Can I just say that I’m pretty peeved we are considering some sort of restriction easing for the Xmas period, yet I had to just deal with a lockdown Diwali at the weekend.
This is how I feel following the
#BawaGarba
finding:
1) You’re employer will scapegoat you for systemic failures.
2) Your seniors will throw you under the bus.
3) Reflective practice will land you in trouble.
How the
@gmcuk
think this is good for patients is beyond me.
It’s ok BBC and NHS Employers - I can fix this headline for you:
“Highly trained senior doctors charging an amount commensurate with their experience and expertise as healthcare professionals for extracontractual work”
Basically, the GMC is going to change the standards of medical education and training so that they don’t run into quality assurance issues when they have to regulate MAPs.
The collusion of national bodies in this race to the bottom is both overt and upsetting.
1/4: We’ve recently been asked some questions relating to our new position statement, which sets out our vision for the future of medical education and training across the UK. We want to make sure that we’re clear on what this means & the benefits it could bring for doctors &
Goodness this PA/AA stuff is a fiasco.
No scope defined, Medical Royal Colleges with huge conflicts of interest, a professional regulator doubling down with a comms policy to quash concerns, and a Government rushing through legislation.
A real race to the bottom.
Hang on, hang on.
Why can’t we just pay HGV drivers less and make them work more hours? That will fix the supply and demand mismatch surely?
Seems to be the strategy with primary care right?
🤷🏽♂️🤦🏾♂️🙄
I’ve deliberately steered clear of MAPs and all that as I don’t have any experience of them. But I’ve got to say this has annoyed me.
I worked seriously hard, over many years, and accrued a load of debt to become a consultant on the GMC specialist register.
What is this?
Out now: our self-assessment tool supporting the career progression from Advanced Clinical Practice to Consultant Practice! Track your development as an aspiring or consultant practitioner 👉
Rota gaps are rife. Senior colleagues in your new post asking if you can cover gaps as a locum - ok.
Senior colleagues asking why you “can’t” cover them in front of everyone else when you say no - bullying.
Unacceptable.
I have never met an NHS psychiatrist that believes serotonin depletion is the unifying cause of depression.
We know we don’t understand the physiology of depression. We also know the psychotropic medications work in certain circumstances.
That article = tabloid academia.
The BMA voted democratically for pay restoration at their ARM. So industrial action may happen. What’s so hard to understand? The ‘militant’ label is unhelpful.
If it comes to IA and junior doctors walk out, I’ll be supporting them.
Junior doctors are itinerant for years, without any ability to ‘bed in’. Service provision fodder and often treated like rubbish by HR.
Having a doctors’ mess is a basic part of the social contract. Removing them will only worsen recruitment and retention.
Get an inside look at the role of Physician Associates in psychiatry from the perspective of one of our own PAs. Check out this video for a personal account of the difference PAs are making in mental healthcare!
#physicianassociates
#psychiatry
Having read this MPTS report, I am struggling to see how the tribunal determined that, on the balance of probabilities, Dr Pandian did not examine the patient…🤷🏽♂️
Patient accuses doctor of documenting a physical exam that never happened. Doctor maintains innocence - has documented the exam.
@gmcuk
finds doctors FtP impaired because the patient could recall the situation better than the doctor, who had to rely on notes.
@BAPIOUK
“It’s easier to select clinicians who show an aptitude for management and give them the right development and training than to give managers from a non-clinical background a deep understanding of the service they’re managing.”
@mancunianmedic
@bmj_latest
@loyalmoses
@juniordrblog
That’s untrue. The parents are searching for treatment. There isn’t a treatment (the Italian hospital is offering palliation).
@RoshanaMN
…guilt-ridden for being unable to breast feed. There’s something very wrong when a crisis team’s intervention is giving the parents permission to formula feed so mum finally gets to sleep... (2/2)
@Spook14xx
@juniordrblog
The Courts are not allowing for assisted death here. They were asked whether it was in the child’s best interests that ventilation was stopped. They said yes (several times).
10pm on a Friday night? After you’ve not turned up to meetings with the BMA. After you’ve said you’ve no mandate to discuss pay? After we’ve cancelled swathes of elective care that cannot be reinstated at this late hour to ensure patient safety on the strike days?
Nonsense.
I’ve written to
@BMA_JuniorDocs
inviting them for formal pay talks on the same basis other health unions accepted, including calling off next week’s strike.
Let’s have a constructive dialogue to make the NHS a better place to work and ensure we deliver the care patients need.
CMHT resource has been decimated. Proper assertive outreach is rare. It fails people with the most severe of mental illnesses.
But Notts HC putting this statement out is awful. Engagement is a two way street. Walking away from any responsibility.
#ValdoCalocane
More “PAs/managers are paid more than doctors”
#MedTwitter
chat.
