It is an enjoyable and rewarding part of my week. I work with several other established GPs who are a wonderfully coherent team. We are paid for 2 sessions a week, and certainly earn that money, as we are training more than 60 doctors in our little corner of this Sceptered Isle.
Today we had a session that was led by me, and we had a radiologist from the local hospital talking about effective use of radiology. We have access to a wide range of radiological investigations, including ultrasound, CT scans and MRI scans. It looks like General Practice costs for radiology in our area is around £1.2 million - spent, per annum, on diagnostic imaging. This might seem a good deal of money, but when the whole lot is totted up, and the usage from General Practice is analysed, then it seems a pretty effective and important use of resources.
When the service was opened up to primary care in around 2007, there was the usual argument about GPs being irresponsible in their usage of diagnostic radiology. This is actually quite far off the mark, and it would appear that many requests are carefully thought through, and the clinicians follow one JD's basic rules:
What difference would the results of these investigations make to a patient?
This also encompasses normal results, as a normal result of a CT scan of the brain for an adult with headaches, or a non-specific MRI scan of a chronic back pain will save using up valuable hospital resources. Do not underestimate the value of a normal result. We have shown we use these tests sparingly and efficiently, and my colleague was happy to confirm this.
This is really about sharing facilities, respecting each others' expertise, and relying on good clinical judgement.
That is the way it should be.
Collaboration every time.
7 comments:
Just a quick question Doc, do you have similar sessions with the doctor from your local pain clinic? I ask because as a pain clinic doc myself, I often wonder the GPs really know what they want out of a pain service.
Good question. I might well address a post about this soon. Not tonight, I'm too knackered to make sense.
It's more like a battle trying to get any sort of investigation in North Wales. We have no access to MRI, CT or echocardiogram as "mere GPs". :-(
MRI, CT, ah you mean those machines that lay unused for 131 hours a week or more? any other business with a long waiting time would simply pay the staff a bit of overtime, but the NHS preders rationing "free at the point of use" doesnt it?
echocardiogram? GP's in other countrys buy the machine and get on with it...
Dear Anon at 19.34
I don't know where you live but the CT and MRI scanners where I work are busy 7 days a week often to 10 o'clock at night with a mixture of inpatients, outpatients and CT is available 24 hours a day for emergencies.
A relative of mine had a CT scan of his brain in the early hours of Sunday morning in Birmingham. (QEHB)
^^ I would imagine he did since the QEHB is a neuro centre for that area of england. It's also brand new, plent of lovely fat cash being thrown around there.
At my hospital we have two MRI machines, one that is used day and night and patients que for on some occasions, in beds. The other is in a "research suite" just down the corridor, fully functioning and used for about 10 hours a week for "research purposes". And it's a better model then the one we use regularly.
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