Discover and read the best of Twitter Threads about #TeamGp
Most recents (24)
1/ I don’t know which medic needs to hear this, but post-exertional malaise (#PEM) is NOT fatigue.
Short explanatory 🧵
#MedEd #MedTwitter #TeamGP #ME #LongCovid
Short explanatory 🧵
#MedEd #MedTwitter #TeamGP #ME #LongCovid
2/ Patients with #MyalgicEncephalomyelitis and approximately 50% of patients with #LongCovid experience Post-Exertional Malaise (#PEM), also called, Post-Exertional Symptom Exacerbation (#PESE)
DOCTORS ARE LEAVING UK
We live in a global market for health care workers
If the UK continues to undervalue Doctors they will leave in increasing numbers
Pay, conditions & workload is a RETENTION issue
GMC Report 👇🏻
gmc-uk.org/-/media/docume…
#GPCrisis #PayRestoration
We live in a global market for health care workers
If the UK continues to undervalue Doctors they will leave in increasing numbers
Pay, conditions & workload is a RETENTION issue
GMC Report 👇🏻
gmc-uk.org/-/media/docume…
#GPCrisis #PayRestoration
GPs leaving
GP Partners
GPs earn a fantastic income compared with most
But it’s been the about the same since 2004
Maybe that’s fine
But have invested in Primary Care & continued to provide care by employing more staff, supplementing costs & on average lost 40% income
#teamGP Thank you!
GPs earn a fantastic income compared with most
But it’s been the about the same since 2004
Maybe that’s fine
But have invested in Primary Care & continued to provide care by employing more staff, supplementing costs & on average lost 40% income
#teamGP Thank you!
GP - Salaried income
This has increased yearly but lags far behind inflation
There is not enough funding in General Practice to pay staff in line with inflation
Partners have subsidised any increases
This has increased yearly but lags far behind inflation
There is not enough funding in General Practice to pay staff in line with inflation
Partners have subsidised any increases
To those intent on psychologising #LongCovid & #MECFS because ‘there is no biomarker’- let me tell you something as a senior Dr. Many diseases don’t have biomarkers & diagnosis is clinical. Take asthma for example. Symptoms vary between patients. 1/n
Many patients have abnormal exhaled nitric oxide (FeNO) & histamine challenge tests- some don’t. Yet if the patient’s symptoms & signs fit with asthma, we have no hesitation in making the diagnosis. 2/n
There is the well-known example of multiple sclerosis. Many deemed it psychogenic because there was no lab or radiology test that was diagnostic. Until of course the MR scan was invented. 3/n
GP Appts - Workflows - Thread🧵
Annual reviews- predicable constant flow
Monthly - some Chronic disease follow-ups/Mental Health/ Acute follow-ups - more predictable
Acute - illness/change in condition/seasonal/variable
Urgent - unwell/need treatments/assessments
#TeamGP
Annual reviews- predicable constant flow
Monthly - some Chronic disease follow-ups/Mental Health/ Acute follow-ups - more predictable
Acute - illness/change in condition/seasonal/variable
Urgent - unwell/need treatments/assessments
#TeamGP
Is it possible to manage flows through GP surgeries better
Annual reviews for chronic disease
A birthday month spread throughout the year
Pre-booked months ahead of time
🧵/2
Annual reviews for chronic disease
A birthday month spread throughout the year
Pre-booked months ahead of time
🧵/2
Reviews
Also reasonably predictable numbers
Some needing FU from annual reviews
Some FU from acute presentations
Mental health etc
Prebook within the month - arranged at time of previous appt with clinician
🧵/3
Also reasonably predictable numbers
Some needing FU from annual reviews
Some FU from acute presentations
Mental health etc
Prebook within the month - arranged at time of previous appt with clinician
🧵/3
As a practice, we may finally have a system that strikes right balance between access, continuity of care, and improved patient/staff satisfaction.
So what are patients currently complaining about to us? A 🧵
So what are patients currently complaining about to us? A 🧵
@NickFerrariLBC spoke to @ClareGerada on @LBC today to discuss why 1 in 4 patients “still can’t see a GP”. As opposed to asking how, despite the current staff shortages, 3 in 4 patients *still* manage to see a GP. Common themes seem to be coming through…
“I can never get to see a doctor”
Fairly easy to defend this one, usually by looking them square in the eyes during our face to face consultation, booked earlier that day, and politely correcting them.
Fairly easy to defend this one, usually by looking them square in the eyes during our face to face consultation, booked earlier that day, and politely correcting them.
