The Rolo Crisps of Gravy Pancakes (RCGP). No parody. "Vitriolic" & "Pathetic". Biting the hand that feeds it. Spelling poor. Parody RCGP Chocolate fellow (wink)
3/4
I want a strong college. I...we want things to be better. This is a photo of the phone box outside. The contrast between the two are the divide between coal face General Practice and where the College is.
Pull us up. Please.
When the Surgical team think you are a piece of shit GP and reject your acute referral and say send to the medics and you tell them that you are married to the Surgical Consultant who is on call today so will discuss it with them directly.
Pt has a cough for 60 minutes and calls GP.
GP advises self-care.
Pt calls 111 five minutes after this. They advise review within 2 hours with GP.
GP calls and gives same advice for self-care.
Complaint lands with GP.
Pt is fine.
And we wonder why no one wants to be a GP.
Hey Hospital Chief Executives, this is what we expect to see in all Doctors Messeses from Tuesday, especially Barts.
Amazon say they can deliver this Tuesday. Your move.
Medical school being cut from 5 to 4 years is wild.
Like are they just going to leave massive chunks out?
Have they decided that we need to know less?
Or that there is less to cover or less to learn?
Why not 3 years or 12 weeks?
Explain this to me like I’m 5 years old.
"One of things we've put forward.. self referrals so individuals dont have to go to a dr in order to get referred to specialist help.. if youve got internal bleeding & you just need a test there ought to be a way that doesn't involve going to see a GP"
Keir Starmer on
#BBCLauraK
How much is your life worth if you are a junior doctor?
41 minutes. That's how long it takes to replace you.
41 minutes.
My heart goes out to those affected by this tragedy.
Reposted upon reflection and have blurred out semi identifiable info. We can do better than this.
Please do not name the trust if you saw my previous tweet. Have contacted the trust in question.
This hit me hard.
I am so sorry to the Junior Doctors that we have let down by not calling for this sooner.
I am sorry to my children and parents who if they stay in this country will likely have a poorer health service.
I am sorry to the public for not shouting louder.
If you try and book a ticket for an Ed Sheeran concert and there are no tickets left, do you assume that he is sitting by himself in an empty stadium building lego and counting his money?
@DrNeenaJha
@EmergMedDr
Sorry Neena but my personal experience is that my GP surgery has been effectively closed for 18 months. Cannot get to see a GP in person and if you’re lucky enough to get through on the phone the receptionist invariably says “There are no appointments available. Ring 111”. ☹️
GMTV complaining that it takes 10 days to get an appointment at the GP surgery.
No mention that it takes one year plus to see a specialist, sometimes two.
You know what, scrap us all! Let’s see how long it takes for them to realise.
Wow. Lots of people revealing what they think about Pharmacists.
For the record Pharmacists are ducking excellent. They are a vital part of primary care and would do a lot better at antibiotics than all those cardigan GPs.
Remember when the Chair of the RCGP wrote a letter stating how SAS doctors should not enter GP surgeries?
And we didn't know their conflicts of interests at that stage.
....and yet we have the College fully supporting PAs.
I can smell the shit from all the way down here.
A few weeks ago I took a cheap shot
@drclairetaylor
with regards to GPs considering PEs for patients with long COVID.
I have now picked up 2 PEs on the back of that exchange. I wanted to apologise formally to her. Thank you for educating me.
It was an open goal…they just had to tap the ball in to secure the next election.
But they have decided to fuck things up.
This is the age of mediocrity when it comes to politicians.
It was an open goal. They just had to tap the ball in.
History will remember the Royal Colleges & the BMA for sorting out the PA issue.
And that's okay.
I will remember
@Dr_Done_
@Xeon4f145d96s1
and a few others who have possibly had more positive impact on patient safety than anyone else I know.
The Cardiologist has criticised us for referring a patient to the rapid access chest pain clinic as they felt they needed to be seen sooner. Ends up that it was the Cardiologist asked the GP to do the referral to RACPC after seeing them in ED.
My response will be delicious.
GP surgery in Cornwall desperate for GP next wk. Contacted by locum agency agreed to shift but one mention of my name….this was response…cowards. No conversation. Cancel culture at its finest! Rather no dr than me. Hows that for patient safety!
Asking the questions that someone should?
Why do politicians keep banging on about training more doctors and completely ignore Retention.
What is the political cost with addressing retention? Wouldn't it be cheaper, and quicker. What am I missing?
Referral rejected today as we hadn't put the age of the patient.
