surgical centres that will be the way things go anyway. Thy will want to cut out the middle man as the market becomes more competitive.
Anonymous
there you go rant has returned to type CENSORSHIP!!!!!!!
fucking censorship
just like the maoist state u dream of
u cunts
ur getting as bad as the PCTs
yea GPs in the UK are just another delay in the referral process
for many (not all) conditions there is no reason why folk could not self refer
so the letter should go
"dear cunt
i pay your wages (seems to be one of the sayings that really pisses off the rants)
i wont shag your daughter
just let me get access to a doctor, any doctor sometime that doesnt fuck off my employer so much that i loose my job
yours most humble
no one"
Rant is a Cunt,
It will take months to get a reply.
They are the problem with the system (rants don't like that either)
This little war started when rant felt it appropriate to portray the patient as the problem with the system. Considering that all he does on this site is complain, bit like the pot calling the kettle black in his world.
Why don't we have the right to take exception to your immature, ignorant outbursts. Like Rant is a Cunt said we pay your salary.
No one, if you want to see the future of this form of dinosaur, look at Germany. There is 35% unemployment among generalists there.
No One,
Hang a blog off that ID. I am sure rant would stop by for a cup of tea. It will be just like old times! You could call it; "Too bad third world countries have a better health system than us". You could have guest contributers like the man whose entire family was killed by Shipman. Survivors of the Maidstone massacre. You know, people with fond NHS stories to tell.
i agree with anonymous, would be great to have a site where you won't be censored and patients could discuss, in a mature way, the crap service we donate so much money to.
http://notdrrant.blogspot.com/
Fantastic!
Don't worry rant we will still visit. A lot!
"Dr Rant is a Cunt"
Now, that's what I call a pseudonym!
Love the new blog (is it meant to be called 'Event the 3rd world' or is there an extra 't' that snuck in there?).
I love the 'talking to my friends' trollonymous chat. Funniest discussion we've had ever, I think. (Why it's on the care homes topic is a mystery to me).
I've added it to my RSS reader. If it stays up well add it to our blog roll.
Now if you just answer the quiz (sensibly!), I'll put the anonymous comments that are blanked out back on:
1. You have shortness of breath when you walk up hill. Which specialist would you go and see?
2. You have chest pain. Which specialist would you go and see?
3. You have a painful back. Which specialist would you go and see?
4. You have a headache. Which specialist would you go and see.
here you have a typical rant trap. Too little information makes it possible to ridicule and call names. Why don't you post sensible symptoms? Or do you diagnose over the phone against such sketchy data?
Ok,
I'll start with the last one.
You have a headache which gets worse as the day goes on. It is across the front of your head, and also behind your eyes. It came on gradually over three months and is getting worse. Which specialist should you see?
Note: As you are suggesting removing all generalists and only having specialists, you must answer this question based on a choice that even the stupidest person in the country could reasonably be assumed to make.
Still waiting for an answer.....
Internest, but of course we don't really have any of those because the medical profession has failed to modernise.
Annoyingmous:
The fact you need to see a GP for your free diabetic clinic, subsidised prescriptions and free 6 monthly GP check ups means you're sucking up more of my health care taxes than I am. But that's ok. You're obviously a needy sort of person.
As for the GP/specialist argument - why don't you go to a private endocrinologist, podiatrist, opthamologist for all your diabetic reviews instead of going to the single point direct access GP?
You're essentially arguing that not only should you not need to write a begging letter - but it is actually against your principles to go to a 'generalist' anyhow.
I'm sure you can find the services you need elsewhere if you're prepared to travel and pay the private consultation costs.
Don't worry about the charities you claim to pay loads to either - even tho it's bullshit - I can see you'll be the first one queueing at the Soup Kitchen when you're hungry, and demanding that Gordon Ramsey should be cooking for you while everyone else gets my old school dinner lady.
In internist?
'Internist' is the North American name for a General Medical Consultant Physician.
As the name suggests, General Medical Physicians are 'generalist' specialists. GPs are also specialists in this sense of the word in that they have specialist training in Primary Care (actually, they are among the best trained primary care doctors in the world).
Because of this, we now use the word 'specialist' to describe someone who specialises in a sub-branch of medicine (eg: a gastroenterologist) and 'generalist' for someone who does not (eg: a GP or a general physician).
Internists function as primary care physicians in some systems, although they are not as well trained as UK GPs in primary care (ie: first contact care with any patient with any condition).
