Dr Goblin @DrGoblin3 Twitter profile

Last Seen Profiles

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@FRuzihan

@anon131072

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@KlarkLeyso86026

@FBatistaJ

Dr Goblin

@DrGoblin3

1 year

The staff ID badge office in every NHS hospital:

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Dr Goblin

@DrGoblin3

4 months

Is this a serious question? I’ll assume it is. Let me explain. You go to the GP a with a sore throat. GP talks to you, examines you and feels it’s nothing serious. GP sends you away but gives you weirdly strict safety-net advice for a sore throat. 1/10

Colin Hide

@HideColin

4 months

@drphilhammond High risk? What about a Drs job is high risk please?

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Dr Goblin

@DrGoblin3

2 months

PAs being offended by the @TheBMA document on their scope is pure narcissism. Their scope is dictated by the supervising doctor, and that's who this document is for. And my GOD is it overdue.

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Dr Goblin

@DrGoblin3

2 years

God give me the confidence of a patient who, the day after 16 pints of cider and 8 lines of coke, won’t accept “hangover” as a diagnosis.

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Dr Goblin

@DrGoblin3

4 months

So, being a doctor really is hard and risky. We either overdo it and cause problems, or under-do it and cause problems. Striking the balance is so difficult, and we’re always learning from our mistakes and those of others. It never stops. 10/10

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Dr Goblin

@DrGoblin3

2 years

If I were to say someone “has got a cob on”, what do you think I meant?

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Dr Goblin

@DrGoblin3

8 months

FY2: They came in with an AKI so I gave them a few litres of fluid, but then they got a bit short of breath with their heart failure so I also gave a bit of furosemide 🤝👊🫠 The post-take acute medical consultant:

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Dr Goblin

@DrGoblin3

8 months

I suspect most people looking at this would still assume Raj is a medically qualified doctor. He should not use the title in a workplace setting. @drammarahughes this isn’t going to go away.

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Dr Goblin

@DrGoblin3

3 months

A trained PA is Employed. Full stop. No more formal training. No more mandatory exams. What's the doctor equivalent of that? 🤔 Oh yeh, it's a GP, Consultant, or non-training doctor. So let's show how we get to that point, compared to the PA's journey: 4/5

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Dr Goblin

@DrGoblin3

6 months

Personally I don’t want @gmcuk regulating PAs. But they will. So, at the very least I want: - a separate register with an individual identifier that is immediately and obviously different to doctors’ 7-digit e.g. PA12345 - their fees to be the same as ours

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Dr Goblin

@DrGoblin3

1 year

Clinic: This pt must have bi-weekly bloods. GP to do. Me: No. Clinic: OK fine then they absolutely must have weekly bloods. Me: No. Clinic: Well alright but twice monthly at a bare minimum. Me: No. You do them. Clinic: …we’ve had a think and they don’t need bloods.

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Dr Goblin

@DrGoblin3

3 years

My last one. Saving it for a troponin in a 20 year old with chest pain 👍

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Dr Goblin

@DrGoblin3

10 months

This reminds me of the time I was "called upon" mid-flight to flex my medical muscles. Patient w LoC. The call put out. Me and the wife looked at each other and sunk down in our seats a bit. When nobody else stood up we felt guilty and sheepishly went over. 1/7

John Greenwood

@JohnGreenwoodMD

10 months

Had an incredible in flight emergency experience on @AmericanAir Yesterday. Patient w LOC & about 30-40 min until landing. Team rapidly assembled (Akeila - an ER Nurse from @BayhealthDE , Eddie a cardiologist from @MaineMed , and Anna the flight attendant) to care for the pt 1/7

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Dr Goblin

@DrGoblin3

2 years

3x F2F appts DNAd today. All 3 “insisted” on F2F and all were “urgent”. One showed up 4 hours late with “I forgot”. Absolutely incredible.

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Dr Goblin

@DrGoblin3

2 months

It’s not about a PA missing complete heart block. It’s about a PA either 1) not wanting to ask their supervising GP for help, 2) not feeling they could ask for help, or 3) not having an accessible supervising GP. 1 is a meeting without coffee. 2 and 3 are the Surgeries’ fault.

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Dr Goblin

@DrGoblin3

5 months

Have kids they said. It’ll be the best thing in your life they said.

