For those of you who missed it, in the comments section of the care home piece the following attack on generalists occurred:
For all you laymen out there, keep in mind that GP's, in a majority of cases, acquired the minimum qualification as a doctor because they are either thick or lazy, sometimes both. Consultants regard them as medical accidents waiting to happen. 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. Most countries are moving away from GP's and demanding that the medical profession modernises. This blog would suggest that we won't get very far down that road here in the UK anytime soon.
When the Shrink and A&ECN came to the defense of generalists, Anon came back with:
GP's are generalists and dangerous. The argument used is one that does not hold water. If specialisation is not needed then why don't general surgeons do neurosurgery instead of puss bellies? Based on your arguments, specialised consultants are a waste of money.
If you want to repair your plumbing you don't leave it up to the electrician. Cars have become so complicated you have to use a specialist mechanic. Medicine has become too complicated and specialised to rely on generalists.
When Dr Rant pointed out to Anon that he might have problems picking the right specialist and posed some examples asking which specialist he would pick, he finally came up with this:
Internest, but of course we don't really have any of those because the medical profession has failed to modernise.
Having pointed out that:
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.
Anon plowed on with:
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.
Now while all of the above morons may in fact simply be a single troll, the level of sheer stupidity is hard to ignore.
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35 comments:
Clarity rant, is not your strong suit. Blind unsubstantiated verbal diarrhea is more your style. I would stick with what you know.
It is nice to see a doctor (if you really are one and not some hopped up allied health person) covered in more shit than their patient for a change.
How can someone justify cutting out a generalist and choosing your own specialist? Anon is blatantly self-diagnosing (is that a word?) when selecting their specialist and I would rather have someone with 5 years of med school and 4 years of post grad training take that risk and refer.
Also I thought generalists were estential to care for the whole body. Cardio doesn't give a shit about the brain, they just toss them once the hearts fixed. Who's going to look at every problem and create a structured treatment plan?
Or has grey's anatomy steered me so wrong?
Keep it Up Team Rant
dear nhs is
just because gordon tells you your worth it doesnt mean you are
you are as ignorant as you are cunt
your contempt betrays your intellectual failings and inadequacy. you clearly lack any knowledge of the benefits accrued from the holistic care a generalist provides
perhaps you should find some fast moving traffic to play with
For all those wanting to see a specialist.... fine. Do it. My life will be a lot easier. If you come to me and ask to be referred without my opinion I will not stand in your way.
Half of my job as a GP as I see it is to protect the punters from the shit infested cesspits called hospitals and the specialists whom have no understanding of the effects their medicinees may have on other systems of the body.
So please, refer yourselves away.While your at it, pop down to the local health food store and grip some electrodes after parting with 50 quid to see what you're allergic to.
Don't fall in the trap! Someone is trying to drive a wedge between GPs and hospital specialists for some 'sinister' reason!
UNITY UNITY UNITY, otherwise you are all ......
I think I love you, and i hope that in four years time I get to grow up to be just like you.
You stupid prick.
If you have a problem with your car you take it to a mechanic who is skilled in sorting out general problems with whatever piece of shit you drive - or do you have the Chief of Electrical engineering from Renault come down to sort out your blown fuses?
GPs are specialists in Family Practice and Primary Care - its just that their title is different for historical reasons that you are too thick to understand this point.
I am training to be a surgeon but in many ways I regard my speciality is easier than my friends who have chosen General Practice, which deals with far more uncertainty.
In fact, my fiance, a trainee Consultant in Academic Dermatology,
switched careers to train as a GP, and apart from having every qualification under the Sun and being a Cambridge graduate, has found General Practice more of a challenge than anything else she has done so far.
Go ahead and refer yourself to a specialist to sort out your learning disabilities - but guess what - even in the private sphere they won't see you unless you have been referred by a GP.
Have you ever stopped to consider why this is? You fucking retard.
Here's an idea for you - why don't you trade in your car for an F1 racer (which is faster), a dump truck (which can carry more) and one of those vehicles you see at the airport which tow baggage trollies?
Because (you imbecile) apart from being so prohibitevely expensive that no-one would be able to afford this, none of those vehicles is better at doing the job of your family car than your family car which is just as specialised as the other vehicles.
It amazes me that you have to break down these points into bite sized pieces small enough for your addled intellect to digest.