#MedTwitter #teamgp #NHSCrisis
So after my recent tweet got some traction, here is what I have learnt about how public perception of GPs. A 🧵
So after my recent tweet got some traction, here is what I have learnt about how public perception of GPs. A 🧵
GPs are apparently awful for not responding quickly enough to someone calling having a heart attack. (GPs are not an emergency service. If you think you are having a heart attack - please call 999 or go to A&E)
GPs apparently earn a fortune which is bad. The evidence for our ‘fortune’ is apparently because of our houses and cars. Not on the mandatory declaration of GP earnings each surgery publishes on their website.
I co-authored this essay on the dire state of Cancer Care in the UK with national treasures @prof_price and @ProfWishart which was published in The Lancet (@TheLancetOncol_) today. Let's hope the policymakers listen...
thelancet.com/journals/lanon…
thelancet.com/journals/lanon…
Here's a good summary:
independent.co.uk/news/health/nh…
independent.co.uk/news/health/nh…
It’s very clear that Britain is in the midst of a growing cancer emergency. Just as there was a concerted national effort to tackle the COVID Pandemic, we need a similar national drive to address the declining state of cancer diagnosis and treatment in the UK.
The absolute worst day I’ve had in 15 years as a GP 😕 11 hours without a break, ambulance taking >90 min for a blue light response, abuse from patients (a minority, but still not nice to receive). #TeamGP urgently needs better funding and staffing.
So many people are lovely and understanding despite getting a less than par service at times and taking ages to get thru to us etc. And I totally get the frustration with GP right now. Abuse is often directed at the wrong people tho, who are trying their best and can’t help it.
Golly. Overwhelmed by the lovely and supportive comments. Wouldn’t at all blame anyone for having a rant about accessing GP. Sadly some sad and frustrating experiences for patients at the mo. Thank you all. Think I must have something in my eye 😉
#ContinuityOfCare
a thread 📜
1/n
Great to see Continuity of care high up the political agenda
But why does it matter?
@jkaffash @costanza_fierce
pulsetoday.co.uk/news/politics/…
a thread 📜
1/n
Great to see Continuity of care high up the political agenda
But why does it matter?
@jkaffash @costanza_fierce
pulsetoday.co.uk/news/politics/…
#ContinuityOfCare 2/n 📜
Continuity of care is a highly cost effective health intervention
It does not grab the headlines as well as flashy new hospitals -
but is proven to:
⬆️ your life expectancy
⬇️ hospital admissions
@pash22 @pwhitakerwriter
Continuity of care is a highly cost effective health intervention
It does not grab the headlines as well as flashy new hospitals -
but is proven to:
⬆️ your life expectancy
⬇️ hospital admissions
@pash22 @pwhitakerwriter
#ContinuityOfCare a 📜3/n
Powerful evidence from the world of midwifery 🫄
They have dedicated **Continuity of Carer champions** for a reason 🤔
Follow ⬇️
@mcareetrixie #Midwife #Maternity
Powerful evidence from the world of midwifery 🫄
They have dedicated **Continuity of Carer champions** for a reason 🤔
Follow ⬇️
@mcareetrixie #Midwife #Maternity
My elderly frail mother, with a Clinical Frailty Score of 7, was admitted to hospital late this evening for suspected sepsis. The staff @beaumont_care who looked after her until the ambulance arrived were fantastic, as always. Mum's NEWS score - very high, 17 - was...
...established by the staff nurse and communicated to 999 and the paramedic crew who arrived. The ambulance took significantly longer than it should, but that was absolutely not @NIAS999 's fault, who are dealing with extraordinarily high pressure right now.
My mother was taken to @NHSCTrust Antrim Area Hospital ED, where unfortunately she had to wait in the ambulance for nearly an hour before being handed over to ED staff. This delay, of course, meant the paramedic crew were unable to respond to other calls during that period.
Latest #TeamClots preprint on clotting abnormalities in #LongCovid. We demonstrated that the average levels of 6 inflammatory procoagulatory molecules were significantly higher in the soluble fraction of blood in #LongCovid when compared to controls medrxiv.org/content/10.110… 1/n
These werealpha-2-antiplasmin (A2AP), serum amyloid A (SAA), platelet factor 4 (PF4), E-selectin, von Willebrand Factor (VWF) & platelet endothelial cell adhesion molecule-1 (PECAM-1). The mean A2AP level exceeded the upper limit of the lab reference range in #LongCovid 2/n
Considering that large quantities of these molecules have already been detected inside microclots using proteomics, the elevation in plasma/serum means that total levels of these inflammatory mediators are indeed alarming in #LongCovid 3/n
1/ Clear evidence of a circulation problem in #LongCovid. We know #SARSCoV2 causes a pan-vasculitis & hyper coagulability. Every long hauler whose blood has been tested has been +ve for microclots
⚠️Medics, pls note, a normal D dimer does NOT exclude the presence of microclots🧵
⚠️Medics, pls note, a normal D dimer does NOT exclude the presence of microclots🧵
2/ D-dimer measures fibrinogens degradation products (FDPs). Because the microclots are not being broken down, d-dimer will not be raised.
