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OwlFancier posted:Even if it means they call in a junior to come and have a go with your bollocks. You still feel better afterwards (and also don't die of cancer as much) I don't have bollocks, so I get to have medical equipment inserted in the nether regions every three years. Not as painful I imagine but still less fun than, well not going. Jose posted:pop it and see what happens imo It doesn't feel poppable, it was an ulcer for ages, then now there's a hard painless lump in the same place. I googled it and convinced myself I definitely had cancer, then googled it again and convinced myself I didn't and it was fine. Actually getting someone who doesn't just rely on google would probably be sensible.
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Feb 1, 2016 22:33
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Gonzo McFee posted:Go to the Doctor. I guess, I mean he'll find some whatzit to splunge into your lump's polarity flow after about forty minutes or so but you'll have to do a lot of running down corridors first
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Feb 1, 2016 22:34
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Go. To. The. Doctor. Edit: Not the poo poo one on BBC.
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Feb 1, 2016 22:35
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My feet are wet, should I dig down? I think I'll dig down.
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Feb 1, 2016 22:36
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hookerbot 5000 posted:Actually getting someone who doesn't just rely on google would probably be sensible. Just adding to the chorus: please go!  Edit: vv Amen to that brother. Just having a cotton bud shoved up there for an STD test was quite enough for me. Prince John fucked around with this message at 22:38 on Feb 1, 2016 |
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Feb 1, 2016 22:36
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Medical equipment up the nether regions I can give or take, but having a tube shoved backwards up your piss pipe is not a fun experience. Especially not when the reason you're having it done is because the piss pipe is scarring itself closed. E: If not the doctor then the dentist, they can do an oral xray.
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Feb 1, 2016 22:36
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Feel like throwing my 2 pence worth in. I'm a GP in a pretty busy semi-rural practice. We have a lot of very deprived patients and a smaller number of affluent patients. The number one complaint that we get is over appointments. Its almost impossible to sort to everyone's satisfaction but we try and every few years a new system is tried out. For most ailments 2-3 weeks is medically entirely acceptable. For more urgent problemswe will see you the same day, either a doctor or an advanced nurse practioner as appropriate. There is, of course, the matter of what is and isn't urgent is a source of disruption. For most people we can agree an urgency for others there is a disagreement and then we need to reach an agreement. Believe it or not I spent 20 minutes on Friday afternoon trying to convince a lovely old lady with chest pains and a recent heart attack to go to A+E while she complained about an appointment for her longstanding and stable arthritis (I'm seeing her in a couple of days for the arthritis, I am not saying it isn't a serious problem for her but compared to another heart attack it slips down the priority list). Ultimately problem, though, is volume. To give you an idea of scale we can have upwards of a hundred patient contacts a day split between one morning doctor and an afternoon doctor. Plus the messages, requests and queries we get that aren't logged. Its exhausting but its better than the previous system (slightly), though I don't know how sustainable it is. Education is a lot of the cause for this. People asking for antibiotics for colds to get over them before they go away was a big theme over the Summer but our patient population has become deskilled in self care for minor illnesses. There are some really troubling public health campaigns which aren't helping, especially the local radio campaign which encouraged everyone over 65 to see a doctor if they had a cold. Another part is financial, a lot of our patients are unemployed or in very low income occupations, this group tends to have a higher burden of co-morbidity and as they qualify for free prescriptions will ask for over-the-counter medications on prescription as its cheaper. This isn't a judgement, its simply factual and entirely understandable (some of our patients are pennies on the right side of a crippling debt spiral each week) but does have a big impact on workload. There are a lot of practices worse off than us. We are slightly under-doctored workforce wise and consequently everyone is working more than their contract clinically and staying after to check results, process prescription requests, patient's correspondence etc. In some practices they are so short they rely on locums and other contracted doctors who have strictly contracted sessions which leaves only one or two GPs to do all this work. I'm not trying to make excuses. Its a constant source of frustration that people struggle with access but there's not an ideal solution. At the moment we are trying systems, trying to educate patients and soaking the workload ourselves but we cannot sustain the latter much longer. We get fantastic support from out patients and that's what its all about. I won't bore you with my stories of lovely families and people but 99% of our patients are pretty great and of the other 1% I'd say half of them are the same unless we catch them on a bad day. I think why I made this post is because there is so much misinformation and half-truth floating around that its really important to be open and honest and share some of our perspective. We don't always get it right. We miss things, we are slow diagnosing things and I know when I'm tired I can get grumpy on the phone. Most of the time I like to think we get things generally right and every so often we do something to make someone's life better. The only way we can do what we do is openly (within the limits of confidentiality) and honestly.