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Dr Goblin

@DrGoblin3

3 years

It’s terrifying when experienced, stoic GP partners crack under the pressure and go off. No warning signs. You can’t know what people are going through. I’m a bit shaken.

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Dr Goblin

@DrGoblin3

8 months

Why are non-diabetic rich people sticking glucose monitors on their arms?

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Dr Goblin

@DrGoblin3

3 years

At a wedding. Loads of doctors, some of us are GPs. It’s all kicking off as the hospitalists declare they’re seeing patients as we refuse. Oh ffs. Sigh.

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Dr Goblin

@DrGoblin3

2 years

Patient with his new walking stick (and some memory issues): “this is my lightsaber!” Me, over-caffeinated: “whoa yeh!”*makes saber noises and pretends to spa like Darth Maull* Patient, looking blank. His wife: “he said it’s his life saver, doctor…?”

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Dr Goblin

@DrGoblin3

7 months

It’s not about a PA “missing” an aorta. It’s about the consultants using them as junior doctors.

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Dr Goblin

@DrGoblin3

3 years

If a sentence starts with “it’s not Covid because…” and doesn’t end with “…I’ve had a negative PCR done in the last few days.” then I really don’t want to hear it. So bored of this game now.

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Dr Goblin

@DrGoblin3

17 days

😑

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Dr Goblin

@DrGoblin3

5 months

Read this from the new Good Medical Practice. With PAs being used as they are, we’re beyond parody at this stage.

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Dr Goblin

@DrGoblin3

10 months

I won't say we got a round of applause as we returned to our seats, because it didn't happen, but you could tell everyone was impressed. The stewardesses gave us both a sandwich and a can of coke, and insisted we only pay cost price. 8/7

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Dr Goblin

@DrGoblin3

13 days

If you’re ordering a D-Dimer “urgently tomorrow”, you shouldn’t be ordering a D-Dimer. Or seeing patients, probably.

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Dr Goblin

@DrGoblin3

3 months

Medical people, do you ever get that cringey dread feeling that you’ve overreacted over a patient and everyone down the line is judging you? How do you deal with it?

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Dr Goblin

@DrGoblin3

6 months

“I’m one of the clinicians/practitioners” is not good enough as an introduction. It says nothing.

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Dr Goblin

@DrGoblin3

2 years

Not going to lie: NHS execs getting arsy about the BMA consultant rate cards is getting me a bit excited. The only tool they have is guilt trips and they know it.

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Dr Goblin

@DrGoblin3

4 months

Good doctors will review, think and judge likelihood. And accept the “risk” of getting it wrong. All health systems would collapse if every symptom is investigated to the nth degree “just in case” - this isn’t unique to the NHS. 9/10

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Dr Goblin

@DrGoblin3

4 months

Non-doctors will accept less risk for any given case. This isn’t a slight - they just aren’t trained for it. A computer will never allow risk - why do you think 111 sends an ambulance so much? 7/10

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Dr Goblin

@DrGoblin3

4 months

Oh and by the way: over-investigating and over-treating literally anything is its own quagmire of avoidable harm, but that’s a thread for another time. 5/10

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Dr Goblin

@DrGoblin3

4 months

@HideColin It’s almost like you don’t want to be educated, Cole…? 🙄🤷

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Dr Goblin

@DrGoblin3

4 months

If you hear hoofbeats a 1000 times, it’s probably horses. Except when it’s a zebra. This is the risk. The doctor might get it wrong. But look at the alternative of accepting no risk. 6/10

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Dr Goblin

@DrGoblin3

3 months

Yeh. That PA education flowchart thing is a disgrace. So I made more honest ones. Let's break them down... 1/5

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Dr Goblin

@DrGoblin3

3 months

Seems I’m expected to take up the slack for NHS emergency dentistry tonight. I do not, under any circumstances, give dental treatment other than appropriate analgesia. Why am I expected to?

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Dr Goblin

@DrGoblin3

1 year

Patient asks for a specialist test not available to the GP. GP says he can't, but he'll ask the specialist about it. Specialist says No, as it doesn't change management. GP passes along the message. Who gets the complaint? Correct. 😂

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Dr Goblin

@DrGoblin3

8 months

Our ST3 can’t pass one of our exams. They’ve just been Dx with dyslexia. Mid-30s, and achieved these heady heights despite it. Always struggled, but tried harder, compensated and push on. I am genuinely in awe of them.