This, - you stupid, stupid, cunt - is why running the health service should be left to the people who understand the first thing about it.
Sorry Rant just noticed my typo
*prohibitively
"Dealing with uncertainty" - great phrase, Hawkeye.
I doubt if patients really understand the acumulative psychological pressures associated with clinical risk stratification (outside of hospital) ?
The problem is exacerbated by insatiable demand - for example, why have A&E attendences gone up by over 30% in the last 10 years ?
Even allowing for the fact some patients are disatisfied with their GPs it doesn't really explain such a steep increase ?
In the end certain patient groups lose out because most GPs or A&E services still take the time/effort to exclude serious underlying problems.
But the cost of dealing with the neurosis of the worried well (day in day out) may well be a poorer service for those who really need it ?
So N-I-C-U next time you decide to rubbish the bedrock of the NHS please take a moment to consider why there are 250 million GP consultations every year.
How many individuals could have sorted stuff out for themselves ?
How many are making stupid decisions about their own health, then insisting on tablets rather than making lifestyle changes ?
How many will insist on a second or third opinion ?
I agree the issues are complex but getting rid of the generalists would only result in complete melt down (think of those poster with very long queues trying to register with a dentist) - is this what you really want ?
Good point A&ECN.
And as well as those queues (which would surely develop as the specialities are struggling to cope with current demand), another thing our fuckfaced moron of an acquaintance might want to consider is this:
I am training in a speciality - over 99% of the patients I see require a specialist opinion as correctly referred by the GP. If you get rid of said GP and I now see only 5% of my patients who need a specialist opinion and the other 95% have General problems does this not a) now make ME a generalist and b) erodes the specialist skills and knowledge I had to begin with?
You fucking idiot.
As a follow up to the comment on Canadian waiting times, I spoke to a Canadian-trained GP yesterday.
Canadian GPs train for a minimum of two years after medical school.
NHS GPs train for a minimum of five years (four before they extended the pre-registration house officer year to two years).
He also pointed out that he far preferred the NHS personal consulting style of taking patients into your consulting room and spending time with them. In Canada the GPs use multiple examining rooms and the initial history is taken by a nurse. The GP then 'pops in' to each room to finish the consultation. Much like A&E doctors do in the UK.
Also, unlike the NHS, GPs are not required to take on, or keep, a patient if they don't want to. Millions of Canadians can't get a GP.
The Fuckwit Epipemia just don't know how good they've got it.
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!
Classic Contrarian Troll:
Claims initially that UK GPs are poor trained idiots.
Shown that UK GPs are highly trained.
Claims then that they are overtrained for their jobs!
Claims that GPs are 'wasting time' taking the history.
Claims GPs should instead be 'speaking to the patient and diagnosing the problem'.
Both these things are the same.
As predicted, Trollonymous claimed he was leaving and not coming back, and did.
As predicted he is now mutating into a bitter troll and a vulgar troll
Damn, we're good!
Zanu-Labour must be getting desperate given the amount of vitriol displayed here. Give up you twats the public have finally sussed you out and you're living on borrowed time. Everything you try to control is destroyed and we're sick of it. Modernisation = f*ck up & our money.
Labour MPs should make a note of that job website for future use.
Even members of the medical profession accept that GP's are over-paid monkeys.
All too often lazy, undereducated and spend their time referring to proper Doctors in the hospitals.
The far seeing Darzi clinics will forces standards upwards. Judging from this site some Doctors like Rant are terrified of having to prove their "professionalism" in the new NHS, they are terrified they may be found out and have to work for 5 minutes or undergo extensive retraining to achieve the expectations of patients.
For this and the curtailing of the bloated medical profession the government deserve credit.
for all of you who would like to take care of rant in a more mature manner it would appear that http://notdrrant.blogspot.com/ are taking a different tack! Post below from the blog. Agree with anonymous by the way. Bright lights are coming rant! You ill either have a lot less time to blog or, I'm betting, a lot more!
"I am so glad you have started this site and hope that you continue to update it. I will contribute regularly to the debate. I too have spent the last several months very concerned by the rhetoric on the Dr. Rant site. As a stay at home Mum I can check the site regularly and it has always upset me that most of the Dr. Rant posts appear during the day when he should be working. I have decided to take a different view of the Dr. Rant site as have 5 of my friends. We decided last week to write to our MP. I find it very troubling that a person who makes such a good living off the back of taxpayers can be allowed to write what has been posted on the Dr. Rant blog. My husband is incensed and suggest I write to our MP which I and 5 others have done. We all sent the letter I will post below.