It took them 4 weeks to reject it.
The DOB, address, Phone number, email, NHS number, and post code was on the form.
There is no box to put age.
Don't you dare say LMC. Don't.
Why do the public blame GPs if they can't get a GP appointment but do not blame hospital consultants when they can't get a specialist appointment?
Is the public right? What did GPs do to deserve such direct criticism? What can we do to communicate the situation?
I bet you a Twix that if I tried to book a conference at the RCGP I would be blocked.
Shall we find out? Who is up for a
@Parody_RCGP
conference at the RCGP?
Hit the Like button if you are up for it?
Why is Labour not laying the blame against the party that has been in power for 12 years. Instead they are going after GPs who are one of the few that are over performing with less funding and fewer GPs.
The goal was wide open. They just had to tap the ball in.
An observation...
Consultant clinic - nurse/HCA to help do obs first.
Dentist - dental nurse to assist.
Optician - assistant to do preliminary Ix.
ED/MAU - team to do obs.
GP - GP to kindly do it all themselves in under 10 mins.
I am taking a break.
The shit is hitting the fan in General Practice right now.
50% down to workdumps from secondary care. 30% down to a historic lack of supporting General Practice from "leaders".
I have to save my practice first before trying to save the rest of you.
Dear Hospital team,
If you are going to tell patients that it's the GPs fault that they are waiting so long as we only marked the referral as routine you know what will happen?
Every referral from now on is ....
For the record GPs can’t charge for private referral letters.
They can charge if specific forms need to be completed (I am looking at you vitality).
Also you think £20 is lucrative? That doesn’t even cover the time taken to do the work.
@carolvorders
@Conservatives
I've just had my 5th out of 6th GP appointment cancelled. A receptionist has decided, wrongly, who I should be seeing. But yet these GP's say they are overworked??
@_SandraWindsor
@Somerstown4
@AllisonPearson
Except the royal college of emergency medicine has repeatedly said that this is bullshit.
But we will believe you Sandra. Cause you clearly know what’s doing on.
Be a GP they said. It's one of the hardest jobs in medicine they said. You will be valued they said.
The
@rcgp
are meanwhile getting sponsorship from PAs who are actively advertising a model of replacing GPs.
Email from a GP Locum agency to locum GPs....
#oneteam
#help
Just a reminder that it would have cost less to simply employ GPs to see undifferentiated patients than the cost of using PAs. And that’s before you factor in pay outs for negligence claims.
Let that sink in.
@rcgp
Shaking right now!
The PA debate in the House of Lords-
@JimBethell
said:
“We have to find people from somewhere (to do GP appointments) & they’re going to be some people (Physician Associates) that don’t necessarily go through the 10 years of qualification TO BECOME A GP”
🚨
Imagine being so confident in your own misogny to think that this was acceptable to think, then write, and then send.
Imagine this being the thing that your patients and colleagues will remember you for.
Prick.
If you are a hosp doc whose department has a +12 month wait don’t come on twitter and bitch about how you can’t get a GP appt.
Have some ducking insight.
@NHSE_WTE
Or perhaps you could be less shit and do what you were setup to do.
This is happening on your watch....and it will be you and your family that will struggle with getting care.
Take a look in the mirror, and know that you have failed generations.
Someone at work today asked me if I had heard of the twitter Parody RCGP account. Of course I played dumb.
As soon as I got back to my room I shed a little tear.
Is this going to be the best thing I have done professionally? Probably.
And I can’t even share it with my mum.
The Chair of the RCGP has developed a PA course at a Uni.
Did I know? Yes around a week.
Is it concerning? Yes.
What does it mean? In the land of no accountability from leaders probably nothing.
One of the biggest
#anonsrazor
to date.
@Dr_Done_
@Xeon4f145d96s1
I’d like to thank me for working hard on this. Me, for deserving this and finally me for being the best at this.
Also to my LMC and the GPC rep who told me that I don’t understand how general practice works… go duck yourself.
Thank you to all who vote in Medical personality of the year 2022, but there was one clear winner.
Congratulations
@parody_RCGP
for being voted
#MPOTY22
by the
#Twitterverse
after over 500 votes!
See below for our mega runner up
BREAKING:
Footage of a GP jumping through some of the hoops to try and refer a patient to CAMHS.
Sadly the referral was rejected by a nameless bod with "does not meet the threshold for referral".
Don't tell me LMCs are effective.
Don't tell me that the Royal College are working hard.
Don't tell me that the BMA are doing good work.