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Dr Goblin

@DrGoblin3

3 months

I've probably missed something, but you get the idea. To try and claim equivalence in the training of these two cohorts is, frankly, appalling. It misleads ALL stakeholders, and undermines any credibility PA-supporters have. Let's have more grown-up discourse than that. 5/5

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Dr Goblin

@DrGoblin3

3 years

Hospital docs at teaching days: we’re always happy to hear from you, please drop us a line we’d be only too happy to help with anything 🥰😘 Hospital docs on the phone: Who the FUCK are you and why are you calling me?? 🖕🤌

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Dr Goblin

@DrGoblin3

4 months

Other professions have their role to play. But there is a reason that when things become difficult, vague, off-piste and unclear, the buck will ALWAYS stop with a doctor. 8/10

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Dr Goblin

@DrGoblin3

4 months

In fact, the specialist can’t cope with that many pts being referred like that. The guy with the cancer now can’t be seen quickly. Not so great, eh? And what about all the stress and anxiety those 9,999 people had while they waited? It was just a sore throat. 4/10

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Dr Goblin

@DrGoblin3

3 years

@spooky32 @ChrisReeves_3D @MrsFlowers007 I think that’s the fabric softener actually

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Dr Goblin

@DrGoblin3

1 year

I explain the prostate cancer and PSA thing for laymen: The UK doesn’t have a prostate cancer screening program, for various reasons. If it did, it probably wouldn’t be done by your GP; it would probably be a centrally arranged test, like we have for aneurysms and bowel cancer.

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Dr Goblin

@DrGoblin3

6 months

Me to pts: Seriously, don’t worry. Life’s too short to live in fear. You could be run over on the way home. Relax. Hug your children. It’s fine. Me to my doctor: My eyelid twitched 3 times in a row I don’t think an urgent referral to neurology is too much to ask.

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Dr Goblin

@DrGoblin3

4 months

Let’s say the GP referred you to the cancer specialist as soon as they saw you. Great, right? But what about the 9,999 other patients just like you who were also referred straight away that didn’t turn out to have cancer? You might say they didn’t need the specialist. 3/10

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Dr Goblin

@DrGoblin3

1 year

What we're seeing, finally, is a cohort of doctors unwilling to subsidise UK healthcare with their goodwill. If your health service doesn't run without goodwill, it's not a good health service.

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Dr Goblin

@DrGoblin3

7 months

@DrLindaDykes Junior docs were gaslit. Consultants were ignorant or complicit. I’m biased, but it’s the anons on SM that brought this issue to the fore and ensured it finally got the scrutiny it needed.

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Dr Goblin

@DrGoblin3

2 years

Why do I feel like a cold caller trying to flog statins when I phone an unsuspecting patient with a QRISK of 11%.

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Dr Goblin

@DrGoblin3

4 months

This is referring to PAs replacing GPs. People never think it’ll happen to them. Surgeons in particular have thought this for years. They’re going to be in for a shock when the Consultant PA starts disagreeing with them.

David Chung 🦀

@cruncherwax

4 months

@StevenMAlderson I don't think it'll be ED Consultants. The job is too hard. A question every 90 seconds, on anything, no chance

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Dr Goblin

@DrGoblin3

2 years

An A&E want my advice on how to do discharge summaries for us GPs. I know how I want it. You? I think: - Why attended - Diagnosis - Tests done + any abnormals - Follow-up (admitted, discharge to GP or specify clinic/2ww) That’s it. I don’t want a story or “GP to do”.

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Dr Goblin

@DrGoblin3

1 year

I feel awful. No energy. Everything hurts when I leave bed. Nauseated. Guts feel like a bag of jelly. No fever, just persistent tachycardia. 🤷 Made me think though:

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Dr Goblin

@DrGoblin3

3 years

The spin will be: Work shy GPs reject generous Government help and vote to strike in response to being asked, reasonably, to actually see their patients. Strap in chaps. This is gonna get tasty.

