I was recently invited to address the annual general meeting of PROSPECT, a local prostate cancer support group. The brief I was given was to discuss the GP’s role in diagnosing prostate cancer and the latest research in this area; a daunting task to tackle in a room full of men with prostate cancer at various stages on their cancer journey.
I spoke of the GP’s role across the continuum of cancer, from prevention and early diagnosis through to survivorship support and palliative care. I tried to discuss some of the latest studies in the field, such as the PROMIS study and the CAP trial, in a digestible form for these men. I also mused with them about the potential role new genetic technologies will have in the future in guiding GPs in determining cancer risk … Read more
‘Encourage more GP practices to teach medical students‘.
Sounds simple doesn’t it? That was the brief for me starting as GP Engagement Lead in September 2016. Teaching is something I’m passionate about and is one of the highlights of my week in practice. It’s always a good day at work when I’ve had students with me and I love to share my enthusiasm for teaching with other GPs.
However, encouraging GPs to take on new work, as exciting and rewarding as it is, is difficult at a time of unprecedented workload and pressure in general practice. Enter ‘Step up and Teach’ – a campaign we’re running to highlight the benefits to practices of teaching medical students. The question we want practices to ask themselves is ‘can we afford not to teach?’.
Domestic violence is a violation of human rights with damaging social, economic and health consequences. It is any incident of controlling, coercive, threatening behaviour, violence or abuse. That abuse can be psychological, emotional, physical, sexual and financial.
The “domestic” element refers to abuse between people aged 16 or over who are, or have been, intimate partners or family members, regardless of gender or sexuality. Men, women or transgender people in straight, gay or lesbian relationships can perpetrate or experience it. So does this mean domestic violence is gender neutral? Is gender irrelevant to prevention efforts and to responding to survivors’ needs? We do not think so.
The 3D study, led by researchers from the Centre for Academic Primary Care (CAPC), is examining a new approach for GP practices to manage patients with multiple long-term health problems.
Meeting a need
Existing treatment is based on guidelines for each separate condition meaning that patients often attend multiple appointments for each disease which can be repetitive, inconvenient and inefficient. They see different nurses and doctors who may give conflicting advice. These patients frequently get depressed and they also sometimes complain that no-one treats them as a ‘whole person’ or takes their views into account.
The 3D approach was developed by patients and GPs together to address these issues. Based around patient-centred care, the approach focuses on three ‘D’s: Depression, Drugs and the patient’s Dimensions of health, such as their quality of life, priorities and … Read more
GPs are vital to the delivery of end of life care. They coordinate care, provide generalist palliative care, help prevent unnecessary hospital admissions, and, in England, commission local health and social care services. Crucially, they help shift care from hospitals to the community, which is where most people would prefer to die.
However, before I even knew what that term meant, I was several other things: a writer, a performer, a poet. I am drawn to words, and to the stories that they form. This is why I am passionate about qualitative research. I also love performance, and believe it is a fantastic mechanism for powerfully communicating important messages about humanity.
On my arrival at the University of Bristol, I was therefore thrilled to learn that the project I would be working on with Principal Investigator Ruth Riley included a collaboration with a performance artist, who would be communicating our findings about GPs’ mental health to an audience. This performance was to happen as part of the Elizabeth Blackwell Institute’s (EBI) Feel It Festival. … Read more
Seek the truth, not what is comfortable. Seek the real, not the easy.
— Gerald May
Talking about domestic violence and abuse can be uncomfortable. Avoiding talking about uncomfortable subjects keeps them hidden, fails to challenge injustice and arguably colludes with perpetration. We have a responsibility to shine a light into these dark corners.
In the Centre for Academic Primary Care at the University of Bristol we conduct research on improving the health care response to domestic violence and abuse. We have measured the prevalence and impact of domestic violence in patients in general practice and sexual health services; developed and rigorously tested training for doctors and nurses in general practice to ask about DVA and link patients disclosing abuse to specialist domestic violence advocates; run programmes on … Read more
Nearly 14 years ago in summer school at University of California Santa Barbara, Professor Don Zimmerman provided my introduction to the analysis of institutional, in particular medical, interaction.
Those studies set the benchmark for my own research ambitions but the main obstacle I faced was getting access to data.
For all the right reasons, medical consultations data are challenging to collect. Where ethical approval is in place for reuse it is often restricted to the original research team. Sometimes retrospective approvals for reuse of existing data are possible but even then, consultations data that has been collected without reuse in mind is often of variable quality; the process of data collection and participant characteristics are not well-documented, recordings can be incomplete and they are often audio-only.
The idea for the Primary Care Consultations Archive was born with this … Read more
While violence against men continues to fall in the UK, women affected by violence and domestic abuse are bearing the brunt of a hidden rise in violent crime. This rise coincides with the austerity-led cutting of domestic violence services.
Domestic violence and abuse (DVA) damages physical and mental health resulting in increased use of health services by survivors of abuse. The prevalence of DVA among women attending general practice is higher than in the wider population. Women experiencing DVA are more likely to be in contact with GPs than with any other professionals. Reduced investment in specialist domestic violence services further increases the demand for direct general practice responses to DVA. Although victims tend not to disclose spontaneously to their GP, they have an expectation, often unfulfilled, that doctors can be trusted with disclosure, and can offer them … Read more
GPs often say they make the worst patients, but who do they turn to when they need help? That’s what I aim to find out on a new research project about GPs with mental health issues.
My new job is firmly at the centre of the zeitgeist. GPs are all over the news on a daily basis. Doctors are judged by journalists and picked apart by politicians for running unsafe surgeries, for closing their doors to new patients, and for long waiting lists. If you read (and believe) certain sectors of the UK press, you might be forgiven for thinking that GPs have a lot to answer for.
The reality is, of course, way more complex than the Daily Fail might have us believe. Yes, GPs are retiring early. Yes, many practices are unable to add new names … Read more