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Feb 1, 2016 22:38
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If you could ask for anything to help with your work, what would it be?
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Feb 1, 2016 22:43
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EdBlackadder posted:GP experiences This is a good post and thanks for making it. e: and the whole saving people's lives thing, that's cool too Party Boat fucked around with this message at 22:49 on Feb 1, 2016 |
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Feb 1, 2016 22:44
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You're a good lad, Tone.
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Feb 1, 2016 22:47
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Party Boat posted:This is a good post and thanks for making it. OwlFancier posted:If you could ask for anything to help with your work, what would it be?
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Feb 1, 2016 22:51
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Sorry I should have said thank you also, doctors are probably the best thing about this country so thankyou for everything you do. When you say educating people on self care, what sort of things do you have in mind? You mentioned people were becoming deskilled in self care for some conditions, I'm curious what that means.
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Feb 1, 2016 22:54
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Well I know what the next book I buy is going to be http://www.lulu.com/shop/jason-unruhe/a-marxist-analysis-of-stalker/paperback/product-22465664.html
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Feb 1, 2016 22:55
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EdBlackadder posted:Cheers man can you give us some common examples of where people need eduction about self-care?
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Feb 1, 2016 23:00
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Renaissance Robot posted:Rules are overrated I thought the original argument was about antibiotics, my bad. We need a system which can cope with 'unnecessary' visits - if we have enough GPs, it's not a problem for their time to be taken up with hypochondriacs. But at the same time, we need to educate children about what does and doesn't require a visit to a GP, so that when they become adults they have good judgement about it, and know what they can handle at home versus what they can go to a chemist for an OTC treatment for versus what needs a GP versus what needs minor injuries versus what needs A&E versus an ambulance. We also need good, well-resourced, knowledgeable clinical advice services pre-GP, and telephone and internet GP appointments, and all manner of other things that a modern, well-resourced NHS could do. But it comes back again to those two things: a properly resourced service, and good education. Neither of which our current government has any loving interest whatsoever in providing. EdBlackadder posted:Good Words
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Feb 1, 2016 23:00
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So apparently this Saturday is a "day of action" for MRAs all over the country, organised by "ROOSH" or whatever the gently caress his name is.Listing here. Maybe the fine denizens of this thread would want to join others in greeting these foul people as they reveal themselves to the world from behind their keyboards...
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Feb 1, 2016 23:03
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ForeverBWFC posted:So apparently this Saturday is a "day of action" for MRAs all over the country, organised by "ROOSH" or whatever the gently caress his name is.Listing here. Maybe the fine denizens of this thread would want to join others in greeting these foul people as they reveal themselves to the world from behind their keyboards... If anyone asks you where the pet shop is, lamp them in the loving face. Got it.
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Feb 1, 2016 23:09
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Are You A Heterosexual Man With Standards? Join 40,000 other men on my free email newsletter and learn how to meet women. Articles include: 7 Tips For First Dates That Lead To Sex, How To Tease A Girl, How To Handle Flakey Girls, and a whole lot more. Enter your first name and email below...