So,
1. Not knowing what a general physician is called makes it pretty difficult for you to go and see one directly.
2. Not knowing that we even have general physicians in the UK would make it a lot harder for you to arrange to go and see one directly.
3. Had you managed to work out (1) and (2) and the delay had not killed you, you chose to go and see a 'hospital generalist', not a true specialist.
4. You didn't know that UK GPs are specialists in primary care. GPs are not just doctors with no extra training who failed as hospital doctors - they receive at least three years of specialist training, including one year as a GP registrar. In fact, in the current NHS there is a lot of competition for places on GP training schemes.
When the RCGP suggested that GPs change their name and call themselves 'Primary Care Specialists' or some such I thought that it was a daft idea.
I see from the sheer moronicity of your fuckwitted, arrogant, slag-off-GPs-even-though-I'm-pig-ignoranct cuntocity that perhaps I was wrong.
Anon, you are a total fuckwit.
Only three more to go, Anon (in reverse order)
3. You have a painful back. Which specialist would you go and see?
(Hint: the answer is not 'internist')
"an internest, but of course we don't really have any of those because the medical profession has failed to modernise."
Sorry, I'm still laughing at this one.
Using 'but of course' followed by a statement that is wrong on almost every level. That true fuckocity,
1. We do have 'internists' (note the spelling).
2. Using an American title for an NHS service.
3. We used to have far more general phycisians, but 'modernisation' has meant that more and more of them have ended up specialising.
How do you manage to squeeze so much ignorance into such a small number of words?
If you don't belive Dr Rant, then take a look at this post by the American Doctor DB:
http://www.medrants.com/index.php/archives/3595
Does anybody else get the feeling that Dr Rant is a Cunt and NHS is Killing us are the same person?
wrong again dickheaddumbshitstudentplonker
I love a good quiz:
. You have shortness of breath when you walk up hill. Which specialist would you go and see?
none, exercise more
2. You have chest pain. Which specialist would you go and see?
take an aspirin and call an ambulance
3. You have a painful back. Which specialist would you go and see?
physio
4. You have a headache. Which specialist would you go and see.
take an aspirin and call the neurologist in the morning if it is still there
not that hard rant, my dog could do your job!
readers should note that the ambulance won't take you to your GP or even ask him to attend when you get to the hospital
1. You exercise more, and suffer a sudden cardiac arrest because the shortness of breath was due to coronary artery disease.
2. You bleed to death in the ambulance from the aspirin because your chest pain was being caused by oesphageal spasm and you had a related bleeding peptic ulcer.
3. You die from a dissecting aortic aneurysm, which was the cause of your initial back pain.
4. The neurologist can't see you for three months because without any GPs everyone with a headache wants to see a neurologist.
In the mean time the headaches get worse and you accidently take two extra paracetamol. Sadly, you are one of the unlucky people who gets liver failure from even a little extra paracetamol.
You die horribly.
You're not very good at this, are you?
Interestingly you have just outlined a not dissimilar scenario that could be played out at any generalists surgery. Lack of expertise and onsite diagnostics make you just as dangerous as the patient self diagnosing. I would much rather cut out the amateurish middle man.
Once again you return to your roots. Ask a broad based question and ridicule. Very good rant, you are at the top of your game when it comes to being a champagne socialist!
to be fair to you rant I should add one last comment; fantastic control of data flow so that you insure an outcome that benefits you. Once again you have illustrated with precision the problem with the NHS.
It is interesting that the doctors scream the loudest about a national IT system. You hide behind cost and waste when in reality you don't like the scrutiny it will bring. If you read the NAO report you would notice that doctors are as heavily critisied as the government for the failure to implement on time as "they systematically refuse to implement the system due to unsubstantiated prejudices." Where is the blog headline that shouts "GP's financially RAPE the public again - BASTARDS!"
nhs is killing us - of course the flow of data is controlled but not to benefit staff, no, this process is driven by the principle of balancing the needs of different patients (many of whom might be demanding a service on the same day day).
Remember Wanless estimated that there are around 250 million annual GP consultations each year.
Or imagine a busy A&E department with 50+ patients, all with an array of different problems (some relatively trivial, others latently life-threatening, such as a hyperkalaemic diabetic).
Would you prefer it if staff said, right you lot, sort the order of the list out amongst yourselves then let us know who is going to be seen first (and who will be last, etc) ?
And since you see no role for generalists presumably patients are meant to work out for themselves if a headache (say) requires the opinion of:
a neurosurgeon (subarachnoid haemorrhage, glioma, etc),
or an oncologist (brain mets),
or neurologist (migraine),
or rheumatologist (temporal arteritis)
or hepatologist (encephalopathy)
or medic (malignant hypertension).
or infectitious diseases (meningitis)
or maybe even a psychiatrist if we think of factitious disorders, etc.
