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Welcome News


MISSED OR DELAYED DIAGNOSES MOST COMMON IN MALPRACTICE


Welcome to your


REFLECTING on my time as a GP trainee I was always unsure about whether my referrals to secondary care were appropriate. This caused me endless worry at times with multiple discussions with my GP tutor. On page 4, I address the increasing scrutiny of referrals made by GPs and how to help ensure you refer safely and without worry. There is a lot to learn during


GP training. Two key elements of the MRCGP exam are learning logs and personal development plans, and on page 5, GP and author Dr Milan Mehta offers some tips to make the most of these tools. Another element in your professional development is revalidation, a process that all doctors must engage with. Find out more about what is expected of you on page 6. Rural GP Chris Duckham divides his time between treating patients in the far north of Scotland and serving up


inventive dishes in his restaurant. On page 10 he tells Adam Campbell about foraging for bog myrtle and caring for an ageing population. The RCGP’s new chair Dr


Maureen Baker knows how important strong leadership skills are for the next generation of UK GPs. On page 7 she talks about what makes a good leader and offers her views on the future of general practice. Headache is a key area of


special interest for general practice. On page 8, Dr David Kernick talks about his work as a GPwSI in headache and the career opportunities available. End of life care can be a challenging area for GPs and on page 12 Dr Niall Cameron considers some key ethical arguments in the debate over assisted suicide.


• Dr Peter Livingstone Editor


MISSED or delayed diagnoses account for a significant percentage of malpractice claims in primary care according to a systematic review of studies conducted across five countries and published recently in BMJ Open. Researchers in Dublin reviewed 34 studies of malpractice claims in primary care identified in a systematic literature search, including 15 based in the USA, nine in the UK, seven in Australia, one in Canada and two in France. The researchers found that the commonest “medical misadventure” resulting in claims was failure or delay in diagnosis, accounting for 26–63 per cent of all claims across the included studies. These included missed or delayed diagnoses for cancer and


myocardial infarction in adults and meningitis in children. The second commonest


domain was medication error, representing 5.6–20 per cent of claims across the included studies. Errors involving antibiotics, anticoagulants, antidepressants, antipsychotics and steroid preparations were most frequent. The authors state that the


prevalence of malpractice claims in primary care varied across countries.


“In the USA and Australia


when compared with other clinical disciplines, general practice ranked in the top five specialties accounting for the most claims, representing 7.6–20 per cent of all claims. However, the majority of claims were successfully defended.”


EDITOR: Dr Peter Livingstone


ASSOCIATE EDITOR: Joanne Curran


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HALF OF GP TRAINEES WORK BEYOND COMPETENCE


A GMC survey has revealed that 50.4 per cent of GP trainees have felt forced to cope with clinical problems beyond their competence or experience at some stage in their current post, and of these one in five reported this occurred at least monthly. The findings emerged in the GMC’s recently published National Annual Survey 2013 which asked 54,000 trainee doctors in the UK for their views on the quality of their training. This year the survey had its highest response rate since it began in 2006, with 97.7 per cent of doctors in training responding. Among other findings, 34.3 per cent of GP trainees rated the intensity


of their workload as ‘heavy’ or ‘very heavy’. Over one in ten (13.8 per cent) reported that they worked beyond their contracted hours on a daily basis; 29.6 per cent said this happened at least weekly. GP trainees reported the highest satisfaction ratings out of all the


those surveyed with 87.9 per cent describing their training as ‘excellent’ or ‘good’, compared with 80.8 per cent across all specialties. Surgical trainees had the lowest satisfaction ratings at 77.1 per cent. Source: GPonline.com


PHOTOS: PAUL GRAHAM


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