MKeech

SEM registrar and London GP. Views my own

[MKeech @MKeech2]

@Finumus1 @NHSuk Depends on what low means…Shows the classic problem with some private providers happy to do and charge for investigations but then not actually manage the results. Doings tests is the easy bit!

[MKeech @MKeech2]

@Finumus1 If you have to do them. But those false positives are more likely to harm you than the potential benefits.

[MKeech @MKeech2]

@Finumus1 @HaircutTungsten Interesting, I probably examine 80-90% of my non review patients in GP? One of the big barriers will be digital/general literacy along with regulation. AI is pretty dependent on how good your prompts are - many people struggle to describe their problems in a ‘medical’ way.

[MKeech @MKeech2]

@Hrushworth Random removes autonomy and worst (by scoring matrix used) going to least desirable year after year is also bad for patient equity.

[MKeech @MKeech2]

@Hrushworth Is this politically possible? Not sure but there is the fundamental tension of doctors not wanting to go equally to everywhere people need and should get equal quality care - I would rather incentives pay/perks/whatever over a demoralising random stick or just on grades etc

[MKeech @MKeech2]

@Hrushworth Yeah that would be seen as even worse many! Would be the end of the national contract which would be radical and hugely resisted for ‘race to the bottom’ concerns as is already happening in parts of the GP market which has the IC model.

[MKeech @MKeech2]

@Hrushworth 1) BMA don’t want it 2) Even most non-unionist doctors would think it ‘unfair’ that you get paid less for working at an ‘elite’ hospital 3) politicians and trusts also not keen I suspect for the pay increase costs it could mean alone let alone optics

[MKeech @MKeech2]

@KlausRB @maxtempers But you have provisional registration as an F1. So the option is go where told or leave medicine. Which is a choice, but pretty extreme one to have to take after at least 5 years working towards the career because of a random number generator.

[MKeech @MKeech2]

@Parody_RCGP ‘The service might not have time’ but obviously GPs do…

[MKeech @MKeech2]

@LukeAmos__ @Parody_RCGP I haven’t directly - Expecting individuals rather than organisations to do that is rather a high bar to set.l for participation in discourse and society.

[MKeech @MKeech2]

@LukeAmos__ @Parody_RCGP I have been issuing 2 month scripts since I was a trainee? Hardly ‘new’

[MKeech @MKeech2]

@Parody_RCGP That’s a problem with the pharmacy funding model which I agree isn’t good. Generally things that make it easier for patients and reduce admin burden I am in favour of.

[MKeech @MKeech2]

@Parody_RCGP Would it be much better or a waste of time? Whereas getting most people on to 2 monthly scripts for stable non control drugs they take regularly actually saves time. I agree pestering GPs about it isn’t helpful and invariably involves a monitored drug.

[MKeech @MKeech2]

@rcolvile @hor22189 London weighting doesn’t really vary medical pay as it has been static for well over a decade unlike salaries and is the same at each grade. The justification that while London is expensive it is still oversubscribed so doesn’t need even more incentive in higher base pay.

[MKeech @MKeech2]

@Finumus1 Make sure you are not unnecessarily fatigued and do what they say with respect to eating/coffee beforehand.

[MKeech @MKeech2]

@Parody_RCGP @DrGoblin3 Maybe not but I suspect going to be net work positive to see so I don’t have to deal with the discharge summary and likely follow up appointment if I get it right first time.

[MKeech @MKeech2]

@SahalQuazi @DrGoblin3 Are you not now almost guaranteeing 2 appointments rather than one here? Or are you expecting a very high rate of 'mild safety-net?' given we are pretty happy 'no red flags'