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Feb 1, 2016 23:13
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fuckng lol Black Guys Game March 25, 2008 Game Roosh There are two kinds of black guys: the urban / hip-hop kind that is heavy on the slang and mimics stylings they see in rap music videos, and college-educated black guys whose style is a mix of urban and suburban mall-strip culture. I’m not impressed with the game of the former. Over 50% of the time, I notice their opener is “Hey *slang identifier*, you got a man?” If you are a single girl that has no information about this guy besides his appearance and common line, why would you say no? He’s giving you an out and the whole interaction that follows is usually him trying to convince the girl to put the man aside and give him a chance. Direct game does have its uses, but the boyfriend question puts you at a huge disadvantage as soon as you open your mouth. It would be like calling the cops and telling them which bank you are going to rob right before you rob it. Why make it harder for yourself? I’m confident there is a whole generation of black men growing up that is used to the fact that 99% of all women have a boyfriend.
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Feb 1, 2016 23:15
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I didn't know roosh was UK based.
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Feb 1, 2016 23:16
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Read Next: How being around women is making men more like women, but only because feminism, and agriculture, or something, but you should hang around a lot of women anyway, to get laid, but you must retreat to your secure manosphere to avoid becoming a flamboyant homosexual and getting married in the butt. e: ^^^ He isn't afaik, but he's traveling to the UK to one of the events. But won't say which one.
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Feb 1, 2016 23:17
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OwlFancier posted:Sorry I should have said thank you also, doctors are probably the best thing about this country so thankyou for everything you do. I was the emergency doctor, for lack of a better term, on Friday afternoon. It was reasonably quiet for a change but about half of the patients I had contact with had mild viral illnesses (cold, sore throats, coughs, diarrhoea) for 1-3 days without any fever or really feeling very unwell in themselves. They all wanted 'to get checked out' and I spent the bulk of my time explaining how long these illnesses last and what to look out for in a more serious illness (simple things like a fever or not gettiing better, mostly). Another 3 were parents of babies and toddlers with temperatures and runny noses, well in themselves and still feeding. I generally see those regardless and spend some time discussing what to look out for and how long they last but there is usually a couple of parents ringing up every couple of days when they haven't got any better (or usually any worse). (The flipside is there are people who still, despite the FAST radio/TV/poster campaign who ring up and say 'I think I'm having a stroke', book an appointment in a couple of days when they start getting chest pains or pass visible blood in their urine and book an appointment in a fortnight. For the record those are all things that need acting on sooner than that. Generally our reception team are good at an initial triage but they aren't clinicians and they don't know what to expect.) There are people who 'don't like to bother the doctor' who can present late and there are people who come with every minor illness. There's a middle ground where people can look after a cold, a diarrhoeal illness or a minor injury and a lot of our patients seem to have lost those skills. Or perhaps its more appropriate to say that those patients see us more rarely. In any situation the contact statistics for the practice over its 80 odd year history have shown a growing number of patient contacts, especially for urgent appointments and our audit shows a high proportion of these are generated by these minor illnesses. Our patient population hasn't grown enough to account for this so the conclusion has been drawn that part of our increased workload has been the loss of these self care skills for whatever reason (personally communication has only relatively recently been something that the medical profession has valued and I think some of this is going to be due to us failing to pass information on to people). It may be erroneous but its something that we can work with our patients (individually and as a wider profession) to improve. Edit: The antibiotic issue is a big one and the post above about educating people on what does and doesn't need antibiotics is spot on. The medical and nursing professions have been hammering this for over a decade internally to varying degrees and us newer guys (I finished by speciality training in August) are more conscious of the issue but there is a long way still to go. I don't disparage my colleagues but some (doctors and prescribing nurses) are higher prescribers than others and looking at the notes not always strictly within guidelines. Of course the guidelines are not the be all the end all but they are a good standard to stick by (though they lag behind the evidence). I am a big believer in reassessing situations as they change (and sometimes delayed antibiotic prescription) but with the difficulties with workload sometimes it can be difficult. The Royal College of General Practioners is running a big campaign on this at the moment. Right now I have an antibiotic prescribing pledge up on my wall, a practice down the road has a phone message and several others nearby have both or none of these as [art of a large national study on how these will affect antibiotic prescribing. EdBlackadder fucked around with this message at 23:37 on Feb 1, 2016 |
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Feb 1, 2016 23:20
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Guavanaut posted:Read Next: How being around women is making men more like women, but only because feminism, and agriculture, or something, but you should hang around a lot of women anyway, to get laid, but you must retreat to your secure manosphere to avoid becoming a flamboyant homosexual and getting married in the butt. I hope it's the Leeds one, I'll be up round that way Saturday aft. Might take the wife along and start 'game' on the ones with the stupidest hats while she laughs.
