Category Archives: Manor Field Surgery

I was taken aback yesterday (Human Factors, Elaine Bromiley & your local medical school)

Yesterday, Friday, I was out and about visiting some of our patients. We have an odd or you might say unusual model of healthcare provision in the surgery, I, as a geriatrician, not a GP don’t see a significant number of the ‘regular’ patients, instead I focus on those who are older or living withContinue reading “I was taken aback yesterday (Human Factors, Elaine Bromiley & your local medical school)”

Photographic evidence. A long, convoluted road.

Sorry, you are inadequately tenacious to change the world. Go to prison. Do not stop at Go. Do not collect…

My blood pressure is too high and when I get out of bed in the morning, I almost collapse. What should I do?

  Thanks to Nigel for inspiring this blog. If follows-on from yesterday’s about postural hypotension. I don’t think, in fact, I am almost certain, no patient has ever asked me this specific question, although it is a thing. It is a condition that is tricky to manage and I suspect, one which is becoming moreContinue reading “My blood pressure is too high and when I get out of bed in the morning, I almost collapse. What should I do?”

The cost of loneliness (Roubles, dollars or robots?)

One patient recently attempted to resuscitate her (toy) baby when the batteries ran-out.

Safety netting – to net or not?

Sure, some readers will think, ‘Honestly, this isn’t nannyworld, people have some responsibility, they should use their common sense.’

The week that was and was not!

Still recovering from IDLES my daughter tested positive for Covid.

Broken hearts, or why telephone consultations are less than 35% effective (homage to Heathcote)

Although doctors are being battered over the head for not enough F2F appointments, in reality, telephone reviews are much harder than seeing a person in the surgery.

Take away, facial expression, eye contact and body-language and it is far more difficult to know or understand what is going-on.

It’s worse than it’s ever been. Just kidding… Not.

‘When will I receive my Covid booster?’ Asks patient Annie, 98, unable to leave her house for the past three years.

‘We are working-our way round,’ Says the doctor.

Manor Field Surgery Blog 10 Dizziness (three-part series) 

The most significant, particularly for older people (the definition of older is anyone who is older than you) when the effects of ageing can impair balance, coordination, and reflexes. 

Shady Towers, Social Care, Nora and Whitey on the Moon.

The PM announced a rise in NI tax this week. I understand this is to offset some of the damage they have done to the NHS over the past decade. Fantastic. (And yes, Whitey is still on the moon).

To stop or not? (Jerzy Kosinski, Oliver Sacks & other ideas)

If you watch the Robin Williams / Oliver Sacks movie/book Awakenings you will see what dopamine can and cannot do to the brain.

If I told you I’m good, you would probably say I’m boasting & Teamworking

We want to be associated with the best – the best team, country, organisation.

Others don’t really care.

Some see the whole of the moon.

Others Brigadoon.

State of frustration

I wanted to begin by discussing my recent practice FB post. I called it >very frustrating situation<. That was the best I could think at the time. What is or has been frustrating? Well, I won’t go on too much about Covid (lie). The vaccine has been rolling out over the past month. And, inContinue reading “State of frustration”

A long line of worriers and wear a facemask?

I come from a long line of worriers, which is apposite as the subject of this blog relates to discussions with my brother about Covid. You see, he has been a mask wearer. He also has asthma like me and the combination of worrier, asthma and the time of Covid is a toxic cocktail forContinue reading “A long line of worriers and wear a facemask?”

Covid – My blog is calling (Week one, through a doctor/dad/outsider’s lens)

Fear of doing the wrong thing is a fundamental of quality improvement. If you are afraid to act because people might call you out or think you stupid, you won’t do anything, and the quality won’t improve. It won’t necessarily deteriorate either, yet, in times of radical change, that is worse.

Broken sleep & Coronavirus (Bruce Lee, the philosophy of time and space and this week)

Getting rid of the routine allows people to focus on what is important. (Bruce Lee said this in the 60’s – ‘Hack away the un-essential’)

Doctor, my husband will see you now. Home visits, and why we should fight for them.

For today, I hope to keep popping out, spending quality time with patients, understanding what is important to them, their preferences, hopes, fears and aspirations, and supporting them to stay outside acute care.

GPs ending home visits – what the heck?!

Many are the result of an acute deterioration in the health of an older person, who, terrified of being admitted to hospital calls their GP. Many patients do not want to be admitted; they want to stay at home and recover.

Manor Field Blog Number 19 COPD

It is never good to start something with an obscure medical acronym; ‘Chronic Obstructive Pulmonary Disease’ is however a bit of a mouthful and I suspect for many, even those who have the condition it doesn’t explain much more.

General Practitioner and General Physician

A patient with a headache is more likely to receive paracetamol from a GP, a CT scan from a General Physician and an MRI from the specialist.

Who is more effective?

My Job

Mostly, my approach is to consider that we, that is the community services (those outside the acute hospital) can and do support a far broader range of patients than people realise and, when working well together, can care for a significant proportion of the people who otherwise arrive at the door of A&E.

Influenza

This morning I had a brief discussion with one of our patients; she is on the cusp of her 65th birthday. And, for those involved in the administration of the flu vaccine, this is a thing. Under 65s get one vaccine and overs another. Why would this be? At first, my assumption was that asContinue reading “Influenza”

Manor Field Surgery Blog Number 15 – Sick Day Rules

Whenever I heard this phrase, sick day rules, it makes me think that someone is celebrating sick days, as in, ‘Rod Rules!’ it isn’t meant to mean that, although I can’t think of an alternative. So, what are these rules? They are in effect advice for people taking different medicines (or who have specific healthContinue reading “Manor Field Surgery Blog Number 15 – Sick Day Rules”

Manor Field Blog 14 – AED (Automated External Defibrillators)

Many people will have noticed, over the past couple of years, brightly coloured boxes appearing outside pubs, public buildings and garden centres; our local Scout headquarters has one. Usually there is a key-code attached to a lock. Do most people know what these are? AED which is short for Automated External Defibrillator is a deviceContinue reading “Manor Field Blog 14 – AED (Automated External Defibrillators)”

Doctoring, fast and slow.

In life, there are those who work and act quickly; my mum would say, ‘chick-chak’ which I think is a derivation of Hebrew meaning, ‘promptly, without messing about,’ and, those who tend to dilly-dally.