Don't tell me that secondary care is pushed and stretched and we need to work together.
Stop with all your virtue signalling. It's shit.
Pt due to see specialist for an ongoing problem. Appt cancelled on day of appt.
Pt unhappy so told to call PALS.
PALS say to speak to the GP as they should be able to sort the problem.
We say we can't.
Patient formally puts a complaint in against the GP.
They didn’t reply when they were being racist ducks.
They didn’t over the promise of a laptop.
They haven’t in so many cases despite the entire profession calling them out.
But when it’s about a PA they will reply to an anon account.
@Dr_Done_
This case was first considered by a medical practitioners tribunal in 2017. It involved a series of concerns raised by three patients. Subsequent reviews took place in 2018 and 2019 - you can read how each of the three determinations were reached on the doctor’s record on the…
Hey Team,
I am getting ready to logoff for the festive period. I started this account as the RCGP was tone deaf.
I was told by LMC that I didn't understand General Practice and I suspect due to systemic racism my real voice was marginalised.
1.3 million impressions
Bite me.
Specialists KINDLY publish guidance telling GPs to manage Potassium’s of 6.4 in the community.
Duck no. General practice is not an urgent medical service to manage this.
Did anyone actually speak to a GP about this?
KINDLY.
1️⃣
Key thing in this flowchart = a well outpatient without AKI who has potassium 6.3mmol/L on routine bloods can be managed as an outpatient
(yes they need prompt review, repeat bloods and some thought - but what they don’t need is a repeat test in ED at 3am)
Telephone Triage at every GP Surgery this morning:
Do a PCR test. PCR test. No, not a lateral flow test. A PCR test. PCR test. PCR test PCR test....no lateral flow tests don't count.
P C R Test.
This was in my DM
An epileptic pt sees the GP as wishes to be referred back to the Neurologist for consideration of coming off meds. Referral made.
Referral rejected. Neurologist states that they will only see if the patient wishes to discuss withdrawing from meds.
Letter from consultant.
I was seeing this patient about condition X but his main problem is condition Y which has nothing to do with me.
However I have examined him and organised some investigations and referred him to the right team.
The Consultants husband is a GP.
I received a complaint for my attitude recently.
Apparently, replying to a letter back to a consultant with “Consultant to kindly organise their own onward referral” is rude.
All laws should be passed within 14 days. I am on the side of hard working people.
If you have an urgent constituent need, you should be seen the same day by your MP.
"Yesterday I cried at work.
I'm a 35 year old highly respected GP with multiple glowing patient feedback.
I had lunch at 1520, and left work at 1915.
I'm not sure when I will return".
Another message from a colleague. They have given permission for us to post it.
#GPCrisis
This is a tweet from a locum PA firm who are sponsoring the 2023 RCGP Annual conference.
It is terrifying.
Perhaps they could find the time to find a place for locum GPs, and salaried GPs and well GPs as a whole?
My last PDP had a bit about using social media to improve the visibility of primary care issues.
My new appraiser thinks that I haven’t achieved this.
Could you retweet/like if you think that he is wrong.
Come on GPs, do you really think this?
Or is this someone at your surgery who thinks that someone with 2 years experience could do what you do?
If so, what kind of circus are you running?
If you don't respect yourself, how can you expect others to?
Patient referred to Hospital department by GP.
Patient doesn't want to see the Consultant they have been allocated. Told to ask for another referral by the GP.
What shall I tell my kids this evening as to why I am late coming home
@NHSEngland
tonight?
Update: look who else is sponsoring the RCGP conference?
You can’t make this shit up.
The company associated with disgraced ex President of PAs (the one who didn’t disclose COI).
It’s like the Oncologists getting Benson and Hedges to sponsor them.
#oneteam
Guess who appears to be a sponsor of the 2023 RCGP Annual conference? Yep
The same company who suggest that surgeries should hire PAs rather than....checks notes....actual GPs.
Further info on LocumPA
Well ducking done NHS England you have enabled this. As we all predicted you have once again done us in. We expect this from politicians but from you…it’s pathetic.
Who will look after you and your relatives when we are all gone?
Meanwhile GPs dust off exit plans.
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
Hey secondary care,
Over the coming weeks and months you are going to find that General Practice is a little more salty. Spikey.
The cardigans are coming off and we are not going to be your plebs anymore. It's not personal this is survival.
Hard truths: 5-10% of patients seen by doctors in NHS suffer adverse events. Risks higher: emergency care, overstretched services, rural areas, people like myself (those trained abroad, working in rural or deprived areas). For PAs vs doctors ? I am not aware of comparative data.