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Feb 1, 2016 23:27
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Tesseraction posted:No I've had to severely cut back on my drinking since 150-170 units / week was technically killing me. Also literally killing me. Were you REALLY drinking that much in a week?? In a really heavy weekend, I might get through 50 units and I regret it for days afterwards. I'm actually drinking a lot less now, 'cos I got a Fitbit and was taken aback to discover that a single night of heavy drinking would mess up my resting heart rate for a week afterwards. Perhaps I'm just getting old.
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Feb 1, 2016 23:28
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EdBlackadder posted:Yesss more medical posters Do you think part of this is down to a belief (accurate or otherwise) that it takes a long time to get an appointment, so if you need to be seen soonish you need to specify it's 'urgent'? As opposed to, I don't know, wanting to see the doctor sometime for some advice or a checkup, where waiting weeks isn't a big deal I assume a lot of people who show up with minor ailments just don't realise they're not things they need to see a doctor about, so it makes sense that they wouldn't want to wait too long - maybe 'urgent' is just the new normal?
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Feb 1, 2016 23:30
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OwlFancier posted:I didn't know roosh was UK based. he travels around the world being creepy, got banned from a few countries IIRC anyone who manages to wound his pride (drenching him in piss scores triple) has a drink of their choice on me
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Feb 1, 2016 23:36
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Renaissance Robot posted:My feet are wet, should I dig down? That reminded me of the following. quote:OP: "Help! HELP! I'm stuck in a well!!!"
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Feb 1, 2016 23:38
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Pistol_Pete posted:Were you REALLY drinking that much in a week?? In a really heavy weekend, I might get through 50 units and I regret it for days afterwards. Yeah, two 24-packs of 500ml @ 5% + 3-5 trips to the pub where I had at least 2 pints. It's not good for you but I won't pretend I wasn't enjoying the permahaze.
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Feb 1, 2016 23:38
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My wallet's enjoying my change of tac.
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Feb 1, 2016 23:39
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It's all about the military grade hard drugs.
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Feb 1, 2016 23:42
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ForeverBWFC posted:So apparently this Saturday is a "day of action" for MRAs all over the country, organised by "ROOSH" or whatever the gently caress his name is.Listing here. Maybe the fine denizens of this thread would want to join others in greeting these foul people as they reveal themselves to the world from behind their keyboards... Some of those listings have got to be made up to make it look like a bigger deal than a bunch of dickheads hanging out in a park at night surely? I mean, obviously Iran and the UAE are seething hotbeds of radical feminism, but Nepal?
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Feb 1, 2016 23:42
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Tsietisin posted:That reminded me of the following. 
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Feb 1, 2016 23:42
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ForeverBWFC posted:So apparently this Saturday is a "day of action" for MRAs all over the country, organised by "ROOSH" or whatever the gently caress his name is.Listing here. Maybe the fine denizens of this thread would want to join others in greeting these foul people as they reveal themselves to the world from behind their keyboards... do you not have better things to do? like admittedly this also holds true for fascists who turn up for this poo poo and such but how can people be arsed loving hell. i just don't get it. my weekends involve waking up, doing whatever basic stuff needs doing and maybe getting to the supermarket before its rammed and then playing games a bit and then sorting out what i'm doing for the rest of the day with friends or just playing more games
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Feb 1, 2016 23:46
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Tsietisin posted:It's all about the military grade hard drugs. The heaviest drug I've taken is an anti-biotic. For strep throat. Realtalk I've never even done the ganj.