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Dr Goblin

@DrGoblin3

8 months

@drammarahughes Being a Partner, Phil and Ammara probably can't force him to stop using "Dr". But they're complicit in this, and the Practice risks criticism. Ideally this would be sorted in-house, but I think unfortunately this is going to need scrutiny from @gmcuk .

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Dr Goblin

@DrGoblin3

4 months

You don’t get better, but don’t get too much worse - but the advice hits home so you go back. GP checks you over again and refers you to a specialist, quickly. You’ve got cancer. So where’s the “risk” here? 2/10

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Dr Goblin

@DrGoblin3

3 months

@Azeem_Majeed Simple cases are nice to have, I agree. Personally I don’t mind just doing complex stuff. I can, others can’t. BUT. What I can’t do, is the same volume of work with all my cases complex. I can do fewer complex or more simple. Govt want both, of course.

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Dr Goblin

@DrGoblin3

2 months

I sat in with some 111 call advisors - the ppl who talk you through the questions - and it’s totally changed my view. These people aren’t robots sending ambulances to everyone; they’re saints, doing a tough job with little thanks. Tune in next week for more non-PA positivity.

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Dr Goblin

@DrGoblin3

10 months

Email sent. I’m leaving my salaried post.

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@DrGoblin3

4 months

Doing some OOHs. One local GP surgery was shut in the afternoon for training. Just one surgery. Just the afternoon. The OOH screen looked like a car crash as a consequence. We’ll miss primary care when it’s gone.

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Dr Goblin

@DrGoblin3

10 months

The pt hesitantly nibbled a couple, proceeding to gorge themselves on the pack at our urging. Their eyes lit up, the colour came back to their cheeks, and their ideas, concerns and expectations were well and truly sorted. Success. 7/7

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Dr Goblin

@DrGoblin3

9 months

@JaneGr01 @MHA_92_ Today would be good. Doctors are working over the weekend.

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Dr Goblin

@DrGoblin3

5 months

Apparently the Jnr Doctor strikes have caused relationships with Consultants to become so fractured that some have even started stealing their shoes.

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Dr Goblin

@DrGoblin3

1 year

We’re now seeing the 2nd wave locally: parents who got antibiotics (sometimes 2 lots) and are coming back because nothing’s changed. This isn’t healthcare, this is absolute madness.

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Dr Goblin

@DrGoblin3

7 months

Nothing like a young, palliative cancer patient on a Friday to really put things into perspective and force you down a black hole of existentialism and introspection. How do y’all cope with this?

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Dr Goblin

@DrGoblin3

6 months

Guys. Don’t offer a locum GP a salaried post halfway through their first shift with you. It doesn’t scream “well-run stable surgery” 😑

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Dr Goblin

@DrGoblin3

1 year

I don’t have anything useful to add to the debate about Junior Doctors. Know only that: - I support them fully - I wish it had happened in my time as one of them - I really want one of those orange beanies

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Dr Goblin

@DrGoblin3

1 year

I can’t even get patients with a QRISK >10% to take statins 🙄

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Dr Goblin

@DrGoblin3

2 years

@noodles_nood The people who say this have a 98% chance of never having paid tax.

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Dr Goblin

@DrGoblin3

1 month

Yeh, I tell patients I’m not a PA 🙄

IncogPA

@IncogAssociate

1 month

@makepumps666 @TheSooperCynic Do you introduce yourself by stating what you are not?

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Dr Goblin

@DrGoblin3

8 months

If I’d had to contend with PAs or ANPs dictating what I did and prescribed while they were in clinic or theatre, I’m pretty sure I would’ve been kicked out of the Foundation Programme for the rampage I’d have eventually gone on.

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@DrGoblin3

1 year

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@DrGoblin3

2 years

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Dr Goblin

@DrGoblin3

1 year

@HelenBevan @PennyPereira1 @DrAmarShah @NHSConfed Christ, this really is popping a bit of tinsel on a turd isn’t it. Cracking management speak though - beautifully verbose and meaningless 👍👌

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Dr Goblin

@DrGoblin3

2 years

Not 👏 every 👏 cough 👏 needs 👏 antibiotics

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Dr Goblin

@DrGoblin3

3 months

I’ve been using this supposed piece of shit for a week since my Cardiology 3 went missing. It’s fine. Absolutely fine. Expensive stethoscopes are a con.