3/ Unfortunately a blood test for microclots is not yet currently available in the UK outside of the research setting.
Radiologist @DrGrahamLJ is spot on. In acute COVID19 the anomalous hypercoagulation triggered by the virus IS the disease. Not a secondary consequence of it. We should stop calling it a pneumonia; it’s a vasculopathy. The same process continues in #LongCovid.
Not saying this is the only thing happening in #LongCovid- viral persistence, immune dysregulation, autoimmunity and reactivation of other viruses may be playing a part but it’s clear that the aberrant hypercoagulability is a key feature.
1/ #HerotoZero Health and care staff, demand FFP3 or down tools.
Do not risk your life or health. Employers have a legal duty under the Health & Safety at Work Act to provide safe working environments.
Protect yourself. No one will protect you if you fall. 👇🏼🧵
Do not risk your life or health. Employers have a legal duty under the Health & Safety at Work Act to provide safe working environments.
Protect yourself. No one will protect you if you fall. 👇🏼🧵
2/ You will not be protected if you fall unwell. Long COVID is growing in prevalence and is currently absent of treatment or cure. NHS workers who develop Long COVID will NOT be financially supported. independent.co.uk/news/health/go…
3/ Failures in PPE policy and provision have, throughout this pandemic, placed the lives of health and care workers at risk.
In Cheshire and Merseyside we have published a Consensus on the Primary Secondary Care Interface. I think this is important and want to tell you about it. Here's a thread.
First of all, here's the Consensus itself, so please go take a look. I'll wait. cheshireandmerseysidepartnership.co.uk/consensus-on-t…
We developed this as part of our system wide approach to pressures being felt in all parts of the NHS. One element expressed by healthcare staff was the perception of work being shifted from Secondary to Primary Care and vice-versa. The Consensus looks to help this.
🚨Attention medics.🚨 An important thread on #MyalgicEncephalomyelitis Forget what you think you know. It is not psychosomatic. These pts are desperately physically unwell, likely with a chronic infection. #MedTwitter #MedEd #TeamGP 🧵 1/
Bedbound & housebound, they make up #millionsmissing. They maybe out of sight, but they are never far from my mind.
Neglect of #ME is the biggest medical scandal of the 21st century. The medical community will soon look back on their treatment of #pwME with horror & shame./2
Neglect of #ME is the biggest medical scandal of the 21st century. The medical community will soon look back on their treatment of #pwME with horror & shame./2
But some Drs maybe forgiven for their ignorance. #ME fails to feature on the UK medical curriculum and as such, awareness & understanding is low.
The condition has also been highly stigmatised & erroneously - but deliberately - labelled psychological./3
The condition has also been highly stigmatised & erroneously - but deliberately - labelled psychological./3
UK patient travels to Germany, starts treatment for #LongCovid. Attends local LC clinic- they note pt is improving on the treatment but refuse to prescribe it because ‘we don’t agree’. No reason given. Arrogance, hubris & medical orthodoxy at its best #TreatLongCovid #TeamClots
@uclh this is you. Not good enough.
Sharing with the express permission of the patient.
It’s 2022 and we are 2.6 years into this nightmare.
Sharing with the express permission of the patient.
It’s 2022 and we are 2.6 years into this nightmare.