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Feb 1, 2016 23:46
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Jose posted:do you not have better things to do? like admittedly this also holds true for fascists who turn up for this poo poo and such but how can people be arsed loving hell. i just don't get it. my weekends involve waking up, doing whatever basic stuff needs doing and maybe getting to the supermarket before its rammed and then playing games a bit and then sorting out what i'm doing for the rest of the day with friends or just playing more games How is it not entertaining to put your fist in a fascist's face?
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Feb 1, 2016 23:47
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Oh no, does Jose live behind... the gamergate?
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Feb 1, 2016 23:49
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not really no. i'm not a violent person and they're insignificant in the grand scheme of things and my time on this planet is short
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Feb 1, 2016 23:49
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JFairfax posted:Are You A Heterosexual Man With Standards? I would suggest signing every member of UKIP up but chances are good they'd welcome it or are already members.
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Feb 1, 2016 23:49
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Jose posted:not really no. i'm not a violent person and they're insignificant in the grand scheme of things and my time on this planet is short Some people are less lazy than we. Maybe now I've kicked a boozing habit I can start getting swole and join them. Or play video games. *strokes neckbeard*
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Feb 1, 2016 23:53
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baka kaba posted:Do you think part of this is down to a belief (accurate or otherwise) that it takes a long time to get an appointment, so if you need to be seen soonish you need to specify it's 'urgent'? As opposed to, I don't know, wanting to see the doctor sometime for some advice or a checkup, where waiting weeks isn't a big deal Yes and yes, basically. Our schedule for making doctor/nurse/nurse practioner appointments available to book is there are appoinments open from 4 weeks ahead (for your routine check ups etc), appointments in 2 working days (for things which need to be seen sooner but not right now), appointments the same day and a GP telephone triaging even more urgent issues (requests for home visits for urgent problems, really urgent medical problems and people wanting telephone advice rather than feeling they necessarily need to be seen) and seeing people in the next few hours when appropriate. There have been other things tried (like one week appointments) and I think this breakdown will change soonish as its not an unqualified success. People are clever. People also as a rule don't like to have things hanging over them and like to be seen when they decide they need to see someone, be that now or at a future time of their preference. People also get really pissed off when they are told to call back every day to get an appointment which is absolutely reasonable if you ask me. Some of the issues we're experiencing with our current system is exactly what you describe, people learn what to say and do to get put on the morning/afternoon callback list. Our receptionists are really caring, good people and are not clinicians so a small subset of our patients have learnt that if they cry down the phone the receptionists will jump them forward in the queue, for example. This will never change, people will learn any system and some systems encourage/reward certain behaviours and actions. We try and react and adapt which is really difficult. Before I started at the practice they tried a system called Stour which was based around same day telephone triage by a doctor for all appointments. The patient feedback was excellent but the working pattern and workload was unsustainable for the clinicians and it was scrapped before there were resignations. As a profession GPs have soaked up a lot of work from a lot of places without historically being very good at managing our workloads. This has to change and as unlike hospitals we can't discharge patients we need to look at other ways to do so. This reminds me of an anecdote. As a student I had a lecture from a surgeon where he showed us a list of half a dozen different ways to do an operation. His next opinion was that there were so many ways because they were all absolutely crap and as soon as there was a good way the others would stop being used. Every GP practice manages its appointments in a slightly different way because there isn't a really great system (and a few thousand people are inevitably more complex than a surgery). Sorry for another long post. I'm wordy and get more so when I'm tired.
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Feb 1, 2016 23:55
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