It’s petty nonsense. The crux is that doctors are underpaid. Fix that. Stop comparing apples and pears.
#payrestoration
If two docs are doing the work of 3 then they should be remunerated as such. Why the NHS refuses to do this (and would rather pay extortionate amounts to on-the-day agency cover) is very odd.
On call today and supposed to have 3 SHOs. 2 arrived as “insufficient interest” in the locum shift.
My 2 SHOs are working extra to cover an unfilled role, but management refused my request to split the extra locum cash between the 2 who turned up. Seemed fair no?
#orthotwitter
To my more senior consultant colleagues.
Please understand the deserved privilege you’ve benefited from, and how below inflation pay awards erode your final salary pension.
Think about the recruitment and retention debacle this drives.
Strike now for a better NHS tomorrow.
Consultants who bought their properties 10 years ago: If you couldn’t afford to buy your current property at its current valuation, at the current comparable salary you’d have now, you should probably be striking.
“... resilience training expects that individuals merely adapt to system-wide challenges within healthcare, rather than address them. Compensating for a flawed system sounds more like compliance than resilience.”
@bmj_latest
@RoshanaMN
Completely agree. Our NCT experience was really good with a pragmatic facilitator, but the breast feeding consultant was triggering. She was an example of why women end up under crisis teams with severe postnatal depression…(1/2)
Today there is an interview with RCP president
@DrSarahClarke
in The Times. Please read our statement that clarifies both Sarah and the RCP’s view on the right of union members to take industrial action.
One of the comments to this article says it all:
“Go to the negotiating table and offer a double digit at least. Don’t just sit there and hide and write articles here. Do your job.”
#JuniorDoctorsStrike
The NHS sees more pressure than usual over Easter and the 4 day junior doctors' strike threatens to cause significant disruption.
I urge
@BMA_JuniorDocs
to call off strikes and get back around the table to find a fair offer. Read more
@Telegraph
👇
How are you meant to do all this extra-curricular stuff whilst working as a (likely full time) doctor and not being a radiologist?
Well obviously you can if you’re blessed with lashings of privilege…
Med Ed needs to change. This is a joke.
Clinical leaders need to stop rubbishing concerns raised through social media. This is 2023. It is how the world works now. And anonymity is increasingly the only way you’ll get to the truth.
Tone deaf doesn’t even begin to describe this. 🤦🏾♂️
Is it reasonable to attribute provenance to multiple anonymous anecdotes posted from an anonymous account?
Formal processes exist to report concerns about access to training:
Student > med school > GMC
Trainee > DME > PGDean > GMC
Im more than happy to consider genuine concerns
Government and the medical profession has allowed doctors’ pay to fail to keep up with inflation for the last 10 years.
Now we’re asking for this to be rectified.
It’s not a request for a pay rise.
@TheBMA
@BMA_JuniorDocs
Am I alone in thinking it is wrong for consultants to strike? Nurses, paramedics, junior doctors, yes, they are just ‘workers’ but consultants are senior leaders, just like senior managers. They demean themselves by striking.
*Breaking news*: confirmation from
@gmcuk
that doctors who complete CESR-CP will from now on receive a CCT.
JDC have long been lobbying for increased flexibility; this represents a step forward in recognising alternative training routes, and valuing an individual's experience.
The main reason I currently plan on avoiding inpatient psychiatry as a career is because ward staff genuinely believe that people suffering with emotionally unstable personality disorder are ‘manipulative’.
Simplistic twaddle.
@estherbeadle
@wendyburn
@DrKateLovett
“Striking off a doctor who has an unblemished record and who was clearly in an under-resourced and unsafe situation will set a dangerous precedent.”
@drcmday
@54kdoctors
#BawaGarba
@techpriest
I asked why I was allowed to wear it on my hand, as to me that’s more likely to be a risk. Got told I shouldn’t be questioning these to things. My registrar turned around and told them ‘it was for religious reasons’ and asked them to leave. They did.
Really pleased today. Appointed as the Deputy LNC Chair at
@NottsHealthcare
. Will be particularly focussing on improving the working lives of junior doctors in the Trust, including rostering, fatigue, facilities and the new contract changes.
@BMA_JuniorDocs
@KiaraVin1
@EMrJDC
@Doctors_Vote
@ELHT_CEO
Hi, we're aware of the form and looking to assess its content. Professional standards are important to us and expected from all our colleagues. We’re committed to continuing the work with our doctors, to ensure those levels are met.
@AliJaneMoore
I’m a Guardian of Safe Working Hours. This is unacceptable. Payment of ‘overtime’ isn’t sufficient either. Contractually, this is a fine, payment to the doctor, and immediate compensatory rest.
Private school debate once more on the
@two_medics
pod this morning. Just to say it’s not hypocritical to criticise something you’ve benefitted from. Perhaps adds more validity to your view.