If otheres here would like to do the same, most MP's email addresses are their surname followed by the last initial so David Cameron is camerond@parliament.uk. All email address are on the Parliament website. A solicitor frind of ours is not convinced that Dr. Rant is a doctor. He says that Rant as a contractor has a duty of care under law to the people he contracts with (NHS) and is severely in breach of that given the posts on the blog.
Sorry this is so long winded. I should also say that I have already received a positive response to my email directly from my MP. Our text is below, sorry this is so long!
Dear Sir/Madam,
I am writing to you with the utmost urgency to bring to your attention an individual who proclaims to be a GP contracted to the NHS. He writes daily in the www.drrant.com blog usually during office hours that might suggest that the GP’s day is not nearly as “busy” as they tend to complain about.
The problem that I have with what is posted on the blog by “Dr. Rant” and others he claims as contributors is that they are generally abusive of the people you, the government, are paying him to take care of. I am angered in the first instance that a person whose entire income is derived from public funds is allowed to espouse the type of abusive insensitive, hateful and destructive views about the people they as supposed to care for and the employer who through my taxes pays their salary without having his/her contract terminated and being disciplined by the appropriate professional body for unprofessional behaviour.
If you look through the posting on the dr rant site it becomes very apparent that the person/persons responsible have little regard for either their patients or the department which employees them. One has to be concerned that with such vehemently held negative views about patients and their lack of intellect, openly ridicule the right of the patient to participate in their own treatment through dialog and choice as not being valid, you have to ask if these people are fit to treat patients at all. I am deeply concerned that they are not. A person cannot hold such strong and prejudiced views without these influencing them in day-to-day life. Applied to medicine this almost rabid view of the world might well translate into malpractice.
I would also like to copy an extract from one of the blogs posts to illustrate the complete disregard for patients the authors of the blog display, I quote:
“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.”
Paragraphs such as this repeat themselves over and over again in the blog.
I hope that you as a member of the government will share my sincere concern as to the fitness of these individuals to continue to be a part of the NHS and the medical profession and hope that you also agree that attitudes like this only undermine the NHS and potentially put patient’s lives at risk. I would ask that you immediately ask the GMC and the Department of Health to determine the individuals responsible identities, ascertain if they are indeed employed by taxpayers, and if they are take immediate action to stop the divisive and dangerous dissemination of inaccurate information by people employed through my tax money, while at the same time determining if patients lives are at risk. I would also like to know why the NHS feels it should contract with people who show such little regard for the patient.
Sincerely Yours,
A Taxpayer"
"During times of universal deceit, telling the truth becomes a revolutionary act." -- George Orwell
Anonymous,
This Labour government's deceit is now unspinning quickly. The Blogs are playing a part in this.
Taking the history is the key act of medicine. It's where the doctor and patient learn about each other and about whatever disease (if any) is present. It is not a minor inconvenience to delegate- it is the heart of good medicine- That combination of compassion and knowledge that marks out the good doctor.
The NHS is currently failing to provide the conditions for the practice of good medicine. As doctors we need to say this. And to counteract Government spin which is far too uncritically passed on by the dead tree press.
Dr Blue - Consultants routinely rely on history and SOAPs from GP's and others including physios.
anonymous in Clincal Epidemiology (haynes et all 1991) there's a lovely story of an American attending physician who got a consult request from another doctor. He read through all the long list of test results.
"oh dear", he said,"nothing for it but to take a proper history this time"
hilarious
you've now got a mirror site where people make thinly veiled threats of GMC complaints for unprofessional conduct !
Control, control, must suppress freedom of speech, aargh...
up yours new lab
yeah, I was reading the paper the other day, and someone failed to stop at a red light and had an accident. What's your point?
has runt turned anonymous? Doesn't look like the person complained to the GMC. Looks like runt might end up having questions asked about his behavior to the Secretary of State for Health. Should be fun! runt might be looking for a job, if indeed he really has one!
Dr Rant, you should adjust your settings so that the tome of posting does not show but only the date.
