Well thought out checklist on being normal

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http://paulocoelhoblog.com/2011/06/19/inventory-of-normality/

posted from Bloggeroid

Nigel Edwards (nedwards_1) on Twitter

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d nedwards_1 Thank you for the ticking off! The reality I refer to is the consulting room where I spend nearly all my time. IMHO, health service management should make my life easier not harder. The sole reason that health service management exists is the presence of Doctors. Everything about healthcare has evolved to bring doctors into line especially with the managed healthcare systems that have evolved. Without doctors healthcare is nothing. Even so, please point me to sources to improve my understanding of the larger picture. In short, healthcare professionals need to be freed up to deliver healthcare, not overburdened with ticking boxes and form filling. Finally, the competition issue is spurious. In Australia rural healthcare centres work on a hub and spoke model because the centres of excellence are so far away. The model of organisation is based on the premise that a unified accounting system improves financial management and then the imaging and pathology systems are folded into that architecture with the clinical guidelines/referral pathways following. An example of 'following the money' as a recipe for success. So successful in fact that this model is being repeated for the higher education system in Australia. Here in the UK we are blinded by the proximity of everything. To my mind, a more honest assessment of the available skill set in district general hospitals is needed to better prepare for the healthcare needs of a district. More collapboration, and less competition, between nearby hospitals (similar to the cancer network model) may prove more efficient than the current system for most conditions. GPs are NOT physicians. We cannot be expected to deliver the level of assessment a specialist can in the time available for each patient. It is not fair on the patient, and certainly not fair to the GPs.

Death becomes us?

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Am I the only GP to think that the performance management elements for General Practice are becoming so complex that the patient as a human being is being replaced by a collection of targets?

If taken to extremes by the boffins demanding better value for money in the NHS, there will be no room left for the 'mystery of general practice'.

My first impression is that the rules for making the most of the opportunities before us are so complex that there is little chance for many of us to get 100%. We get paid less (Government is happy) while our enemies deride us for having the opportunity to earn so much. 

I know we cannot roll the clock back, but if arguably intelligent professionals are struggling to understand this, most patients will remain ignorant of the revolution in healthcare going on around them. All it takes for evil to succeed is for the good to do nothing; and many of our patients are good people!!

Time after time my colleagues and I complain about QoF and the dehumanising of medical care. Yet, LMC and our leaders seem unable to make little if any headway in halting the erosion of the core values of primary health care.

This is a shame and our professional descendants will reap a healthcare system which I hate to imagine.