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@DrGoblin3

2 months

Speaking to medical students and early doctors and I just can’t convey how bonkers and unprecedented the current situation is: Our union really fighting on every front at every level; a royal college imploding in real time with severe criticism from non-anon people. It’s mad 🤯

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Dr Goblin

@DrGoblin3

1 year

Quinsy, again. Bastard tonsils. I used the 111 website to see a man about a dog, answered honestly, didn't just play the system. Callback within 30 mins by paramedic to triage, call from GP within 2 hours to discuss. Rarely gets said, but 111 worked really well for me.

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@DrGoblin3

7 months

Nobody: Not a single soul: New mothers to the GP: I brought the vomit and poo with me if you want to see it?

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Dr Goblin

@DrGoblin3

1 month

Stevie Nash has just shot all PAs in the foot. GP surgeries/PCNs aren’t going to want any PAs if they’re damned if they do and damned if they don’t.

PulseToday

@pulsetoday

1 month

PA union warns of legal action against GP practices using BMA guidance #PAs #MAPs #BMA

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@DrGoblin3

2 years

@Xeon4f145d96s1 I’d love to have been a fly on the wall at the meeting where this was dreamt up, agreed and planned.

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@DrGoblin3

3 months

@YSTeachingNHS When do the heart disease, AKI, PE and Aorta trolleys do their rounds?

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Dr Goblin

@DrGoblin3

2 months

It’s so hard watching parents get old.

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@DrGoblin3

16 days

I don’t want to do Med3 “sick notes”. I’ve no interest. It’s not a mark of being in a trusted position; it’s a total pain in the arse that complicates patients’ relationships with me and adds to my workload. “Take them away” from me? Pfft. You’re welcome to them.

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Dr Goblin

@DrGoblin3

9 months

Appraiser: Hmm you haven’t really done much CPD this year…? Me: I’m on Twitter a lot discussing medical stuff and it’s been really useful. Appraiser: Oh? Show me your account and I’ll have a look. Me, remembering my anon Goblin account: Lol no babes

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@DrGoblin3

2 years

This isn’t a criticism. I’m getting calls from paramedics at pts homes. They’ve been there for ages trying to figure out a complex history and make a diagnosis, and they want my help. It’s obviously not an emergency. Is this really the best use of their time?

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@DrGoblin3

2 months

Everyone’s favourite Dr PA is speaking at the November @PulsePCN event in London in November… @BenAllenGP I think you’re also attending 😬

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Dr Goblin

@DrGoblin3

3 years

You are not officially a GP until someone asks you “so when are you seeing patients again?”.

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@DrGoblin3

21 days

@DrAsifQasim @TrinCollCam For gods sake. Which GPs think it’s OK for a PA to supervise their medical students?? Have the students complained to the university? What is the university doing about it?

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Dr Goblin

@DrGoblin3

4 months

How the Govt and NHS imagines the one anaesthetist supervising hundreds of AAs will be:

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Dr Goblin

@DrGoblin3

1 year

Honestly I’m not even arsed

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@DrGoblin3

2 years

1st customer of the day - telephone call “Mum’s fallen and can’t get up but we didn’t want to call the ambulance and waste their time.” What to say.

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@DrGoblin3

2 months

It’s why I do what I do.

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Dr Goblin

@DrGoblin3

7 months

Oh look! An email from the GMC about the new Good Medi- *deleted* 🤷

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@DrGoblin3

28 days

@DrRaniKhatib @WYpartnership @NHS_RobW @DrJamesThomas1 You could, I don’t know, provide the increased dose…?

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Dr Goblin

@DrGoblin3

1 year

@Ben_Abe4 No, an ACP is not a medical doctor. If this person was seeing patients and introducing themselves as a doctor in this context then that’s a problem.

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Dr Goblin

@DrGoblin3

2 years

Patient: *farts* LIVI Doctor: You need a F2F with your own doctor urgently and they need to order you FBC, U&E, LFT, Calicum, CRP, TSH, B12, Vit D, A1c, qFIT, USS Abdomen, 2ww colorectal and gastro…

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@DrGoblin3

9 months

@Dr_Done_ @ExplosiveEnema The FY homework jibe is the cuntiest thing I think I’ve ever seen.

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Dr Goblin

@DrGoblin3