Good response re: Physician Associates from
@rcpsych
- they are not doctor replacements and the
@rcpsychTrainees
committee will lead on a review of their role to support psychiatry MDTs.
LTFT should simply be available to all. Flexible working isn’t a new craze - the ‘want’ for it has been around for years. I’d happily do 80% if the option was available - would totally negate the risk of burnout.
TPDs everywhere: if you make LTFT training posts more flexible your recruitment challenges may disappear... talented trainees dropping out of training to do stuff like humanitarian work.
@wgcs_health
@Juliemrog
- we could fix this in Wales..!
@Medic_Russell
I wonder how trans people have received this? My immediate thought was why can’t it be ‘people with vaginas’, but is that just my unconscious bias coming out? ‘Bodies with vaginas’ made it sound like they’re cadavers…!
@sallyvale14
@juniordrblog
@DrAdrianHarrop
That’s not to do with the
#NHS
. That’s to do with the law - a child has legal rights of their own, independent to that of their parents. Hence the involvement of the Courts in this case.
@AgnesAyton
@gmcuk
Yet this official graphic from RCPsych is basically saying PAs can come in and sort all physical health issues out. It’s so insulting to psychiatrists, rotational junior doctors in psychiatry and patients.
@silv24
It may be prestigious but they’ve always been after the likes.
Also they probably wanted to be inclusive of trans and non-binary people. It’s ended up being just creepy…
I think a lot of us ‘seniors’ need to realise that just because we got through ridiculous hours that were usually not remunerated, it doesn’t mean this was fine (or that we were fine).
@techpriest
Being a dr means working hard. As an F1 I regularly left between 6-7. Didn’t moan cos that’s what the job is. It’s tough. It means putting your patients first.
Only 18 months late. Finally going to my MRCPsych graduation. Looking forward to meeting Twitter folk in real life...!
@DrKateLovett
@wendyburn
et al...😝
@rcpsych
@SameiHuda
@joannamoncrieff
Purporting to have had ‘my sights on lithium for a long time’ is riddled with bias and an a priori hypothesis. Any objectivity is lost, the scientific method goes out the window, and all you’re left with is ideology and the perpetual search for one’s own confirmation bias.
Finally attending an
#RCPsychIC
. Has only taken me 6 years into being a doctor...! Really looking forward to the great programme. I’ll also be helping on
@FMLM_UK
’s stand - they’ve done loads for my leadership and management development, and the specialty has always supported me.
@wendyburn
@drraja_
On a home visit follow up to a patient with dementia some years ago, I asked if she could remember me. With the answer being no I explained I was the doctor looking after her memory.
Long pause.
Patient to me with a grin: “you’re not doing a very good job are you...!”
🤷🏽♂️😁😆😂
@Cal2bmrs
@juniordrblog
The Courts were asked to deem what was in the best interests of the child, and they agreed that ventilation should be stopped. Palliative care comes afterwards and the hope is a plan will be agreed with the parents.
@DrTobyGilbert
@ACEMcCormack
Pabrinex is the only UK parenteral preparation. Oral thiamine cannot replenish depleted states (and therefore not treat Wernicke’s).
.
@MattHancock
needs to do something about this ASAP.
It’s a joke.
Consultants are having to pay for the pleasure of working, and the only way to avoid this is to work LESS. This means the service the NHS provides WILL get worse. 🤦🏾♂️
Here is the judgement from
#BawaGarba
and the request to appeal.
I have little knowledge in this area of law, but it reads to me that systemic factors were ignored, an expert witness threw her under the bus and her consultant abdicated his duty.
A bunch of anti-psychiatry stuff is appearing on my Twitter feed, seemingly coming from psychologists.
Who are these people? I work with and know several clin psychs and academic psychologists - none of them are like this...
@techpriest
Really felt supported by the registrar. But also a shame that line had to be resorted to. Afterwards I looked this stuff up and saw the whole thing was nonsense. This was local protocol followed like a prophecy, rather than an evidence-based one. Hopefully they’ve changed.
Robert Francis called for regulation of non-clinical hospital managers c. 10 years ago following the Mid Staffs scandal.
We got the watered down Fit and Proper Persons Test.
Surely the
#LucyLetby
horror will have to bring this in…?
Oh look. Consultants think less of our SAS colleagues. What a surprise. Everyone knows this. This just puts it in black and white. This is a problem across the medical profession, not just psychiatry…
Today we published an independent analysis of the member feedback given to our consultation on the two proposals being put forward at our EGM on 8 September 2022.
READ MORE HERE ⬇️
@CardiffFeminist
@OrthopodReg
Plenty of others have already pointed out this - one hypothesis is that you are actually the problem, and with every doubling-down response you give that explanation becomes more and more likely.