Did you know that some GPs fear liking posts from this account as they don't want to end up in trouble from other GPs. (They have messaged me to tell me).
What have we come too when GPs are worried about this kind of backlash? How can we ever grow as a profession?
GPs do around 10,000 consultations a year. But it's the one or two consultations that we keep ruminating about. It's what keeps us awake.
Twitter is no different. I am taking a break folks. See you soon.
Imagine it this way....A major hospital trust has been told not to discharge IPs until the GP has reviewed the discharge summary and agreed. This is to ensure that there is no work dumping and that the patient has been given appropriate treatment and follow up arrangements.
Why I love primary care. My morning so far...
Mental Health
Mental Health
Mental Health
Mental Health
Supraventricular Tachycardia
Mental Health
Mental Health
A GP associate in training is a Doctor (5 yr med degree) who has complete foundation training (2 yrs) as a doctor and is training to be a GP (3 years).
A Physician Assistant is someone who has simply completed a 2 year degree.
Which sounds more senior? Will the public know?
Hosp secretary tells patient to ring the GP to write an expedite letter for a hosp procedure.
We respond saying that the secretary should write to us outlining the need for us to write a letter to them.
Consultant now demanding a call back saying that we are being ridiculous.
Guess who appears to be a sponsor of the 2023 RCGP Annual conference? Yep
The same company who suggest that surgeries should hire PAs rather than....checks notes....actual GPs.
Further info on LocumPA
"PAs aren't here to replace Drs"
Anyone want to tell that to one of the main sponsors of
@RCPhysicians
and
@FPARCP
, "Locum PA LTD" who on their case study page outline reducing expensive GPs by replacing them with PAs?
Yr 1 Consultant will make £99,532 FT
Salaried GP £78,541 FT (BMA recommendation)
6 sessions is actually FT so actually £52,234.
Is a GP worth half a hospital consultant? (and that's without CEAs)
This is not okay right....BMA?
Where is seniority?
@msteggy
@DAUK_GP
@BMA_GP
A PA should not have the power to decline a GP referral.
To be honest we just send a letter and send them to ED. Our local hospital hasn’t picked up the phone to accept referrals in around 5 years.
The future of the NHS isn’t just scary for patients, but doctors too.
Always check you’re speaking to another doctor, or you’ll be responsible & thrown under the bus.
This is from a GP surgery in my constituency, and makes the point more eloquently than I ever can in the House of Commons - that without a workforce plan the
@NHSuk
will never turn the corner…
When there are no mental health services, zero capacity left in general practice, community services closed and patients are struggling to buy food this is what we should be doing?
Tell me you are not a front line GP without telling me you are not a front line GP.
BMA Election results. Here is who I recognise from the list who I see as good eggs. Apologies if I have missed anyone off.
Congrats to:
Selvaseelan Selvarajah
@DrSelvarajah
Shan
@DrShanHussain
Paul Evans
David Wrigley
Gaurav Gupta
@drguptagaurav
Emma Runswick
I call Dr Lung again and after giving him the patients full career and travel histoy and the family medical histories of his 6 house mates and the pet names of his recent sexual partners, plus the wing spans of his pet parrots and pigeons,
It's interesting that others from the same Department agrees with this GMC bullying approach. (They have liked this post).
If this doesn't tell you about a toxic environment, I don't know what else to tell you.
@uklee
@D__Melb
@EmergMedDr
If you can't get tickets to see Taylor Swift immediately do you assume she is sitting around in an empty stadium checking out Instagram?
If they don’t pick up in the time I’ve done my letter then they go to ED.
Can you imagine a consultant being delayed on a ward round for twenty minutes cause the GP wasn’t accepting a discharge.
This is the hospitals issue to fix.
Parody Top Tip
Are you a GP Registrar or new GP?
You are ducked.
Are you in the middle of your career as a GP?
You are ducked.
Are you at the end of your career and have a role at NHS England or the RCGP or BMA?
You will be fine. Drink the wine! Pull that ladder.
@DrRaniKhatib
@Megsenmumdr
@hswapnil
@WYpartnership
@NHS_RobW
@DrJamesThomas1
Was it hidden in paragraphs of text?
Did you stipulate you have counselled the patient.
Warned about side effects?
Told them how to get in touch with you if any problems?
Set out duration and dose?
Clearly documented it in an agreed way?
If not then you are dumping.