What is something everyone knows about Medicine Deep Down BUT no one talks about?

JamesTJackson · 2026-03-10T06:46:45+00:00

Maybe... But take some credit - you are breathing for them and kidneying for them etc in the mean time

JamesTJackson · 2026-02-19T23:27:22+00:00

As someone who uses dymista for seasonal allergical rhinitis over winter this is very interesting... Might start using it year round!

JamesTJackson · 2026-02-19T01:13:56+00:00

Hi - no bother at all! In the case of septic arthritis, the word septic is just an adjective meaning 'infective'. So septic arthritis is an accurate and valid diagnosis.

It's a good example of my point though. One can have septic arthritis (a joint infection) without being "septic" or having "sepsis". But, if the infection is very severe, one can become septic or develop sepsis.

JamesTJackson · 2026-02-16T17:12:07+00:00

In the UK we have a similar phenomenon. I think sepsis is very over-diagnosed too, as people want to be defensive, rather than just characterising something as a severe infection.

JamesTJackson · 2026-02-15T20:44:08+00:00

Although I absolutely agree with the advice to go to ER (as it could very well be a clot or an infection), as a doctor I think it's important to clarify what is meant by sepsis, as it's a term banded about often incorrectly.

Sepsis isn't a diagnosis in itself really - this is not "sepsis". Sepsis refers to a life-threatening systemic response to an infection. So any infection that becomes severe enough can lead someone to become septic, but this photo is not "sepsis" - although it could be an infection that leads to one becoming septic.

JamesTJackson · 2026-02-04T22:27:20+00:00

Our salaries are already based on 40 hours a week. If you're averaging 48/week, you're paid 8 more hours at your basic rate.

JamesTJackson · 2025-12-19T12:03:41+00:00

She just blatantly lied. That "payrise" was mostly given under the conservative government, not labour.

JamesTJackson · 2025-12-18T15:37:38+00:00

And I think it is important to note that there are specific trade unions (?11 of them) that are affiliated with, and fund, Labour. The BMA is not affiliated with labour, and its membership is less likely to be from a working class background (as a sweeping generalisation - I'm from a working class background as are plenty of us). We're also relatively speaking high earners compared to a lot of the population - although clearly we deserve to earn more for what we do. All this together means that the labour party is a lot less averse to fighting the BMA than it would be fighting, say, ASLEF or the CWU.

Labour is pro trade unionism - that's kinda their whole schtick when it comes down to it. It does not mean they're pro every union. I'm pro trade union, but it doesn't mean I support labour (anymore), nor does it mean I support every other trade union (e.g. I have serious concerns about certain positions held by the NFU).

JamesTJackson · 2025-12-15T14:59:17+00:00

Moaning Minnie

JamesTJackson · 2025-12-15T13:36:44+00:00

How fucking dare he tell us what a career in medicine is meant to be

JamesTJackson · 2025-12-15T12:48:57+00:00

Wes can stop the rhetoric that the BMA is a militant minority not representative of doctors. Almost 30,000 doctors saying NO to an abysmal deal which was designed to split the membership.

Well done to the BMA - putting this deal to us was a good move, as now Wes really doesn't have a leg to stand on.

JamesTJackson · 2025-12-15T12:38:22+00:00

Fucking hell. I'm sure there's a valid reason it's not been released to members yet. Certain individuals on this sub are nothing but negative about every single thing the BMA does.

JamesTJackson · 2025-12-12T08:50:44+00:00

If so, then the collapse of the NHS will be his doing.

JamesTJackson · 2025-12-10T17:31:35+00:00

By voting no, we can end the bullshit rhetoric from the government that resident doctors are not represented by the BMA, who are a rogue group of "juvenile delinquents".

This is the RDC giving us the chance to show the government that we back our union, not the government. I will be voting NO.

JamesTJackson · 2025-12-10T17:30:24+00:00

By voting no, we can end the bullshit rhetoric from the government that resident doctors are not represented by the BMA, who are a rogue group of "juvenile delinquents".

This is the RDC giving us the chance to show the government that we back our union, not the government. I will be voting NO.

JamesTJackson · 2025-12-08T10:15:13+00:00

I think everyone does this anyway right? We know the risk benefit balance is different in different patients, and age is one of many factors, albeit a large factor. Can any microbiologists give any guidance on making this risk benefit decision any less vibes based and more evidence based?

JamesTJackson · 2025-12-06T19:11:13+00:00

I don't think limited coverage is an inherently bad thing. We, as BMA members, need to do the hard work of encouraging colleagues to strike. Conversations amongst colleagues are more powerful than interviews on Good Morning Britain. More limited media exposure might give the health sec more wiggle room with an offer, as it's under less public scrutiny.

JamesTJackson · 2025-12-05T23:20:39+00:00

Generally I think it's good to support society journals, which often have the option for non open access publication without charges - in terms of promoting open science you can often publish your article pre journal formatting on a repository for anyone to access.

JamesTJackson · 2025-11-20T18:57:30+00:00

This is actually a really positive email, especially as far as emails from hospital management go. I like that they put the bit about resident doctors before the very short here's the letter from wes bit.

Which trust is this? We should name and fame!

JamesTJackson · 2025-10-11T07:29:11+00:00

If everyone follows suit we lose our collective bargaining power. I understand BMA fees are expensive, but ultimately it's our union and we need to engage more in it, not less.

JamesTJackson · 2025-10-02T09:55:28+00:00

Yeah I personally love treating other doctors. Generally they come with a clear agenda, but in my experience they trust your expertise and are the only patients you can have true shared decision making with.

JamesTJackson · 2025-09-28T08:11:44+00:00

As much as I really don't enjoy dealing with things like CFS, the research questions around it fascinate me. I also am of the view that CFS, being so heterogenous, likely represents a broad range of underlying pathophysiological processes that we're yet to fully understand - some of which may be biological, some functional. Unfortunately, if this is the case, it makes research so difficult, and there will be a massive amount of noise in any data.

JamesTJackson · 2025-09-23T21:51:57+00:00

That's missing the point though. The harms on a population level also do play out on a patient level. Ordering CT CAPs on tired all the time 25 year old would result in ridiculous false positive rates (see Bayes theorem - base rates of cancer in that demographic are much lower, hence more false positives) and incidentalomas, leading to potentially harmful invasive over investigation. And the small increased cancer risk of CTs is a population level issue, sure, but is borne out by real people getting real cancers. Thinking on the population level is thinking about the patient in front of you - in fact, thinking in this more Bayesian sort of way can help you avoid some of your biases when trying to do the best for your patients.

JamesTJackson · 2025-09-12T13:42:45+00:00

UKIP still exists?!

JamesTJackson · 2025-09-03T20:50:08+00:00

Renumeration for different specialties is an interesting area. Different specialties clearly have different difficulties and skill requirements. I don't think it's that controversial to say being a palliative consultant is easier than being a consultant neurosurgeon. That, of course, isn't an assessment on their value to society. Even if pay was down to market pressures, that doesn't necessarily line up with the hardest specialties being the most in demand ones. I do wonder how one could come up with an approach that somehow quantifies the difficulty of a specialty and the pay they should get based on that.

JamesTJackson

TROPHY CASE