I could go on, but you get my drift.
Admit it N-I-K-U this is getting a bit silly now ?
'dickheaddumbshitstudentplonker'
Love it! I can I change my blog name to that?
"I would much rather cut out the amateurish middle man."
I've just proved that you are too stupid to work out which specialist to see, so I think we can safely ignore everything you say now as being the ramblings of a moron or the taunts of a troll.
Of course, if you think that seeing a specialist in Primary Care is no better than self diagnosis by a fuck-stupid retard like yourself, then be my guest.
Basically, the NHS's biggest problem is that it inhibits Darwinism. Without the NHS, morons like you would die in larger numbers, and we would not have to suffer you and your stupid-gene possessing children.
Trollonymous/Anon/No-One/NHSiskilling/AntiRant are all Children of the NHS.
What an amazing irony.
"1.none, exercise more"
Would you be happy if your GP told you to do this or would that be "a dangerous generalist underdiagnosing serious conditions that need a specialist opinion"
"2.take an aspirin and call an ambulance"
And where does the Ambulance take you - you dozy bastard? NOT to the cardiologist or cardiothoracic surgeon but to A&E where you are seen by a generalist, treated and referred appropriately. But of course the thought hadnt occured to you had it that generalists also work in hospitals? DUH
"3. physio"
You do realise that most Physios are generalist physios dont you? they can actually refer you to physios with specialist interests at the hospital but curiously you dont mind seeing a generalist first - why doesnt your logic apply here? Were you ignorant or just didnt think it through properly?
"4. Take an aspirin and call the neurologist in the morning if it is still there"
Even if you guessed correctly and the neurologist was the appropriate person to see, has it occurred to you that if the specialist neurology clinics are flooded with people with generalised, undifferentiated complaints - the so called specialist will now become a generalist as most of their time will be spent seeing general patients - and complex cases will have to be reffered on. What will you do then? Ban this tier of doctors so you can cut out the middleman again? Perhaps you could whittle things down so that there is a solitary Professor of Paediatric Neuroendocrinology seeing every patient in the UK.
What are you, retarded?
ah, the sidebar rant conversation we are all supposed to accept as gospel! Fuck off rant. So you had a conversation with a doctor! Anecdotal twaddle, the Canadian system is a carbon copy of our own because civil servants from this country created it. The fact that you train for 5 years and appear not to add any value suggests we have an even greater failing than they.
Most other countries leave the history up to trained professionals (physician assistants etc.) who are not the doctor so they can free their time to speak with the patient and diagnose the problem. You have proven that GP's in the UK feel most comfortable doing mundane bookkeeping chores that add little or no value to the patient experience. I am sure it is a comfort zone issue for you and your mates and also a control issue. It is yet another symptom of your inability to move on and modernise your practice.
So you can fuck off runt, all your anecdotal bullshit is wearing thin. You must be asking yourself when the GMC or DofH are going to come knocking on your door and ask for that license you bought online. Very few employers of contractors would allow them to hurl so much abuse and lies at the system that provides them with an income and not want to extract the cancer. I can only think you are on a waiting list to be fucked up your ass runt!!!!!!! Might want to buy some vaseline, and start looking here for your next job www.monster.com. You can push delete now!
Halfwit Pierce is a complete plonker! Fuck off asshole. I am sure it won't be long before you are struck off for being thick and killing one of your patients. The least trained most arrogant in any profession make the most and biggest mistakes! Just ask a consultant. Those are the smart fellows with the million £ incomes.
"I am sure it won't be long before you are struck off for being thick and killing one of your patients. The least trained most arrogant in any profession make the most and biggest mistakes! Just ask a consultant. Those are the smart fellows with the million £ incomes."
If that day ever comes, I may come and work with you at Burger King.
Your only concern should be that i will inevitably out-compete you as others so far have in your pathetic life and then I am going to get promoted and make your life hell when you are working for me.
Thats pretty funny Hawkeye.
Imagine working with this person, i bet he is outcompeted by every new employee he works with.
He seems the sort...sits in his cubicle (or behind a till) coming up with reasons "life is sooo unfair" and that everyone get promoted over him because of a vendetta and fear of his abilities.
God i wonder what would happen if loads of doctors became unemployed and ended up in his industry? I wonder if they would actually demote him to teaboy?
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