Well the Troll is a bit more outed.
Using terms that only either NHS patient groups or a HCP would use.
The post also now indicate a more disturbed personality.
Either a person with psychiatric disorder (as a guess, based on rants at doctors he has never met and aimed at a blog which has no effect on healthcare) or maybe a HCP who hates doctors.
Then again based on the posts, the places they get the onfo from and the strong support for almost all labour health policies i would say paid troll/ party activist.
Shame really, even the public on this site are telling him they don't believe him and yet he thinks he has support.
Fantastic News Dr Rant!
Congratulations on your first psycho stalker! That makes you a celebrity don't you know?
Hopefully, the lunatic fringe will give your blog a bit more exposure, and the number of visitors it deserves!
M
dear anon
the vitriolic tone of your posting, the emotional incontinence leads one to have genuine concerns for your mental health
perhaps a visit to broadmoor beckons
or is it the implosion of new labour thats triggered your latest crisis
the soviet style darzi clinics will work to the detriment of patients with chronic illnesses - those who most depend on continuity
i suggest a few options
1)f*ck your mother
2)ring nhs direct
3)vote labour
see which works best for you
tally ho
"As a stay at home Mum I can check the site regularly and it has always upset me that most of the Dr. Rant posts appear during the day when he should be working."
Dearie me. As I understand it, dr rant is not a single doctor. This is something I worked out minutes after my first visit to the site by the large icon on the right showing "the doctor rant team". This is then backed up later in the disclaimer. If you're going to take this to the government, read the site properly.
Secondly, has it never occurred to you that a.) doctors and nurses have breaks, during which they are totally at liberty to vent some of their frustration at a failing system by writing up their issues, and
b.) that doctors and nurses have shift work - not nice comfy 9-5 jobs for the most part, so saying the rants come in the day when they ought to be working is entirely irrelevant.
Thirdly, so you really think you can get any sort of idea to how they behave towards their patients by how they talk on their blog?? I have no doubt that to their patients they are are perfectly professional and do their job competently, otherwise they wouldn't still have jobs. Do you really think blogs are any sort of accurate representation of their behaviour in real life?
Fourthly, if you continue to complain about doctors pointing out the (numerous) problems with the nhs, you are driving yet another nail into the coffin of free speech and driving the country further towards the insane levels of political correctness. Have fun with that!
Fifthly, the quote you nicely mined was in response to a troll and given completely out of context. I haven't checked, but I have a feeling that wasn't even from dr rant, but from a member of public. I may be wrong there, but even if it was by dr rant, it has been given out of context, without even a mention of the troll who provoked it, and so is utterly meaningless.
So all in all, nice letter!
If they try and censure Dr Rant then we doctors will have to all start swearing to show solidarity. After all they cannot get rid of all of us.
Re Helen's post: speaking as an uninvolved observer, this didn't come across at all as being for real. It sounds more like some NuLabour propaganda which can safely be ignored.
nhs is killing us - what on earth is the matter with you? You seem to have a terrible grudge. If you have had a bad experience with a GP I have a small suggestion for you. Try being pleasant: it will always get you better results than being unpleasant. If someone doesn't respond appropriately when you are pleasant that's unfortunate, but no reason to change your approach or to start blaming everyone else for one person's shortcomings.
few would notice if they got rid of you............
Come on NIKU you can do much better than that. Can't Brown's Broadcasting Corporation help you out here with more inane meaningless soundbites ?
The public can see through all of your propaganda and bullshit and it makes them sick as they're the ones footing the bills while you bastards feather your nests.
I'm still laughing at the arrogant delusion that you bunch of second raters would attract "trolls" from the government.
Yeah, I'm sure Brown is shit scared of this chimp farm.
Anon,
You know, that's actually the first time you've made me laugh out loud.
Actually I think it's a great idea. Anyone who knows that it's their feet that are hurting can just refer themselves straight to a specialist paediatrician - assuming there are any left who have not been firebombed by angry mobs looking for sex fiends!
Are hospital specialists expected to deal with every primary care problem as well now? Should upper respiratory tract infections go to the immunologist or ENT surgeons for management? What about patients worried about feeling a little 'down'? Straight to the psychiatrist, I imagine. As for health promotion - surely high blood pressure should be managed by a cardiologist or some such.
Cutting out the middle man indeed.
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