🧵 on repeat infections, negative lateral flow & #PCR tests, and the use of #COVID19 antibody tests. An n=1 experience #OmicronVariant #LongCovid #MedTwitter #TeamGP #psychtwitter #LongCovidKids #COVIDisAirborne #CovidIsNotOver 1/n
I had acute #COViD19 in Nov 2020, PCR +ve. Developed #LongCovid a month after. Had one dose #Pfizer Feb ‘21 which gave me new symptoms. Out of interest I had my anti-spike antibodies done May ‘21- they were above the upper limit the assay could measure 2/n
With the passage of time my antibodies dwindled. I had them rechecked in Dec 2021- both nucleocapsid & spike antibodies were below the protective limit. Therefore I had no protective antibodies. 3/n
🧵 If the use of airborne #PPE & improving air quality in healthcare settings are to be ‘optional’ & ‘a matter of personal choice’, then we should give strong consideration to applying the same rule to the following #MedTwitter #MedEd #TeamGP 1/n
1. Handwashing before, between & after patients (& audits of it)
2. Plastic gloves & aprons
3. ‘Bare below the elbows’
4. Jewellery
5. Hair above the collar
6. Mandatory training
2/n
2. Plastic gloves & aprons
3. ‘Bare below the elbows’
4. Jewellery
5. Hair above the collar
6. Mandatory training
2/n
If you are recoiling in horror because
1. ‘Airborne transmission of COVID is controversial’
2. ‘The above are established evidence-based practices’
3. ‘COVID is mild, we can’t avoid it, we have to learn to live with it, we’re all vaccinated now anyway’,
then;
3/n
1. ‘Airborne transmission of COVID is controversial’
2. ‘The above are established evidence-based practices’
3. ‘COVID is mild, we can’t avoid it, we have to learn to live with it, we’re all vaccinated now anyway’,
then;
3/n
Pleased to share @FarazFallahi’s #MECFS video this time with English captions featuring some of my favourite German & Austrian names #LongCovid #MyalgicEncephalomyelitis #pwME #MedTwitter #MedEd #TeamGP #psychtwitter. A sobering watch.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe neuroimmunological disease that mainly occurs after infections (including COVID-19).
Please watch, like and share the video - help us to finally get attention!
Please watch, like and share the video - help us to finally get attention!
Unfortunately, there are no therapies, hardly any research funds and no significant care structure. Due to COVID19 the number of sick people is increasing drastically.
Those affected demand:
Those affected demand:
What I have learned since being unwell myself has destroyed any faith I had in my profession’s leaders. I used to think that deep down most senior clinicians acted because they had the best interests of the patient, their colleagues & society at heart. That illusion is gone. 1/n
Be it the treatment of those with #MECFS #LongCovid #Fibromyalgia #POTS #MCAS #EDS #HSD #PansPandas #Lyme #FQtoxicity #vaccineinjuries & other so-called invisible illnesses; 2/n
the refusal of senior medics to stand up & protect colleagues, the public & schoolchildren from airborne spread of #SARSCoV2 as they are too afraid to displease those in the ivory towers of infection control, @UKHSA & @NHSE management & @UKgovcomms; 3/n
I’ve been wondering whether to post this for a while, because I knew that it would increase the trolling in the short term. But I’ve decided to do it.
Since I’ve started @EveryDoctorUK, the organisation and myself have been subjected to smear campaigns and bullying from many…
Since I’ve started @EveryDoctorUK, the organisation and myself have been subjected to smear campaigns and bullying from many…
…high profile individuals, including some within the medical profession. A tiny number of influential people have successfully sabotaged newspaper articles containing important petitions, sabotaged collaborations by meeting with potential collaborators and smearing our name…
…by spreading misinformation about us. By setting up fake social media accounts to spread rumours and obtain information. By setting up abusive parody accounts (look up ‘EveryDogtor’ on Facebook for example). By accusing me of severe mental health problems publicly, on our …
When I was 7 yrs old, my cousin Sameera died from #leukaemia
She was 15 & initially we thought she had the ‘flu
There were no curative treatments in the 80’s & she sadly died
I was heartbroken
In our faith, people gather at the family home to pay their respects
1/5
She was 15 & initially we thought she had the ‘flu
There were no curative treatments in the 80’s & she sadly died
I was heartbroken
In our faith, people gather at the family home to pay their respects
1/5
After school, I would go & visit my aunt & cousins
The front door was always open
People would come & join in prayers
And I remember our childhood #GP , Dr Minwalla, coming after surgery
He wasn’t #Muslim but was very much our family dr & came every evening
2/5
The front door was always open
People would come & join in prayers
And I remember our childhood #GP , Dr Minwalla, coming after surgery
He wasn’t #Muslim but was very much our family dr & came every evening
2/5
He would come in, take off his shoes & just sit in the corner with a cup of tea
I remember his burgundy socks & sometimes he would smile at me as I said a prayer on little colourful beads
He’d stay for a bit & then head home
At the time, I thought this was rather special
3/5
I remember his burgundy socks & sometimes he would smile at me as I said a prayer on little colourful beads
He’d stay for a bit & then head home
At the time, I thought this was rather special
3/5
